WE AFFIRM THAT:
1. Patients at the end of life should receive diligent and competent care to relieve their pain and suffering. The physician has the obligation to use all the means available to achieve this end.
2. If a patient refuses treatment or requests its withdrawal, his or her wishes must be respected.
3. Modern palliative care skills, drugs and technology permit adequate symptom control for all terminally ill patients. These methods should be universally accessible.
4. A physician who is caring for a dying patient, and who cannot adequately control the person’s symptoms, should have access to the necessary expertise and support to be able to do so.
5. When suffering remains uncontrolled by state-of-the-art palliative care, individually adjusted sedation to a point of comfort may be used. In this, as in all palliative care, the goal remains optimal quality of life.
6. To provoke death voluntarily, by lethal injection or any other method, cannot be considered under any circumstance as “medical care”, and is contrary to medical ethics. It is never necessary to kill a patient in order to end his or her suffering. The 2400-year-old Hippocratic tradition was a major advance in civilization. It forbids euthanasia and mandates the protection of the weak and the maintenance of trust between the physician and the patient. It calls on physicians and other health professionals to use their knowledge and skills to heal the sick, creating a climate of mutual solidarity. It is ironic that the accepted standards of this ancient code of conduct, written at a time when the means of countering end of life suffering were very limited, might be considered inadequate in this age of refined capacity to control symptoms.
7. We must learn from the negative experiences of countries that have legalized euthanasia. Decriminalization often causes more problems than it is claimed to solve; those documented in the medical and legal literature include:
- High rates of euthanasia without consent;
- The impossibility of ensuring adequate reporting and respect for safeguards;
- A loss of trust in the physician-patient relationship;
- Conflicts within medical teams and within patients’ families
8. Medical licensing bodies must continue to fulfil their role as protectors of the public and of life, and support physicians in their efforts to improve the quality and accessibility of care of the dying, thus allowing all patients to receive excellent symptom relief throughout their illness and at the time of death.