AMA TO VOTE ON ASSISTING SUICIDE

By Burke J. Balch, J.D.
Director, Robert Powell Center for Medical Ethics

The American Medical Association (AMA) has long stood solidly against physician-assisted suicide. At its annual meeting in Chicago June 14-19, however, its House of Delegates will vote on a resolution, the adoption of which would effectively reverse that stand.

The Wisconsin Medical Association has proposed Resolution 213, which would reverse the AMA's support of Attorney General John Ashcroft's November 2001 ruling that federally controlled drugs may not be used to assist suicide in any state, including Oregon - - the only U.S. jurisdiction that has so far legalized the practice.

At the time of the Ashcroft ruling, AMA President Dr. Yank Coble (then president-elect) noted, "[T]he AMA has consistently held that physician-assisted suicide falls outside the realm of legitimate medical practice."

Proponents of Resolution 213 claim that doctors may be reluctant to prescribe painkilling drugs if the use of drugs to kill patients is forbidden. However, Attorney General Ashcroft made clear that enforcement will rely on self-reporting by doctors who clearly state they've used federally controlled drugs to assist suicides (as required by Oregon law), not on second-guessing or reviewing doctors' pain relief prescriptions.

To be legal under Oregon law, any case of assisted suicide must be reported as such to state authorities, with information specifying the drugs used. The Justice Department made clear that it will enforce its determination by reviewing those records, not by scrutinizing prescriptions for pain relief.

Indeed, on the day of his ruling, Ashcroft wrote the AMA, "[T]here will be no increase in D[rug] E[nforcement] A[dministration] scrutiny of physicians' prescription of controlled substances to control pain in any state, including Oregon, as a consequence of today's decision. Consequently, physicians throughout the country should feel confident that they may prescribe federally controlled drugs to the full extent desirable to relieve pain without any fear that their prescriptions will be questioned or investigated as a result of today's action."

Accordingly, Dr. Coble said, "We see nothing in this decision to concern physicians committed to aggressive pain treatment at the end of life."

The Ashcroft Directive was challenged in the courts and is unlikely to take effect until an ultimate decision by the U.S. Supreme Court. Euthanasia proponents hope that if the AMA reverses its support of the directive and files a "friend of the court" brief attacking it, the Supreme Court will be less likely to agree that the federal government can legally refuse to facilitate assisting suicide with the use of federally controlled drugs.

"It is important," said NRLC Executive Director David N. O'Steen, Ph.D., "that pro-life people ask their doctors to contact the AMA delegates from their state, urging them to reject Resolution 213 and instead reaffirm the medical profession's commitment to rejecting the legitimacy of physician-assisted suicide as a medical practice." The names of AMA delegates should be available from NRLC state affiliates.