Physician-assisted suicide is legal by law in the District of Columbia, Washington, Oregon, California, Vermont, and Colorado; and in Montana through a state supreme court ruling. It will become legal in Hawaii next year. A bill to legalize assisted suicide is under consideration in Indiana.
Matt Valliere, executive director of the Patients' Rights Action Fund, said the AMA vote is "a lost opportunity and a failure to stand against a policy that has grave consequences for everyone, but especially persons living with illness, disabilities, or socio-economic disadvantage."
"Assisted suicide is not medical care," Valliere said June 12. He said the vote decision "does not take into account that this bad public policy puts vulnerable patients at high risk for coercion, mistakes and even abuse."
The AMA's current guidance describes physician-assisted suicide as "fundamentally incompatible with the physician's role as healer." It would be "difficult or impossible to control" and would pose "serious societal risks."
While it is "understandable, though tragic" that some patients in extreme duress from their suffering may decide that death is preferable to life, "permitting physicians to engage in assisted suicide would ultimately cause more harm than good."
The guidance says physicians should not abandon a patient once a cure is determined impossible. They must respect patient autonomy, provide good communication and emotional support, and must provide appropriate comfort care and pain control.
Speaking to CNA, Valliere said there could be many reasons why certain delegates didn't vote to affirm the report.
Like-minded physicians who oppose assisted suicide should join the AMA and become active in their state delegations and work to become delegates, he added.
"They can and should also be discussing with their colleagues the very real dangers that assisted suicide public policy and practice pose," he said. Many voting delegates come from other areas of medicine with limited involvement with death and dying.
Organizations like the 140,000-member American College of Physicians, the second-largest national physicians' organization, recently reaffirmed their opposition to assisted suicide.
The decision comes amid a significant increase in suicide in the U.S. On June 7, the Centers for Disease Control and Prevention reported that the suicide rate has risen steadily in almost every U.S. state, and 25 percent nationwide, in the period from 1999 to 2016. Nearly 40,000 Americans died by suicide in 2016, twice the number of homicides that year.
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Valliere reflected on the tension behind opposing some suicides and advocating suicide for others.
"When some people get suicide prevention, and others get suicide help based on health or disability status, that's a clear problem of unequal protection under the law," he said.
He warned that assisted suicide could undo decades of efforts by disability activists. Many in the disability community, for instance, live "full professional lives," have children, and are active members of their communities.
"And yet, if they didn't have a ventilator, they'd be dead," he said.
The legal definition of "terminal illness" is different than the clinical definition. Some laws such as Oregon's consider diabetes a qualifying terminal illness for assisted suicide.
"So if someone like my father, who has diabetes and has been on insulin for half his life, could be having a bad year, fall into deep acute depression, and go off his insulin, they would declare him terminal according to assisted suicide public policy. He would qualify for the law," warned Valliere.