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A careful explanation why the AMA should continue its opposition to physician-assisted suicide

by | Jun 8, 2018

By Dave Andrusko

Whenever, and it could be very soon, the AMA decides whether to go “neutral” on physician-assisted decision, the verdict will carry enormous weight.

Also invariably, when pro-death forces prevail, one very important reason is because the “body’s defenses” (in the form of leading medical organizations) chose no longer to see “helping” patient to die as an invader that must be fought with unrelenting vigor but welcomed in.

As we wrote last month, fortunately the AMA’s Council on Ethical and Judicial Affairs (CEJA) recommended that the AMA retain its position in opposition to assisted suicide. But while the CEJA’s recommendation is important, it is by no means definitive. The real vote comes when the AMA House of Delegates votes on its recommendation.

Enter a terrific piece written for USA Today by Joseph E. Marine, a member of the AMA and an associate professor of medicine at Johns Hopkins University. The subhead to his column is a nice synopsis: “Accepting physician-assisted suicide is a slippery slope. The American Medical Association believes it is wrong for doctors to kill. Let’s stick by that belief.”

The AMA’s current position is that 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.” Yes, yes, and yes.

Dr. Marine reemphasizes many of the most thoughtful reasons to oppose neutrality but adds more information and nuance. Let me mention just two illustrations.

First, so-called “safeguards” which are promises to prevent “abuses,” are illusions at best, and cynical acts of deception, at worst. Dr. Marine writes

They include no requirement for psychiatric evaluation, for witnesses to the consumption of the lethal overdose, no medical examiner inquests, no independent safety monitoring board and no mandatory routine audits of records and documentation. There is no requirement that the prescribing physician have a meaningful long-term patient-physician relationship with the patient seeking assisted suicide and physicians are immunized from ordinary negligence.

Moreover, and this is very, very important

[A]ll medical records and documents connected to the provision of assisted suicide are protected from legal discovery or subpoena, ensuring that no investigation is ever likely to take place.

Second, if “assisting” a suicide is defined as a “compassionate” form of “medical care,” the logic of extension is irrefutable. If helping someone kill themselves is an act of “generosity,” it is wrong not to extend this to others. As NRL News Today readers know well, this is exactly the experience in Netherlands, Belgium and now Canada.

Many-to-most proponents barely talk about “pain” anymore as a justification. Physicians “ought” to help their patients any time the patient decides his or her life is (in whatever sense) intolerable. What about those with mental or emotional issues? Don’t ask.

An essay very much worth reading, especially the concluding section about the impact of economics. It is much cheaper to kill someone than help them deal with whatever existential issues of purpose and meaning they may be grappling with.

Dr. Marine’s conclusion is straight to the point:

Assisted suicide is dangerous, is unnecessary and will permanently damage the integrity of and public trust in the health professions and the health care system. The AMA House of Delegates should strongly support adoption of the CEJA report and maintain its ethical position against physician-assisted suicide.

Categories: Assisted Suicide