On May 20, 2013, Act 39, Vermont Patient Choice and Control at the End of Life Act went into effect, when Governor Shumlin signed it into law. The law is currently in effect giving terminally ill, mentally capable Vermont residents with six months or less to live the option to request a prescription medication to end unbearable suffering. Patient Choices Vermont leads Vermont-based efforts to implement the law.
What patients need to know about medical aid in dying in Vermont
What doctors need to know about medical aid in dying in Vermont
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On May 20, 2013, Governor Peter Shumlin signed Act 39, Vermont Patient Choice and Control at the End of Life Act into law. The law went into effect immediately, and Vermont became the first state to authorize medical aid in dying through the legislature. Compassion & Choices partnered with Patient Choices Vermont to support their efforts to bring this option to Vermont. This included identifying experts to testify at hearings, providing strategic direction, mobilizing supporters and providing funding.
Immediately following authorization, Compassion & Choices worked with Patient Choices Vermont to launch an access campaign, designed to ensure that patients were able to access the law. For the first several years of implementation, Compassion & Choices had a Vermont-based staff person working in partnership with Patient Choices Vermont on both protection and implementation efforts. Our efforts included funding the first training for doctors in Vermont during the summer and fall of 2013 with a statewide tour along with Vermont Ethics Network. We also collaborated on efforts to get health systems and hospices to adopt supportive policies and to identify pharmacies.
In May of 2016, Vermont Governor Shumlin signed into law S.108 (Act 27), which removed the sunset provision in the law that brought uncertainty to patients and physicians about the future of medical aid in dying in Vermont. In 2017, Compassion & Choices’ Doctors for Dignity worked with local Vermont Doctors to submit a resolution to the Vermont Medical Society urging them drop its opposition to the law. On November 4, the Vermont Medical Society adopted a new position of neutrality. In their new policy, they noted: “Even when physicians use all the tools at hand to care for pain and suffering, a small number of patients still suffer. Each of these patients is unique; each one of the patients will challenge the caregiver’s skills in the extreme; and each one’s care should be highly individualized and decided in private amongst the patient, physician and family. The Vermont Medical Society recognizes that medical aid in dying, in the form of Vermont Act 39, is a legal option that could be made in the context of the physician-patient relationship. Recognizing that principled physicians disagree about the ethics of Act 39, the Vermont Medical Society is committed to protecting its members’ freedom to decide whether to participate in medical aid in dying according to their own values and beliefs.”
Over the years, several challenges have been brought against the Patient Choice and Control Act; none were successful thanks to advocacy by Compassion & Choices and Patient Choices Vermont. Most notably in 2016, the Vermont Alliance for Ethical Healthcare and Tennessee-based Christian Medical and Dental Association filed a lawsuit in July, 2016 against the State of Vermont. The groups claimed that both Act 39 and Vermont’s Patient Rights law violated the plaintiffs’ religious rights by requiring doctors to discuss all end-of-life care options with their patients, or to make efforts to ensure patients receive information on those options if the doctor refuses to discuss themselves (see complaint posted here).
Shortly after, Compassion & Choices, Patient Choices Vermont and two terminally ill Vermonters filed a motion to intervene in the case so that we would have the ability to join the lawsuit and protect Vermont’s End-of-Life Choice Act (Act 39). In December of 2016, a federal judge granted our motion. In April 2017, the federal judge dismissed the lawsuit. That dismissal was upheld in December 2017 when a federal court reinforced a physician’s duty to inform patients about all end-of-life options, including medical aid in dying. Since that time, Vermont’s law has not faced any additional threats. Patient Choices Vermont remains in Vermont, leading efforts to protect and implement the law. You can read more about Vermont Alliance for Ethical Healthcare, et al. v. Hoser, et al. here. To learn more about the challenges to Vermont’s law and what we did to defend it, watch this video.
State-specific advance directives make clear your end-of-life preferences if you are unable to make or communicate medical treatment decisions yourself. For the Vermont advance directive form, click here.
