The Legislature may have 180 members, but the biggest votes in Vermont’s history often come down to a single individual. And in the Senate Wednesday evening, Sen. Peter Galbraith used his turn at the wheel to derail a decade-old push for a state-sanctioned process by which doctors could hasten the death of their terminally ill patients.
As one of four senators refusing to say publicly whether he supported “death with dignity,” the Windham County Democrat has been at the center of the intrigue since last month. On Tuesday, he broke his silence by voting in favor the bill. His support would prove fleeting.
The controversial legislation outlined a process by which physicians could prescribe lethal doses of medication to mentally competent, terminally ill patients with less than six months to live. Galbraith said he supports the intent of the bill – to allow suffering individuals to bow out on their own terms, surrounded by friends and family. But he said the “state-sponsored process” constituted undue government intervention in what should be a sacred exchange between doctor and patient.
Instead of a defining a lengthy and highly regulated procedure by which patients of sound mind can seek a fatal dose of barbituates from their consenting doctors, Galbraith said, the state ought to simply indemnify any physician who agrees to prescribe the medication.
Under normal circumstances, Galbraith’s proposal wouldn’t have stood a chance. But Wednesday wasn’t a normal day.
The vote on the bill Tuesday passed by a 17-13 margin, and Galbraith wasn’t the only ‘aye’ to register concerns with the bill. Sen. Bob Hartwell, a Bennington County Democrat, also dislikes the legislation, and said his ‘yes’ vote Tuesday was only to give its supporters a chance to make it more palatable before a final vote Thursday.
Galbraith’s amendment sought to strike entirely the underlying bill, which was modeled after a 15-year-old statute in Oregon and has been years in the making here. He then replaced the 22-page bill with a five-paragraph amendment that insulates from civil and criminal liability a doctor who prescribes a “lethal dosage” to a terminally ill person. The amendment also protects from liability any friend or family member who is in the presence of the person when they ingest the medication.
The amendment gave opponents of the original bill the opening they’d been looking for. By voting in favor of Galbraith’s bill – a measure most wouldn’t support generally – they could effectively kill off the legislation it sought to replace. Sure enough, all 13 people who voted against the bill Tuesday voted in favor of Galbraith’s amendment today. They were joined by Galbraith and Hartwell, which led to a 15-15 tie on the floor of the Senate. That left the tie-breaking vote to Lt. Gov. Phil Scott, an avowed opponent of “physician assisted suicide.” He voted ‘yes’ for Galbraith’s amendment.
It was a dramatic moment that took even jaded Statehouse veterans by surprise.
It isn’t the end of the road for the original bill. Sen. Claire Ayer, an Addison County Democrat, chairwoman of the Senate Committee on Health and Welfare, has spent the last six weeks shepherding the Oregon-style bill through the Senate. “As much as I detest” the Galbraith amendment, Ayer said, she encouraged her colleagues to vote in favor of it.
By getting it through the Senate and over to the House, she said, lawmakers can bring the bill back to its original form and get a second chance to pass it as-is. Sen. Dick McCormack agreed, saying there are procedural reasons to pass the bill, “even in its presently grotesque form.”
Galbraith said his amendment differs philosophically from the bill it replaces in only one area.
“And that is as to what safeguards are built in,” Galbraith said. “The other bill leaves it to the state to decide who can do what under what circumstances. I believe the best safeguard is the close relationship between a doctor and their patient.”
He seemed taken aback by the intensity of the hostility to his amendment.
“It’s not grotesque. It’s not a travesty,” he said. “It isn’t exactly what they wanted, but it delivers the result they were looking for.”
Ayer said the underlying legislation sought to end precisely the kind of ill-defined, poorly overseen, under-the-table process that Galbraith’s bill would legalize. She said the legislation sought to engender deeper conversations between doctors and patients about the dying process, and make sure terminally ill people understand the range of palliative care options available. Ayer said she worries the Galbraith amendment may also create some new legal loopholes ripe for exploitation by unscrupulous doctors or caregivers.
Dick Walters, head of Patient Choices Vermont, an advocacy group pushing the bill, said Galbraith’s amendment “strips all of the carefully crafted and well-tested safeguards from the bill and instead gives physicians full immunity when prescribing lethal doses of medication.”
The bill comes up for final reading Thursday, creating another potentially interesting vote. A number of senators who supported the underlying bill voted against Galbraith’s amendment today. The amendment carried only because of unanimous support from opponents of the underlying bill. But the original bill is dead now, in the Senate at least, and can’t be resuscitated regardless of the fate of the Galbraith amendment. That means the same people who wanted to see the bill killed off entirely can now vote against the Galbraith amendment without consequence. And if senators who supported the original version don’t come around to Galbraith’s language, the legislation, in all its forms, could die for good.
Walters said he hopes senators who support the underlying bill will hold their noses and vote ‘yes’ for the amendment.