Indiana Resolution opposing assisted suicide passes in Committee

Indiana Resolution 17 titled: A Concurrent Resolution opposing and condemning assisted suicide passed on Wednesday February 29 passed on the Indiana Senate Committee on Health and Provider Services by a vote of 9 to 2. The following is the wording of the resolution.  

Whereas, The State of Indiana has an unqualified interest in the preservation of human life and the State's prohibition on assisting suicide in IC 35-42-1-2.5 both reflects and advances its commitment to the State's interest;

Whereas, Neither the United States Constitution nor the Constitution of the State of Indiana contain a right to assisted suicide and neither include a right for one individual to authorize another to end their life in violation of federal or state criminal laws;

Whereas, Suicide is not a typical reaction to an acute problem or life circumstance, and many individuals who contemplate suicide, including the terminally ill, suffer from treatable mental disorders, most commonly clinical depression, which frequently goes undiagnosed and untreated by physicians;

Whereas, In Oregon, 46 percent of patients seeking assisted suicide changed their minds when their physicians intervened and appropriately addressed suicidal ideations by treating their pain, depression, or other medical problems;

Whereas, Palliative care continues to improve and altering the treatment focus to relieving pain and allows a person to die naturally, comfortably, and in a dignified manner without a change in the law;

Whereas, Experiences in Oregon and the Netherlands explicitly demonstrate that palliative care options deteriorate with the legalization of physician-assisted suicide;

Whereas, A physician's recommendation for assisted suicide relies on the physician's judgment — to include negative perceptions — that a patient's life is not worth living, ultimately contributing to the use of "futility care" protocols and euthanasia;

Whereas, The legalization of assisted suicide sends a message that suicide is a socially acceptable response to aging, terminal illnesses, disabilities, and depression and subsequently imposes a "duty to die";

Whereas, The medical profession as a whole opposes physician-assisted suicide because it is contrary to the medical profession's duty to the Hippocratic Oath and their role as healer, and undermines the physician-patient relationship;

Whereas, Assisted suicide is significantly less expensive than other care options and Oregon's experience demonstrates that cost constraints can create financial incentives to limit care and offer assisted suicide;

Whereas, As evidenced in Oregon, the private nature of end-of-life decisions makes it virtually impossible to police a physician's behavior to prevent abuses, making any number of safeguards insufficient;

Whereas, Assisted suicide is a direct threat to human dignity, patient rights, and the disabled when the medical goal must be to eliminate suffering rather than the person who suffers;

Whereas, Patients should be allowed to die naturally through the use of ordinary treatment to sustain needs, increase comfort, and place the focus from curing back to caring rather than obligate the use of extraordinary medical treatment that would prolong their dying; and

Whereas, A prohibition on assisted suicide, specifically physician-assisted suicide, is the only way to protect vulnerable citizens from coerced suicide and euthanasia: Therefore,

Be it resolved by the Senate of the General Assembly of the State of Indiana, the House of Representatives concurring:

SECTION 1. That the Indiana General Assembly, in its unqualified interest in the preservation of human life, strongly opposes and condemns physician-assisted suicide.

SECTION 2. That the Indiana General Assembly strongly opposes physician-assisted suicide because anything less than a prohibition leads to foreseeable abuses and eventually to euthanasia by devaluing human life, particularly the lives of the terminally ill, elderly, disabled, and depressed, whose lives are of no less value or quality than any other citizen of this State.

SECTION 3. That the Indiana General Assembly strongly opposes physician-assisted suicide even for terminally ill, mentally competent adults because assisted suicide eviscerates efforts to prevent the self-destructive act of suicide and hinders progress in effective physician interventions, including diagnosing and treating depression, managing pain, and providing palliative and hospice care.

SECTION 4. That the Indiana General Assembly strongly opposes physician-assisted suicide because assisted suicide undermines the integrity and ethics of the medical profession, subverts a physician's role as healer, and compromises the physician-patient relationship.

SECTION 5. The Secretary of the Senate is hereby directed to transmit copies of this Resolution to Governor Eric Holcomb, the Commissioner of the Indiana Department of Health, and the Indiana State Medical Association.

Madam President: The Senate Committee on Health and Provider Services, to which was referred Senate Concurrent Resolution No. 17, has had the same under consideration and begs leave to report the same back to the Senate with the recommendation that said resolution DO PASS.

