Medical Groups Sue Over Vermont Requirement to Counsel Patients on Assisted Suicide

Hospital-compressedBURLINGTON, Vt. — Two medical groups have filed a federal lawsuit to challenge language in the Vermont’s assisted suicide law that they believe requires physicians to counsel patients about ending their lives.

The Vermont Alliance for Ethical Healthcare and Tennessee-based Christian Medical and Dental Association were represented in the suit on Tuesday, along with several doctors in the state who are concerned about how the government interprets the “Patient Choice and Control at End of Life Act,” also known as Act 39.

As previously reported, in 2013, Democratic Gov. Peter Schumlin signed legislation legalizing assisted suicide, making the state the fourth in the nation to allow terminally ill patients to be granted the “right to die.”

After the bill was made law, the Vermont Department of Health outlined that a section of the text requiring that a patient receive “all available options related to terminal care” means that doctors must counsel patients on assisted suicide or provide referrals to other physicians who will do so.

“Do doctors have to tell patients about this option? Under Act 39 and the Patient’s Bill of Rights, a patient has the right to be informed of all options for care and treatment in order to make a fully-informed choice. If a doctor is unwilling to inform a patient, he or she must make a referral or otherwise arrange for the patient to receive all relevant information,” the department outlined in a FAQ on the matter.

Therefore, a number of doctors who are concerned about their oath to “do no harm” have now filed a legal challenge against the requirement, including Drs. Rachel DiSanto and Dr. Brian Kilpatrick, as well as hospice nurse Lynn Caulfield.

“This is nothing but the redefinition of ‘palliative care’ to mean providing assisted suicide, an intolerable position for Plaintiffs and other conscientious physicians and healthcare professionals,” the legal complaint reads.

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“Plaintiffs, state and national associations of conscientious healthcare professionals whose personal and professional ethics oppose the practice of assisted suicide, bring this action on behalf of their members against the operation of Act 39 to force them to counsel and/or refer for the practice,” it outlines.

The groups and physicians are seeking an injunction against the enforcement of the law, as well as declaratory judgment that the state’s interpretation of the law violates the U.S. Constitution.

“The government shouldn’t be telling health care professionals that they must violate their medical ethics in order to practice medicine,” Alliance Defending Freedom (ADF) Senior Counsel Steven Aden said in a statement announcing the suit. “These doctors and other health care workers deeply believe that suffering patients need understanding and sound medical treatment, not encouragement to kill themselves. The state has no authority to order them to act contrary to that sincere and time-honored conviction.”

The assisted suicide advocacy group Compassion and Choices Vermont told the outlet Seven Days that they support the requirement.

“Physicians should not impose their personal ethics and values on their patients and deny their legal right in Vermont to receive information about all of their end-of-life care options so they can make an informed decision about their treatment options,” Director Linda Waite-Simpson stated.

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  • bowie1

    Under those conditions how many would want to go into medicine?

    • axelbeingcivil

      Being a doctor is, close to universally, considered one of the worst professions to go into. The majority of doctors surveyed says that, if they knew what they did once practicing at the start of it, they’d never have gone into their profession.

      It’s an awful job to have. Lots of respect is due for those who do it with diligence.

      • Hmmm… I don’t think that is right. I would suggest that being a DOCTOR is one of the most noble and inspiring and affirming professions.

        However, being a government-controlled bureaucratic medicine flunky, following computerized rules and collectivist groupthink because if you don’t the almighty government will take away your license and your livelihood, and being force to participate in a system of compulsory health insurance (which is liked forcing the consumption of a poison), compulsory speech, and indentured servitude, as medicine has become in this country, well, that is pretty much as bad as you describe it.

        • axelbeingcivil

          So, you oppose medical licensing, then?

          • Of course I oppose medical licensing. Governments have a tendency toward not only incompetence, but abuse of power. The only solution is to give them as little power as possible. Medical licensing has served as a nice way for the AMA to maintain monopoly prescribing privileges, and to provide a large hammer over the head of any physician or other health care practitioner who doesn’t bow and do the biddings of the politically powerful. Licensing accomplishes nothing that the market and all the internet information cannot provide much more efficiently, effectively and fairly.

          • axelbeingcivil

            History doesn’t seem to remotely suggest that’s the case. Information is shared and spread inconsistently, and markets bow to more forces than public conscience. Indeed, the Food and Drug Act of 1906 came into existence precisely because, despite people apparently being aware of the horrendous practices of the meat packing industry, public will was insufficient to put a stop to it.

