Monday, June 20, 2005
The AMA's House of Delegates will decide by Wednesday whether the doctors' group should approve new policy that would put the AMA on record in opposition to state and federal legislation that "presumes to know the patient's wishes" in cases like Schiavo.
Michael Williams, M.D., a neurologist at Johns Hopkins in Baltimore, who chairs the American Academy of Neurology's ethics committee, said here that several states have reacted by enacting or by considering legislation that presumes a desire for "artificial hydration and nutrition" in perpetuity in lieu of an advance directive or living will to the contrary.
Current AMA policy states that it "is not unethical to discontinue all means of life-sustaining medical treatment in accordance with a proper substituted judgment or best interests analysis" and further states that courts should "determine who is to make treatment decisions, including appointing a guardian, rather than making treatment decisions."
The AMA is also considering a proposal from the American Association of Public Health Physicians that would require health insurers, including Medicare and Medicaid, to obtain written advance directives from all new patients at time of enrollment in health plans.
Moreover, the Public Health Physicians are asking the AMA to amend the group's Principles of Medical Ethics to "explicitly recognize the rights of the patients and legally responsible family members when patients are unable to speak for themselves in determining the care provided."