(Reference is to SC 17 as introduced.)
CHARBONNEAU, Chairperson
Committee Vote: Yeas 9, Nays 2

Assisted suicide bills are not what they appear to be.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The assisted suicide lobby has introduced assisted suicide bills in at least 18 States in 2020. All of these bills include "safeguards" that appear to provide oversight of the law.

Recently I published an article explaining how the "safeguards" are written with loosely defined language to permit the laws to be redefined over time. I also explained that the "safeguards" are designed to convince legislators to legalize assisted suicide, while the assisted suicide lobby intends to remove them overtime. 

For instance, the Hawaii legislature passed an assisted suicide bill in 2018 that came into effect on Jan 1, 2019. There were 27 assisted suicide deaths in 2019.

The assisted suicide lobby is proposing to expand the assisted suicide law after only one year. The Hawaii legislature is debating bills SB 2582 and HB 2451 to expand the assisted suicide law by:

• permitting nurses to prescribe the lethal drugs,
• shortening the waiting period in general, and 
• waiving the waiting period when someone is "nearing death."

The Hawaii legislature also debated bill SB 3047 that would have allowed:

• assisted suicide for incompetent people who requested death in an advanced directive,
• physicians to waive the counseling requirement, 
• assisted suicide to be approved by "telehealth" and 
• require insurance companies to pay for assisted suicide.

Its hard to believe that the assisted suicide lobby wants death by "Telehealth."

The Washington State legislature is debating Bill 2419, a bill to study the "safeguards" in their assisted suicide law. One of the issues to be studied is allowing euthanasia (lethal injection) rather than limiting it to assisted suicide.

Last year the Oregon legislature expanded their assisted suicide law by waiving the 15 day waiting period.

Assisted suicide may not be a peaceful death.

The assisted suicide lobby has been using experimental lethal drug cocktails as they attempt to find a cheaper way to kill. The current assisted suicide drug cocktails have caused painful deaths that may take many hours to die. A recent article stated:

The (first drug mix) turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.

The assisted suicide lobby is working on their third experimental lethal cocktail. Assisted suicide is not guaranteed to cause a "peaceful or painless death."

Our greatest concern is the New York assisted suicide bill. Governor Cuomo stated that he will sign an assisted suicide bill into law.

New York Assembly Bill A2694 and Senate Bill S3947 where introduced as the Medical Aid in Dying Act.

As Margaret Dore, the President of Choice is an Illusion stated in her article: New York: Reject Medical Aid in Dying Act:

“Aid in Dying” is a euphemism for euthanasia.[3] The Act, however, purports to prohibit euthanasia. On close examination, this prohibition will be unenforceable.

If enacted, the Act will apply to people with years or decades to live. It will also facilitate financial exploitation, especially in the inheritance context. Don’t render yourself or someone you care about a sitting duck to heirs and other predators. I urge you to reject the proposed Act.

Assisted suicide is an act whereby one person (usually a physician) provides a prescription for a lethal drug cocktail knowing that the other person intends to use it for suicide.

Euthanasia is an act whereby one person (usually a physician) lethally injects another person, usually after a request.

Several of the assisted suicide bills have language that can be interpreted to permit euthanasia.

Assisted suicide bills are usually designed as an application process for obtaining a lethal dose.

For instance the Maryland assisted suicide bill HB 0643 may permit euthanasia (homicide) because it doesn't require the person to self-administer. The Maryland bill doesn't protect the conscience rights of medical professionals either.

The Massachusetts assisted suicide bill can also be interpreted to permit euthanasia.

The New Hampshire assisted suicide bill gives physicians the right to write a lethal prescription but the term self ingest is not found in the main text of the bill. Only within the life insurance section is there a statement that may be construed as limiting the act to assisted suicide where it states:

Neither shall a qualified patient’s act of ingesting medication to end such patient’s life in a humane and dignified manner have an effect upon a life, health, or accident insurance or annuity policy.

Even this statement does not refer to self-ingestion.

The New Hampshire bill permits euthanasia by giving a physician the right in law to write a lethal drug prescription, but it does not limit how the lethal drugs can be used.

New Hampshire assisted suicide bill will create a perfect crime (Link).

Assisted suicide bills are intentionally written in a deceptive manner, so that if legalized, the legislation can be interpreted in a wider manner. Further to that, the assisted suicide lobby has no intention of maintaining the "safeguards" in the bills. These "safeguards" are simply mean't to sell assisted suicide to the legislators.

