The American Medical Association refused two resolutions at its annual meetings to reverse or weaken its stance against medical aid in dying (MAiD).Fifty draft resolutions were proposed for the House of Delegates interim meetings in Maryland November 10-14. Resolution 4, first tabled September 19, would have revised the AMA Code of Medical Ethics to support euthanasia. The resolution would have had the AMA explicitly “oppose criminalization of physicians and health professionals who engage in medical aid in dying at a patient’s request and with their informed consent and oppose civil or criminal legal action against patients who engage or attempt to engage in medical aid in dying.”One aspect of the change would eliminate subsection 4 of H-14.966, which reads, “Physicians must not perform euthanasia or participate in assisted suicide. A more careful examination of the issue is necessary. Support, comfort, respect for patient autonomy, good communication and adequate pain control may decrease dramatically the public demand for euthanasia and assisted suicide.""In certain carefully defined circumstances, it would be humane to recognize that death is certain and suffering is great. However, the societal risks of involving physicians in medical interventions to cause patients’ deaths is too great to condone euthanasia or physician-assisted suicide at this time.”The resolution also said that involving “suicide” in the term for medical assistance in dying “may misrepresent and stigmatize patients’ rationale and choices.” Instead, it preferred “Medical Aid in Dying.”The resolution also alleged “patients of colour are less likely to complete advance directives or be asked their end-of-life preferences” compared to “white patients.” It acknowledged “financial concerns might cause patients to choose MAiD “over continuation of care” but said such considerations already factor whether or not they choose hospice care.The resolution also noted that death by removal of a feeding tube may take over ten days, causing “dramatic physical alterations due to starvation and causing anxiety [to] caregivers.”MAiD is legal in ten states plus the District of Columbia, meaning one-quarter of Americans could already receive euthanasia, as pointed out in the resolution. Oregon was the first state to legalize the practice in 1994, followed by Washington State in 2008, Montana in 2009, Vermont in 2013, and California in 2015. The District of Columbia, Colorado, Hawaii, Maine, New Jersey and New Mexico have followed since.A 2020 Medscape survey found 55% of physicians supported legalization of MAiD, including 51% of primary care doctors and 57% of specialists.The American Medical Association House of Delegates debated neutrality on MAiD at three previous meetings. After extensive debate, the AMA ultimately retained its existing Code of Medical Ethics opinion that “physician-assisted suicide is fundamentally incompatible with the physician’s role as healer.”Resolution 5, also defeated, would have taken the AMA to a neutral stance. The resolution pointed out 61% of US adults support allowing medical aid in dying. It alleged MAID “can provide comfort and dignity for terminally ill patients who are suffering and have exhausted all other treatment options.”The resolution alleged when state laws forbade euthanasia, the “moral conflicts with the existing ethical principles…can contribute to additional distress and anxiety in the terminally ill patient.” In addition, the resolution said the AMA’s own opposition to MAiD “further creates conflict in the ethical obligations of physicians who may be asked to provide guidance or participate in the process.”Alex Schadenberg, president of the London, Ontario-based Euthanasia Prevention Coalition, called the AMA decision “great news.”“Thank you to the medical professionals who got involved and achieved this success,” he said.
