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Massachusetts Medical Society ends opposition to physician-assisted suicide, adopts neutral stance

Dr. Roger Kligler of Falmouth reacted to the vote. Society members viewed a projection of proposed language changes. Kligler, a Falmouth physician suffering from metastatic prostate cancer, supported the resolution.
Jessica Rinaldi/Globe Staff
Dr. Roger Kligler of Falmouth reacted to the vote. Society members viewed a projection of proposed language changes. Kligler, a Falmouth physician suffering from metastatic prostate cancer, supported the resolution.

WALTHAM — The Massachusetts Medical Society voted Saturday to end its longstanding opposition to physician-assisted suicide and adopted a neutral stance on what it now calls “medical aid-in-dying.”

The society’s governing body approved the changes in separate votes. Delegates voted 151 to 62 to retract the policy opposing physician-assisted suicide. The provision establishing a neutral position on medical aid-in-dying passed by a margin of 152 to 56 votes.

Terminology played a key role in the group’s debate over the issue. The policy that was rescinded used the term physician-assisted suicide, language that is opposed by many in favor of allowing doctors to help patients with terminal illness end their lives at the time of their choice.

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In a separate vote, the society agreed on a definition for medical aid-in-dying that encompasses the possibility that Massachusetts physicians could one day be authorized to write prescriptions for lethal doses of medication to help the terminally ill die when they see fit.

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The definition notes that the practice would have to be legalized before it could be recognized as a way to care for the terminally ill. The policy notes that physicians would not be required to prescribe lethal doses of medication to the terminally ill if it violates their ethical beliefs.

Dr. Henry Dorkin, president of the group, said the decision marks a new chapter in the way the society treats legislative proposals that would permit physicians to help terminally ill patients end their lives.

“We’re not going to take our previous position, dig in our heels, and say, ‘We won’t think about this or look at it from all perspectives,’ ” Dorkin said in an interview.

The group adopted its new policy during a meeting at a hotel in Waltham. During the hours-long session, members of the society’s House of Delegates tweaked the policy’s language and listened to testimony from people who favored the change and some who opposed it.

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Dr. Roger Kligler, a Falmouth physician suffering from metastatic prostate cancer, supported the resolution to end the society’s opposition to physician-assisted suicide. The neutral stance, he said, removes a major hurdle facing efforts to make it legal in Massachusetts for physicians to prescribe lethal doses of medication to terminally patients who request it.

“This is wonderful and a game changer,” Kligler said.

Dr. Mark Rollo, a family physician in Fitchburg, opposed the change, saying the new position paves the way for policies that could negatively effect people of color, the poor, and the disabled. Those groups, Rollo said, are at risk of being encouraged to end their lives instead of pursuing potentially costly therapies to prolong life.

“Certain underprivileged people will get letters that say, ‘I’m sorry, we’re not going to pay for your chemotherapy but we will pay for your suicide pills,’ ” he said. “That has already happened. My society has opened the door for that. It’s very disappointing.”

The society adopted the term “neutral engagement” to describe its new stance. The position, the group said, means it may act as a medical and scientific resource for lawmakers debating proposals about medical aid-in-dying.

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The policy also lets the society offer resources to physicians grappling with clinical, ethical, and legal questions about the practice.

Society members viewed a projection of proposed language changes.
Jessica Rinaldi/Globe Staff
Society members viewed a projection of proposed language changes.

Dr. Barbara Herbert, who supports medical aid-in-dying, said the society is deeply divided over medical aid-in-dying. While working in another state during the height of the AIDS crisis, she said, she provided prescriptions for lethal doses of medication to terminally ill patients.

“I think there are a number of people who believe that as physicians we can never do this,” said Herbert. “Many of my closest allies absolutely believe that this is murder and I think we can’t discount the power of that commitment or passion.”

Earlier this year, the society surveyed members about medical aid-in-dying.

The survey found that 60 percent of respondents favored letting doctors prescribe lethal doses of medications to patients with terminal illness who seek it.

On the question of what the society should do, respondents were more divided. Forty-one percent wanted the group to express support for medical aid-in-dying, 30 percent wanted to maintain the status quo, and 19 percent backed a neutral position.

Advocates of medical aid-in-dying say medical societies have a lot of clout in policy debates over allowing physicians, in limited circumstances, to provide lethal medications to dying patients who request it.

California and Colorado approved similar bills only after medical societies in those states dropped their opposition, according to Compassion and Choices, a Denver group that supports 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, including the American Medical Association, continue to disapprove of it. In 2012, Massachusetts voters narrowly defeated a “death with dignity” ballot referendum.

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.

Massachusetts Medical Society members lined up to speak about the resolution.
Jessica Rinaldi/Globe Staff
Massachusetts Medical Society members lined up to speak about the resolution.

Laura Crimaldi can be reached at laura.crimaldi@globe.com. Follow her on Twitter @lauracrimaldi.