BOSTON — The Massachusetts Medical Society has dropped its longstanding opposition to physician-assisted suicide, which could give momentum to perennial legislation to legalize the controversial practice.
The society’s governing body last Saturday adopted a neutral stance on the practice, which it refers to as “medical aid in dying,” allowing the organization of about 25,000 physicians and medical students to “serve as a medical and scientific resource as part of legislative efforts.”
“We’re not recommending to the state what to do with this legislation, one way or the other,” said Dr. Henry Dorkin, the society’s president. “But this will allow us to testify and provide counsel to the Legislature as they discuss this issue in an even-handed manner.”
Dorkin said the society’s membership is split over the issue, though a majority of members support its new neutral policy.
“It’s an area of intense passion on both sides of the question,” he said. “This was quite evident in our deliberations on the issue.”
Supporters of a proposal to allow medically assisted suicide — filed by Rep. Louis Kafka, D-Stoughton, and Sen. Barbara L’Italien, D-Andover — said they believe the decision will give a boost to the legislation, despite years of failed efforts to win support for so-called “right-to-die” proposals.
“This is a real game-changer,” said Marie Manis, campaign manager for the Massachusetts chapter of the national advocacy group Compassion & Choices. “Our legislators have looked to the medical society to see what their stance is on this issue, and I think this will make a big difference.”
More than 45 lawmakers have signed onto the House and Senate proposals, which are stalled in a legislative committee.
“Neutrality gives the bill a new life,” said L’Italien. “There will still be pressure from faith communities and groups opposed to it, but I do think we will make some forward momentum on this now that the medical society has dropped its opposition.”
Option for patient, out for doctors
A U.S. Supreme Court ruling in 1997 left the issue of physician-assisted suicide largely up to states. Thirty-seven states have since banned the practice, either at the ballot box or by legislative act.
But, in recent years, so-called right-to-die measures have surfaced in at least a dozen states including Connecticut and Maryland.
Physician-assisted suicide is legal in the District of Columbia and six states — Vermont, Washington, Montana, Oregon, Colorado and California.
California’s Legislature legalized the practice in 2015 after local American Medical Association chapters dropped their decades-old opposition.
The new policy adopted by the Massachusetts Medical Society says physicians “should not be required to practice medical aid-in-dying that involves the prescribing of lethal doses of medication if it violates personally held ethical principles” and that medical aid-in-dying should be practiced only by “a licensed physician.”
Supporters say patients facing impending death should have the right to die on their own terms and avert needless pain and suffering. They’ve packed legislative hearings in recent years, offering emotional testimony.
“We’re talking about people who have a terminal illness, who are going to die,” L’Italien said. “It’s a question of managing their pain and allowing them some measure of control over how their life is going to end.”
At a recent hearing, Rep. Chris Walsh, a Framingham Democrat who is battling lymphoma, told fellow lawmakers he would want the option of ending his life if his illness became terminal.
Opponents to assisted suicide — who include medical and religious groups, as well as advocates for those with disabilities — say misdiagnoses are common. Terminally ill patients suffer from depression, they note, and may irrationally decide to end their lives.
Others argue that assisted suicide only truly benefits those who can afford it.
Supporters counter that the legislation, modeled after Oregon’s law, has numerous safeguards including a prohibition to keep doctors from prescribing lethal drugs to people with depression or impaired judgment.
The bill would require patients to make two verbal requests for a doctor’s intervention at least 15 days apart, as well as a written request signed by two witnesses.
A change in the conversation
The measure follows a failed ballot initiative in 2012 that would have allowed the terminally ill to end their lives with medication prescribed by physicians.
The referendum was narrowly defeated, with 48 percent voting against it, according to Secretary of State William Galvin’s office.
Right-to-die advocates say they were heavily outspent at the last minute by a coalition of religious leaders, anti-abortion activists and conservatives who poured more than $2.6 million into an aggressive campaign.
By comparison, advocates spent about $700,000 on TV ads.
Methods of physician-assisted suicide vary by state but typically involve a prescription. Doctors are required to notify patients of alternatives, such as hospice care, and wait at least 48 hours after receiving a written request from a patient.
A 2016 Gallup poll found that 69 percent of the country believes doctors should be allowed to end a patient’s life by painless means. At least 51 percent say they would consider ending their lives if faced with a terminal illness.
Rep. Lenny Mirra, a West Newbury Republican and longtime supporter of the measure, said he thinks the medical society’s decision changes the conversation on Beacon Hill.
He said the government shouldn’t be standing in the way of people’s personal medical decisions.
“The ballot question a few years ago was really close,” he said. “Hopefully this will be enough to tilt it the other way.”
Christian M. Wade covers the Massachusetts Statehouse for North of Boston Media Group’s newspapers and websites. Email him at email@example.com.