Willing Providers in Montana Are Safe to Practice Aid in Dying

April 3, 2009

In December, a Montana District judge ruled that mentally competent, terminally ill Montanans
have a fundamental right to a dignified death as protected by their state constitution. Yet four
months into this ruling, two terminally ill Montana residents who wish to access this
constitutional right cannot find a willing physician to help them. This is emotionally devastating
for them both, as they had hoped to access the comfort and peace of mind the law would bring.

Janet Murdock, 67, of Missoula, has terminal ovarian cancer. “I was so hopeful when the court recognized my right to die with dignity,” she said. “I feel as though my doctors do not feel able
to respect my decision to choose aid in dying. Access to physician aid in dying would restore my
hope for a peaceful, dignified death in keeping with my values and beliefs.”

Doctors need not leave patients like her out in the cold.
Montana Physicians are free to practice aid in dying without fear of prosecution. A physician prescribing life-ending medications to an eligible patient runs no risk of prosecution under Montana statutes.

“Physicians either have not heard about the decision or do not understand its implications for practice,” said Compassion & Choices Legal Director Kathryn Tucker, who argued the case with Montana litigator Mark Connell. “We must remedy this. Surely in this context ‘justice delayed is justice denied,’ as patients who are currently confronting end-stage terminal illness will not live to see the Montana Supreme Court rule.”

Professional Medical Groups Support Aid in Dying
Professional medical associations are increasingly adopting policies in support of aid in dying, reflecting a trend among major medical groups. In 2008, the APHA, the nation’s largest public health association, adopted policy supporting aid in dying. The policy supports “allowing a mentally competent, terminally ill adult to obtain a prescription for medication that the person could self-administer to control the time, place, and manner of his or her impending death …’”.

The American Medical Women’s Association adopted a position in March 2008 supporting the practice. According to the group’s position statement, “The American Medical Women’s Association supports patient autonomy and the right of terminally ill patients to hasten death.”

The American College of Legal Medicine adopted a policy in October 2008 supporting aid in dying. The group was the first professional organization to reject inappropriate use of the term ‘suicide’ when referring to a terminally ill patient who seeks aid in dying.

Polls Show Individual Physicians and the Public Support Aid in Dying
“Caring for dying patients includes the sacred duty to listen to their fears, communicate their options, and honor their choices for end-of-life care.”–Physicians for Compassionate Choices

The practice of aid in dying conforms to ethical principles.
“The Hippocratic Oath demands this foremost from physicians: Do No Harm. Prolonging the suffering of a dying person is doing harm. Offering a choice to end the suffering, if that is what the person desires, is the way to do no harm.”– Dr. Richard Ikeda, M.D., Director, Health for All Community Clinics, Sacramento

“In 2006 a national survey of 1,088 physicians (57 percent) revealed they believe it is ethical to assist an individual who has made a rational choice to die due to unbearable suffering.”
– Louis Finkelstein, Institute for Religious and Social Studies

A nationwide Gallup Poll released in May 2005 shows a solid majority of people from all backgrounds and beliefs agree that terminally ill patients should have the right to self-administer lethal medication to achieve a peaceful death. When asked if doctors should have the right to help a terminally ill person die, 75 percent of Americans said yes.

In October 2005 a national survey of physicians and the general public by HCD Research revealed the majority of both groups believe that physicians should have the legal right to dispense life-ending prescriptions to terminally ill patients who have made a rational decision to die due to unbearable suffering. Nearly two-thirds of physicians (62%) believe physicians should be permitted to dispense life-ending prescriptions.” – HCD Research End-of-life Care Should Focus on the Patient

The majority of physicians, who support legal aid in dying, are now able to practice medicine according to their own deeply held values and beliefs, without fear of government interference. The court has removed government restrictions on physicians who support aid in dying but have had to tell their patients “no” in the past.

Compassion & Choices is a resource for physicians.
Compassion & Choices is available to physicians for information about Montana’s newly recognized right, patient evaluation and medication protocols. Counselors and informative materials are available at no charge by calling 800-247-7421.

Compassion & Choices
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Patricia A. González-Portillo
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