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Vermont Hospitals Take Wait-and-See on Aid-in-Dying

Medical Association Advises Careful Design of Policies

Montpelier — Vermont’s new aid-in-dying law, which allows doctors to prescribe lethal medication to terminally ill patients who request it, is set to take effect as soon as Gov. Peter Shumlin signs it on Monday. But most Vermont hospitals are expected, at least for the time being, to opt out of implementing it.

That word came yesterday from officials at several hospitals, as well as from Jill Olson, vice president for policy and government affairs at the Vermont Association of Hospitals and Health Systems.

Olson said her group is advising hospitals to take their time to develop policies for how to handle aid-in-dying on their properties and among their medical staffs. “There’s a lot of work to do to get ready to do it,” she said.

Shumlin is set to sign the bill in a Statehouse ceremony set for 2 p.m. Monday, making Vermont the fourth state to allow such a practice. Aid-in-dying laws passed by public vote in Oregon and Washington; a court decision made it legal in Montana.

The House gave the bill final passage on Monday; it could have been brought up for a reconsideration vote on Tuesday but was not. That means less than a week passed between the time it was clear the bill would pass this year and when hospitals would be legally authorized to begin using the process the new law sets up.

“We are not ready,” said Laural Ruggles, spokeswoman for the Northeastern Vermont Regional Hospital in St. Johnsbury.

Sen. Claire Ayer, D-Addison, chairwoman of the Senate Health and Welfare Committee and the Senate’s chief champion of the legislation, said yesterday that she was not surprised the hospitals would want additional time before implementing the new law.

“My guess is they want to make sure they have everything all lined up and they know exactly what they’re doing,” she said.

Many bills contain an effective date that comes well after they’re signed into law by the governor. But Ayer said because the bill passed right at adjournment, legislative procedure required that it either be signed by Shumlin within five days or wait until January, when lawmakers return for the second half of their biennium, for enactment.

She said hospitals feeing rushed was a “downside,” to the quick effective date. “Having it not take effect until January would be a worse downside,” she said. “There are people who are waiting for this bill.”

Using the procedures outlined in the law is voluntary for hospitals and for physicians, and the law bars hospitals from requiring that employees be willing to use it as a condition of employment.

That’s why at Fletcher Allen Health Care, Vermont’s largest hospital, a temporary policy says only that aid-in-dying procedures are not to be used with inpatients who might want to take the lethal medication while they are in the hospital, said spokesman Mike Noble.

Many of the more than 750 doctors who are employees of Fletcher Allen work at satellite clinics outside the main Burlington campus. Nothing prevents them from prescribing the medication at a patient’s request and allowing the patient to take the drug at home, Noble said.