Model Resolutions

RESOLUTION TO PROTECT PATIENTS AGAINST INVOLUNTARY DEHYDRATION AND STARVATION

WHEREAS: The Arizona Medical Association is opposed to euthanasia, including “physician-assisted suicide”; and

WHEREAS: The diagnosis of Persistent Vegetative State cannot be made with certainty,” being mistaken in up to 43% of cases, especially when functional neuroimaging has not been performed; and

WHEREAS: Patients in a “minimally conscious state” or with a “locked-in syndrome” may be aware of their surroundings yet unable to communicate this awareness; and

WHEREAS: Patients with severe brain injury, who may be diagnosed as being in a Persistent Vegetative State, are often not terminally ill; and

WHEREAS: Severely disabled patients may nonetheless desire to live, regardless of what their expressed premorbid wishes may have been; and

WHEREAS: Death from thirst or starvation can be extremely painful; and

WHEREAS: Disabled persons look upon their feeding tubes as “assistive devices” that permit them to be nourished without tremendous burdens on caregivers and without the distress of choking spells; and

WHEREAS: Withholding fluids and food from a person who is not terminally ill (i.e. almost certain to die in less than a week) is a method of deliberately causing death that would not otherwise occur, and

WHEREAS: it is unlawful to execute a person who is not mentally competent, even if guilty of committing a crime at a time when he was mentally competent; and

WHEREAS: even mentally disabled patients are persons who are entitled to protection against deliberate infliction of pain or death,

BE IT THEREFORE RESOLVED THAT: The Arizona Medical Association oppose as unethical the withdrawal of fluids and nutrition from a patient who is not terminally ill, unless the patient is mentally competent, capable of expressing in some way his current wishes, and affirms his rejection of food and fluids to the point of becoming unarousable; and

BE IT FURTHER RESOLVED THAT the Arizona Medical Association defines enteral feeding and hydrating of patients as humane care rather than as medical care, even if a nasogastric or gastrostomy tube is required; and

BE IT FURTHER RESOLVED THAT the Arizona Medical Association exhort physicians to refuse to participate in the dehydration or starvation of mentally incompetent persons, as well as the execution of any person, and

BE IT FURTHER RESOLVED THAT the Arizona Medical Association direct its delegation to present and advocate the adoption of a similar resolution by the American Medical Association.