Brattleboro Memorial Hospital
Brattleboro Memorial Hospital

BRATTLEBORO -- It's been almost a year since Gov. Peter Shumlin signed Act 39 into law, making Vermont the fourth state in the country to allow terminally ill patients to request medication to end their lives.

Many Vermont laws are passed with a six-to-18-month waiting period which allows attorneys, municipalities and stakeholders a chance to prepare for the changes that the law forces.

But when Shumlin signed Act 39 the law went into effect immediately, and Brattleboro Area Hospice Care Coordinator Ryan Murphy said the law has raised a long list of questions for the terminally ill and their families, as well as for doctors and hospice providers.

On Monday, March 24, Brattleboro Area Hospice and the Brattleboro Memorial Hospital Ethics Committee will host a forum on Act 39 to give the public the most up-to-date information on the law.

The forum will be held in the Brew Barry Conference Room at Brattleboro Memorial Hospital and will run from 6 to 8 p.m.

Vermont Ethics Network Executive Director Cindy Bruzzese will lead the discussion, which the program hosts stress is not a debate either for or against the law, but rather a chance for the public to ask questions and get information on patient options when asking a doctor for medication to end a life.

"There has been a fair amount of a lack of clarity around this law and this is a chance to learn more about how it works," Murphy said. "We want to talk about the guidelines and clarify what the law does, and we also want to give people a chance to ask questions."

Vermont's physician aid in dying law allows a capable, terminally ill adult to request and obtain a lethal prescription for medication to self-administer.

Murphy said Brattleboro Area Hospice has had at least two clients who inquired about the end-of-life medication option, and in both cases the clients were not able to find a doctor who would be willing to prescribe the medication.

"If a doctor says ‘no,' we are not sure of the next step," he said. "It has been a lot to take in a short period of time."

Murphy said Brattleboro Area Hospice staff members recommend that a client contact his or her own doctor, but at this point there are no statewide registers to find doctors who are willing to prescribe end-of-life medication.

"Part of the purpose of the forum on Monday is to try to get a better understanding on how to proceed as the law evolves," he said. "What I hear is that a lot of physicians don't feel like they have enough information to feel confident in providing information to their patients."

The BMH Ethics Committee is made up hospital staff along with a member of the faith community, a counselor, an attorney, a hospice worker and area residents.

BMH Chief Medical Officer Dr. Kathleen McGraw said the committee asked to hold the forum.

After the law went into effect, BMH, along with every other hospital in the state, opted out from allowing physicians to prescribe the medication for use on hospital grounds.

BMH doctors can prescribe the medicine to hasten death when the patient follows the guidelines of the law.

McGraw said she did not know what conversations have taken place between doctors and their patients concerning the law.

She also expressed some frustration over how quickly the law was allowed to go into effect.

Doctors are protected under the law, but hospitals and pharmacists are not mentioned in the wording.

"There was a lot of push to get the law done rapidly, and I think over time it is going to have to be revised," McGraw said. "There was no time to report and keep track and figure out what is working and what is not, and there are any number of things that might have to be reconsidered once we have some time under our belt."

"The language of the law is broad, and doctors don't feel like they are protected," said Brattleboro Area Hospice Program Coordinator Patty Dunn. "It has been frustrating, but we hope that as the law evolves doctors become more comfortable with it."

Dunn stressed that Brattleboro Area Hospice maintains neutrality on the option. The organization neither recommends nor discourages its clients from considering the option. But when a client asks questions, Dunn said, hospice staff members want to make sure they have the latest information.

And Monday's forum will give the staff a chance, as well, to ask Bruzzese what is happening on a statewide level.

The forum will offer an overview of Vermont's law and offer some insight into the issues patients, doctors and family members have faced during the law's first year.

At hospice, Dunn said, the organization is working out some if its own challenges, such as developing the proper protocol for volunteers who do not want to take part in the conversation about seeking medication to end a life.

"This is going to be an ongoing conversation," she said. "We want people to be aware of the law and aware of their options."

Howard Weiss-Tisman can be reached at 802-254-2311, ext. 279, or hwtisman@reformer.com. Follow Howard on Twitter @HowardReformer.