Montana's New Aid in Dying Law: Legal Does Not Mean Accessible.

On New Year's Eve, Montana's Supreme Court ruled in the Baxter v. Montana appeal case that aid in dying is not prevented by the state's laws or constitution. The decision wasn't exactly what patients' rights activists were hoping for because now the legislature, decidedly reticent to take up the issue and notoriously more conservative, is invited to address the issue.

But as women's rights advocates know well, legal does not mean accessible. Montana doctors are not jumping to use the new aid in dying ruling because, many say, the law does not have guidelines regarding use. Other's have noted that opponents to aid in dying, primarily "pro-life" groups who have become expert at blocking access to abortion, a legal medical procedure in the US, will use their access-limiting expertise to prevent dying patients from using aid in dying.

From provider refusal laws ("conscience clauses") that allow pharmacists to refuse to fill lethal prescriptions for terminal patients, to restrictions on Medicare and Medicaid coverage of aid in dying, to pressure from Christian doctors' associations, to "shaming" campaigns that confuse the public's understanding of what aid in dying is, "pro-life" groups are already working in Montana to, if not change the laws, make receiving aid in dying assistance there very difficult.

From Billings Gazette today:

It could be a while before Montana doctors are willing to help terminally ill patients die, despite the recent state Supreme Court decision that nothing in state law prevents physician-assisted suicide.

The court decision made Montana the third state where it is legal, but the state has no specific laws outlining guidelines for doctors like they do in Oregon and Washington. That will leave Montana doctors on their own to determine how to proceed if they choose to help a dying patient commit suicide.

The Supreme Court said nothing in the law prevents a doctor from prescribing death-inducing drugs to terminally ill, mentally competent patients. And the court said doing so would be a defense against homicide charges.

But doctors, just because they could have a defense to charges of murder, aren't likely to rush into the process. They are hoping the Legislature — until now hesitant to wade into the debate — will craft a legal framework for assisted suicide.

"I think legally they could proceed, but I think they would need to do so with an extreme mount of caution and substantial guidelines on whether that was a proper thing to do," Missoula doctor Stephen Speckart said.

The Montana Legislature has been closely divided in recent years along partisan lines, making it very difficult for controversial legislation of any type. If that continues into 2011, there are no guarantees that lawmakers will provide any guidance at all.