            The existence of the internet hasn’t changed that. Greater presence of information is a double-edged sword, with people simultaneously having more information but having more than they know how to access or what to do with. Misinformation is as common as information and hard to counteract, which is why being a merchant of doubt is such a profitable business.

            (And when such things fail, self-regulation in the form of licensing committees are the usual solution anyway.)

            Deregulation has never been a panacea. Sometimes it helps, sometimes it doesn’t. History’s shown regularly that medicine is one of those things where it doesn’t, especially since the cheapness of selling false hope in an unregulated market will attract far more hucksters than honest merchants.

          • So your solution is to put power in the hands of those who hunger for power. Defaulting to government solutions means giving ones power over to the worst sort of types–like a distillation of criminals–seeking power over others. There is a very good reason why government solutions are so lousy.. They are created by lousy people who don’t try to persuade, but instead immediately turn to force. That being said, I find it of little value to argue with people. I will point out only that those who turn to government (to force) to solve problems are people who have the mentality of war. The initiators of force are the initiators of war. Progressive mentality (in either major party) is dominated by the acceptability of the initiation of force against the innocent, justified by all sorts of distortions borne of internally contradictory notions. Licensing is government force, justified by some unproven notion that it protects innocent from hucksters. It doesn’t. It just gets used by other hucksters who get given an aura of credibility! And your FDA comment? Hah! Since 1962 changes to the FDA, when proof of efficacy became demanded, instead of just safety, estimates are that the FDA efficacy regulations have saved approximately 7500 lives. Simultaneously, the same regulations have resulted in the delayed availability of eventually-approved drugs, delays that resulted in 4.5 million early deaths. FDA’s ratio of risk to reward is so horrific that they should ban themselves.

          • axelbeingcivil

            My argument would be that government solutions, like all solutions, must be weighed. They are not perfect, but they are often better than the alternative.

            Just the same, before any elucidation of such an argument can occur, you have me curious: Are you an anarchist? Or do you simply believe in smaller government?

          • Just to be sure we are on the same page, Anarchy does not mean the absence of laws. It means the absence of rulers. (Monarchy, one ruler; Oligarchy, many rulers; Anarchy, no rulers.)

            As such, 90% of our existence and relationships are anarchical, voluntary, by our own choice, without any ruler dictating, but accomplished under the natural laws (no initiation of force or fraud, do what you say you will do). Simple stuff. We are almost all anarchical for the most part. It is a strange perversion to believe that we need to be ruled. Especially when those who seek to rule are generally the worst sort of people. For example, right now, people are trying to choose between a sociopath and a narcissist to be their ruler. Silliness. Me, I’ll double my vote. I don’t want to vote against just one of them. I’ll vote against them both by voting for a third party. Gary Johnson is humble. That makes him a better candidate by far. As I plan to vote, I must not be a true anarchist.

          • axelbeingcivil

            That was a fair answer but one that doesn’t really answer my question (not for any fault on your part).

            If you advocate for a society where laws exist – and I would say any society where laws exist has a form of government – then how can you demonize the use of force to enforce those laws?

          • I demonize the INITIATION of FORCE against anyone who has not broken a NATURAL LAW. Civil laws, or roman political law, aren’t laws. They are rules designed to benefit those who make them–those brutes who have taken power over others by direct force or by collectivist mentality (mob rule, “democracy” etc.). Defying natural laws results in the same problems that occur if you try to defy physical laws.

            Laws DO exist, in ANY society, always, and the real laws are all the same. The same way the laws of physics exist everywhere on Earth. The problems occur when the civil laws defy these always-existing (and very FEW) natural laws. When the civil laws involve initiating force (or fraud) against people who are innocent (who are obeying natural law), then the civil law is the illicit law, and the civil law is destructive. Of course I do not support the use of force to impose the political laws upon the innocent. But I support the use of force to defend against those who initiate force.

            So the answer is I support the use of force to enforce natural law… Meaning I support the use of force to defend against those who initiate force or fraud against their fellow man.

          • axelbeingcivil

            My response is that what you consider a natural law is ultimately arbitrary.

            The laws of physics are natural laws in the classical sense. You cannot defy the law of gravitation; you can work against gravitational forces but gravitation is a universal law, just like entropy is. These laws of nature are inviolable in, as far as we can see, all reference frames.

