A group representing internal medicine doctors has reaffirmed its opposition to physician-assisted suicide, saying the practice “alters the physician’s role as healer and comforter” and “affects trust in the patient-physician relationship and the profession.”
In a paper published on Sept. 19 in the Annals of Internal Medicine, the American College of Physicians called for better promotion of palliative and hospice care, which opponents of physician-assisted suicide say are underutilized areas of medicine that could address concerns of patients facing difficult illnesses.
“The American College of Physicians acknowledges the range of views on, the depth of feelings about, and the complexity of the issue of physician-assisted suicide,” the group’s leader, Dr. Jack Ende, said in a press release. “But the focus at the end of life should be on efforts to prevent or ease suffering and on the often unaddressed needs of patients and families. As a society, we need to work to improve hospice and palliative care, including awareness and access.”
The American College of Physicians called for better promotion of palliative and hospice care, which opponents of physician-assisted suicide say are underutilized areas of medicine that could address concerns of patients facing difficult illnesses.
Palliative care focuses on symptom management, such as pain and nausea resulting either from a medical condition such as cancer or from side effects of the treatment itself. Hospice care, on the other hand, is related to palliative care but it is meant to address comfort concerns for patients with fewer than six months to live.
Patients asking for information about ending their lives with the assistance of drugs should be counseled by doctors, the A.C.P. said, suggesting that requests “for physician-assisted suicide are unlikely to persist when compassionate supportive care is provided.”
“Through effective communication, high-quality care, compassionate support, and the right resources for hospice and palliative care, physicians can help patients control many aspects of how they live out life’s last chapter,” Dr. Ende said.
The paper from the A.C.P., which claims more than 150,000 members spread throughout 145 countries, said too many Americans do not fully understand their medical options when confronting a terminal illness—including the option to forgo treatment altogether even if that means a patient will die.
“As noted in the paper, medical ethics and the law strongly support a patient’s right to refuse treatment, including life-sustaining treatment,” the organization said in a statement. “Vigorous management of pain and symptoms such as nausea at the end of life is ethical and, indeed appropriate, even when the risk of shortening life is foreseeable, if the intent is to relieve those symptoms.”
Discussion about physician-assisted suicide was once taboo, but the practice is gaining support across the country. A 2015 Gallup poll that tracks support for physician-assisted suicide found that 68 percent of Americans supported physician-assisted suicide, up from just 52 percent in 1997, when Oregon became the first U.S. state to legalize the practice. The Catholic Church is opposed to physician-assisted suicide and Catholic leaders have been involved in campaigns to fight legalizing the practice in several states, including in Massachusetts, where voters narrowly rejected the measure in 2012.
In addition to the A.C.P, the American Medical Association also opposes physician-assisted suicide. Its Code of Medical Ethics, which was updated in June 2016, states, “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.”
Death With Dignity, an organization that promotes legalizing physician-assisted suicide, has recently claimed victories in legalizing the practice in California and Colorado, joining Oregon, Vermont, Washington and the District of Columbia. It plans to support campaigns in more than a dozen other states in the next few years.