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06 Oct 2015

By Dr Michael Gannon, Chair of the AMA Ethics and Medico-Legal Committee

As part of its five year position statement review cycle, the AMA’s policy on euthanasia and physician assisted suicide is now due for review. This will be coordinated by the Federal AMA’s Ethics and Medico-Legal Committee (EMLC).

The current policy is contained in the AMA’s Position Statement on the Role of the Medical Practitioner in End of Life Care 2007. Amended 2014, provided in full at the end of this article (it is also available on the AMA’s website at https://ama.com.au/position-statement/role-medical-practitioner-end-life...).

The current policy states that medical practitioners should not be involved in interventions that have as their primary intention the ending of a patient’s life. This position is qualified by clearly stating that the following actions (or inactions) do not constitute euthanasia or physician assisted suicide so long as they are undertaken in accordance with good medical practice:

  • not initiating life-prolonging measures;
  • not continuing life-prolonging measures;
  • not offering futile care;
  • the administration of treatment or other action intended to relieve symptoms which may have a secondary consequence of hastening death (commonly known as the doctrine of double effect).

At this early stage of the review, we invite AMA members to provide your views on the current policy via email to ethics@ama.com.au by COB Friday, 11 December 2015. This initial method of engagement allows members to express their views in an open-ended manner, without the limitations associated with directed survey questions.

This initial engagement is restricted to AMA members only. While all comments will be kept confidential, we ask that you include your name in the response so that we can verify that you are an AMA member.

Member comments will be considered in a de-identified way by the EMLC and Federal Council and will be used to inform the next stage of the review process. 

We will keep all members informed of the progress of the review and further opportunities for member engagement.

The Position Statement on the Role of the Medical Practitioner in End of Life Care 2007. Amended 2014 reads as follows:

1. The AMA believes that while medical practitioners have an ethical obligation to preserve life, death should be allowed to occur with dignity and comfort when death is inevitable and when treatment that might prolong life will not offer a reasonable hope of benefit or will impose an unacceptable burden on the patient.

2. Medical practitioners are not obliged to give, nor patients to accept, futile or burdensome treatments or those treatments that will not offer a reasonable hope of benefit or enhance quality of life.

3. All patients have a right to receive relief from pain and suffering, even where that may shorten their life.

4. While for most patients in the terminal stage of an illness, pain and other causes of suffering can be alleviated, there are some instances when satisfactory relief of suffering cannot be achieved.

5. The AMA recognises that there are divergent views regarding euthanasia and physician- assisted suicide. The AMA believes that medical practitioners should not be involved in interventions that have as their primary intention the ending of a person's life. This does not include the discontinuation of futile treatment.

6. Patient requests for euthanasia or physician-assisted suicide should be fully explored by the medical practitioner in order to determine the basis for such a request. Such requests may be associated with conditions such as a depressive or other mental disorder, dementia, reduced decision-making capacity, and/or poorly controlled clinical symptoms such as pain. Understanding  and  addressing  the  reasons  for  such  a  request  will  allow  the  medical practitioner to adjust the patient’s clinical management accordingly or seek specialist assistance.

7. If a medical practitioner acts in accordance with good medical practice, the following forms of management at the end of life do not constitute euthanasia or physician assisted suicide:

  • not initiating life-prolonging measures;
  • not continuing life-prolonging measures;
  • the administration of treatment or other action intended to relieve symptoms which may have a secondary consequence of hastening death.

8. Medical practitioners are advised to act within the law to help their patients achieve a dignified and comfortable death.

 

 

 

 


Published: 06 Oct 2015