Act No. 39 (S.77).

An act relating to patient choice and control at end of life

This act creates a process in statute by which a physician may receive immunity from civil and criminal liability and professional disciplinary action for prescribing to a patient with a terminal condition medication for the patient to self-administer to hasten his or her death.  It requires the physician to document the occurrence of 15 separate actions, some of which include multiple steps.  After three years, the act repeals the statutory process and replaces it with immunity for physicians who take certain steps with respect to a patient with a terminal condition, including prescribing a dose of medication that may be lethal to the patient, if the patient later makes an independent decision to self-administer a lethal dose of the medication.

The act states that a patient’s right to ask questions and receive information from his or her physicians exists regardless of the purpose of the patient’s inquiry or the nature of the information provided.  It specifies that a patient with a terminal condition who self‑administers a lethal dose of medication is not a person exposed to grave physical harm under Vermont’s duty to aid law, and that no one will be subject to civil or criminal liability solely for being present when a patient with a terminal condition self-administers a lethal dose of medication or for not acting to prevent the patient from self-administering a lethal dose.

The act prohibits a health care facility or health care provider from imposing any penalty on a physician, nurse, pharmacist, or anyone else for actions taken in good faith reliance on the provisions of the chapter created by the act or refusals to act under the chapter.  It also specifies that no physician, nurse, pharmacist, or anyone else is under any duty to participate in providing a lethal dose of medication to a patient.  The act protects individuals and their beneficiaries from being denied life insurance benefits for actions taken in accordance with the chapter and prohibits issuers of medical malpractice insurance from conditioning the sale, procurement, or issue of, or the rate charged for, a medical malpractice insurance policy based on whether a physician is willing or unwilling to participate in the provisions of the chapter. 

The act specifies that it does not limit or otherwise affect the use of palliative sedation; that it does not authorize anyone to end a patient’s life by lethal injection, mercy killing, or active euthanasia; and that actions taken in accordance with the chapter are not suicide, assisted suicide, mercy killing, or homicide.  The act also directs the Department of Health to adopt rules for the safe disposal of unused medications prescribed under the chapter. 

Multiple effective dates, beginning May 20, 2013