Doctors for Dignity: August 2016 Bulletin
Every month, Doctors for Dignity Campaign Manager Rebecca Thoman, M.D., sends a bulletin to all Doctors for Dignity. The following message was sent in August 2016:
Last month, the New York State Academy of Family Physicians (NYSAFP) Congress of Delegates voted to remain neutral on “state or federal legislation regarding aid in dying by means of patient-directed, patient-administered prescription medication.” They are now the second state affiliate (after California Academy of Family Physicians) to adopt a neutral position.
Doctors for Dignity commends our primary care colleagues in New York for respecting patient autonomy at the end of life.
If you would like to introduce a similar resolution to your state or specialty society, Doctors for Dignity can help. Email [email protected] for more information.
This month, Compassion & Choices Medical Director David Grube, M.D. answers the following:
Doesn’t the Hippocratic Oath preclude physicians from helping patients die?
Dr. Grube: The Hippocratic Oath is an ancient Greek document that is no longer used at any U.S. medical school graduation ceremony. It begins by asking for allegiance to Apollo and other mythical gods and goddesses. However, like the US Constitution, many of its important principles endure while the application of those ideals has evolved over time. The standards of 21st Century medical ethics can be found within it: Patient autonomy. Beneficence. Non-maleficence. Social justice. And most of all, duty to one’s patients and the patient’s desires and goals. As medical professionals, one of our greatest challenges is to respect our personal commitment to do no harm (professional integrity) in the face of the ambiguities resulting from advanced medical technology. While physicians can now prolong and extend life, thereby conflating the roles as healer and comforter, teacher and guide, shared medical decision making obliges the doctor to embrace full informed consent, especially in care at the end of life. Medical professionals can no longer simply fight disease at any cost, but must help patients weigh risks, benefits, and quality of life as they make their medical choices.
The Lown Institute’s Right Care Educator Program provides chief residents with training and support to implement Right Care Rounds in their home institutions. Right Care Rounds uses the familiar format of a case presentation, incorporating evidence-based discussions that explore the drivers of medical overuse and promote appropriate, patient-focused care. Goals for Right Care Rounds include teaching clinicians to: recognize and avoid overuse; consider both clinical and social needs of patients; and identify opportunities to improve the quality of care. Right Care Rounds may also address barriers to accessing care, how to care for patients without strong social networks, and failures in patient safety. Applications due August 15.
Thanks for all you do,
Rebecca Thoman, M.D.
Campaign Manager, Doctors for Dignity