Vermont House weighs "death with dignity" bill (Credit: WPTZ)

On Monday night, the Vermont legislature passed a bill allowing doctors to help terminally ill patients die if the patient requests it. The controversial proposal, which Gov. Peter Shumlin (D-VT) has pledged to sign into law, is the first to pass a legislative body in the nation. Vermont will become the fourth state to allow doctors to prescribe lethal doses to patients with 6 months or less to live, after a court order in Montana and ballot initiatives in Washington and Oregon legalized the practice.

Vermont’s bill protects physicians from criminal, civil or professional punishment for prescribing lethal doses of medication to mentally competent, terminally ill patients. Before taking this option, a patient must state their request 3 times, get 2 medical opinions, be offered a psychiatric examination, and wait 17 days to fill the prescription. In 3 years, Vermont’s stricter requirements would expire and professional practice standards would begin to govern the law.

According to a study in one Seattle hospital, loss of autonomy was the reason 97 percent of cancer patients chose to end their lives. As the AP notes, Vermont is one of the fastest-aging states in the nation, with a quarter of its population projected to reach 65 years or older by 2030.

During two days of debate in the packed State House, proponents and opponents alike shared emotional stories of watching loved ones waste away or learning of a friend’s suicide. One woman testified that she had been misdiagnosed with an incurable disease by 2 doctors and warned that others who have been misdiagnosed may kill themselves before learning they were untrue. Others told stories of family members who outlived bleak prognoses.

Despite the fierce debate on both sides of the deeply fraught issue, few patients actually take advantage of physician-assisted suicide. Since Washington passed their law in 2010, just 255 people have received a lethal prescription, some of whom later chose not to go through with the program. These low numbers suggest that the program is used sparingly in only the most desperate cases. Moreover, a majority of Americans believe doctors should be allowed to comply with the wishes of terminally ill patients who want to hasten their death.

A Vermont man’s lawsuit alleging a state penitentiary forced him to work against his will has been allowed to move forward. A three-judge panel of the U.S. Court of Appeals for the Second Circuit found that the former inmate, Finbar McGarry, is entitled to a trial even though a lower court dismissed his case. McGarry is claiming his rights were violated under the Thirteenth Amendment, which outlawed slavery and involuntary servitude after the Civil War.

McGarry, who was at the time working on a chemistry PhD at the University of Vermont, was arrested in 2008 on a domestic disturbance charge and was sent to jail when bail was denied. As he awaited trial, he claims he was forced to work in a prison laundry at the Chittenden Regional Correctional Facility in South Burlington for three days a week up to 14 hours. He was paid just 25 cents an hour for six weeks.

When McGarry got an infection on his neck and refused to work, he was threatened with solitary confinement. A month before charges were dropped and he was released in 2009, McGarry sued for $11 million in damages. According to the Second Circuit, McGarry appears to have a pretty strong case:

The Thirteenth Amendment provides that “[n]either slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction.” Shortly after its passage, the Supreme Court held that the Amendment “is not a mere prohibition of State laws establishing or upholding slavery, but an absolute declaration that slavery or involuntary servitude shall not exist in any part of the United States.” Contrary to the district court’s conclusion, it is well-settled that the term “involuntary servitude” is not limited to chattel slavery-like conditions. The Amendment was intended to prohibit all forms of involuntary labor, not solely to abolish chattel slavery.

McGarry’s allegations state a claim under the Thirteenth Amendment. He alleges that his work in the prison laundry was compelled and maintained by the use and threatened use of physical and legal coercion. He supports his allegations with well-pleaded facts that the defendants threatened to send him to “the hole” if he refused to work and that he would thereby be subjected to 23 hour-per-day administrative confinement and shackles. These allegations plausibly allege “threat of physical restraint or physical injury” within the meaning of Kozminski.

Exploiting prison populations as an involuntary work force seems to be common practice. Recent reports found a private prison in Georgia paid its convicted prisoners and civil detainees $1 an hour for manual labor around the facility. Many states facing budget crises are increasingly using prison labor to fill the jobs of public employees. Because McGarry’s case relies on the fact that he was not “duly convicted” of a crime before he was forced to work, however, it is unlikely that his case will set a precedent that will benefit prison laborers who are incarcerated post-conviction.