The
Massachusetts Medical Society appreciates the opportunity to provide testimony
relative to House bill 1926 and Senate bill 1208, An Act relative to end of
life options. Specifically, the MMS wishes to provide information relative to its
new position of “neutral engagement” on the issue of medical aid in
dying/physician assisted suicide (MAID/PAS).
The
Medical Society adopted this policy last year as part of a broader position
statement on end-of-life care. The policy states:
“The MMS
defines medical aid-in-dying as the act of
providing care — palliative, hospice, compassionate — to patients at the end of
life. The act of a physician writing a prescription for a lethal dose of
medication to be used by an adult with a terminal illness at such time as the
patient sees fit will, if legalized, be recognized as an additional option in
the care of the terminally ill. (HP)
The MMS adopts the position of neutral engagement, serving as a medical and
scientific resource to inform legislative efforts that will support patient and
physician shared decision making regarding medical aid-in-dying, provided that physicians
shall not be required to provide medical aid-in-dying that involves prescribing
lethal doses of medication if it violates personally held ethical principles. (HP)
The MMS asserts that medical aid-in-dying that involves prescribing lethal doses of
medication should be practiced only by a duly licensed physician in conformance
with standards of good medical practice and statutory authority. (HP)
The MMS will support its members regarding
clinical, ethical, and legal considerations of medical aid-in-dying, through education, advocacy, and/or the provision
of other resources, whether or not members choose to practice it. (HP)
The MMS supports
effective palliative care, especially at the end of life. (HP)”
In
light of this new policy, the Medical Society wishes to make a few points
regarding House bill 1926 and Senate bill 1208. While the recent vote of the
MMS policy-making body changed a longstanding position opposing MAID/PAS, it
did not establish an inverse position of support for legislative efforts. Instead,
in passing this neutral engagement policy MMS is promising to play an
educational role to ensure that legislative efforts do not inadvertently put
our patients at unintended risk of any sort. We have closely followed the
enabling legislation in the states that have legalized MAID/PAS and appreciate
that the prevailing patient protections from other states have been included in
the current MA legislative proposals.
In
addition, the new MMS policy, as included above, underscores the importance of
voluntary physician participation. We therefore appreciate the thoughtful
provisions in Section 15 of these bills which offer the ability of physicians
to conscientiously object to participate in this practice, and to provide broad
legal protections for those who make this decision.
In
the absence of a position for or against this bill, we wish to reiterate our
commitment to actively listening to the continued discourse on this topic; to
pledging to serve as a medical and scientific resource as appropriate within
this new neutral position; and to assuring the public that the Massachusetts
Medical Society stands ready to help support its members regarding clinical,
ethical, and legal considerations of medical aid-in-dying, whether a physician chooses to participate in any authority
provided under these two bills if they are to pass.
And
most importantly, we continue to underscore the need for effective palliative
care, especially at the end of life. We hope that, regardless of the fate of
this bill, the impassioned stakeholders from both sides of the debate can all
agree on the importance a broad-based, systematic commitment to improve access
to hospice and palliative care for all persons in the Commonwealth.
