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As the issue of euthanasia, particularly doctor-assisted suicide, has come to the forefront, the AMA has taken a strong position on this controversial subject. This time the AMA has taken a firm stand for life. They filed an amicus brief in the 9th Circuit case regarding doctor-assisted suicide. In this brief, the AMA stated, "There is, in short, compelling evidence of the need to ensure that all patients have access to quality palliative care, but not of any need for physician-assisted suicide ..." The AMA is keenly aware that doctors perform a crucial act of healing and saving life. Accepting a dual role of taking life, while at the same time protecting life, would undermine their credibility and the sacred trust that exists between a patient and doctor.
Thus the AMA has recently announced the implementation of the Institute for Ethics. The goal of this entity within the AMA will be to educate 10% of its member doctors (estimated to be 20,000) on hospice and palliative care. Further, they believe that providing responsible alternative treatment to ending life will all but eliminate the quest for euthanasia.
This aggressive new project will be headed by Linda Emanuel, Professor of Bioethics at Harvard. The two-year pilot program is funded by a 2-million-dollar grant from the Robert Wood Johnson Foundation. Ironically, this foundation is also well known for aggressive pro-abortion funding. However, in addition to assisting the Institute for Ethics, it has also funded other hospice and palliative care efforts.
Serving as a senior consultant on the project is Carlos F. Gomez, MD, PhD. Dr Gomez, a native of Havana, Cuba, is currently Assistant Professor of Medicine at the University of Virginia School of Medicine. His major role with the Institute will be as a spokesman and public speaker. He will also advise Professor Emanuel and others on its organization and future plans. This new position will require Dr Gomez to commute weekly to Chicago from Charlottesville, Virginia, forcing him to juggle existing responsibilities of teaching, treating patients and caring for his family.
"It sort of surprised me how strong a stand the AMA took on euthanasia. I don't believe they want to be recognized as executioners," said Dr Gomez. He feels that assisted suicide is particularly ill-timed with health care reform taking place and cost-cutting a major issue. "To throw this in at this time is absolutely insane," he said.
According to Gomez, ignorance and fear is driving the euthanasia debate. Their goal is to educate more doctors to alternatives to doctor-assisted suicide. This will be done by conducting regional meetings for doctors around the nation. During these meetings Dr Gomez and others will provide intensive training in pain control, compassionate care and alleviation of fears. It is their hope that the educated doctors will in turn enlighten their colleagues and communities regarding effective palliative care.
The AMA is aware of many of its physicians shortcomings regarding pain and palliative care. In its amicus brief the AMA stated, "The delivery of [adequate pain relief] is 'grossly inadequate' today, and efforts to make such care universally available have not yet succeeded." Dr Gomez added, "We now have lots of documented evidence that an aggressive drug regimen can effectively protect dying patients from pain. Doctors won't have any trouble prescribing medication if they are careful and document their actions."
Regarding how their efforts will directly affect patients, Gomez said, "Anything we can do to educate doctors to the needs of patients is good. We will teach them to discuss pain control and alternative treatments with their patients. During the dying process, a doctor should be encouraging and bolstering his patients. We hope to have a very direct impact on patients' lives." Gomez speculated that the next five or six years will tell if they are successful.
The AMA has watched, with great interest, doctor-assisted suicide in The Netherlands expand to include euthanasia even without a patient's knowledge or consent. Doctors in The Netherlands often resort to euthanasia when it appears that their efforts to cure the patient have been unsuccessful. The AMA does not want to see a repeat of this situation in America. Holland has shown that once the doctor has accepted the fact that he can end life, no amount of rules or regulations will protect the public.
It was only natural that the AMA would recruit the participation of Dr Gomez. He received a four-year Robert Wood Johnson Generalist Scholars Award in 1994 to develop a palliative care curriculum and teaching service for medical students at the University of Virginia. He has authored a book, Regulating Death: Euthanasia and the Case of The Netherlands, and coauthored with Dr Steven Miles, Protocols for the Use of Life-Sustaining Treatments. In addition he has extensive bedside experience treating dying patients.
Gomez and others feel that educating 20,000 doctors in two years is an "ambitious but doable" undertaking. They are convinced that when patients are offered a reasonable alternative, they will reject euthanasia. "The other side is preying on fear and anxiety," said Dr Gomez. "When you attack that fear directly, you take the steam out of the other side's arguments."
The program is expected to be up and running in six to eight months. It will take that amount of time to train the needed speakers and get things organized. It is too early to tell if the Institute will be involved in sponsoring and promoting anti-euthanasia legislation on the state or national level. However, the Institute for Ethics plans to set the tone for the AMA whenever it speaks on this issue -- a powerful and influential voice in America's medical communities.
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Posted 9 Sep 2000
Copyright 1997 by Life Issues Institute.
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