Hospitals continue End-of-Life debate

Wednesday May 22, 2013

BRATTLEBORO -- Even though the aid-in-dying bill encouraged more debate in the Statehouse than any other bill in recent history before it finally passed, those conversations will continue in area hospitals before the law is put into effect.

Officials at Brattleboro Memorial Hospital and Grace Cottage Hospital both said Tuesday that their doctors, ethics committees and boards of directors are going to have to talk about how, and if, their hospitals are going to take part in the controversial procedure.

Gov. Peter Shumlin signed the End-of-Life Choices law on Monday, making Vermont the fourth state in the nation to allow doctors to prescribe lethal medication to terminally ill patients.

With Gov. Shumlin's signature, the law went into effect immediately, but BMH Chief Medical Officer Dr. Kathleen McGraw said staff and board members will have to talk about how the hospital will respond to the new law.

"There are varying opinions about the bill, and about whether it is appropriate or not to have a medical facility take part," McGraw said. "It may have the support of the staff and it may not. The questions is, ‘is it appropriate, and do we want this to happen in our hospital?' We'll have to see."

Under the law that Shumlin signed this week, hospitals can opt out of offering the procedure and if the hospitals do support the procedure doctors cannot be forced to prescribe the lethal medication.

Doctors also can not be punished if they refuse to prescribe the lethal dose of medicine to a terminally ill patient.

McGraw also points out that very few patients who are terminally ill spend their final days in the hospital.

The way the law is written hospitals have to formally vote to opt out of the law, which McGraw said BMH will probably do, at least in the short term, to give the board time to gather input from the staff.

She said it was unclear how BMH would formally move forward, thought she said the hospital Board of Directors probably will have the final say.

"We are going to get input from the medical staff," she said. "I know that has been a very debated topic, but we have to have our own discussions before we can decide if we will do this or not."

She said doctors in the satellite offices, such as those at Putney Family Healthcare, will be able to establish their own policies around the law.

The BMH board is scheduled to meet on June 11.

Jill Olson, vice president for policy and legislative affairs with the Vermont Association of Hospitals and Health Systems, said she is advising hospitals to opt out of the law, at least for now, to ensure that all of the legal and procedural steps are in place before a doctor writes that first prescription.

"If hospitals want more time they have to take action to opt out because of the way the law is written," Olson said. "Vermont is one of only four states that have done this, so there is a lot to sort out. We will be working with hospitals to help them figure out how they want to proceed."
Laws typically go into effect on July 1 after a bill is signed, or even later in the year if the statute requires additional time to establish the proper procedures.

The aid-in-dying bill went into effect immediately.

Grace Cottage Hospital Senior Director of Development and Community Relations Andrea Seaton also said her hospital is going to take its time before moving forward with the new law.

Seaton says conversations among the staff, ethics committee and board will be held in the coming weeks to help Grace Cottage decide how to proceed.

"We're currently in the process of examining all of the provisions and implications of the physician aid in dying bill," Seaton said. "We need to take some time to do this rather than rushing into decisions on a topic that raises strong emotions."

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


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