Hawaii is debating the expansion of its assisted suicide law only one year after it came into effect, and Washington State is examining all of the safeguards, while Oregon expanded its assisted suicide law last year.

Clearly assisted suicide bills are not what they appear to be.

Maryland assisted suicide bill may permit euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

In 2019, the Maryland assisted suicide bills passed in the House by a vote of 74 to 66 but failed in the Senate by a vote of 23 to 23.

In 2020, the Maryland assisted suicide House Bill HB 0643 and Senate Bill SB 701 may permit euthanasia. Most of the new assisted suicide bills have loose language to allow a wider interpretation.

The Maryland bill is designed as an application process for obtaining a lethal dose. Most assisted suicide bills state that the person self-administer the lethal dose, making it an assisted suicide.

The Maryland assisted suicide bill does not require the person to "self-administer" the lethal drugs but rather the bill says "may self-administer."

You may be told that "may self-administer" means that the person may change their mind. The term, may self-administer means that someone else can administer the lethal drug cocktail, allowing euthanasia or homicide.

When examining the bill further the potential for euthanasia becomes more clear. The assisted suicide bill § 3–103 states:

A licensed health care professional does not violate § 3–102 of this subtitle BY TAKING ANY ACTION in accordance with Title 5, Subtitle 6A of the health – general article.

The Maryland assisted suicide bill allows another person to administer the lethal drugs, which is euthanasia, and it provides full legal protection for the Health Care Professionals who do so.

Another addition to the recent assisted suicide bills is the acknowledgement that it may take at least 3 hours to die.

Current lethal drug cocktails may cause painful assisted suicide deaths that can take many hours to die.

For more than a year, the assisted suicide lobby has focused on eliminating "safeguards" in assisted suicide legislation.

Assisted suicide lobby researchers are working on their third generation of lethal drug cocktails. The results of the first two experimental lethal drug cocktails were:

The (first) turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.

The first two lethal drug cocktail experiments failed to provide a painless, fast death. 

People who participate in these lethal drug experiments have consented to ingesting the lethal drugs, but are they consenting to participate in human experimentation?

New Hampshire "assisted suicide" bill appears to permit euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

New Hampshire Legislature.

The deceptive language in most assisted suicide bills allow f0r different interpretations, such as the Indiana assisted suicide bill that may permit euthanasia.

Assisted suicide is an act whereby one person, usually a physician, assists the suicide of another person, usually by writing a prescription for lethal drugs.

Euthanasia is an act whereby one person, usually a physician, intentionally causes the death of another person, to "end suffering."

New Hampshire Bill HB 1659 is designed as an application process for obtaining a lethal dose. Most assisted suicide bills state that the person must self-administer the lethal dose (assisted suicide) and some bills say that the person may self-administer the lethal dose (may can be interpreted to permit euthanasia).

In its Statement of Purpose, HB 1659 states:

...to provide such patient with a prescription for lethal medication which will allow the patient, if the patient chooses to do so, to self-administer and thus control the time, place, and manner of death.

The term "self-administer" does not appear anywhere else in bill HB 1659. 

The assisted suicide lobby will suggest that the phrase, if the patient chooses to do so means that the person may choose not to take the lethal drugs but this phrase can also mean that the patient is not required to self-administer but can administer the lethal drugs in another manner, such as euthanasia.

For more than a year, the assisted suicide lobby has focused on eliminating "safeguards" in assisted suicide legislation. 

The Washington State legislature is debating Bill 2419, a "study bill" to consider eliminating "safeguards" in assisted suicide laws.

Bill 2419 Section f - questions the requirement that lethal drugs be self-administered. If lethal drugs are not self-administered then someone else can administer. Can you say euthanasia / homicide.

New Hampshire House Bill HB 1659 uses different terminology than most assisted suicide bills and it appears to intentionally permit euthanasia.

