AMA Refuses to Back a Ban on Drug Ads

The American Medical Association on Tuesday adopted a policy opposing any legislation that presumes patients would want life-sustaining treatment unless they have clearly stated otherwise.

The policy came in response to the Terri Schiavo case. Many attending the annual meeting of the nation's largest physicians group said Schiavo's fate should have remained a matter decided by her family and her doctors.

The Florida woman died in March after her feeding tube was disconnected following a long, highly publicized court battle between her husband and parents over whether she would have wanted to be kept alive.

Several states are considering or have passed laws that presume patients would want life-sustaining treatment, said Dr. Michael Williams, a Johns Hopkins Hospital neurologist who helped sponsor the measure.

"While the (Schiavo) circumstances were heart-wrenching and compelling, they're so rare that they're not a good basis to revise existing law," Williams said. "I wish there had not been politics involved in it and I hope there won't be in the future should similar cases arise."

Tuesday's action also reaffirmed existing AMA policy that says it is ethical in some cases to discontinue life-sustaining treatment if it is in the patient's best interests.

Existing AMA policy did not help Schiavo and "did not help the courts and Congress keep their noses out" of doctor-patient issues, Dr. Arvind Goyal told AMA delegates Tuesday.

Schiavo collapsed in 1990 after a chemical imbalance caused her heart to stop. She left no written instructions in the event she became disabled, and her husband said she never would have wanted to be kept alive in what court-appointed doctors called a persistent vegetative state with no hope of recovery.

Her parents, however, doubted she had any such end-of-life wishes. They maintained she would benefit from rehabilitation, despite most doctors saying her condition was irreversible.

AMA Trustee Dr. John Armstrong said the case underscores the importance of patients making their end-of-life wishes known while they are still healthy, through living wills or advanced directives.

Also Tuesday, the AMA refused to back a ban on prescription drug ads, despite rising concerns about the dangers of certain heavily marketed painkillers and antidepressants.

Policy-making delegates at the AMA's annual meeting voted without debate to refer the measures for further study on the advice of a committee that said such a ban could run afoul of the First Amendment.

In related action, the AMA adopted a report declaring that these antidepressants have benefits and should remain available to youngsters who need them.

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