Physician Aid in Dying June 2016

Background

In the nearly 25 years since the MMA last formally considered its policy on physician aid-in-dying, five states have laws allowing for a physician to prescribe terminally ill patients medication to end their lives.  Legislation to allow the practice was introduced in the Minnesota House and Senate in 2016.  While a hearing on the bill was held in the Senate during the 2016 legislative session, no formal action was taken nor was the bill considered in the House.  The bill’s authors have indicated their intent to continue to promote the bill and advocate for its passage in future legislative sessions.  

Existing MMA policy opposes the participation of physicians in assisted suicide:  
 

240.21 Decisions Near End of Life

The MMA endorses the AMA Council on Ethical and Judicial Affairs recommendations adopted at the 1991 AMA Annual Meeting as follows:
 
  1. The principle of patient autonomy requires that physicians must respect the decision to forego life-sustaining treatment of a patient who possesses decision-making capacity. Life-sustaining treatment is any medical treatment that serves to prolong life without reversing the underlying medical condition. Life-sustaining treatment includes, but is not limited to, mechanical ventilation, renal dialysis, chemotherapy, antibiotics and artificial nutrition and hydration.
  2. There is no ethical distinction between withdrawing and withholding life-sustaining treatment.
  3. Physicians have an obligation to relieve pain and suffering and to promote the dignity and autonomy of dying patients in their care. This includes providing effective palliative treatment even though it may foreseeably hasten death.
  4. Physicians must not perform euthanasia or participate in assisted suicide. The societal risks of involving physicians in medical interventions to cause patients' deaths is too great to condone euthanasia or physician-assisted suicide. (HD-SR30-1992)
The MMA 2015 Annual Conference included a session regarding issues related to end-of-life, including physician aid-in-dying.  The topic was further discussed as part of the 2015 Open Issues Forum. Following the Annual Conference, the MMA Policy Council considered policy development on the issue of physician aid-in-dying, specifically whether the MMA should change or reconsider its position of opposition.  The Policy Council referred the issue to the MMA Board of Trustees and urged the board to direct staff to “further analyze the proposal before the Minnesota Legislature in order to understand its intent and implications.”  In addition, the Policy Council included a recommendation to amend MMA policy on physician aid-in-dying by striking the current language in opposition.

Subsequently, the MMA Board of Trustees considered the Policy Council’s recommendations.   After discussion, the board voted to table the Policy Council’s recommendation to amend MMA policy on physician aid-in-dying.  The MMA Board instead approved the creation of a task force to examine MMA policy on physician aid-in-dying, because the policy has not been updated in over two decades and because of the possibility that aid-in-dying legislation will be debated in the 2017 legislative session and beyond.  

Charge 

The Physician Aid-in-Dying Task Force is charged with considering the complex and controversial issues related to physician aid-in-dying and to make recommendations to the Board of Trustees to maintain or modify existing MMA policy on physician aid-in-dying.  The Task Force will review physician aid-in-dying legislation proposed in Minnesota, and proposed and/or passed in other states, in the course of developing its recommendations. 

It is anticipated the group will meet three times between July and November.

Members & Staff

The Task Force will be comprised of 6-8 invited physician members. Invitations to participate on the task force will be extended to members of two existing MMA committees:  Ethics and Medical-Legal Affairs Committee and the Health Care Access, Financing & Delivery.  Staff will also seek committee members with specialties in hospice/palliative care and medical ethics.  The MMA Board Chair will have final approval of task force membership.

Staff will work to find Task Force members with diverse opinions and expertise on the issue.  Non-physician guests will be invited to participate in some meetings if they bring a helpful expertise or perspective.  
  • Stuart Bloom, MD
  • Ken Kephart, MD
  • Jennifer Kuyava, MD
  • Kathryn Lombardo, MD
  • Lisa Mattson, MD
  • David Plimpton, MD
  • John Song, MD
  • Benjamin Whitten, MD
  • Teresa Knoedler - Staff
  • Eric Dick - Staff

Deliverables

  • New! MMA Physician Aid in Dying MMA Survey Resuts - Posted 6/14/17

  • MMA Physician Aid-in-Dying Task Force Report and Recommendations
  • Develop specific policy recommendations regarding physician aid-in-dying, to be considered by the MMA Board of Trustees at its November 19, 2016 meeting.
  • A memorandum explaining Task Force processes, considerations, rationale and decisions, to accompany its policy recommendations to the MMA Board of Trustees.
  • Provide structure and content guidance on the Physician aid-in-dying policy forum that will be held on September 23th, 2016, at the MMA annual conference. 
  • Identify educational resources that will help physicians understand and examine the clinical, practical, legal, and policy issues associated with physician aid-in-dying.

Minutes/Agendas

​October 26, 2016 - Agenda - Minutes
October 5, 2016 - Agenda - Minutes
August 24, 2016 - Agenda - Minutes
July 27, 2016 - Agenda - Minutes

 

Resource Materials