On January 18th, Patient Choices Vermont posted draft assisted suicide legislation, sponsored by Senator Jeanette White, to be introduced in the 2011 Vermont legislature.
In a first round of analysis I have compared the drafted 2011 legislation to the 2009 S144 legislation. In a nutshell, the proposed 2011 legislation is very similar to the S144 bill from 2009.
There are two major changes in the 2011 draft legislation;
(1) The counseling referral for mental health is now optional based on the opinion of the physician. In the new legislation a patient only has to go to mental health counseling if, in the opinion of the attending or consulting physician, the patient needs it. In the 2009 legislation this mental health consultation was mandatory, thus drafters of the bill have dropped a safeguard in the new legislation.
(2) Drafters have added a new requirement that the attending physician refer the patient to a palliative care consultation if the patient is not receiving hospice care at the time of the written request for medication, and the physician must attest to its completion.
Changes in specific sections of the legislation are detailed below:
- In Section 1 FINDINGS:
Sections (1)-(3) have been updated to reflect new 2009 Oregon suicide data, and the latest 2010 census data.
- Under section 5280 DEFINITIONS:
(4) The definition of “counseling” has been expanded to include a confirmation that a patient is not suffering from mental disorder or disease, including depression – previously this section only included impaired judgment without mention of depression or mental disease or disorder specifically
(8) A new section was added to include the definition of “palliative care”
- Under section 5282 ATTENDING PHYSICIAN: DUTIES:
(6) A new duty was added to refer the patient to a palliative care consultation if the patient is not receiving hospice care at the time of the written request for medication
- Under section 5284 COUNSELING REFERRAL:
The counseling referral for mental health is now optional based on the opinion of the physician. A patient only has to go to mental health counseling, if in the opinion of the attending or consulting physician, the patient needs it. In the 2009 legislation this mental health consultation was mandatory, thus, they have dropped a safeguard.
- Under section 5285 PALLIATIVE CARE CONSULTATION:
This section is completely new and requires the attending physician to refer the patient to a palliative care consultation if the patient is not receiving hospice care at the time of the written request for medication, and the physician must attest to its completion.
- Under section 5290 MEDICAL RECORD DOCUMENTATION:
(5) This is a new section that requires the attending physician to attest that the patient received a palliative care consultation if the patient was not receiving hospice care at the time of the written request for medication.