The children of Warren Loomis recall their father practically begged doctors to end his life as he was losing a painful battle with esophageal cancer. The cancer had obstructed his main bile duct, causing debilitating pain, sleeplessness and extreme disorientation. But Loomis, a 67-year-old retired engineer from Norwich, was told Vermont law forbade doctors from giving him anything to hasten death.
“Dad said straight out to a number of people, ‘What can I do here? How can I die? I want to die,’” recalls his daughter, Molly Loomis of Burlington. “The answer was: He can stop eating.”
More than two weeks later, in November 2007, Warren Loomis died after choosing starvation. Aaron Loomis of Burlington, the eldest of Warren’s three children, says the experience was “excruciating.”
It might be less so for others facing terminal illnesses if supporters of an Oregon-style “death with dignity” law have their way in Vermont. They have reason to believe right-to-die legislation could win passage this year, despite anticipated opposition from medical professionals, religious groups and disability-rights advocates who warn that “physician-assisted suicide” is a slippery slope.
Unlike in past years, when it failed to take hold in Vermont, “death with dignity” now has an important ally: the governor. Newly sworn-in Gov. Peter Shumlin pledged support for right-to-die legislation during the 2010 campaign, and, as a state senator the year before, he cosponsored S.144, “An Act Relating to Patient Choice and Control at the End of Life.”
The Oregon-based Death With Dignity National Center has targeted Vermont as the most likely state for a legislative victory this year. In December, Peg Sandeen, the center’s executive director, flew from Portland to Montpelier for multiple meetings with lobbyists, grassroots activists, and Shumlin himself.
After the trip, Sandeen posted a confident prediction on the organization’s website: “Vermont will be the next state with a Death With Dignity law,” she wrote. “Every element is in place. Every player has a plan of action. Every commitment has been fulfilled. Everyone interested in Death With Dignity should turn their eyes toward Vermont.”
“Dignity” supporters such as Dick Walters say that terminally ill patients should have the right to end their own suffering. The 85-year-old retiree — a resident at Wake Robin in Shelburne — is the founder of Patient Choices Vermont, which is lining up cosponsors for the legislation and expects a bill will be introduced later this month.
To make the sell, Patient Choices Vermont has contracted the Montpelier lobbying firm Sirotkin & Necrason to work the legislature. Patient Choice hired Amy Shollenberger, who most recently ran Doug Racine’s campaign for governor, to mobilize grassroots support around the state.
Patient Choices Vermont has been busy fundraising, too. During the fall election campaign, the group’s political action committee donated a combined $22,991 to Shumlin and several lawmakers on the legislative committees that will have to approve the bill before it goes to the full House and Senate. The group donated the maximum $3000 to Shumlin in the general election and gave $350 each to state Rep. Ann Pugh (D-South Burlington), who chairs the House Human Services Committee, and state Sen. Claire Ayer (D-Addison), the newly named chair of the Senate Health and Welfare Committee. Both Pugh and Ayer have cosponsored death-with-dignity bills in the past.
Proponents have tried for years to pass the bill, and at significant expense. The closest they came was in 2007, when the bill reached a vote in the House but was put down, 63 to 82. That year Patient Choices Vermont ended up spending $120,000 to promote its position, while the main opposition group, Vermont Alliance for Ethical Healthcare, spent $43,000 on paid advertising and lobbying, according to tax filings.
Content-wise, this year’s legislation will mirror previous versions, Walters says. The law would give terminally ill patients with fewer than six months to live the option to request a prescription for medication that would hasten death. The drug most commonly used in Oregon is a barbiturate, typically a fatal dose of sleeping pills such as Secobarbital or Pentobarbital, explains Dr. David Babbott, a retired University of Vermont medical professor and board member for Patient Choices Vermont. Babbott says the drugs depress respiration, causing the breathing center to stop functioning. Patients usually fall asleep within minutes and die a couple of hours later, he says.
Backers say the law would have numerous safeguards to prevent abuse. The patient would have to request the drug at three different times — twice verbally and once in a written statement witnessed by two individuals who are not family members, health care providers or anyone who would benefit from the person’s death. After getting a required second opinion on diagnosis and prognosis, the patient would then have to wait 15 days to get the “medication.”
Most importantly, supporters say, the fatal dose could not be administered by a doctor. The patient would have to ingest the medication, either as a liquid or mixed in with food.
None of this is likely to go down easy with the Vermont Alliance for Ethical Healthcare. It held an organizational meeting on January 7 and is hatching plans for a counteroffensive using lobbyists, paid media and grassroots organizing, says interim president Joseph Nasca, a pediatrician who practices in Georgia.
Nasca argues that helping patients die is a “transgression of medical practice” and violates a physician’s ethical oath. To hammer the point home, Nasca spontaneously recited the oath during a phone interview, stressing that the pledge he made in 1988 binds him to “maintain the utmost respect for human life.”
“I guess everybody has the right to commit suicide, but please don’t drag me into this as a doctor,” Nasca says. “Why don’t we just make the police force the suicide agent? They can do it with a gun faster than I can do it with pills.”
In 2007, a Zogby Poll found that 82 percent of Vermonters surveyed supported legislation that would “allow a mentally competent adult, dying of a terminal disease, the choice to request and receive medication from a physician to peacefully end suffering and hasten death.” Supporters like Walters argue the poll demonstrates clear and broad support for a right-to-die law. Opponents like Nasca argue the meaning of the poll question isn’t clear.
“To me it conjures up this image of a person who’s dying in pain and a doctor giving some morphine to alleviate the suffering,” Nasca says. “That’s not what we’re talking about. This bill is about a prescription for an overdose, but it doesn’t say that, does it?”
Whatever it’s called, the lethal-dose option is something Hans Penner wants to be available when he reaches the end. The 76-year-old retired Dartmouth College professor, who also lives at Wake Robin, spent a year on the board of Patient Choices Vermont. Then, last summer, his volunteer work hit close to home when he was diagnosed with inoperable stage 4 lung cancer.
Currently undergoing chemotherapy, Penner says that if and when things get bad he wants to be able to end his life — and his suffering — voluntarily.
“I’m a good Darwinian. I understand that it’s a natural thing,” Penner says of death. “But I want to be able to make decisions right through the end. If that’s what it came to, my hope is the legislature would have passed that bill.”