We sent the following email, part of a monthly series, to our Doctors for Dignity in October:

Momentum is building for medical societies across the country to withdraw their opposition to medical aid in dying.

Last month, at their annual meetings, the Colorado Medical Society (CMS) and the Maryland State Medical Society (MedChi) withdrew their opposition to medical aid in dying and adopted positions of neutrality. Doctors for Dignity commends our colleagues who helped lead the change.

CMS President-elect Katie Lozano, MD, FACR, made this statement regarding the CMS position and the upcoming ballot initiative Proposition 106, which would authorize medical aid in dying in Colorado.

The board of directors of the Colorado Medical Society, out of respect for the strongly held divergent, principled views of our colleagues regarding end-of-life assistance as proposed in Proposition 106, voted to take a neutral public stance. Our position was derived from extensive deliberation and consultation with the state’s leading clinical experts on palliative care, our appointed Council on Ethical and Judicial Affairs and a statewide survey of our members. Ultimately, Proposition 106 represents the most personal of decisions that must be left to our patients to determine in November. Should this measure pass we will continue to do our utmost to assure the highest standards and safeguards for our patients. If you would like to work with your state, local, or specialty society to develop a position of neutrality toward medical aid in dying, contact us for assistance at [email protected].

This month, Compassion & Choices Medical Director David Grube, M.D. answers the following:

Q: How is self-administration defined and practiced under the Oregon Death with Dignity Act?

A: In all authorized states, medical aid in dying requires that the dying individual be mentally capable, volitional, and self-administer the medication that has been prescribed by the Attending Physician.

The medication is ingested, which simply means it is introduced into the gastrointestinal tract. In most instances this means swallowing, but some individuals have a feeding tube (j-peg, etc.) and the medication can be introduced into the body through it. Preparation of the medication (opening capsules, mixing solutions, filling a reservoir or feeding tube) can be done by a family member, loved one, or nurse; however, volitional ingestion means that it is the dying person who must instigate the action (push a plunger, open a valve or clip, etc.) of ingestion.

Some individuals (e.g. those with ALS) do not have use of their arms so volitional ingestion for them might mean sucking on a straw that is in the liquid medication. In this instance an assistant may hold the medication. Active vomiting is a contraindication to oral ingestion.

Compassion & Choices has created a series of educational videos for physicians about medical aid in dying. Choose the topic that interests you and watch the video on YouTube:

Thanks for all you do,

Rebecca Thoman, M.D.
Campaign Manager, Doctors for Dignity

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