The majority of physicians now support medical aid-in-dying for the terminally ill, but their patients are still far more likely to approve of the practice.
Despite ethical concerns, a new survey from Medscape of 5,200 physicians surveyed across 29 specialties found 58% agree that physician-assisted suicide or physician-assisted dying should be legalized for terminally ill patients. (Proponents now prefer to use the term medical aid-in-dying rather than suicide.) That’s up 12 percentage points from 2010 when 46% of doctors said it should be legal for doctors to prescribe drugs to help terminally-ill patients end their lives.
However, it’s still a lot lower than the 72% of the general public who support medical aid-in-dying, according to a 2018 Gallup poll. That number dropped to 65% when the question asked was whether doctors should help patients “commit suicide.”
Support among doctors for physician-assisted dying has increased steadily in the past few years in the Medscape poll that looks at ethical issues faced by physicians. But the issue continues to divide those in the profession. Physicians in the survey said they opposed the idea citing ‘do no harm’ and a belief that doctors ‘can be wrong.’
“This option seems to have been successful and appropriately used in the few states where it is legal. It is also humane,” said an obstetrician/gynecologist in the survey.
“Too often doctors are wrong. It is wrong to take a life. The physician’s oath is to do no harm,” said a pediatrician.
At the American Medical Association’s annual meeting in June, members argued for and against the controversial issue, with the country’s largest physician organization voting to continue to review its stance on the topic. But a recommendation that the AMA continue its opposition to medical aid-in-dying was voted down.
It’s no surprise that more physicians approve of medical aid-in-dying, Kim Callinan, CEO of Compassion & Choices, an advocacy group, said in an email to Fierce Healthcare.
“Physician support for medical aid-in-dying is growing and will continue to grow as more states authorize this end-of-life care option, because more patients are demanding it, and more national and state medical societies are dropping their opposition to it and adopting positions of support or engaged neutrality,” she said.
The laws themselves have protections for patients, which can help overcome doctors’ ethical misgivings, she said. For instance, two doctors must confirm the person requesting medical aid-in-dying has an incurable, terminal illness, which she says, minimizes the chance of a misdiagnosis.
“We are in constant contact with physicians across the country through our doc2doc consultation and doctors for dignity outreach programs, so we know they increasingly understand that doing ‘no harm’ means supporting their patients' values and priorities, including honoring their desire for a peaceful and compassionate death,” Callinan said.
The Medscape survey also asked doctors whether aid-in-dying should be legal for patients with irremediable suffering even if the disease isn’t imminently terminal. In that case, only 27% of respondents said yes, 45% said no and 28% said it depends.
The survey also touched on other ethical issues for physicians and found the following:
- Nearly half of all doctors (45%) say they would perform an abortion, even if it conflicted with their own beliefs—an increase from 34% in 2010.
- One in four doctors said they would not treat a family that refused to get the recommended vaccines for themselves or their children.
- 43% of physicians think it's unethical to discuss their political beliefs with patients.
- 63% said they would not undertreat a non-terminally ill patient’s pain fearing they might get in trouble with the Drug Enforcement Administration, state laws or medical boards or that the patient might become addicted.