            But supposed laws of nature against, say, homicide are not inviolable. It is exceptionally possible and demonstrated on a daily basis that one human being can kill another. There is no physical law that prevents this.

            That means that humans are ultimately the ones defining what a “natural” law is, since there is no physical reality to base it upon. Why should your definition be privileged over others?

            Furthermore, how, precisely, do you have a society that enforces supposedly natural laws without, say, taxation? Taxation is deprivation of a person of their property with or without consent. If taxation is voluntary, it is essentially payment of a private police force and one either runs into the free rider problem or a massively unequal state of affairs, whereby whomever has the most resources may effectively institute a de facto dictatorship.

            I am curious as to your answers to this.

          • The Free Rider problem can not ever morally justify compulsion. The Free Rider problem is the problem of the provider of the service involved, not a crime committed by the free rider. One cannot compel the innocent, just because you don’t appreciate their behavior. Off to church. Back later.

          • Back now. Society doesn’t need a powerful overlord to enforce natural laws. One of the features that make a law “natural” is that it, like physics, is self-enforcing. There is a whole set of literature and philosophy on the natural laws that man does not invent, but instead discovers, often through trial and error. Those relationship rules that help us survive teleologically are, effectively, the natural laws. We have discovered a couple that help us survive: “Don’t initiate force or fraud” (the crux of all moral criminal law); and “do what you say you are going to do” (the crux of moral contract law). The problems are when civil law initiates force (e.g. the drug war) or fraud, (e.g. the Federal Reserve). Very bad things happen when civil law contradicts natural law.

            A de facto dictatorship, by the way, doesn’t exist in the presence of a morally educated population who know to expel from the community anyone who initiates force or fraud–outcasting them or making them outlaws. Almost all (but not all) politicians would be outcast from a community because of their willingness to use force to accomplish their aims.

          • For example, Obamacare is all about initiation of force (health insurance mandates) in an attempt to overcome free rider problems caused by prior government initiation of force (forced commerce in medical care). Of course, the problem with our medical finance issues are the result of too much health insurance, not too little. But the government commits negligent malpractice in their failed diagnosis and then not only prescribes the wrong therapy, but also forces us to imbibe more of the very same toxic poison that made us all sick. One of the definitions of freedom is “the right to do what one ought”. Obama an his cronies take away that right and force us to do what they want.

          • axelbeingcivil

            Enjoy! I look forward to hearing about your concept of natural rights.

  • RWH

    What exactly is the problem of a doctor telling a patient that assisted suicide is an option, that s/he is uncomfortable with that, and a contact number for a person who can talk with the patient and his/her family in a fair and unbiased manner? I would think that someone deliberately holding out on me as a patient is deceitful and dishonest. It leaves both the doctor and the hospital with the liability of someone accusing them of malpractice, for not providing them with all of the options and then letting them decide. Maybe life would be better if we stopped talking about me, me me, my preferences, my beliefs, my desires, and started thinking of others and giving them the entire picture. Once a person decides on medical treatment, it is his or her option and his/her responsibility for the morality and the consequences of that morality. And maybe loved ones who have someone terminally ill in pain should buck up and be willing to tell that person that it is okay to go.

    • Amos Moses

      “What exactly is the problem of a doctor telling a patient that assisted suicide is an option,”

      It is one thing to explain that no treatment is a valid option ………… quite another to take a life actively …… no matter who is doing it ……….. first rule of medicine ……. Do No Harm …

    • bowie1

      Most doctors probably go into medicine to save lives and not end them. It’s part of the Hippocratic Oath to do no harm.

      • axelbeingcivil

        If “Do no harm” were absolutely literal, a doctor couldn’t prescribe a medication with side effects or perform surgery by cutting open the patient. They couldn’t allow patients with treatable conditions to choose alternative medicine that they know will ultimately do nothing.

        The tenet of “Do no harm” requires physicians to put the interests of their patient first; to not take actions that will put their own benefit before their patient’s. They must always act for their patient’s health and, importantly, in accordance with their patient’s wishes.

        I can understand that some doctors will object to providing assistance with a patient’s wish to die. It is a heart-breaking thing and I do not begrudge them in the slightest if they choose to absolutely refuse to have no part in it. It’s a haunting thing to even think about. I just thoroughly object to the claim that doctors who do provide assistance are violating their oath.

        • hytre64

          I would qualify intentionally ending the patient’s life as “doing harm”.

          • axelbeingcivil

            If it’s against their considered will, certainly.

