CT Cancer Patient, VT Doctor Settle Suit Challenging Residency Mandate in VT Medical Aid-in-Dying Law

March 14, 2023

CT Cancer Patient, VT Doctor Settle Suit Challenging Residency Mandate in VT Medical Aid-in-Dying Law

Lynda Bluestein, a terminally ill Connecticut woman, and Dr. Diana Barnard, a Vermont physician, reached a settlement with Vermont officials Tuesday of a federal lawsuit asserting that the residency requirement in Vermont’s medical aid-in-dying law violates the U.S. Constitution’s guarantee of equal treatment. The lawsuit was filed last August on behalf of Bridgeport, CT resident Lynda Bluestein and hospice and palliative care physician in Middlebury, VT, Dr. Diana Barnard, who regularly treats patients that reside in northern New York State. The lawsuit complaint is posted here

The settlement stipulates that Vermont officials “agree not to enforce the residency requirement” for Bridgeport, CT resident Lynda Bluestein and that she may use Vermont’s Patient Choices and Control at the End of Life Act of 2013 if she complies “with all requirements of the Act, and fill[s] and use[s] any prescriptions she may receive in Vermont.” The settlement also stipulates that “the Vermont Department of Health will support repealing the residency requirement contained in the Act if a bill to repeal the residency requirement is proposed.” The settlement agreement is posted here The link to the motion to dismiss the lawsuit is posted here.

Vermont officials’ support for legislation to repeal the residency requirement is timely. Vermont lawmakers are considering bills introduced in the Senate (S. 26) in January and passed in the House (H.190) on Feb. 17, and to repeal the residency requirement of Vermont’s Patient Choices and Control at the End of Life Act.

“I was so relieved to hear of the settlement of my case that will allow me to decide when cancer has taken all from me that I can bear. The importance of the peace of mind knowing that I will now face fewer obstacles in accessing the autonomy, control, and choice in this private, sacred, and very personal decision, about the end of my life is enormous” said Bluestein, 75, who was diagnosed in 2021 with Stage IIIc fallopian tube cancer.

Cancer patient Lynda Bluestein receiving chemo last month.Cancer patient Lynda Bluestein receiving chemo last month.

“While I am relieved for myself that I, personally, will have fewer constraints on accessing Vermont’s Medical Aid in Dying (Act 39), this is also a justice issue for me. Not everyone in Connecticut has the support system or the means to make a move such as my husband and I are contemplating even remotely possible. Choice itself is also a privilege and that includes the role of the individual in end-of-life decision-making.  So I plead with Vermont lawmakers: Please pass the current legislation, S 26, to repeal the residency requirement, so other terminally ill non-residents can access Vermont’s medical aid-in-dying law and don’t have to suffer needlessly at the end of their lives.”

Compassion & Choices Vermont lawsuit is the second in the nation to successfully challenge the residency requirement of the state’s medical aid-in-dying law. Last May, Compassion & Choices also settled a federal lawsuit with Oregon challenging the residency requirement of its medical aid-in-dying law. Eight of the 11 jurisdictions nationwide that have authorized medical aid in dying continue to enforce their residency requirement for medical aid in dying: CaliforniaColoradoHawaiiMaineNew JerseyNew MexicoWashington, and Washington, D.C.

“We are thrilled that Lynda no longer has to worry about needless suffering at the end of her life, thanks to this settlement,” said Amitai Heller, senior staff attorney for Compassion & Choices. “But we intend to refile this lawsuit if Vermont lawmakers do not pass legislation to repeal the unconstitutional residency requirement for medical aid in dying. We hope other jurisdictions with medical aid-in-dying laws will recognize this issue and repeal their residency requirements, so we don’t have to file litigation to make it happen.”

“I am grateful that Lynda will be able to now access medical aid in dying without completely upending her final months. I now urge Vermont lawmakers to repeal the residency requirement for medical aid in dying for the sake of all of my out-of-state patients,” said Dr. Barnard, whose practice specializes in hospice and palliative care in Middlebury, VT, where she also treats patients who live nearby in northern New York State. “There is no good reason that non-residents should not be able to use Vermont’s medical aid-in-dying law that has eased the suffering of numerous terminally ill Vermonters since it took effect a decade ago.”

The majority of Dr. Barnard’s practice is dedicated to providing palliative care and consultation at Helen Porter Rehabilitation and Nursing, and the University of Vermont Health Network-Porter Medical Center, an integrated academic health system that serves more than one million residents across Vermont and northern New York. Since Vermont’s Patient Choice and Control at End of Life Act passed in 2013, Dr. Barnard has received numerous requests from non-residents seeking a prescription for medical aid in dying, but has been unable to even consider them solely based on the prospective patients’ residency.

“We are grateful for the Vermont defendants’ efforts to resolve this and look forward to continued movement on this issue,” said attorney Ronald A. Shems, a partner in the Montpelier, VT law firm of Tarrant, Gillies & Shems, LLP, who is the local counsel to Compassion & Choices in the case. ”We will continue to advocate for this change until all of Dr. Barnard’s patients can receive the same quality end-of-life care options, no matter which side of the Vermont border they happen to live on.”

“To be an effective clinician, Dr. Barnard must establish trusting relationships with patients, families, and providers at a medically complex and highly emotional time,” said attorney Alan Howard, a partner at the law firm of Perkins Coie and co-counsel in the case. “Medical aid in dying is the only medical procedure in Dr. Barnard’s day-to-day practice for which a patient’s lack of Vermont residency categorically denies the otherwise appropriate care that she can provide.”

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