AMA addresses advance directives issues
The AMA’s House of Delegates will decide by Wednesday whether thedoctors’ group should approve new policy that would put the AMA onrecord in opposition to state and federal legislation that “presumes toknow the patient’s wishes” in cases like Schiavo.
Michael Williams, M.D., aneurologist at Johns Hopkins in Baltimore, who chairs the AmericanAcademy of Neurology’s ethics committee, said here that several stateshave reacted by enacting or by considering legislation that presumes adesire for “artificial hydration and nutrition” in perpetuity in lieuof an advance directive or living will to the contrary.
Current AMA policy statesthat it “is not unethical to discontinue all means of life-sustainingmedical treatment in accordance with a proper substituted judgment orbest interests analysis” and further states that courts should”determine who is to make treatment decisions, including appointing aguardian, rather than making treatment decisions.”
The AMA is also consideringa proposal from the American Association of Public Health Physiciansthat would require health insurers, including Medicare and Medicaid, toobtain written advance directives from all new patients at time ofenrollment in health plans.
Moreover, the Public HealthPhysicians are asking the AMA to amend the group’s Principles ofMedical Ethics to “explicitly recognize the rights of the patients andlegally responsible family members when patients are unable to speakfor themselves in determining the care provided.”