AMA Reaffirms Stance Against Physician-Aided Death

Marcia Frellick

June 11, 2019

CHICAGO — Delegates voted overwhelmingly to affirm the current policy opposing physician-assisted dying here at the American Medical Association (AMA) 2019 Annual Meeting.

After impassioned testimony from both sides at last year's meeting, the Council on Ethical and Judicial Affairs was asked to further examine the issue.

"The AMA House of Delegates concluded that established guidance in the Code of Medical Ethics supports shared decisions that respect the deeply held beliefs of physicians and their patients with respect to assisted suicide," said AMA President Barbara McAneny, MD.

"There are irreducible differences in moral perspective between thoughtful, morally admirable individuals who oppose physician-assisted suicide and equally thoughtful and morally admirable individuals who support it," she told Medscape Medical News.

"Nonetheless, individuals from all perspectives are committed to the core values of care, compassion, respect, and dignity for their patients — an underlying principle of medical ethics. How each individual understands and acts on physicians' common goals of relieving suffering, respecting autonomy, and maintaining dignity at the end of life is directed by their individual deeply held beliefs," she explained.

Group Says AMA Decision "Defies Logic"

This is a conflicting message, according to Compassion & Choices, an advocacy group based in Portland, Oregon.

The current Code of Ethics states that "permitting physicians to engage in assisted suicide would ultimately cause more harm than good" and that "physician-assisted suicide is fundamentally incompatible with the physician's role as healer, would be difficult or impossible to control, and would pose serious societal risks."

"It defies basic logic for the AMA to maintain that medical aid in dying is unethical but that ethical physicians can provide it," David Grube, MD, an AMA member and retired family physician who is national medical director for Compassion & Choices and who has written prescriptions for medical aid in dying in Oregon, said in a statement.

Other physician organizations — including the American Academy of Family Physicians, the American Academy of Hospice and Palliative Medicine, and the American Academy of Neurology — have adopted neutral stances on the issue, he pointed out.

But concern about putting vulnerable patients at greater risk led the Patients Rights Action Fund, an advocacy group based in New York City, to support the position of the AMA.

"We applaud the American Medical Association for maintaining their longstanding opposition to physician-assisted suicide. In doing so, the AMA sides with patients and people with disabilities who would be at risk for deadly harm through mistakes, coercion, and abuse, all the while carefully guarding the trust upon which the patient–physician relationship is based," said Matt Vallière, executive director of the Patients Right Action Fund.

"Patients deserve care and protection, not a prescription for death. We trust that this decision will encourage states considering legislation to continue to reject assisted suicide," he added.

Eight states and the District of Columbia have passed laws supporting physician-assisted dying, and New Jersey will become the ninth on August 1. In 2016, a federal law was passed in Canada that allows eligible adults to request medical assistance in dying.

A 2018 survey conducted by Medscape showed that 58% of physicians support physician-aided dying, up from 46% in 2010. And a 2018 Gallup poll showed that 72% of the general public supports physicians being able to help terminally ill patients die.

The report from the Council on Ethical and Judicial Affairs also noted that physicians should engage terminally ill patients in difficult conversations about their options.

McAneny, Grube and Valli è re declare no relevant financial relationships.

American Medical Association (AMA) 2019 Annual Meeting. Presented June 10, 2019.

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