Why Vermont's Death With Dignity Law Sparked Debate

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Why is Vermont’s “Death With Dignity” law so controversial? What are the pros and cons of physician-assisted death?

Vermont has become the first state to remove the residency requirement for physician-assisted death, sparking renewed debates around “Death with Dignity” laws. This change means that terminally ill individuals from outside the state can now seek life-ending care in Vermont.

In this article, we’ll discuss the details of the law and the pros and cons.

Vermont Opens Physician-Assisted Death to Non-Residents

Vermont’s Death With Dignity law has made it the first state to eliminate the residency requirement from its law regarding physician-assisted death. The law has allowed doctors to prescribe lethal medication to qualifying patients for the past decade.

In this article, we’ll look at the laws regarding physician-assisted death in the US and around the world, discussing the arguments of advocates and critics of these laws.

Where Is Physician-Assisted Death Legal?

Physician-assisted death (sometimes called physician-assisted suicide) is currently legal under varying circumstances in 10 states and Washington, D.C. Oregon’s Death with Dignity Act was the first—it was passed in 1997, more than a decade before any other state passed such a law.

States vary in the terms on which individuals can qualify, but in all cases, a minimum requirement is a terminal illness with a prognosis of six months or less to live. In the US, physician-assisted death laws only allow the health care provider to prescribe the life-ending medications, requiring that the patient take the drugs themselves. This is distinguished from physician-assisted euthanasia, in which the physician administers the drugs to the patient.

Countries vary on their policies—some require a terminal diagnosis, while others allow individuals with chronic and debilitating, but not necessarily terminal, illnesses to seek assisted death. But all countries have stringent requirements, such as verification of diagnosis by multiple doctors, proof of the patient’s cognizance, and waiting periods between the request and prescription.

In a few countries, the right to request physician-assisted death has even been extended to those with mental illnesses. Let’s turn now to the arguments for and against physician-assisted death.

The Arguments in Favor of Physician-Assisted Death

The national organization Death with Dignity is a major advocate for physician-assisted death laws. They say their mission is “to ensure people with a terminal illness can decide for themselves what a good death means in accordance with their values and beliefs.” Some of the commonly cited arguments in favor of physician-assisted death include:

Bodily autonomy: People should be able to make choices regarding their own bodies, health, and lives.
Physicians have a duty to ease suffering: This argument says that the healthcare professions’ creed to do no harm means they have the obligation to ease the suffering of their patients. If an individual has no chance of a life without suffering, doctors have a duty to help them end that suffering.
Dignity in dying: When an individual can choose when to end their life, they can plan to die surrounded by their loved ones in their own home (or wherever else they wish to be).

Advocates for physician-assisted death also point out that in the US in 2021, over 26,000 people intentionally killed themselves with a gun. While nobody’s arguing that all of those people should have had life-ending medication provided to them, they say we must consider how many of them might have been in a situation where they could have had a more compassionate option. Euthanasia is universally considered to be the most compassionate choice for a beloved pet who’s suffering. Death-with-dignity advocates question why we don’t extend the same compassion to our beloved fellow humans, who can make the choice themselves.

The Arguments Against Physician-Assisted Death

Canada is considered one of the more liberal countries with regard to assisted-death laws and has recently deliberated extending the right to those with mental illness. But critics say this is a slippery slope that could encourage suicide as a viable option for potentially treatable illnesses. They urge Vermont and other US states to consider Canada a warning rather than a model. Since Canada passed its Medical Assistance in Dying (MAID) law in 2016, over 30,000 people have made use of it.

Some of the most commonly cited concerns with physician-assisted death include:

The possibility of coercion: Healthcare providers or family members may be able to coerce the ill into choosing to end their lives when they’re in a vulnerable state.
Religious objections: Many religions consider the taking of human life to be unacceptable.
Violation of the physician’s oath: This perspective says that helping a patient die violates the healthcare profession’s creed to do no harm, and that it’s inherently unethical for a physician to intentionally cause a patient’s death under any circumstances.
It’s akin to eugenics: There’s a potential for expanding the right to assisted death to those who aren’t terminally ill. Disability and mental health advocates claim that if people with chronic but not terminal conditions, or those with mental illness, are allowed to access assisted death, it could communicate to disabled and mentally ill individuals that their lives are not worth living. They argue further that because poorer people are less likely to have access to quality health care, they’ll be more likely to have chronic illnesses. This means that life-ending drugs will ultimately be prescribed more often to those in minority groups and lower socioeconomic brackets, creating a situation where larger numbers of these people are ending their lives—which could look like a modern-day eugenics program.

In the case of mental illness, critics also contend that there’s no way to know for sure that a person won’t recover—mental illness can’t be considered “terminal” in the way cancer can.

Why Vermont’s Death With Dignity Law Sparked Debate