Doctors Condemn Massachusetts Suicide Bill

Bill would force every doctor to participate in prescribing lethal medication

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February 1, 2018

Doctors in Massachusetts are speaking out against a proposal to approve physician-assisted suicide, arguing that its End of Life Options Act could force all doctors to participate in doling out lethal medication and pressure patients into suicide.

On Tuesday, Dr. Tom Sullivan, former president of the Massachusetts Medical Society, led more than 20 physicians into the statehouse to urge lawmakers to oppose a bill that would grant immunity to doctors who help terminal patients kill themselves. Physician assisted suicide—or "Medical Aid in Dying" as supporters call it—violates "a sacred trust" between doctors and patients, according to Sullivan, a cardiologist for more than four decades. He said policymakers should focus on ensuring the comfort of terminal patients through access to hospice or palliative care, rather than suicide.

"I've been practicing 'medical aid in dying' for 40 years—you find it in hospices, compassionate care, and palliative care, not assisted suicide," he said. "What would a legislator know about taking care of dying patients? A great majority of doctors don't want any part of this."

Sullivan and his fellow physicians see their presence as more important than ever. Assisted suicide took center stage in the 2012 elections after supporters put the Death with Dignity Initiative on the ballot. Despite favorable polling numbers—a poll found 58 percent to 24 percent approval for the measure in August—and President Obama's 23-point victory over former governor Mitt Romney, voters rejected assisted suicide 51-49. Advocates have since set their sights on the legislature to pass the bill but have failed to clear committee each year. Opponents lost a key ally in December when the Massachusetts Medical Society (MMS) overturned its long-standing condemnation of the practice and voted to remain neutral on the legislation.

Sullivan and several other former MMS presidents spoke out against the neutral stance during debate. While they were unsuccessful in swaying the vote, they were able to insert language into the society's stance, including conscience protections for any doctor who objected to the practice. The current bill includes no such protections, which would force any doctor in the state to refer patients seeking assisted suicide to a willing physician. A Massachusetts Medical Society spokeswoman told the Washington Free Beacon that the current bill language will not alter the stance of the society. Some doctors are upset at their refusal to lobby for protections for members who do not agree with the practice.

"This is not giving the patient the right to die. It is giving the doctor the right to kill," primary care doctor Mark Rollo told the Washington Free Beacon. "We are mandated by this current bill to transfer a patient to someone else. I don't want to be complicit in killing a patient."

Dr. Laura Petrillo saw firsthand what the transition to assisted suicide means for the medical community. Petrillo began her career as a palliative care doctor in San Francisco just as California lawmakers took up the bill. She spoke out against the measure, but assisted in implementing it after Gov. Jerry Brown signed it into law to ensure that practitioners gave equal voice to alternatives, such as hospice and pain management through palliative care. She recently moved to Boston to take a faculty position at Massachusetts General Hospital.

"Despite working across the aisle with proponents to try to achieve the safest possible implementation in California, I still believe the safest thing is not legalized assisted suicide in any form," she said.

Assisted suicide generally enjoys broad support from the American public with 73 percent of Americans voicing support, according to a June Gallup Poll. Much of that support is superficial, as many people do not consider the realities of assisted suicide, according to Petrillo. Many patients who opt for lethal medication are not yet experiencing extreme pain, but instead fear deterioration in capabilities.

"Physician-hastened death is not limited to the extreme cases of suffering. In many cases patients are experiencing existential dread or fear of having a bad end of life outcome ... it is the fear of pain, rather than the pain they feel at the time [of the suicide]," she said. "A lot of the reasons patients give for physician-hastened death could be addressed by good quality hospice and palliative care."

Dr. Rollo, a former Air Force doctor who has practiced in Massachusetts since 1991, said he was compelled to visit lawmakers to remind them of continued opposition from the medical community. He saw the Massachusetts Medical Society's new stance as an abdication of the Hippocratic Oath, saying that it mirrored the California Medical Association's decision to remain neutral on assisted suicide in 2015, and the practice began in June 2016.

"I want them to realize that even though a select few [MMS] delegates voted for this there are lots and lots of physicians out there that are strongly opposed," Rollo told the Washington Free Beacon. "The legislature should not feel comfortable passing this because it's encouraging people to die and feel like they're a burden—their 'right to die' soon becomes a duty to die."

Doctors who oppose assisted suicide see it as a shortcut for policymakers. Sullivan said it will create perverse incentives for insurance companies and government health programs like Medicaid to skimp on paying for care to save money, threatening "the less fortunate in our society, the terminal, those with congenital illnesses for which there is no cure." Petrillo said it spares lawmakers from developing ways to ensure access to palliative care, pointing to recent advances in the United States as superior to those of countries with assisted suicide, such as the Netherlands and Belgium.

"People are dissatisfied with the status quo. Rather than thinking of developing the slow, difficult path of developing comprehensive palliative and hospice care systems—training people and opening up clinics, none of that is easy," Petrillo said. "A pill that can end someone's life is easy."

The bill has been referred to the state's Joint Committee on Public Health.