Despite calls for legalization from a growing number of proponents and others who came to support physician-assisted suicide in the wake of the high-profile death of Brittany Maynard, the American Medical Association remains firmly opposed to such policy.
Maynard, 29, moved to Oregon to take advantage of the state’s physician-assisted suicide law and ingested a lethal dose of doctor-prescribed barbiturates in November. She had been diagnosed with an aggressive brain tumor in January. Oregon is one of five U.S. states where physician-assisted suicide is legal; legislatures in Washington, Vermont, Montana and New Mexico have also passed measures to enact what supporters call “Death with Dignity” legislation.
The Chicago-based AMA is the nation’s largest organization of physicians and represents nearly 200,000 doctors, medical students and residents. Its policy remains unmoved amid a national debate regarding the risks and benefits of physician-assisted suicide.
“It is understandable, though tragic, that some patients in extreme duress – such as those suffering from a terminal, painful, debilitating illness – may come to decide that death is preferable to life,” according to an AMA statement sent to Life Matters Media. “However, allowing physicians to participate in assisted suicide would cause more harm than good. 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.”
Advocates say that physician-assisted suicide is compatible with modern medical ethics and should be more accessible. Peg Sandeen, executive director of the Death with Dignity National Center in Oregon, told LMM that the attention focused on Maynard’s decision reflects increasing support among Americans for “Death with Dignity” laws.
“I am saddened by the tragedy of this young woman’s death, but I am thankful the state of Oregon offered her options at the end of her life,” she said. “When you have a compelling story, when you show a young family with a member dying, suddenly an issue that has broad support becomes something that everyone is engaged in.”
According to a 2013 study published in the New England Journal of Medicine, Washington physicians are becoming more comfortable with the state’s law.
“Our ‘Death with Dignity’ program has been well accepted by patients, families, and staff. We attribute this to the professionalism of our advocates, the great care taken by our prescribing and consulting clinicians when interacting with patients and families, the low profile of the ‘Death with Dignity’ program overall, and the willingness of the Seattle Cancer Care Alliance leadership to allow considerable debate before the program was developed,” researchers led by Dr. Elizabeth Loggers write. “A few clinicians who were initially strongly opposed to the ‘Death with Dignity’ program subsequently expressed their willingness to participate as consulting or prescribing clinicians, which further supports acceptance of the program.”
The AMA recommends hospice care for those seriously ill and nearing the end of life – care designed to comfort, not cure or hasten death – and multidisciplinary interventions such as pastoral support and family counseling. “Patients near the end of life must continue to receive emotional support, comfort care, adequate pain control, respect for patient autonomy, and good communication,” the statement read.
Dr. Daniel Sulmasy, associate director of the University of Chicago’s MacLean Center for Clinical Medical Ethics, echoed the AMA’s concerns during a recent Intelligence Squared debate in New York that was broadcast nationally on public radio.
“We strongly support the right of patients to refuse treatments and believe physicians have a duty to treat pain and other symptoms even to the point of hastening death,” Sulmasy said. “But empowering physicians to assist patients with suicide is quite another matter. Striking at the heart not just of medical ethics, but of ethics itself, because the very idea of interpersonal ethics depends upon our mutual recognition of each other’s equal independent worth, the value that we have simply because we are fellow human beings.”