Improvements recommended for end of life care

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(Host) Attorney General William Sorrell says significant improvements need to be made in end of life care for Vermonters. Sorrell’s office issued a report on Monday that contains a number of recommendations.

VPR’s Steve Zind reports.

(Zind) Sorrell says too many seriously ill Vermonters aren’t getting adequate treatment for pain and too many haven’t put down in writing how they want to be cared for at the end of their lives. Sorrell says Vermont has lagged behind the rest of the nation in these areas. The attorney general’s report is the result of a year and a half of work by committees made up of health professionals, care advocates, lawyers and senior citizens.

Committee member Dr. Zale Berry of Fletcher Allen Health Care says in many cases physicians are fearful of prescribing adequate pain treatment.

(Berry) “They very much fear that law enforcement may be looking over their shoulder and judging their intentions as different than they truly are.”

(Zind) The fear among doctors is they could be charged with intentionally administering enough pain medication to hasten the death of a terminally ill patient. Sorrell says the law needs to be clear that doctors who are trying to treat pain have nothing to fear.

(Sorrell) “We want doctors to feel comfortable with aggressive pain management at the end of life, to try to make sure that a patient that is terminally ill and in great pain is suffering from as little pain as possible. If the medication that’s administered does have the unintended effect of hastening death, that is within the standard of care and would not be in violation of our laws.”

(Zind) The report also calls for better palliative care education for Vermont’s health care providers.

Sorrell says his report doesn’t deal with the controversial issue of legalizing physician assisted suicide – an issue that stalled in the last session of the Legislature.

It also calls for changes in advance directives. These are documents that allow a person to decide how they’re to be cared for in the event of serious illness. Sorrell says Vermonters need more flexibility in how advance directives are written. Only about a third of Vermonters have advanced directives and the report suggests standardized forms and a more streamlined process as ways to get more people to use them. Sorrell says legislation will be introduced this session that would accomplish this.

The report also calls on the lawmakers to enact legislation to make sure Do Not Resuscitate orders are followed uniformly by health care providers and that providers who do follow them are protected from lawsuits.

For Vermont Public Radio, I’m Steve Zind.

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