Indiana assisted suicide bill fails to protect objecting practitioners

This article was published by the Protection of Conscience Project on January 16, 2020

Assisted suicide evolves from "assistance" to "medical care" 

Affirmation has serious consequences for objecting Indiana physicians

By Sean Murphy

Introduction

On 7 January, 2020, Representative Matt Pierce introduced HB1020: End of life options in the Indiana General Assembly.1 HB1020 is the fourth assisted suicide bill introduced by Pierce since 2017; three previous bills died in committee without hearings.2,3,4,5,6 Parts of HB1020 relevant to protection of conscience are reproduced on the Project website.7
 
Overview

The bill permits physician assisted suicide for Indiana residents 18 years of age and older who have been diagnosed with a terminal illness likely to cause death within six months. Candidates must be competent to make health care decisions and must apply in writing for a lethal prescription; the application must be witnessed by two independent witnesses. Lethal medication can be prescribed or dispensed by an attending physician after a fifteen day waiting period if the patient is acting voluntarily and making an informed decision.

Neither the attending physician nor any other person need be present when the lethal medication is taken, though the attending physician must tell the patient that someone else should be present. The lethal medication must be self-administered. If the medication does not cause death, no one is authorized to kill the patient. 

HB1020 imposes obligations upon "attending physicians"8 and "consulting physicians"9 and it assumes the cooperation of pharmacists in dispensing lethal medication. There is some ambiguity in the description of what is expected of attending physicians. Section 4(a)(13) makes provision or prescription of lethal medication an absolute obligation if all of the conditions specified in the bill are met (". . .the attending physician shall. . ."). On the other hand, Section 4(c) seems to leave some discretion to the attending physician to refuse, even if the conditions are met (". . . the attending physician may . . ."). A later protective provision indicates that an attending physician can refuse, but the ambiguity in the wording of Section 4 remains.

Protective provisions: biased, insufficient and conflicting

The bill makes no reference to freedom of conscience or religion, but Section 12 offers some protection for "health care providers."

Under Section 12(d) a hospital (health care provider) can prohibit physicians (individual health care providers) from participating in assisted suicide on its premises, and, provided it has notified them in advance, can take action against those who defy the prohibition. This would seem to be broad enough to include a prohibition against assessing patients and arranging for assisted suicide elsewhere.

However, Section 12(e) pits health care "facilities" against health care "providers." A facility cannot prevent a physician from "providing services consistent with the applicable standard of medical care." This includes at least providing information about assisted suicide, being present at a suicide, and referring a patient for assisted suicide. What is not clear is whether or not this includes doing so on the facility's premises, notwithstanding a facility prohibition of participation in assisted suicide.

Unfortunately, HB1020 does not explain the distinction between a health care "provider" and a health care "facility." And while the Indiana Code defines both terms, it offers three different definitions of "health care facility"10 and five differing and very lengthy definitions of "health care provider."11 The latter can include individuals (thus covering attending physicians) but also health facilities and incorporated entities. This further complicates interpretation of Section 12(e).

Section 12(a) provides immunity against professional, criminal and civil liability, but only for those who prescribe or dispense assisted suicide medication or are present when it is taken. Those who refuse are unprotected. The bias in favour of assisted suicide practitioners and disadvantage imposed upon those unwilling to provide the service is obvious.

Section 12(b) protects both health care providers who participate and those who refuse to participate in assisted suicide against private disciplinary or punitive actions by professional associations, organizations and other health care providers. It offers the same protection for health care providers who provide "scientific and accurate information" about the service - but not those who refuse to do so.

Section 12(c) states that a health care provider cannot be required to participate in "the dispensing or providing of medication", but this does not clearly protect objecting physicians from demands that they do everything but dispense or prescribe lethal drugs.
Assisted suicide evolves from "assistance" to "medical care"

In 2017, HB1561 Section 12(a) described participation in assisted suicide as "provid[ing] assistance in the completion of a request for medication." It granted professional, civil and criminal immunity to those providing "assistance."

The following year, HB1157 Section 12(a) used the same phrase to describe participation. It conferred immunity upon those providing such "care."

In 2019, HB1184 Section 12(a) evolved further, so that participation in assisted suicide is described in HB1020 as the provision of "medical care," including prescribing or dispensing lethal medication and being present at a patient's suicide. The addition of Section 12(e) in HB1020 reflects and reinforces this evolution when it refers to participation in assisted suicide that conforms to "the applicable standard of medical care."

Now, in 2019 the American Medical Association (AMA) reaffirmed its rejection euthanasia and assisted suicide as contrary to medical ethics,12 so the AMA would presumable reject the bill's supposition that there can be a "medical standard of care" for either procedure. In this respect, the author of HB1020 may be looking to a future in which a medical standard of care is developed as a result of the legalization of physician assisted suicide.

