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AMA Backs Anti-Euthanasia Bill

The American Medical Association voted Wednesday to continue its crucial support for federal legislation intended to prevent doctors from prescribing lethal doses of drugs to terminally ill patients who want to die.

Some AMA delegates asked the nation's largest group of doctors to withdraw their support for the bill that adds regulations to pain medications but also blocks Oregon's 1994 voter-approved doctor-assisted suicide law.

The Pain Relief Promotion Act of 1999 passed the House of Representatives in October in part because it had the backing of the influential AMA, which represents some 300,000 doctors.

Physicians from Oregon and throughout the country asked the AMA to withdraw that support before the Senate votes. Most of the doctors oppose assisted suicide but see the bill as excessive government intrusion into health care.

"They are bringing the government into something that should be between a doctor and a patient," said Dr. Bernard Palmer, an AMA delegate and ear, nose and throat specialist from San Antonio.

The bill's supporters in the AMA say the concerns about government interference have been overblown by activists for doctor-assisted suicide.

"They've been borrowed by the euthanasia movement," said AMA delegate Dr. Rex Greene, a cancer specialist from Los Angeles.

"This is a substantial protection for physicians," Greene said after the vote. "This is a good law."

AMA delegates, however, agreed to work for some changes in the bill to address concerns that the law gives the federal government too much oversight in prescribing pain medications.

A provision in the bill specifies that the Drug Enforcement Administration shall revoke a doctor's license to prescribe controlled substances if the physician uses drugs to help a terminally ill patient commit suicide.

That would undermine Oregon's Death with Dignity Act that was approved by voters in 1994 and reaffirmed in 1997. No other state has adopted a similar measure.

AMA's nearly 500 delegates meeting in San Diego this week have already debated dozens of less controversial health policy issues.

Delegates voted to change the AMA's ethical guidelines to permit doctors to notify state motor vehicle agencies of patients with medical conditions that could make them unsafe drivers.

Public safety takes priority over the confidentiality of patients with conditions such as senile dementia or alcoholism that make them potentially dangerous to themselves and others, AMA officials said.

"We all know that some people are driving when they shouldn't be," said Dr. Herbert Rakatansky, chairman of the AMA's Council on Ethical and Judicial Affairs. "This says that it's desirable and ethical to report that information to the Department of Motor Vehicles."

The policy change did not have universal support among doctors.

Delegates argued it would cause sme people not to seek treatment rather than risk losing their driving privileges. Others said it would fundamentally change the doctor-patient relationship.

"This will change us from physicians to policemen," New Jersey physician Walter J. Kahn said.