Polls show that many Americans think doctors should be allowed to help terminally ill patients end their lives.
The AMA’s Council on Ethical and Judicial Affairs spent two years reviewing resolutions, not so much on whether to support the practice but on whether to take a neutral stance. On 2018 the council recommended that the Code of Medical Ethics “not be amended” and continue to refer to “physician-assisted suicide,” saying that language still “describes the practice with the greatest precision.”
Doctors showed strong support for the status quo, a position that is increasingly at odds with public opinion. Polls show that many Americans think doctors should be allowed to help terminally ill patients end their lives.
Among doctors some argue that physician-assisted death should be a choice for patients who are already dying and want to end their suffering on their own terms. Those on the opposing side contend that such assistance violates one of the core principles of their profession — do no harm — and could become a slippery slope to euthanasia. There’s even disagreement about how to characterize the practice. Opponents say terms such as “aid in dying” are euphemisms that obscure the harsh reality, while proponents see “doctor-assisted suicide” as stigmatizing patients who choose it.
“This is not just a medical issue,” said cardiologist Thomas Sullivan, an AMA delegate from Mkassachusetts who agrees with the recommendation for no change. “This is a social issue. This is a moral issue. This is something that many, many people are faced with from time to time, when your own parents or your own children or your brother or sister or you are faced with a terminal illness.”
Neurologist Lynn Parry, a delegate from Colorado, said she will vote to reject the ethics council’s stance and ask it to spend more time “looking at what protections for physicians, and particularly for patients, would need to be in place” for the AMA to amend its guidance.
“How we look at the universe is really driven by our personal belief system and, in large part, by our philosophies and religious beliefs, and that’s as it should be,” she said.
Her state is among those that allow physician-assisted death. Oregon led the way with a 1994 ballot measure, followed by Washington in 2008 and then Vermont, California, Colorado, the District and Hawaii. A court case established the legality of assisted death in Montana. (California’s 2015 law was overturned by a judge last month, a decision that is being appealed.)
John Radcliffe, right, who was diagnosed with cancer in 2014, watches as Hawaii Gov. David Ige signs a bill in April to legalize medically assisted suicide. (Sophia Yan/AP)
The practice drew intense national attention in fall 2014 after a terminally ill woman named Brittany Maynard moved from her home in California to Portland so she could utilize Oregon’s Death with Dignity Act. The 29-year-old had been diagnosed with a Stage 4 brain tumor — glioblastoma, the same aggressive cancer that Sen. John McCain (R-Ariz.) is battling — and was told it would kill her within six months. She instead set her own timeline, taking a fatal dose of barbiturates that November.
Half a year later, a Gallup poll found nearly 7 out of 10 Americans surveyed said doctors should be allowed to assist terminally ill patients in ending their lives — a notable increase from 2014.
David Grube, a retired family physician from Oregon and national medical director for Compassion & Choices, calls the current AMA policy “antiquated.”
“ ‘Do no harm’ leads to a lot of harm in medicine,” he said, with “people on breathing machines for months and all kinds of things.” He considers the “enemy” to be terminal suffering, especially the cases where doctors can’t ease patients’ pain. Since his state passed its law, Grube said, “more people haven’t died, but fewer people have suffered.”
But doctors are still debating it.
“I just do not believe that in the medical profession, which at its core is about protecting the quality and quantity of life, we should become the agent by which we hand them a prescription so they can choose the exact time and moment of their death,” said M. Zuhdi Jasser, an internist and primary-care physician who serves as an AMA delegate from Arizona.
Jasser, who presented the resolution to maintain the term physician-assisted suicide, said he plans to vote for the association to hold firm.
“The big question that I think physicians are going to be dealing with over the next five, 10, 15 years as more of these states legalize it is: Are our ethical guidelines and core principles going to be determined by cultural shifts and by popular vote or populism,” he said, “or are they going to be things that we adhere to and hold on to regardless of the shifting winds of populists’ concerns?”. (Washington Post, June 10 Lindsey Bever?