Will the American Medical Association (AMA) Heed its own Ethics Council on assisted suicide?

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

On May 4, I re-published an excellent article by bioethicist, Wesley Smith, on the decision by the American Medical Association (AMA) Council on Ethics and Judicial Affairs (CEJA) to continue opposing assisted suicide.

Last week the Psychiatric Times published an excellent article by Dr Ronald Pies, the Psychiatric Times emeritas Editor in Chief, who asks the question: Will the AMA Heed its own Ethics Council Regarding Assisted Suicide?

Pies explains that (CEJA) were asked to examine the AMA position on assisted suicide based on a request that they move to a neutral position on assisted suicide. CEJA, instead of taking a neutral position decides to uphold their opposition to assisted suicide. Pies states:

After much deliberation, 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.

Pies then outlines the American College of Physicians, whose 2017 position on assisted suicide PAS:

Physician-assisted suicide is neither a therapy nor a solution to difficult questions raised at the end of life. On the basis of substantive ethics, clinical practice, policy, and other concerns, the ACP does not support legalization of physician-assisted suicide . . . [Moreover], dictionaries define suicide as intentionally ending one's own life. Despite cultural and historical connotations, the term is neither disparaging nor a judgment. Terms for physician-assisted suicide, such as aid in dying, medical aid in dying, physician-assisted death, and hastened death, lump categories of action together, obscuring the ethics of what is at stake and making meaningful debate difficult; therefore, clarity of language is important.

Pies continues by stating the unanimously supported position of the American Psychiatric Association on assisted suicide:

“The APA, in concert with the American Medical Association’s position on Medical Euthanasia, holds that a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.”

Pies then acknowledges the difficult issues related to assisted suicide but he states:

Critical in this debate is the finding that most persons requesting PAS are not actively experiencing extreme suffering or inadequate pain control. Data from the Washington and Oregon PAS programs show that most patients request PAS because they fear loss of dignity and control over their own lives. These are matters that lend themselves to psychiatric intervention and counseling—not the dispensing of lethal medication.

Pies concludes his insightful article by stating:

The values of Hippocratic medicine admonish the physician as follows: “I [the physician] will neither give a deadly drug to anybody if asked for it, nor will I make a suggestion to this effect.”12 It is my hope that the AMA House of Delegates will uphold the wisdom of its own Ethics Council, and reaffirm that assisted suicide does not belong in the House of Medicine.

The American Medical Association needs to approve the position of their own ethics council and continue to oppose euthanasia and assisted suicide.