PHILADELPHIA -- The American College of Physicians-American Society of Internal Medicine (ACP-ASIM), the nation's second-largest medical organization, has declared its opposition to the legalization of physician-assisted suicide, according to a position paper published in today's Annals of Internal Medicine. The organization decided to oppose legalizing the practice even under narrow circumstances.
"Physician-assisted suicide should not become part of standard medical care. Its routine practice would raise serious ethical and other concerns, undermining the patient-physician relationship and the trust necessary to sustain both the relationship and the role of the medical profession in society," said Lois Snyder, JD, director of ACP-ASIM's Center for Ethics and Professionalism and lead author of the position paper.
The paper strongly supports a patient's right to withdraw from or refuse medical treatment but distinguishes those acts from euthanasia and physician-assisted suicide. The paper suggests many measures to alleviate suffering at the end of life, such as increasing access to hospice care, financing for palliative care, and better control of pain.
"We must solve the problems of inadequate care at the end of life, not avoid them through practices such as physician-assisted suicide," said Daniel P. Sulmasy, OFM, MD, PhD, a member of ACP-ASIM's Ethics and Human Rights Committee and an author of the paper.
In developing the position paper, the Ethics and Human Rights Committee considered the most common arguments for and against physician-assisted suicide.
Reviewing the experience so far in Oregon, where the practice is legal, patients requesting help committing suicide making such a request have been more often concerned about loss of autonomy and control rather than suffering from pain or other symptoms. "We questioned whether it is medicine's role to give people absolute control over the timing and manner of death," said Snyder.
ACP-ASIM has been active in national efforts to improve the quality of end-of-life care, providing authoritative information to primary care physicians, who care for most dying patients. In 1997, ACP-ASIM created a Consensus Panel on End-of-Life Care to develop papers on topics such as communication; the goals of palliative care; evidence-based approaches to manage pain, depression, delirium and intractable suffering, and legal, financial and quality issues.
The College has compiled the papers, originally published in Annals of Internal Medicine and JAMA, into a new book, Physician's Guide to End-of-Life Care, and is also developing patient education materials.
ACP-ASIM is a nonprofit organization whose mission is to enhance the quality and effectiveness of health care by fostering excellence and professionalism in the practice of medicine. ACP-ASIM publishes Annals of Internal Medicine, one of the top three peer-reviewed medical journals in the United States and the leading journal for physicians practicing internal medicine and its subspecialties.
NOTE to Editors: Position paper authors Daniel P. Sulmasy and Lois Snyder can be reached for interview by calling Susan Anderson at the ACP-ASIM Communications Dept., 1-800-523-1546, ext. 2653 or 1-215-351-2653.
Embargoed copies of the paper, "Physician-Assisted Suicide," can be obtained by calling the ACP-ASIM Communications Department 1-800-523-1546, ext. 2656.
To order a copy of Physician's Guide to End-of-Life Care, call 1-800-523-1546, ext 2600 or 215-351-22600 (Mon. to Fri., 9 a.m. to 5 p.m. ET). Refer to priority code PUBLAD. Price: $35; $28 for ACP-ASIM members. For more information, go to http://www.acponline.org/catalog.
Projects and papers of the ACP-ASIM Center for Professionalism and Ethics can be found at http://www.acponline.org/ethics/index.html.
Journal
Annals of Internal Medicine