The California Medical Association (CMA) has changed its long-standing position on the issue of physician aid in dying, and has taken a neutral position on Senate Bill 128 (Monning/Wolk), the End of Life Option Act.

The organization’s physician leadership decided to change CMA’s decades-old policy after several committee hearings and an extensive amount of discussion by members. A final vote was taken by the CMA Board of Trustees in April, making CMA the first state medical association in the nation to change its stance on physician aid in dying.

“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,” CMA President Luther Cobb, M.D., said in a statement. “We believe it is up to the individual physician and their patient to decide voluntarily whether the End of Life Option Act is something in which they want to engage.”

Following the change, CMA has now taken a neutral position on SB 128. While the influential organization is not endorsing the bill, many expect its new unopposed stance will now give the legislation a better chance of passing in the state legislature.

Senator Lois Wolk (D-Davis), a co-author of the bill, called CMA’s decision a “game-changer.”

SB 128 would allow physicians to prescribe a lethal dose of drugs to terminally ill patients with less than six months to live. The bill ensures that participation in the act would be completely voluntary for patients, physicians, pharmacists and other health care providers. Its authors, Senators Bill Monning (D-Monterey) and Wolk, have been meeting with CMA to answer questions about physician protections since before the bill’s introduction in January.

“I am pleased that CMA has made a historic shift from its prior position on this issue, after engaging in a rigorous debate and discussion with its members,” said Senator Monning in a statement, adding, “This change in policy respects the importance of the doctor-patient relationship when a terminally ill patient is faced with making end of life decisions.”

Collaborative conversations that enhance safeguards for both physicians and patients were possible because of CMA’s shift in policy.

Since 1987, CMA has opposed the enactment of any law that would require a physician to aid in the death of a patient. In the 1990s, it condemned voluntary active euthanasia by physicians and opposed physician-assisted suicide clinics.

However, a CMA resolution to remain open to the multiple views and perspectives of various participants on the topic of physician aid in dying was also passed during that time.

Dr. Cobb said protecting the physician-patient relationship is essential.

“CMA’s focus has historically been on improving end of life options and enhancing palliative care and hospice for patients who are terminally ill,” he said. “Ultimately, however, it’s up to the patient and their physician to choose the course of treatment best suited for the situation – and CMA’s new position on physician aid in dying allows for that.”

SB 128 was heard yesterday on the Senate floor and passed with a vote of 23 to 14. The bill now moves to the Assembly.