Physicians' Attitudes, Concerns, and Procedural Understanding of Medical Aid-in-Dying in Vermont

The general purpose of the current study was to collect data on physicians' attitudes towards Act 39, the medical aid-in-dying act that was legislatively approved in 2013. Given the recent nature of the implementation of Act 39, this is the first such study to be conducted in the State of Vermont. The survey was quantitative in nature and addressed three distinct aspects of legalized prescribing of life-ending medication, these being physicians': (I) attitudes regarding ethics and legality of Act 39, (11)understandings of the policies and procedural requirements under the law, including their belief in legal immunity from penalty, and (I1) level of support for certain provisions under the law, such as patient-terminality requirements, verification of terminal diagnosis by a second physician, and whether a psychiatric evaluation ought to be required prior to prescription. In general, the physicians surveyed support medical aidin-dying, agree with the terminality and second-opinion provisions of Act 39, but are divided about whether a mental health professional should be involved in capacity evaluations. Furthermore, religious identification and ethical orientation, but not percent-terminal patient workload, were found to be significant covariates in statistical analyses of physicians' support for Act 39. The respondents agreed that medical aid-in-dying is a valuable treatment option in the realm of palliative care, but expressed that other palliative care treatments should be explored prior to a patient's pursuit of medication to hasten death. Physicians' concerns about legal liability, and their lack of accurate and confident knowledge of the policies and procedures of Act 39, may limit the availability of medical aid-in-dying to interested terminally-ill patients.