Doctors for Dignity Blog
It was in September of 2019 when I first heard Marianne, a stage IV ovarian cancer survivor, testify before the Minnesota House Health Policy Committee about contemplating her death. She had seen other women from her cancer support group endure bowel obstructions, ascites and the unremitting pain that accompanied the final weeks of their lives and was asking lawmakers to authorize medical aid in dying so that she and others could have the option of a peaceful death. Cancer patients like Marianne can legally request and receive a medical aid-in-dying prescription in ten states and the District of Columbia. To qualify they must be an adult with a six-month prognosis and full decision-making capacity. Oregon was the first state to pass such legislation with its Death with Dignity Act, enacted in 1997.
As an Obstetrician-Gynecologist who fully supports medical aid in dying as an end-of-life option, I was pleased to learn that a recent survey of members of the Society of Gynecologic Oncology (SGO) showed strong support (69%) for medical aid in dying. National surveys indicate that a majority of physicians support medical aid in dying (58%) with OB-GYN support at a slightly higher level (64%).
An even more important finding from the study is that 57% of respondents reported having a patient ask about medical aid in dying and an even larger proportion (75%) indicated that an SGO position statement on medical aid in dying would be helpful. While SGO complies with ACOG’s Code of Medical Ethics, current directives regarding end-of-life decision making are outdated (referencing data from 1993) and skirt the issue.
As stated in the SGO principles of ethical conduct and practice, it is important for SGO to have a unified set of ethical principles to which all of our diverse members can agree to uphold, especially in the face of challenging situations involving end-of-life decisions. SGO can and should update its information on medical aid in dying and adopt a policy that respects a diversity of opinions while providing accurate, science-based information. The American Academy of Family Physicians, the American Academy of Hospice and Palliative Medicine and the American Academy of Neurology have all addressed the growing demand for medical aid in dying, clarifying that ethical physicians can disagree while providing guidance and support to members who participate in medical aid in dying as well as to those who do not. It is time for SGO to act.
Marianne is no longer a survivor, though she advocated for the freedom to make her own decisions right up until the very end. During her testimony, Marianne noted that September is Ovarian Cancer Awareness Month. What better way to honor the women we serve this September, then an official commitment from SGO to honor and respect their choices.