The enormous stakes at issue in the campaign to persuade the AMA to go “neutral” on physician-assisted suicide

By Dave Andrusko

“If thought corrupts language, language can also corrupt thought.”‘ — George Orwell, “Politics and the English Language”

“The U.S. Centers for Disease Control report that suicide rates have risen almost 30% since 1999, which happens to be the year when Oregon issued its first report on legally authorized physician-assisted suicides. …

“Giving someone a drug overdose for the purpose of killing himself or herself is not magically transformed into something else because the culprit wears a white coat, or the victim has an illness.” — Cardinal Timothy Dolan, op-ed in the National Catholic Register.

There is no two ways about it. The decision Monday by the AMA’s House of Delegates not to accept its ethics council’s recommendation to maintain the AMA’s firm opposition to physician-assisted suicide is a setback. By returning the recommendation of the Council on Ethical and Judicial Affairs (CEJA) for further study, clearly the debate will resurface, and soon. It provides ammunition to the forces the likes of Compassion & Choices whose goal is for the AMA to go “neutral.”

The current language, which the CEJA recommended be affirmed, reads

“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.”

However, according to the Chicago Sun Times, “some delegates said they felt it was important for the AMA to support physicians who choose to help patients die in states where the practice is already legal.”

Much of the battle, as the CEJA report (two years in the making) suggested was over language. The CEJA report reached two main conclusions:

1. The AMA Code of Ethics should not be amended, effectively sustaining the AMA’s position that physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.

2. With respect to prescribing lethal medication, the term “physician assisted suicide” describes the practice with the greatest precision.

Regarding the latter, he report noted, “Not surprisingly, the terms stakeholders use to refer [to] the practice of physicians prescribing lethal medication to be self-administered by patients in many ways reflect the different ethical perspectives that inform ongoing societal debate.”

Proponents of change favor the euphemisms “death with dignity” or “medical aid in dying.” Three observations.

First, as the CEJA rightly observed, “neutrality” can be read as “little more than acquiescence with the contested practice.” Cardinal Dolan agreed, observing, “It has been read exactly that way wherever a state medical society has decided to go ‘neutral’ on a proposal to legalize the practice. It sends the signal that there is no serious problem with doctors prescribing lethal drugs so their patients can kill themselves.”

Second, the famous anthropologist Margaret Mead keenly warned, “[S]ociety always is attempting to make the physician into a killer – to kill the defective child at birth, to leave the sleeping pills beside the bed of the cancer patient…It is the duty of society to protect the physician from such requests.”

Ironically, in this case, it would be physicians voluntarily turning themselves into killers. “Society” in this case would be protecting the physician from himself by passing laws affirming their current opposition to assisted suicide or writing new laws to declare their resolute opposition. Right now, “society” includes the AMA.

Third, the AMA’s policy against physician-assisted suicide, Cardinal Dolan writes, “is also affirmed by the American College of Physicians, National Hospice and Palliative Care Organization, American Academy of Pediatrics, American Nurses Association and World Medical Association.”

The AMA would not be the first “domino” to drop. Some state medical associations have already caved.

But should it adopt neutrality, it would facilitate acceptance, hugely important in light of the success of the coalition of anti-assisted forces in holding back capitulation in almost all states.

No one said it better than Dr. Diane Gowski, whom the Chicago Sun Times described as a representative from the Society for Critical Care Medicine, who

argued that it was irresponsible for the AMA to call physician-assisted suicide anything else, especially in light of the recent suicide contagion effect sweeping the country.

“Let’s be clear, (physician-assisted suicide) is suicide,” she said. “None of us would hand our patient a gun, so let us not hand them any means to end their life.”