During his three decades as an emergency-room doctor, Bob Uslander had never written a prescription for a lethal dose of medication. But then he shifted to geriatric and palliative care, and in 2016, a patient suffering from the neurodegenerative disease amyotrophic lateral sclerosis (ALS) wanted to use California’s new physician-assisted death law. Uslander was apprehensive. Until then, he had always viewed death as a failure.
“I didn’t really know what it would be like to be with somebody who had made the choice and was taking this medication,” he recalled recently. “I didn’t know if they would just gently fall asleep or if they would be gasping or struggling.”
His patient, a 67-year-old massage therapist with what is commonly known as Lou Gehrig’s disease, also was worried — for an entirely different reason. Her health was declining fast. Breathing and swallowing were becoming harder, and she could no longer walk. Uslander remembers her being terrified about what else would happen before it all ended.
So he wrote the prescription, and when she was ready to use it, he sat beside her and watched her die. “It was very peaceful,” he said. “Every experience I’ve had with aid in dying since then has been similar. There’s a sense of relief. There’s a sense of release.”
Although medically assisted death has gained ground in this country — with six states and the District of Columbia legalizing the practice — it remains a divisive issue among health-care providers. The American Medical Association, the nation’s most prominent doctors’ group, has maintained the same guidance for the past quarter-century: “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.”
Yet this week in Chicago, the AMA House of Delegates will debate and vote on whether the association’s Code of Medical Ethics should be revised.
“The mere fact that they’re considering it again tells you that it’s a changing climate,” said Art Caplan, a professor of bioethics and head of the division of medical ethics at New York University School of Medicine. “The reality is there are many more doctors in the AMA, but also outside the AMA, who have changed their minds about this.” And opinions, he predicted, will “continue to evolve.”
The AMA’s Council on Ethical and Judicial Affairs spent two years reviewing resolutions, not so much on whether to support the practice but on whether to take a neutral stance. The council is recommending that the Code of Medical Ethics “not be amended” and continue to refer to “physician-assisted suicide,” saying that language still “describes the practice with the greatest precision.” The delegates could accept the recommendation or send it back for further review.
It’s uncertain which way the vote will go, but in an open forum on the AMA’s website, doctors, delegates and others showed strong support for the status quo. That position is increasingly at odds with public opinion, with polls showing many Americans saying doctors should be allowed to help terminally ill patients end their lives.
Read the full story at The Washington Post
