Vermont experiments with assisted suicide in the dark

Vermont was the third US State to legalise assisted suicide in May 2013. Since then only two reports have been issued with very minimal data. Essentially this a fatally flawed experiment carried out in the dark.

Compared even to Oregon and Washington, the official statistical reports on assisted suicide in Vermont are extremely minimalist.

Two reports have been issued to date. The first covers 31 May 2013 to 30 June 2017 and the second covers 1 July 2017 to 30 June 2019. 

All we can learn from these two reports is that over this six year period 87 prescriptions were issued under the Act for 68 cancer cases; 11 cases of ALS (amyotrophic lateral sclerosis or Lou Gehrig’s); 3 cases of Parkinson’s Disease or Huntington’s Disease and 5 for undisclosed conditions.

In Oregon lethal prescriptions have been written for conditions not usually considered terminal such as diabetes. It is not clear whether this is the case in Vermont given the limited reporting.

Of these 87 cases for which prescriptions for a lethal substance were written in 57 cases

the “mechanism of death” is reported as having “utilized the patient choice prescription” (Vermont newspeak for having ingested the lethal substance);

22 died from the underlying condition; 1 died from “other causes”; and 2 died from an unknown cause. No information is given in the second report about 4 people who were presumed to be still alive when the first report was issued. Nor is the mechanism of death for the extra cancer case which pops up in the “general statistics”, apparently from the first reporting period, given.

The phrase “mechanism of death” is a neologism to avoid referring to manner of death. The reports both state that “100% of the death certificates listed the appropriate cause (the underlying disease) and manner of death (natural), per Act 39 requirements.”

This is curious as Act 39 as passed does not include the provision in the bill as introduced requiring the “manner of death” following ingestion of a lethal substance to be falsely recorded as “natural”.

Even more curious is how in the two cases where the mechanism of death is reported as unknown or the one case where it is reported as form “other causes” the death certificate can still specify the manner of death as “natural”.

The data was not broken down further by age, sex or by year of death although this data is collected.

No information is collected in Vermont on the reasons for requesting assisted suicide (apart from the underlying condition); on complications; on the substance prescribed; on the length of time from prescription to ingestion, from ingestion to unconsciousness, or from ingestion to death; or on the duration of the patient-doctor relationship.

Conclusion

Vermont's experiment with assisted suicide has yielded no useful official data but anecdotal evidence points to suicide contagion and the fostering of a cavalier attitude among some clinicians towards the elderly, actively encouraging access to assisted suicide instead of promoting a culture of care.