Akram Khan, MD, FCCP, Associate Professor of Pulmonary, Allergy, and Critical Care Medicine at Oregon Health & Science University, talks about medical assistance in dying (MAiD) regarding late-stage neuromuscular disorders.
Recently, the American College of Chest Physicians (CHEST) released new clinical guidelines on respiratory management of patients with neuromuscular weakness. Many of these patients experience unbearable pain and diminished quality of life. Due to this, end-of-life care and physician-assisted suicide are subjects that may need to be addressed with patients by physicians.
MAiD is a sensitive subject in the medical community. Dr. Khan notes his personal opinion on the matter; patients ought to be able to make informed decisions about how they would prefer to pass away and as physicians, one should respect those wishes. However, legislation on MAiD is not currently unified in the United States, and in states where it is legalized, there are still caveats. For example, Dr. Khan mentions that a patient requesting MAiD in the state of Oregon must be able to take the lethal dose of opium orally without assistance from others. In many patients with neuromuscular diseases, this action cannot be performed during the late stages of the disease, and therefore, MAiD is not always an option. This is one reason why Dr. Khan strongly encourages shared decision-making between patients and physicians.
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