Daniel P. Sulmasy, Ilora Finlay, Faith Fitzgerald, Kathleen Foley, Richard Payne, Mark Siegler
Abstract
It has been proposed that medical organizations adopt neutrality with
respect to physician-assisted suicide (PAS), given that the practice is
legal in some jurisdictions and that membership is divided. We review
developments in end-of-life care and the role of medical organizations
with respect to the legalization of PAS since the 1990s. We argue that
moving from opposition to neutrality is not ethically neutral, but a
substantive shift from prohibited to optional. We argue that medical
organizations already oppose many practices that are legal in many
jurisdictions, and that unanimity among membership has not been required
for any other clinical or ethical policy positions. Moreover, on an
issue so central to the meaning of medical professionalism, it seems
important for organized medicine to take a stand. We subsequently review
the arguments in favor of PAS (arguments from autonomy and mercy, and
against the distinction between killing and allowing to die (K/ATD)) and
the arguments against legalization (the limits of autonomy, effects on
the patient-physician relationship, the meaning of healing, the validity
of the K/ATD distinction, the social nature of suicide, the
availability of alternatives, the propensity for incremental extension,
and the meaning of control). We conclude that organized medicine should
continue its opposition to PAS.
Sulmasy DP, Finlay I, Fitzgerald F, Foley K, Payne R, Siegler M. Physician-Assisted Suicide: Why Neutrality by Organized Medicine Is Neither Neutral Nor Appropriate. J Gen Intern Med. 2018 Aug;33(8):1394-1399. doi: 10.1007/s11606-018-4424-8. Epub 2018 May 2.