May 20, 2015
Area(s) of Interest: Advocacy End of Life Issues Patient Care
Sacramento – Today, the California Medical Association (CMA) announced that it has become the first state medical association in the nation to change its position on the long-debated issue of physician aid in dying.By removing decades-old organizational policy, CMA has eliminated its historic opposition and is now officially neutral on Senate Bill 128 (Monning/Wolk), the End of Life Option Act.
“As physicians, we want to provide the best care possible for our patients. 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,” said Luther F. Cobb, M.D., CMA president. “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. 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. Protecting that physician-patient relationship is essential.”
In 1987, the CMA House of Delegates (HOD) directed that CMA oppose enactment of any law that would require a physician to provide medicine, technique, advice or referrals necessary for a patient to pursue end of life. Then, in the 1990s, CMA determined that while physicians may diagnose a patient as having a terminal condition or illness and may find a patient competent to make informed decisions, CMA condemned voluntary active euthanasia by physicians as unethical and unacceptable and opposed physician-assisted suicide clinics. During that time, another resolution passed that required CMA to remain receptive to the multiple views and perspectives expressed by various participants in the social dialogue on physician-assisted suicide.“CMA’s focus has historically been on improving end of life options and enhancing palliative care and hospice for patients who are terminally ill,” said Dr. Cobb. “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.”
Throughout the bill’s process through the legislature, CMA has engaged in open and active conversations with the authors of SB 128. “We all agreed that the greatest importance must be on the primacy of the doctor-patient relationship, consistent with the principle of patient centered health care,” said Senator Bill Monning, co-author of the legislation.
“As the authors of SB 128, we are pleased to learn that the medical community is making a historic shift from a previous position on this issue,” added Senator Lois Wolk.
“Collaborative conversations that enhance safeguards for both physicians and patients were possible because of CMA’s shift in policy,” added Dr. Cobb. “Ensuring that participation in the End of Life Option Act is completely voluntary and that patients have the necessary protections has resulted in sound policy that we’re now able to remove opposition from.”
For a full list of past CMA resolutions on physician aid in dying, you may read our “ON CALL” document from the CMA Health Law Library here.