          • hytre64

            If I were a physician, and a patient came in wanting me to amputate their perfectly healthy arm, I would decline – even though it is the patient’s will – because cutting off their healthy arm would do them harm.

          • axelbeingcivil

            Indeed. But we’re not discussing the perfectly healthy; we’re discussing the terminally ill.

  • Bradley Williams

    Note much abuse has been documented in the Oregon assisted suicide system.
    See the federal case of Thomas Middleton who was killed with the Oregon law for his assets according to the feds.
    There are more details at http://dredf dot org/public-policy/assisted-suicide/some-oregon-assisted-suicide-abuses-and-complications/

    Opposition to euthanasia comes from 95% of the entire spectrum of humanity from atheist to eastern philosophies, once they learn how these laws can easily be administered wrongly against the individual 95% say “I’m not for that”. It is as simple as that.
    Respectfully submitted,
    Bradley Williams
    MTaas dot org
    The promoters have done the public a disservice. Their ordinary bait and switch campaign is demonstrated by their selling “must self-administer” then they do not provide in their legislation for an ordinary witness of the “self-administration”. This omission eviscerates the flaunted safeguards putting the entire population at risk of exploitation.

  • axelbeingcivil

    If it’s an option for a patient, a physician has a duty to inform.

    Take, for example, vaccinating your children. All the research shows it is a very safe, very useful procedure; necessary for protecting us from the reemergence of diseases we’ve long banished like diphtheria, typhoid fever, rubella, etc. They are, without doubt, one of the greatest inventions of humankind and are responsible for the staggering decline in child mortality in the past century.

    But now, due to misinformation, many parents are advocating not getting their kids vaccinated. This is a terrible decision, but one physicians can’t force parents to change their mind on. The doctor has to inform them that they can choose not to get their child vaccinated by law. This also means informing them of all the potential downsides of this, but they have to give the parents the option.

    The same is true of any medical procedure. Consider certain religious groups whose rules prohibit blood transfusions or even taking insulin or undergoing dialysis. These are really easy methods nowadays but the physician HAS to inform them that they have a right to choose not to, even if this will kill them.

    A doctor cannot choose to withhold information. A doctor cannot choose to act against a patient’s will. They can choose, of course, not to take an action if they feel unfit to do so but are required by the strictures of their profession to report the patient to someone who will.

    Just because you disagree with it doesn’t make it any different. It’s not the doctor’s choice; it’s the patient’s. The only choice the doctor has is whether to let themselves be involved or not.

    • Nidalap

      So…when a woman goes in for an abortion, the doctor HAS to inform her that there are other options? Don’t really hear about that too often…

      • axelbeingcivil

        Well, no, not at that point; she’s already chosen what her plan of action is. The doctor’s duty is to inform about the options within that plan of action. Same as with, in this case, a patient who has already chosen that they wish to go for whatever methods are necessary to prolong their life; a doctor has no obligation to inform them about euthanasia, since it’s clearly contrary to their wishes.

        If a doctor determines a pregnancy for someone, though, and the person is uncertain about what to do, then the doctor has a duty and obligation to inform about every option available, including, for those who do not wish to keep the pregnancy, adoption and abortion. Same as if, say, a patient’s cancer has metastasized and reached an aggressive, terminal level.

        • Nidalap

          So, all these patients came into these doctors offices having chosen the plan of action of dying? I think not…

          • axelbeingcivil

            Like I said, the doctor’s duty to inform of all options comes with a diagnosis phase. The doctor has to inform them of all options available during said diagnosis. If they’ve already chosen a plan of action – to fight the ailment as much as they can – the doctor has no duty to inform of the possibility of assisted suicide.

  • hytre64

    It appears to me that slowly but surely, state by state and profession by profession, they are attempting to force Christians to choose between either violating their conscience or being forced out of their chosen profession.

  • If some monarch grants a “right” to suicide, whereas another monarch says assisted suicide is murder, in the first state the doctor would be required to inform, whereas in the other state the doctor would be an accomplice to murder for so informing. Thus the contradictions when people actually start believing that their rights come from government. Governments do not EVER grant rights. Rights are rights. Our job is to keep government from infringing on our rights.

    Forced speech is every bit as harmful as forced limitation of speech. It can never be accepted. This issue should never have been in the government’s purview.

  • TheBottomline4This

    I’m not supportive of assisted suicide.
    Use Hospice care or Palliative care.