American Medical Association reaffirms position that assisted suicide is unsafe

The American Medical Association has decisively reaffirmed its position that:

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.

At the annual meeting of its House of Delegates delegates voted 392-162 (that is 70% for; 30% against) to retain the policy unchanged.

The House of Delegates also voted 360-190 (65% to 35%) to receive a report from its Council on Judicial and Ethical Affairs on physician assisted suicide.

The report recommended rejecting proposals to change the AMA policy and reiterated concerns the inadequacy of alleged safeguards:

From the earliest days of the debate, a prominent argument raised against permitting physician-assisted suicide has been that doing so will have adverse consequences for individual patients, the medical profession, and society at large. 

The question whether safeguards—which in the U.S. jurisdictions that permit assisted suicide, restrict the practice to terminally ill adult patients who have decision-making capacity and who voluntarily request assisted suicide, along with procedural and reporting requirements—can actually protect patients and sustain the integrity of medicine remains deeply contested. 

Although cross-cultural comparisons are problematic, current evidence from Europe does tell a cautionary tale ... amongpatients who obtained euthanasia or assisted suicide, nearly 4 percent “reported only psychological suffering.”

Studies have also raised questions about how effective retrospective review of decisions to provide euthanasia/assisted suicide is in policing practice. A qualitative analysis of cases that Dutch regional euthanasia committees determined had not met legal “due care criteria” found that such reviews focus on procedural considerations and do not “directly assess the actual eligibility” of the patients who obtained euthanasia. A separate study of cases in which psychiatric patients obtained euthanasia found that physicians’ reports “stated that psychosis or depression did or did not affect capacity but provided little explanation regarding their judgments” and that review committees “generally accepted the judgment of the physician performing EAS [euthanasia orphysician-assisted suicide]”.

It remains an open question whether reviews that are not able to assess physicians’ reasoning truly offer the protection they are intended to provide. To the extent that reporting and data collection in states that permit physician-assisted suicide have similar limitations, oversight of practice may not be adequate.

The American Medical Association remains in accord with the position shared by the World Medical Association and all but one or two of its constituent national medical associations.