The Massachusetts Medical Society is poised to tackle one of the thorniest issues facing physicians: whether doctors should be allowed to prescribe lethal medications to terminally ill adults who want to choose when to die.
At a meeting Saturday, the society’s governing board will vote on a resolution to end its longstanding opposition to physician-assisted suicide and instead take a neutral stance. Participants will also learn the results of a survey of Massachusetts physicians on the issue.
“I’m sure it will be lively and spirited discussion,” said Dr. Henry Lawrence Dorkin, the society’s president.
Supporters of ending the medical society’s opposition say the move could clear the way for state legislation that would allow physicians, in limited circumstances, to provide lethal medications to dying patients who request it. California and Colorado were able to pass similar bills only after medical societies in those states dropped their opposition, according to Sean Crowley, spokesman for Compassion and Choices, a Denver-based advocacy group for medical aid in dying.
Medical societies in Vermont, Maryland, Maine, Minnesota, Nevada, and Washington, D.C. have also ended their opposition to physician-assisted suicide. But most other medical societies — along with the American Medical Association — continue to disapprove of it. In 2012, Massachusetts voters narrowly defeated a “death with dignity” ballot referendum.
Dorkin said society members are split on the issue. “There is a lot of passion here,” he said.
In a sign of the controversy’s intensity, the society faced a challenge in merely deciding how to label the resolution, he said.
Proponents reject the phrase “physician-assisted suicide” and prefer “medical aid in dying,” saying that terminally ill people are not suicidal but rather seeking more control over their final days. But those who oppose such practices object to “medical aid in dying,” saying that doctors aid dying people all the time, without helping them to kill themselves.
The medical society is calling the issue “physician-assisted suicide/medical aid in dying.”
Dr. Roger Kligler, a Falmouth physician suffering from metastatic prostate cancer and a long-time advocate for physician aid in dying, plans to speak in favor of ending the opposition to physician-assisted suicide.
“You have people of good will on both sides of this,” said Kligler, an internist who stopped working three years ago because of his illness. “The medical society has to realize they’re never going to convince people who are for it or who are against it to really change their view.”
The solution, he said, is “engaged neutrality” in which the medical society would not take a position on the issue, but would help train physicians in end-of-life care in accordance with the law.
“No one has to violate their ethical principles,” he said. Instead, a doctor unwilling to prescribe lethal medications could refer patients to someone else.
Kligler, who is 65 and has had cancer for 15 years, has filed suit seeking to allow his doctor to prescribe lethal medication that he could take when he wanted to.
In the past year his cancer improved with treatment, but now seems to be worsening, he said Thursday. He does not know how long he has to live. The cancer and its treatments have caused a decline in mental function, weakness, and sleep problems, among other symptoms, Kligler said, but he still enjoys walking with his dog, up to nine miles a day.
“I’m most concerned about having uncontrolled symptoms and not being able to enjoy the richness of life,” he said. He knows that, as a physician, he could find a way to end his life — but said he is fighting for others to have that same opportunity. Two of his friends, he said, recently endured “very bad deaths” despite being in hospice care.
On the other side of the debate, Dr. Barbara Rockett, a surgeon at Newton-Wellesley Hospital, plans to argue in favor of maintaining the society’s opposition to physician-assisted suicide. Reversing that stance would not be a “neutral” move, she said. It’s considered a crime to help someone commit suicide, and remaining neutral on a crime condones it, she said.
The doctor’s role is to find a solution to a patient’s pain, not to look for a way out, Rockett said. “The doctor is not to be the executioner,” she said.
Doctors can refer patients to palliative care or hospice, she said. If a person doesn’t want to go on living, she said, “There are so many ways to commit suicide, we don’t need a physician to assist in this.”
But she added that many patients are depressed and stop making suicide requests once their depression is treated.
A state legislative committee is weighing a bill, modeled after laws in Washington, Oregon, and four other states, that would allow physicians to help terminally ill patients die. It includes several provisions intended to ensure that the patient is of sound mind, within six months of dying, and acting willingly.
The Massachusetts Medical Society represents 25,000 physicians and medical students. Its House of Delegates, meeting Friday and Saturday in Waltham, has nearly 500 members.