H.75 would expand Vermont’s patient choice at end of life law by replacing the term “physician” with “clinician” in key parts of the statute and by expressly allowing additional licensed professionals to participate in the process. Under the bill, naturopathic physicians, nurse practitioners, and physician assistants could take part in evaluating requests for medication to hasten death, and naturopathic physicians could also sign and issue DNR orders and clinician orders for life-sustaining treatment (COLST). The bill also updates definitions and procedural requirements to reflect this broader clinician participation, including telemedicine use when clinically appropriate.
The bill preserves the existing safeguards for end-of-life medication requests: two oral requests separated by at least 15 days, a written request witnessed by two non-interested adults, confirmation of terminal condition, capacity, informed decision-making, and voluntariness, plus consultation with a second clinician and, when needed, a mental health evaluation. It also maintains immunity for clinicians who comply in good faith, while preserving liability for gross negligence, recklessness, or intentional misconduct. In addition, the bill clarifies that participation is voluntary for clinicians and facilities, and it retains the rule that the law does not authorize lethal injection, mercy killing, or active euthanasia.
On the DNR/COLST side, the bill amends the authority section to include naturopathic physicians among clinicians who may issue DNR/COLST orders and recognizes out-of-state licensed clinicians in certain circumstances. It keeps the requirement that DNR/COLST orders be issued on the Department of Health form, signed by the clinician, documented in the medical record, and honored by providers and facilities in good faith. The bill also continues existing protections for out-of-state DNR orders and clarifies that a DNR order only applies to cardiopulmonary arrest and does not limit other treatment.
The overall sentiment reflected by the bill text is permissive and expansion-oriented, with a focus on increasing patient access and clinician participation in end-of-life decision-making while preserving procedural safeguards. Because there are no committee transcripts or recorded votes provided, there is no documented public debate in the supplied materials, but the structure of the bill suggests an intent to broaden access without changing the underlying assisted-dying framework.
The main points of potential contention are likely to be the expansion of authority to non-physician clinicians, especially naturopathic physicians, and the continued use of telemedicine for oral requests and evaluations. Another likely issue is whether expanding who may certify terminal illness, capacity, and informed consent could affect the reliability of safeguards. Facilities may also object to the extent of the bill’s requirements if they have policies limiting participation in end-of-life prescribing, although the bill preserves a facility exception and a general right of refusal for individual clinicians and staff.
The bill would amend 18 V.S.A. chapter 113 to broaden who may participate in Vermont’s patient choice at end of life process and would revise 18 V.S.A. § 9708 governing DNR/COLST orders. It would change statutory references from “physician” to “clinician,” add naturopathic physicians, nurse practitioners, and physician assistants to the class of authorized participants, and allow naturopathic physicians to sign and issue DNR/COLST orders. It would also update related definitions, documentation requirements, immunity provisions, facility exceptions, and insurance protections, while leaving the core end-of-life medication framework intact.
Based on the bill text alone, the measure appears generally supportive of patient autonomy and expanded clinician participation in end-of-life care. The bill is drafted to preserve existing safeguards, voluntary participation, and liability limits, suggesting an effort to balance access with oversight. No committee testimony or votes were provided, so there is no recorded opposition or support in the supplied history beyond the bill’s own policy design.
The likely areas of contention are the expansion of authority beyond physicians to naturopathic physicians, nurse practitioners, and physician assistants, and the use of telemedicine for requests and evaluations related to hastened death. Some stakeholders may also question whether the bill sufficiently protects against coercion or impaired judgment, especially given the broadened clinician roles. Health care facilities may be concerned about conflicts with institutional policies, though the bill preserves a facility exception and a right of refusal for individuals.