I have had the pleasure of hearing from and speaking with a number of members about a resolution adopted at the AAFP’s recent Congress of Delegates meeting regarding “engaged neutrality” on the issue of medical aid in dying.
Understandably, this position change has created concerns among some members, and I have appreciated getting to know and corresponding with you on this issue. I’d like to share a few general thoughts on this matter.
For background, given that adoption of this resolution would create a change in AAFP policy, and that it would be contrary to the American Medical Association’s (AMA) Principles of Medical Ethics, AAFP Congress of Delegates rules require at least a two-thirds vote by the Congress. The amended resolution received more than a two-thirds majority vote approving the new position.
The AAFP policy of “engaged neutrality” does not mean passive approval; rather, it is intended to present that the organization believes that the well-intentioned discussions and decisions surrounding end-of-life care between an individual and their family physician is personal, and it should not be simplified to a yes-or-no decision made by those not involved in the clinical situation.
Seven states and the District of Columbia currently allow medical aid in dying; thus, the AMA policy (and prior AAFP policy) creates an ethical conflict with our members in those states who perform a legal act in conjunction with an informed, autonomous patient, regardless of the circumstances.
While the AAFP recently adopted this position, the entire House of Medicine, state legislatures, and the American people will ultimately decide the issue.
Thank you for all you do, and for your membership and involvement with the PAFP.
— David O'Gurek, MD, President
The Pennsylvania Academy of Family Physicians
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