By Dave Andrusko
Anti-assisted suicide activists are keenly aware that they have succeeded in holding back “Compassion & Choices” in large measure because its coalition is broad, diverse, and encompassing of a wide variety of organizations who often agree on little else.
Probably the most important member of the coalition is the medical community. That is why Compassion & Choices and its allies are so determined to persuade the American Medical Association to change its position of opposition to one of “neutrality.”
The AMA could release a decision later this year.
In the interim, a big, big victory. This week the American College of Physicians issued a policy statement against the legalization of physician-assisted suicide. Nothing better summarizes the heart of the lengthy position paper than this quote from “Ethics and the Legalization of Physician-Assisted Suicide”:
Society’s goal should be to make dying less, not more, medical. Physician-assisted suicide is neither a therapy nor a solution to difficult questions raised at the end of life.
The full report can be read here.
Let me highlight just two passages (the underlining is mine]:
As a proponent of patient-centered care, the American College of Physicians (ACP) is attentive to all voices, including those who speak of the desire to control when and how life will end. However, the ACP believes that the ethical arguments against legalizing physician-assisted suicide remain the most compelling. On the basis of substantive ethics, clinical practice, policy, and other concerns articulated in this position paper, the ACP does not support legalization of physician-assisted suicide. It is problematic given the nature of the patient–physician relationship, affects trust in the relationship and in the profession, and fundamentally alters the medical profession’s role in society. Furthermore, the principles at stake in this debate also underlie medicine’s responsibilities regarding other issues and the physician’s duties to provide care based on clinical judgment, evidence, and ethics. Society’s focus at the end of life should be on efforts to address suffering and the needs of patients and families, including improving access to effective hospice and palliative care. The ACP remains committed to improving care for patients throughout and at the end of life.
Put another way, there are a host of reasons why this is very dangerous territory for the medical community to enter into. Legalizing physician-assisted suicide will alter the moral and medical calculus and take the focus off of where it belongs—on hospice and palliative care.
Despite changes in the legal and political landscape, the ethical arguments against legalization of physician-assisted suicide remain the most compelling. We are mindful that ethics is not merely a matter for a vote. Majority support of a practice does not make it ethical. Medical history provides several cautionary examples of laws and practices in the United States (such as racial segregation of hospital wards) that were widely endorsed but very problematic.
Furthermore, the ACP does not believe neutrality on this controversial issue is appropriate. The medical profession should not be neutral regarding matters of medical ethics (9). The ACP is not neutral on practices that affect the patient–physician relationship and trust in the profession, such as laws that restrict or mandate discussions with, or certain recommendations for, patients.
A.K.A, the ACP refuses to be swept up in the current lobbying campaign orchestrated by the assisted-suicide army.
Congratulations to the American College of Physicians!