Introduction

Webcast archive: American Medical Association, California courts, & Roger Foley

This week we are reviewing news from the American Medical Association, a California court, and Roger Foley.

Webcast archive: American Medical Association, California courts, & Roger Foley

In this episode of Euthanasia & Disability, Amy Hasbrouck, Christian Debray, and Taylor Hyatt discuss:

  • AMA panel recommends staying the course
  • California court declares assisted suicide law unconstitutional
  • Roger Foley calls for a stop to euthanasia in Canada

Please note that this text is only a script and that our webcast contains additional commentary.

AMERICAN MEDICAL ASSOCIATION PANEL RECOMMENDS STAYING THE COURSE

  • The Council on Ethical and Judicial Affairs (CEJA) of the American Medical Association (AMA) was asked to consider and offer recommendations on two possible actions related to their policy on “physician assisted suicide”:
    • Resolution 15-A-16 would change the AMA’s position from opposing AS/E to having a neutral stance on the practice.
    • Resolution 14-A-17 would have the AMA define and add the term “Aid in dying” to policy discussions and position statements.
  • Earlier this month, the CEJA issued a report explaining its decision to recommend no change to current policies.  The report will be considered at the AMA’s meeting next month.
  • The CEJA took up the language question first.  It explained that the terms people use to describe AS/E reflect the political and ethical positions of the two sides of the debate.  Though the resolution did not propose using the phrase “death with dignity,” the CEJA noted that supporters prefer it because it emphasizes “patients’ values and goals,” while “aid in dying” signals doctors’ commitment to care for and support the person.
  • The CEJA felt the term “physician assisted suicide” has “negative connotations regarding patients’ psychological state.” Yet they point out that “aid in dying” and “death with dignity” are euphemisms that “obscure or sanitize the activity.”  In the “absence of a perfect option,” the CEJA chooses to stick with “physician assisted suicide” because it describes the practice most accurately.  In doing so, the CEJA appears to be taking the position that AS/E is, in fact, suicide, which is also good news.
  • The CEJA lists several values that unite the two sides of the debate and says reasonable people can have very different ideas of what actions will best support those values.  These include:
    • Hope for a death that preserves dignity;
    • The sacredness of taking care of someone at the end of life;
    • Recognizing that relief of suffering is a primary goal of medicine; and
    • Fully voluntary participation by both the person making the request and the doctor.
  • The Report suggests that decisions should rest on thoughtful, stable and meaningful values and principles.
  • The report never directly raises issues of discrimination, equity or equality; it only refers to “coercion of vulnerable persons,” and “patients from disadvantaged groups.”  The CEJA does say that taking a neutral position amounts to agreement with AS/E and rejects that option.
  • The CEJA says the question of whether safeguards can prevent unintended consequences for people who request assisted suicide, doctors who provide it, and society at large “remains deeply contested.”  The report cites studies that claim no problems have arisen, and others that question those conclusions, claiming the data are flawed, inadequate or distorted.  The panel also notes that, in Europe, eligibility criteria have enlarged, “due care” procedures are not always followed, and the CEJA questions whether oversight of the practice is adequate to prevent abuses.
  • The panel concluded that “evidence … that there have not yet been adverse consequences cannot guarantee that such consequences would not occur in the future.”
  • The CEJA notes that doctors fail to discuss end-of-life issues, including palliative care, with their patients.  As a result, “many patients may be led to request assisted suicide because they don’t understand the degree of relief of suffering state-of-the-art palliative care can offer.”  Yet they don’t mention that many people don’t have access to palliative care.  This is where the CEJA talks about “disadvantaged groups” and people who are “vulnerable to coercion” but in a way that puts the burden on the individual, rather than on society for creating and maintaining the inequality and disadvantage.
  • So, while the CEJA’s recommendation, to reject the two resolutions, is a positive step, their conservative approach and failure to incorporate principles of equity and discrimination may cause the recommendation to be rejected by progressive members of the American Medical Association.

CALIFORNIA COURT DECLARES ASSISTED SUICIDE LAW UNCONSTITUTIONAL

  • When California’s assisted suicide law was passed, a lot of people were shocked.  That’s because it was passed during a special legislative session on health care funding in October of 2015.  This followed the sponsors’ failure to get enough votes to pass it out of the Health Care committee in July of that year.  By introducing an assisted suicide bill during the special session, advocates by-passed the committee process, where careful consideration and ongoing controversy had defeated all previous attempts at legalization.
  • A group of doctors challenged the law once passed, and this week, a state Superior court judge ruled that the bill should not have been heard during the special session, since it did not concern health care funding.  Though he declared the law unconstitutional, Judge Daniel Ottolia gave the California Attorney General five days to appeal the ruling.  An appeal would allow the law to stay in effect until the higher court rules.

ROGER FOLEY CALLS FOR A STOP TO EUTHANASIA IN CANADA

  • Roger Foley has issued a letter to Attorney General Jody Wilson Raybould calling for Canada’s assisted suicide and euthanasia program to be stopped until legislation guaranteeing adequate supports can be put in place.  He also called for a “public inquiry” on AS/E provided in Canada since the practices were legalized in 2016.
  • “Persons with disabilities are being assisted to their death rather than being assisted with life,” the letter said.  We talked about Foley’s lawsuit on our webcast of March 16 of this year.