Is the AMA Right in Saying Medical Aid in Dying is Incompatible With a Doctor’s Role?

There is currently strident debate in Virginia about legalizing medical aid in dying.* Recently the American Medical Association has reaffirmed it’s code of ethics, saying “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.”

She Wants to Die With Dignity

Several states have passed legislation to legalize medical aid in dying, or will not prosecute doctors who prescribing a dose of powerful sedatives that the patient will take for themselves to end their lives ** There are stringent safeguards*** The intention is to hasten a process that is happening already and to reduce suffering.****


The AMA’s position calls in to question what is the “role as healer”?


“Healer” is probably not appropriate in this circumstance as the doctor is not going to “heal” terminally ill patients. Not going to, as the definition notes, “make healthy, whole or sound.” In fact there is a lot of talk of how attempts to heal and prolonging life often leads to miserable, expensive, high tech death rather than death with dignity.


There are other arguments leveled by opponents of the idea of allowing medical aid in dying - which Dr. Guy Micco of UC Berkley refutes.


I think the AMA ethics committee’s idea is not a valid one however.


The doctors’ role is to reduce suffering, even if it is at the expense of some longevity. Citing medical aid in dying as incompatible with a doctor’s role is just wrong.






*Sometimes called “physician assisted suicide” (which proponents say is inappropriate because it is not really suicide, rather hastening what is happening any way). Or some use the less favored terms “physician assisted death” and “death with dignity.”


**Six states (most recently in Washington DC in February 2017 and Hawaii to go in to effect January 2019) allow doctors to prescribe a dose of sedative medicines to help end life (usually either pentobarbital or secobarbitol - though recent massive price hikes have put these out of reach of many, and required practitioners to find new “cocktails”).


***They must have: Life expectancy of six months or less; the mental capacity to know what they are doing and what the consequences are; make two verbal requests, 15 days apart, and one written request with two witnesses; two doctors—an attending physician and a consulting physician—must verify that the patient meets all the criteria.



**** Opponents say one objection is that symptoms like pain, nausea and shortness of breath can be managed with palliative care techniques. But, writing on the Berkley Wellness website, Guy Micco, MD,clinical director, emeritus, of the UC Berkeley-UCSF Joint Medical Program and former director of the Academic Geriatric Resource Center, where he teaches a course called “The Death Course”notes than 91 percent of patients choosing this option said the reason was fear of losing autonomy. More than 86 percent said the reason was decreasing ability to participate in activities that make life enjoyable. More than 71 percent said they wanted to die with dignity. Significantly, pain and other symptoms do not top the list. Even less important are depression, financial issues, and lack of social support he claims.





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