When assisted suicide becomes "medical care"  

Seven Canadian physicians have described what that future looks like.

"For refusing to collaborate in killing our patients," they write, "many of us now risk discipline and expulsion from the medical profession," are accused of human rights violations and "even called bigots."13

How did this come about?

An important part of the explanation is the Canadian Medical Association's (CMA) classification of assisted suicide and euthanasia as "therapeutic service[s]"14 and "legally permissible medical service[s]."15

Since there is no dispute that physicians have a professional obligation to provide or arrange for therapeutic medical services for their patients, the change in CMA policy implicitly made participation normative for the medical profession (and, by extension, for other health care workers and institutions). From that perspective, as the Canadian physicians note, refusing to provide or arrange for euthanasia and assisted suicide services for legally eligible patients "became an exception requiring justification or excuse." Hence, discussion in Canada is now largely about "whether or under what circumstances physicians and institutions should be allowed to refuse to provide or collaborate in homicide and suicide."13

The seven Canadian physicians authors can't be dismissed as outlying cranks. Almost 60 Canadian physicians from across the country endorsed the article, which appeared in the World Medical Association's professional journal. Signatories included a Canadian Medical Hall of Fame member known as the father of palliative care in North America,16,17 a member of an expert advisory group on euthanasia and assisted suicide convened by Canadian provinces and territories,18 and a regional director of palliative care who resigned when a health authority demanded that objecting hospices permit euthanasia and assisted suicide on their premises.19

Thus, in the long term, statutory affirmation that assisted suicide is not only permitted but is a form of "medical care" would likely have serious adverse consequences for objecting Indiana physicians.

Notes

1. US, HB 1020, End of life options, 121st Gen Assembly, 2nd Reg Sess, Ind, 2020 [Internet]. Indianapolis: Indiana General Assembly; 2020 Jan 7 [cited 2020 Jan 14].

2. US, HB 1561, End of life options, 120th Gen Assembly, 1st Reg Sess, Ind, 2017 [Internet]. Indianapolis: Indiana General Assembly; 2017 Jan 23 [cited 2020 Jan 14].

3. US, HB 1157, End of life options, 120th Gen Assembly, 2nd Reg Sess, Ind, 2018 [Internet]. Indianapolis: Indiana General Assembly; 2018 Jul 1 [cited 2020 Jan 14].

4. US, HB 1184, End of life options, 121st Gen Assembly, 1st Reg Sess, Ind, 2019 [Internet]. Indianapolis: Indiana General Assembly; 2019 Jul 1 [cited 2020 Jan 14].

5. Hussein F. Indiana lawmaker proposes assisted suicide bill. Indianapolis Star [Internet]. 2018 Jan 4 [cited 2020 Jan 14].

6. Arthur V. Assisted suicide legislation stalls in Indiana. Today's Catholic (Fort Wayne, IN) [Internet]. 2019 Apr 4 [cited 2020 Jan 14].

7. Indiana: House Bill 1020 (2020): End of life options [Internet]. Powell River (BC): Protection of Conscience Project; 2020 Jan 14 [cited 2020 Jan 14].

8. "'Attending physician' means the licensed physician who has the primary responsibility for the treatment and care of the patient. For purposes of IC 16-36-5, the term includes a physician licensed in another state." IN Code § 16-18-2-29 (2018) [Internet]. Mountainview, CA: Justia [cited 2020 Jan 14].

9. The term is undefined, so it appears to refer to any licensed physician.

10. For "health care facility" see IN Code § 16-18-2-161 (2018) [Internet]. Mountainview, CA: Justia [cited 2020 Jan 14].

11. For "health care provider" see IN Code § 16-18-2-163 (2018) [Internet]. Mountainview, CA: Justia [cited 2020 Jan 14]

12. Frellick M. AMA Reaffirms Stance Against Physician-Aided Death. Medscape [Internet]. 2019 Jun 11 [cited 2020 Jan 14].

13. Leiva R, Cottle MM, Ferrier C, Harding SR, Lau T, Scott JF. Euthanasia in Canada: A Cautionary Tale. WMJ 2018 Sep [cited 2020 Jan 14]; 64:3 17-23.

14. Doctor-assisted suicide a therapeutic service, says Canadian Medical Association [Internet]. CBC News; 2015 Feb 06 [cited 2020 Jan 14]. Emphasis added.

