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The VT House Human Services Committee heard testimony recently on bill H.168, the proposal to legalize physician-assisted suicide. Much of the testimony was about patients with overwhelming suffering during the dying process.

These are sad and tragic cases; — those patients should have received better palliative care services.

However, it is time to put to rest the misconception that assisted suicide is about suffering. Neither the OR law permitting physician-assisted suicide, nor the VT proposal requires that the patient experience any suffering at all — only that the patient has less than 6 months to live and wants to die.

An OR physician testified last week that not one of the 208 assisted deaths in OR was requested because of pain, though 22% feared pain in the future. The issue is one of control, not “overwhelming suffering.”

Yes, patient control is very important. But let’s deal with it face on, instead of pretending the issue is pain and suffering.

What is becoming increasingly clear is that assisted suicide in OR is also about cost. The most recent Prioritized List of Health Services for OR Medicaid patients added a new condition: No payment for diagnostic testing or active treatment for 26 types of cancer unless the patient has at least a 5% chance of living another 5 years.

So someone who is terminally ill with cancer of the stomach or bowel, for example, and might live many more months or perhaps years cannot receive state funding for measures that could slow down the disease.

But one of the “comfort care” measures the state will pay for is “physician aid-in-dying.”

There must be a better way to address the Medicaid shortfall facing every state than to subtly encourage patients to end their lives prematurely.

Let’s instead ensure dying Vermonters have access to the full range of palliative and hospice services.

[comments of Robert D. Orr, M.D. President of the Vermont Alliance for Ethical Healthcare;, 1May05]