As our society continues to grapple with how to provide people with the best medical care at the end of their lives Medical Aid in Dying (MAiD) is a topic that continues to be discussed. (see note)
MAiD is a medical practice in which a terminally-ill adult, with typically 6 months or less to live, of sound mind, may ask for, and receive, a prescription medication he or she may self-administer for a peaceful death if and when their suffering becomes unbearable. It is a multi-step process, that can be stopped at any point, over at least 15 days designed to insure the terminally ill patient is aware of all end of life options and is of sound mind. (1) It is not euthanasia or assisted suicide in which the physician is involved in actively administering the medication. It is part of a comprehensive end of life care plan which typically includes hospice. Patients give many reasons for requesting MAiD, including a desire to have an element of control over their impending death, preserve independence, and avoid unnecessary suffering.
MAiD is currently available to about 18% of Americans. For the last 20 years public support for MAiD in Gallup Polls has averaged 70%. Support among physicians is rising, with a December, 2018 Medscape ethics poll showing 58% support.
In October 2018 the AAFP Congress of Delegates changed its policy and adopted, by more than 2/3 vote, a position of “engaged neutrality” concerning MAiD. The AAFP position now supports and protects the ability of physicians and their patients to utilize MAiD where legal and applicable, but will not actively advocate for its adoption.
Introduction of a bill authorizing MAiD is anticipated in the next Wisconsin legislative session. In response to increasing attention regarding MAiD, the WAFP board feels it is time for our organization to consider its position. We will be providing educational materials on our website and soliciting your input. Meanwhile, we would be happy to get your feedback at firstname.lastname@example.org.
Robert Sander, MD
Note: In this month’s President’s column, President Steve Bartz has invited WAFP Board member Dr. Robert Sander to provide comments regarding changes in the AAFP position on Medical Aid in Dying.
(1) Orentlicher D, Pope TM, Rich BA. Clinical criteria for physician aid in dying. J Palliat Med. 2016;19(3):259-262.