15. CMA Policy: Medical Assistance in Dying [Internet]. Canadian Medical Association; 2017 May [cited 2020 Jan 14]. Emphasis added.

16. (Dr. Balfour Mount). Phillips D. Balfour Mount [Internet]. Montreal (Quebec): McGill University; 2016 May 03 [cited 2020 Jan 14].

17. The Canadian Medical Hall of Fame. Dr. Balfour Mount, 2018 Inductee [Internet]. [cited 2020 Jan 14].

18. (Dr. Nuala Kenny). Provincial-Territorial Expert Advisory Group on Physician-Assisted Dying. Final Report [Internet]. Toronto (Ont): Government of Ontario, Ministry of Health and Long Term Care; 2015 Nov 30 [cited 2020 Jan 14].

19. (Dr. Dr. Neil Hilliard). Fayerman P. Delta hospice rebels against Fraser Health's mandate to provide medical assistance in dying [Internet]. Vancouver Sun; 2018 Feb 06 [2020 Jan 14].

Indiana assisted suicide bill may permit euthanasia (homicide).

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Indiana House Bill 1020 is sponsored by State Rep Matt Pierce (D) and was introduced on January 7.

House Bill 1020 claims to legalize assisted suicide, but the bill could be interpreted wide enough to permit euthanasia (homicide).

For instance, Section 3. (a) (5) of the bill states that:

has voluntarily expressed to the attending physician a wish to receive medical aid in dying; may make a written request in accordance with this chapter for medication that the patient may self-administer to end the patient's life.

The assisted suicide request form, in the bill, that is designed to be signed and witnessed states:

I request that my attending physician prescribe medication that I may self-administer to end my life in a humane and dignified manner and that the attending physician contact a pharmacist to fill the prescription.

You will be told that may self-administer means that the person may change their mind. Using the term, may self-administer, can be interpreted to mean that the legislation allows someone else to administer the lethal drug cocktail.

It is important to note that one of the witnesses can be an heir. 

The bill requires the physician state on the death certificate that the cause of death is the person's medical condition and not assisted suicide.

The bill also uses a self-reporting system that enables assisted suicide doctors to cover-up questionable deaths.

The bill requires, the attending physician to approve and prescribe the lethal drug cocktail and then report the death after the person dies by assisted suicide. Once a person is dead, who will ever know if something illegal occurred?

The legislation provides a reporting system that allows abuse of the law. No third party is required to approve or report the death, and no one is required to witness the death, to ensure compliance with the law.

Just to ensure that the assisted suicide physician is protected under the law, the legislation only requires that the physician was in "good faith". It is absurd that only a "good faith" compliance is required for a physician to prescribe a lethal drug cocktail.

House Bill 1020 does recognize that these deaths may take a long time. It states that the patient must expect that the death will take 3 hours, but it might take longer.

Recent experimental lethal drug cocktails have resulted in painful drawn out deaths. People have reported that the drug cocktails have burned the persons mouth and throat causing them to scream in pain. The length of the death is usually a few hours, but some of the deaths have taken 30 hours.

Death with dignity? I think not.

Indiana Medical Association opposes assisted suicide.

Alex Schadenberg

Executive Director - Euthanasia Prevention Coalition

The Indiana State Medical Association formally opposes assisted suicide after a debate at their annual convention last weekend. According to ABC 21 Alive in Indiana:

The Indiana State Medical Association says the topic was debated at the annual convention. The association says this was by far the most debated resolution discussed. So much so the meeting went well over the scheduled time due to the many physicians that wanted to speak out against the practice.

The ABC news report continued:

... proponents of the practice said it would decrease healthcare costs at the end of life. They also said it would help patients who commit suicide to die in a more peaceful manner. 

Opponents of the practice said medical professionals should focus on providing care and comfort, not be a source of lethal drugs. They also suggested the practice might lead insurance companies to lean towards lethal drugs over treatment due to cost.

The American Medical Association (AMA) policy on assisted suicide states:

Physician-Assisted Suicide is fundamentally incompatible with the physicians role as healer, would be difficult or impossible to control, and would pose serious societal risks.

Sadly many physicians consider a cost/expense analysis when making life and death decisions. 

Thank you to the Indiana State Medical Association for deciding to provide care and comfort for their patients and not prescriptions for lethal drugs.