End-of-Life Choice, Palliative Care and Counseling

Montana Committee’s Vote Preserves Right to Aid in Dyingby Blaine

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The Montana Senate Judiciary Committee today maintained the Montana Supreme Court’s Baxter ruling. The committee voted 7 to 5 against Sen. Greg Hinkle’s bill (SB 116), that would have revoked the right of terminally ill patients to request aid in dying from their physicians. A bipartisan group of lawmakers – Sens. Augare (D), Blewett (D), Jent (D), Larsen (D), Moss (D), Peterson (R) and Vincent (R) – voted against the measure. The committee heeded testimony from doctors, patients, family members, hospice nurses and clergy, and its vote was consistent with the official positions of both the Montana Medical Association and the National Association of Social Workers Montana Chapter. The committee’s vote leaves responsibility to develop the standard of care for aid in dying with Montana’s medical community.

The Montana Supreme Court on December 31, 2009, in Baxter v. Montana, recognized that the statutes empowering patients to direct their end-of-life care, even when decisions may advance the time of death, reflect public policy in favor of patient autonomy. The court ruling recognizes that it is the public policy of Montana to protect the choice of competent dying patients to choose aid in dying, and makes clear that there is no basis to prosecute physicians who provide it. Today’s vote leaves that ruling intact.

Roberta King, of Missoula, whose father, Bob Baxter, was the lead plaintiff in the landmark case, said, “My father died without the peace and dignity he so dearly wanted for himself and others. I’m sure he would be deeply gratified that other terminally ill Montanans will have the choice and comfort that aid in dying affords them.”

Missoula attorney Mark Connell, who argued the case before the Montana Supreme Court, described the decision as “a victory for individual rights over government control. These are decisions that should be – and now can continue to be – made by the terminally ill patients whose lives, deaths and suffering are at stake, based on their own religious, spiritual and family beliefs.” Connell added: “I know Bob Baxter would be very pleased that the committee declined to over-ride the court’s ruling. Doctors who practice within the clear confines of the court’s decision are protected.”

“The people of Montana strongly support the Baxter decision,” said Sen. Anders Blewett. “I have heard from many elderly Montanans who live in my district on this issue. They are proud of their independence, and believe the power to make their own end-of-life decisions belongs to them, in consultation with their doctor, not to the State of Montana, nor to any organization or institution.”

“The committee’s votes leave the Montana Supreme Court’s decision in place,” said Dr. Stephen Speckart, an oncologist from Missoula. “It now falls to Montana physicians to develop the standard of care to respect and protect their patients’ end-of-life decisions. Montana’s medical community is certainly up to the task of including aid in dying in the options available for patients with end-stage cancer and other terminal diseases.”

The committee also voted last week to table Sen. Blewett’s bill (SB 167), deciding not to adopt specific practice guidance and immunities.

“It is unfortunate that the committee did not go further to codify the court’s decision, providing physicians with additional protections for honoring patients’ decisions,” said Dr. Speckart. “However, Montana’s medical community can rest assured the Senate Judiciary committee examined this issue closely, and concluded that it is proper public policy for physicians to respect a dying patient’s decisions.”

Steve Johnson, a Helena brain cancer patient, said, “I think I should have something to say about my ending. I want my physician to be able to respect and honor my choice to die with dignity. I don’t know whether I would ultimately take medication to end my life peacefully, but I’d like to have the choice.”