ISSUES
A very difficult and profoundly
important issue
May 2, 2013
S.77… It is an act relating to patient choice and control at end of life. It evokes strong philosophical arguments, both pro and con. It evokes very deeply felt emotion.
I voted in support of the bill. From my point of view, the bill is about respect for the right of a patient to make his/her own decisions. It is about rigorous protection of the patient… including ensuring that the patient is aware of the spectrum of alternatives available in his/her decision-making. It is about compassion.
Here’s a very broad overview of the bill’s substance.
The bill permits a “qualified patient” to request and self-administer dose of lethal medication.
What is a “qualified patient”? This person is an adult Vermont resident who has been given a diagnosis of terminal illness, confirmed by at least two doctors, with a prognosis of life expectancy estimated to be six months or less… and he/she voluntarily expresses a wish to hasten the dying process.
Additionally, a “qualified patient” must be “capable,” without “impaired judgment.” A “qualified patient” makes an “informed decision” after being advised of the diagnosis… the prognosis, including the fact that any prognosis is an estimate… the range of treatment options… the range of comfort care options, including palliative care, pain management, and hospice… the potential risks of the lethal medication… the probable result of using the medication. A “qualified patient” must request the lethal medication three times, twice orally and once in writing. The patient must wait fifteen days between oral requests, and then forty-eight hours after the final request. Ultimately, he/she must be able to self-administer the medication. “Under no circumstances” can a guardian, or conservator, or agent named in an advance directive act on behalf of the patient in this ultimate action. The bill is designed for the patient, and for the patient only.
The bill is, in fact, sixteen pages in length… throughout detailing the means of determining that the patient is “capable,” that he/she is acting voluntarily, that he/she has made an informed decision. Included in those sixteen pages is also language which stipulates the consequences of acting in other than the patient’s best interest. If, for instance, there is “false witnessing” of the patient’s written request for the medication, the consequence is imprisonment for not more than ten years, or a fine of not more than $2000, or both. If there is gross negligence, recklessness, or intentional misconduct involved, the consequence is civil or criminal liability. Indeed, If a person violates the provisions of the bill, with the intent to cause the death of the patient, in stark contrast to the aid in dying as outlined in the bill, the consequence is prosecution for homicide.
So, yes, this bill rigorously protects the patient… and rigorously protects the patient’s right to choose. And, yes, I voted in support. I heard from people urging me to vote for the bill and from people urging me to vote against the bill. Since I could not vote both ways, I had to vote my conscience. I had to hold true to the “compass” which guides me through the complexities and challenges presented by life… as do we all.
I am very thankful to the many people who contacted me on this issue, as well as on many of the other issues before the Legislature. It is hard, but part of reality, that we cannot all walk in lock step on each issue. The important thing is that we talk and understand one another… and continue to respect one another even through differences of opinion. I look forward to your continued phone calls, letters, e-mails, and visits at Trader Duke’s on Saturday mornings.
South Burlington Charter Changes
April 14, 2013
On Tuesday, April 2, testimony was taken in House Government Operations, my committee, on our two South Burlington charter changes — H.392, City Clerk and H.393, Library Board of Trustees. After much deliberation, the committee ultimately voted on Wednesday, April 10… by a vote of 1 yes and 10 no, to approve neither proposal. Mine was the only vote in support of the proposals.
Click here to read the full memorandum.
For the record
April 2, 2013
These past three weeks were really, really tough. They were tough physically… we were on the Floor day after day, for more hours than I ever believed possible. They were tough intellectually… we were wrestling with the transportation bill, the revenue bill, the appropriations bill. They were tough emotionally… we were making decisions that have an impact on every single Vermonter.
So now I want to tell you where I came down on these bills, and why.
The transportation bill?
Yes, I voted in favor of the transportation bill. Here’s why.
People have, more and more, been driving fuel-efficient cars, and state transportation revenues have declined such that we have a gap of $36 million. The proposal I voted to support remedies the budget hole, raising the revenue needed to repair roads and bridges which are in terrible condition. The revenue raised also saves us from losing, for lack of a state match, $56 million in federal transportation funds.
The revenue bill?
Yes, I voted in favor of the revenue bill. Here’s why.
The bill raises $20 million to support General Fund spending and $4 million for the Education Fund. The bill doesn’t take money from low-income working families. It focuses on Vermonters most able to pay. It focuses on discretionary items such as candy and soda, excluding them from the sales tax exemption and thereby moving Vermont toward compliance with the national Streamlined Sales and Use Tax Agreement. It raises the meals tax by a half percent for one year only, and yes, it increases the tax on tobacco products by 50 cents and restores the tax on clothing items over $110, the taxable purchase price in 2006 when it was originally eliminated. One more thing: The bill repeals the employer Health Care Fund Contribution… to the tune of a $15 million savings. The tax package, I believe, is balanced and fair.
The appropriations bill?
Yes, I voted in favor of the appropriations bill. Here’s why, at least in part.
The bill appropriates $325,000 to provide all eligible school children lunch as well as breakfast. It Increases the appropriation to Higher Education, the first increase in four years, making available $2.5 million in additional scholarships for Vermont students. It increases payments to Medicaid providers by 3% ($10.6 million) to reduce cost shift and lower private insurance costs. It budgets $6 million for home heating fuel assistance, for the first time replacing federal money. It supports the regional development corporations with an additional $200,000 to expand their work in developing economic opportunities throughout the state. It increases the investment in the Working Landscape program by $325,000, and invests $2 million in the Clean Energy Development Fund. And then the bill also sets aside $6 million in reserve against the impact of the federal sequestration. Money raised in the revenue bill adds an additional $3.1 million to this reserve for a total of $9.1 million.
There you have it. No one likes to pay more, myself included… ever more so since I retired and learned the painful choices necessitated by a very fixed income. I did not make my decisions to support these tax-related bills in any careless or cavalier way. I made my decisions based on the needs of Vermont and Vermonters. I made my decisions based on what I believe to be my responsibility.
As always, I look forward to hearing from you… your calls and e-mails… as well as your visits at Trader Duke’s on Saturday mornings. Please continue to stay in touch.
Revenue for FY14
March 23, 2013
House Ways and Means has completed its work on its proposed revenue package for FY14. The proposal comes to the full House this week. The debate will in all likehood be long, and challenging. I cannot imagine a scenario in which any of the decisions to be made will be easy. As a first step, I believe it important to understand where the committee is coming from.
On VT Digger, the Chair of the committee, Representative Ancel of Calais, said the committee’s tax proposal “raises less revenue than the governor recommended in his budget… His budget included more than $34 million, and we are recommending new FY14 revenue of $23 million.”
She went on to note: “We also had discussions with the Appropriations Committee about the need to put anything over the $20 million we had targeted into reserves, and we are pleased to see that’s what happened. No one wants to pay additional taxes but we focused on those most able to pay and on things that are discretionary such as candy, soda and cigarettes. We didn’t raise tax rates and we didn’t take money from low income working families. Every member of the committee had to make compromises and as a result our tax package is balanced and I believe it maintains equity and fairness.”
Click here for the full article.
I hope that you find what I write throughout the session informative and of interest. Please do not hesitate to contact me about the issues… just click on mftownsend@comcast.net. Help me to serve you the best I can.