Don’t Believe It! Did the Vermont Commissioner of Health Care Administration Really Say Legalizing Assisted Suicide Would Help Cut Costs under Vermont’s Single Payer Health Plan?

Editor’s note. The following appears on the website of True Dignity Vermont: Vermont Citizens Against Assisted Suicide.

Stephen Kimbell

Can Stephen Kimbell, Commissioner of the Vermont Department of Banking, Insurance, Securities and Health Care Administration, have really told the Addison Independent that, ‘‘Passing a law that allows physicians to help end a patient’s life under very controlled circumstances…… is one such measure that could help’’ cut costs under Vermont’s new single payer health plan? That’s what the editor wrote in the July 18 edition of the paper. 

If it is true, it should shock some sense into every Vermonter and people in other places threatened with assisted suicide too. The affluent, well-educated older folks pushing legalization of assisted suicide in Vermont and elsewhere need to wake up and realize that their inability to face the inevitable loss of control and need for care that characterize natural dying is making them targets for genuinely unscrupulous attempts at social engineering that threaten absolutely everyone who needs care. They may not be making this ‘‘choice’’ they value so highly. The state may be making it for them.

It is one thing to acknowledge that a time comes when dying can’t be stopped and the best, and possibly the most life-extending, treatment is good pain relief, companionship, and the spiritual and emotional support offered by a caring community. The one to decide when that time has come is the patient, hopefully in the loving embrace of his family. It is quite another thing when the patient is pressured to commit suicide, no matter how subtly, by a health insurance plan into which he has been forced and which objects to the cost of helping him live while dying.

It is a huge manipulation of language, in fact a contradiction in terms, to call killing oneself accepting one’s mortality. Suicide is a refusal of the process of dying, an attempt to replace the dying process by choosing to drift into a sleep from which one has taken steps never to awake. It has nothing to do with acceptance of mortality, though anyone who has watched the assisted suicide recently televised by the BBC will have seen that such a death is ugly, the opposite of a gentle drifting into sleep, a failure at avoiding everything suicide proponents fear about mortality.

Excellent palliative or hospice care can allow patients to live out their inevitable dying, and arrive at real acceptance of it. Such care is expensive. If the man who will oversee the development of the single payer health insurance plan into which most Vermonters will be forced sees suicide as a cost-cutter, how can any Vermonter not feel the pressure immediately? Many will move away from a state which will not take care of them as they die naturally but will present assisted suicide, even while pretending to offer it only as one choice among others, as the cheapest option. In hard times, isn’t the cheapest option the best? And how soon will it become the only option, as other forms of care are deprived of funding.

The threat to the chronically ill and disabled of the previously unspoken but now overt cost-cutting suicide mindset are obvious and enormous. If it would be cheaper to steer those within six months of death to suicide than to provide six months of hospice care, how very much more money would be saved by suggesting to people with disabilities who require constant and expensive care that they might be better off declining the services with which they can live for years but without which they will die. How long will it be before the already obscure definition of terminal illness is broadened to include any disability which would kill a patient within six months if, for example, he lost his ventilator, or his nursing home care, or his dialysis, or his personal assistant?

There are people who require this type of assistance their whole lives, yet live those lives meaningfully. We have a quadriplegic friend who has been in a nursing home for eighteen years. He must have his catheter and colostomy maintained. He must be turned and bathed. He requires frequent antibiotics for infections. He is in pain and often sedated. During the hours he manages to stay awake, however, he reads, writes, prays, paints gorgeous pictures, and receives guests. Is he terminally ill? He would be the minute the state denied funding for his care. Will Vermont be denying care under the single payer plan and then listing assisted suicide among a range of covered services? Must our friend die to save the rest of us money? He would reach the demoralizing conclusion that some hoped he would if he read the words the Addison Independent indicates it heard from Stephen Kimbell.

No wonder disability rights groups in Vermont oppose legalizing assisted suicide. What threatens people with disabilities, however also threatens the elderly and, yes, even the terminally ill who would actually prefer to live out their days and die naturally, the ones who are actually ready to confront their mortality. Since we will all be terminally ill some day, it threatens all of us. …

We thank the Addison Independent, however, for letting us know that at least some hope the Vermont single player plan can cut costs through assisted suicide. The combination of single payer and assisted suicide would destroy choice in our state. Absolutely no one would be safe.

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