Last week, the California Medical Association (CMA) formally dropped its opposition to physician-assisted suicide. The CMA is now taking a neutral position on California Senate Bill 128, also known as the "End of Life Option Act," which would allow physicians to prescribe medications to help terminally-ill patients end their lives. "The decision to participate in the End of Life Option Act is a very personal one between a doctor and their patient, which is why CMA has removed policy that outright objects to physicians aiding terminally ill patients in end-of-life options," Dr. Luther F. Cobb, president of the CMA, said in a statement.
The group Californians Against Assisted Suicide is fighting the legislation, saying that physician-assisted suicide "is a dangerous public policy that will place the most vulnerable in our society at risk." They say, when legalized, assisted suicide quickly becomes a cheaper form of treatment than life-saving interventions. In a Wall Street Journal editorial, Aaron Kheriaty, MD, associate professor of psychiatry and director of the Medical Ethics Program at the UC Irvine School of Medicine, said there have been cases in Oregon where the Oregon Health Plan refused to pay for "potentially life-extending cancer treatments," but offered to instead pay for assisted-suicide pills.
Only five states—Oregon, Washington, Vermont, Montana and New Mexico—currently have legislation to allow for physician-assisted suicide; many new bills are drafted each year. According to the Death with Dignity National Center, although the majority fail to become law, these bills are a testament to the growing support for the "death with dignity" movement.
A "shift in the conversation"
The CMA is the first state medical society to take a neutral stance on this issue. The American Medical Association continues to oppose physician-assisted suicide, saying it is "fundamentally inconsistent with the physician's role as healer." However, a CMA spokeswoman said that physicians are beginning to change their stance on the issue following a "shift in the conversation" among the American public and healthcare providers. "As physicians, we want to provide the best care possible for our patients," Cobb said in the statement. "However, despite the remarkable medical breakthroughs we've made and the world-class hospice or palliative care we can provide, it isn't always enough."
Kheriaty said that Senate Bill 128 was initially expected to "fly through the California Senate," but is now stalled. He said the bill was recently placed in the Senate Appropriations Committee's "suspense file," where bills are sent when they don't have much support. "Most bills on the suspense file simply die, while others get watered down to appease opponents," he said. But the CMA's change of heart could convince more legislators to support the bill, which will be up for a vote in early June. "The California Medical Association's new 'neutral' position on medical aid in dying is a major milestone because its prior opposition to this legitimate medical practice doomed previous bills," Barbara Coombs Lee, president of Compassion & Choices, an organization that advocates for death with dignity, said in statement. "We are seeing an enormous shift among medical organizations that is more reflective of the opinion of practicing physicians. This shift helps advance medical aid-in-dying legislation in California and throughout the nation."
Senate Bill 128 is the seventh such bill to be introduced in California since 1994. If it passes, it could pave the way for similar legislation in other states.