This may wind up being a sort of seismic shift in how medicine is practiced in the United States, though the objections raised will be loud and long-lasting. This week the American Medical Association voted to override a recommendation from their Council on Ethical and Judicial Affairs that the organization continue to oppose doctor assisted suicide (DAS) for the terminally ill. This wasn’t a move intended to endorse, the practice, but simply to adopt an ethically neutral position on it. (Free Beacon)
America’s largest doctors’ lobby may reconsider its longstanding opposition to assisted suicide after its governing body voted to ignore its own ethics council.
On Monday, a majority of delegates from the American Medical Association refused to confirm the Council on Ethical and Judicial Affairs’s recommendation that it continue to oppose assisted suicide. The council spent two years studying the issue following a resolution from the Oregon delegation asking the AMA to shift to a neutral position on the question of whether physicians can ethically prescribe lethal medication to a patient diagnosed as terminally ill. Its final report acknowledged that advocates of assisted suicide had made strides in advancing the practice and did not condemn physicians who participate in assisted suicide where it is legal, but recommended on maintaining the AMA’s position 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.”
“The Council on Ethical and Judicial Affairs therefore recommends that the Code of Medical Ethics not be amended,” the council said in its report.
Being someone who is definitely in the minority among the ranks of conservatives on this subject, I can understand the objections while being cautiously optimistic about the AMA moving in this direction. Critics of DAS rightly worry about the slippery slope aspect of such treatment. The potential for a wider circle of people being allowed to choose that option is clearly worrying, though we deal with slippery slopes on a regular basis and manage to avoid plunging down most of them. Still, it’s worth our time to look at what’s happened in some European countries where they’ve begun allowing young patients with depression to kill themselves despite not suffering from any terminal physical ailments. Were the AMA to begin drifting in that direction the worst fears of DAS opponents would be justified indeed.
I also understand and accept the concerns of those who firmly believe that a moral objection to DAS should be made, what with suicide being a sin in the eyes of the church. But while it’s fair to express that opinion and preach it loudly if you wish, I also don’t believe that this is a subject where the government (or even the AMA) should be dictating end of life choices for the terminally ill, particularly when palliative care is either ineffective or debilitating in its own right.
One restriction which needs to be enforced is that this should never be a decision made by the doctor, the government or anyone but the patient. Exceptions to that could conceivably include people who prepare in advance a specific document outlining their wishes, similar to a Do Not Resuscitate order. But for some people, when the end is obviously near, the medical professionals have even abandoned all hope and there is nothing on the horizon but pain and a seemingly endless wait for the end, DAS may be the only light they see at the end of the tunnel. Recognizing how controversial that position is, I’ve given it a lot of thought and I remain comfortable with the answer.
If the AMA removes the stigma from doctors who wish to provide this type of care, it would open up new options for the terminally ill. Doctors would need to be carefully monitored with some sort of board approval process in place before doing the deed legally, but it still seems as if it can be managed. (I specify “legally” there because as many doctors would tell you in moments of candor, this goes on already in the United States, with the deaths simply being listed as “natural causes.”)