The American Academy of Family Physicians has taken a neutral position on assisted suicide and will lobby the American Medical Association to do the same, drawing criticism from Catholics but praise from assisted suicide advocates.
Leaders of the physicians’ academy gathered for its Congress of Delegates, which met Oct. 8-10 in New Orleans, approved the resolution of “engaged neutrality,” MedPage Today reports.
The organization represents over 130,000 doctors across the U.S. and is the second-largest constituent body within the AMA.
The resolution passed by a two-thirds vote, which is required for votes that differ from AMA ethical policies, the physicians’ academy said.
The resolution called on the medical academy to reject use of the phrases “assisted suicide” or “physician-assisted suicide” in its formal communications and directed the academy’s delegation to the AMA to promote similar action in that association’s governing body.
Dr. Michael Munger, president of the American Academy of Family Physicians, said his group took a neutral position so it can advocate on the matter at future meetings of the American Medical Association’s House of Delegates. Munger said family physicians are “well-positioned to counsel patients on end-of-life care” and added “we are engaged in creating change in the best interest of our patients.”
The American Medical Association’s code of ethics rejects physician-assisted suicide as “fundamentally incompatible with the physician’s role as healer.” Such a practice would be “difficult or impossible to control” and would “pose serious societal risks.”
“Instead of engaging in assisted suicide, physicians must aggressively respond to the needs of patients at the end of life,” it adds.
Critical of the AAFP’s move was Dr. Barbara Golder, M.D., a board member of the Catholic Medical Association and editor-in-chief of its Linacre Quarterly, who said the move was “very, very disappointing” but should not necessarily be considered a full victory for backers of assisted suicide.
“Some people will want to look on this as a great achievement in terms of advancing physician-assisted suicide, and it certainly puts us on a slippery slope, but I think it’s also important to recognize that the AAFP did not endorse it,” Golder told CNA.
“That tells me that even within their own organization there’s a great deal of discussion and there’s got to be a fairly significant group of physicians within that group itself that understands the dangers of physician-assisted suicide and how it runs contrary to medicine as practiced.”
Backers of assisted suicide, such as the group formerly known as the Hemlock Society, welcomed the change and saw it as grounds for more.
“I believe many AMA constituent societies will follow suit, so it is only a matter of time before the AMA does as well,” said Dr. David Grube, national medical director of the pro-assisted suicide group Compassion and Choices and a former delegate within the physicians’ academy.
In response, Golder facetiously wondered whether Grube has a crystal ball to see the future.
“I don’t know that it’s ‘just a matter of time’,” she said. “Certainly, it’s a worrisome idea that medicine would shift from healing to killing. That’s a fundamental change the likes of which medicine has not encountered, at least in our lifetimes.
“When we find medicine going away from healing towards killing, we in the past have been very repulsed by it. Now suddenly we are not,” she added, warning that it is potentially a “tremendous slippery slope.”
For Golder, assisted suicide is against natural law and “the Catholic notion that life ought to be respected from conception to natural death.”
Golder said opponents of assisted suicide should consider joining medical groups and “being vocal.” She suggested doctors can leverage their patients, because they “have a voice in this as well.”
“The whole point of associations like this is to serve doctors and their patients,” she said. For Golder, assisted suicide disrupts the doctor-patient relationship because it means “as well as an agent of healing, the doctor can also be an agent of death.”
Advocacy and awareness-raising about good palliative care are also needed “so that physician-assisted suicide doesn’t look like an attractive alternative to people who are alone, in great pain, don’t have anybody to care for them,” added Golder.
Dr. Peter T. Morrow, M.D., president of the Catholic Medical Association, said the move ran contrary to “the medical communities’ historical and long-standing opposition against physician-assisted suicide.”
“It is in direct violation of the ‘do no harm’ Hippocratic Oath,” Morrow said in an Oct. 17 statement. “We at the CMA are dedicated to preserving life from conception to natural death and will continue to remain staunchly opposed to any form of assisted suicide. It goes against natural law.”
The Catholic Medical Association has over 2,300 healthcare professionals in 104 local guilds across the U.S. Several of its members had testified against doctor-assisted suicide at AMA’s last House of Delegates meeting in June.
The AMA has about 240,000 members in the U.S., with membership including medical doctors, doctors of osteopathic medicine, and medical students. Its 2018 interim meeting will be held in National Harbor, Maryland this November.
The group’s House of Delegates, meeting in Chicago in June, narrowly voted not to accept a report recommending that they continue their stance of opposing physician assisted suicide. About 56 percent of delegates voted for the report to undergo further review.
At the time, Morrow said that decision was “hugely disappointing.”
Golder told CNA that the AMA “has so far held the line, saying assisted suicide is not appropriate, and we congratulate them for that.”
The seven states of California, Colorado, Hawaii, Montana, Oregon, Vermont, and Washington, plus the District of Columbia, have legalized assisted suicide.
Other AAFP resolutions included a failed vote in support of an elective abortion ban from 20 weeks into gestational age. The body passed resolutions opposing “fetal personhood” language. It recommended that medication abortion drug Mifeprex be removed from the Food and Drug Administration’s requirements for Risk Evaluation and Mitigation Strategy. Such restrictions create an unnecessary burden on physicians who want to offer medication abortion, backers of the decision said.
The delegates passed a resolution calling on the academy to create educational materials about institutional racism and segregated care within the health care system as a cause of racial disparities in patient outcomes.