From time to time, among the many conflicting developments affecting the worldwide euthanasia debate, we have the pleasure of underlining something positive.
On June 10th, the American Medical Association (one of the world’s largest and most influential National Medical Associations), voted to retain its opposition to euthanasia and assisted suicide. This decision followed an exhaustive 18 month review, and three successive recommendations from the AMA Committee on Ethics and Judicial Affairs; the final vote was 360-190 in favour of accepting the CEJA’s final report, and 392- 162 in favour of retaining the current wording of the code of ethics. The unambiguous language retained reads as follows: “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”
This reaffirmation of longstanding policy finds its echo in that of the American College of Physicians (January, 2019): “The College does not support legalization of physician-assisted suicide or euthanasia. After much consideration, the College concluded that making physician-assisted suicide legal raised serious ethical, clinical, and social concerns.”
Moreover, the American Psychiatric Association took in 2016 the extraordinary pro-active precaution of specifically denouncing the practice of euthanasia for mental health indications alone (2016): “The American Psychiatric Association, in concert with the American Medical Association’s position on Medical Euthanasia, holds that a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.”
Taken together, these three policy statements show the firm and courageous stand taken by our colleagues to the south, to the effect that euthanasia is unethical. Period.
Yet how can this attitude be squared with the fact that assisted suicide is now legal in 9 U.S. states and the District of Columbia?
The answer to this question is of the utmost simplicity: 1) because that which is legal is not necessarily ethical, and 2) because the role of medical associations is to faithfully represent the convictions of their members regarding the ethics of medicine, not to address the complexities of larger social policy.
These guiding positions, officially articulated by the American medical profession through its most representative institutions, cannot fail to have resounding effects around the world. Canada and the Netherlands can no longer bully the World Medical Association with arguments implying that “developed”, “modern” nations are espousing euthanasia as a new and enlightened vision of medical practice. Not at all. Both nations are simply illustrating the terrible trap into which we have blundered by publicly guaranteeing, as a benign medical service, something which is incompatible with medical practice as generally understood for more than two thousand years.
What is at issue is a personal right of choice. And whereas a government might decide to permit certain choices (such as euthanasia or assisted suicide) we are in no way obligated, either individually or collectively, to condone or facilitate them. And in particular, the mere fact of permitting minority suicidal choices must not be allowed to justify the destabilization of the whole of health care, to the detriment of the non-suicidal majority.
It is time, and past time, for our representatives at the Canadian Medical Association, the provincial Colleges of Physicians, and other medical associations to realize that their true vocation is to promote high quality professional practice and the well-being of patients, in the principled fashion that most other National Medical Associations – and indeed the World Medical Association itself — are doing, not to disfigure the medical profession in an attempt to address social and budgetary problems which reach far beyond the scope of medicine, and even farther beyond the responsibility of individual doctors.Make euthanasia unimaginable.
Sincerely,
Catherine Ferrier
President