The national dialogue over physician-assisted suicide heated up in the Maryland General Assembly this year with a proposed bill, and Maryland Carey Law’s Diane Hoffmann, JD, MS, (pictured above) followed the issue closely. Hoffmann, the Jacob A. France Professor of Health Law and director of the Law & Health Care Program, took the opportunity to share her expertise with the next generation of physicians through various lectures, including as part of the University of Maryland School of Medicine’s student-organized Humanism Symposium.
The Symposium, started in 2013 by two School of Medicine students, is an elective course that offers medical students and University of Maryland Baltimore faculty the opportunity to examine the full range of what it means to be a humanistic physician. Now in its fourth year, the course is supported by two medical school faculty members and led by four dedicated junior and senior students. The Symposium meets roughly once per week from November through April and addresses topics across specialties, from medical ethics, to cultural differences and spirituality, to the importance of mentorship.
Hoffmann has presented at the Symposium about physician-assisted suicide for the past three years. During that time the number of states that have passed laws legalizing physician assisted suicide has expanded. Six states (Oregon, Washington, Vermont, Montana, Colorado and California) and the District of Columbia now have passed such laws. The case of Brittany Maynard, a 29-year-old woman with an untreatable brain tumor, seemed to catapult the issue to national attention. Maynard moved to Oregon in 2014 to take advantage of the state’s assisted suicide law. Maryland has joined these states and several others in considering passing physician-assisted suicide bills.
After the presentation to the Humanism class, Kaylie Miller – a medical student in the Humanism class and in a multidisciplinary course that Hoffmann teaches at Maryland Carey Law called Critical Issues in Health Care – asked Hoffmann to facilitate an additional discussion about the proposed legislation. At Miller’s request, Hoffmann spoke on the topic at a forum sponsored by Citizen Physicians, the Medical Ethics interest group, and the Catholic Students Association. And following that forum, at the invitation of another medical student (now a fourth-year student) who took Hoffmann’s Critical Issues class three years ago, Hoffmann gave a lecture on the issue. This one was part of the History of Medicine lecture series for the AOA Honor Medical Society.
For each talk, Hoffmann described the Maryland legislation and engaged the students in a discussion about it. Students were able to asked about the pros and cons of legalization of physician-assisted suicide and whether they thought the proposed legislation over- or under-regulated the practice. To put things in context for the students, Hoffmann also described the case of Dr. Lawrence Egbert. Egbert served as the medical director of an assisted suicide organization called Final Exit. He lost his license to practice medicine in Maryland in December 2014 when he assisted six patients in the state in ending their lives. Not one of the six patients was terminally ill, and the method of death was by helium asphyxiation – patients placed their head in a plastic bag to which a hose carrying helium gas is attached. Such a practice would not be permitted under the proposed legislation.
Hoffmann used the forums as an opportunity to ask students how they would respond to a patient who asked for their assistance in ending their life. She told them although the legislation did not pass this year it might pass during their time in practice and they may be confronted with such a request. The talks offered students some time to reflect about their own views on the topic and Hoffmann hopes it gave them a framework to think more deeply about the issue.
This year’s legislation that would allow terminally ill Marylanders to end their lives was withdrawn by its chief supporter Senator Ronald Young, a Frederick County Democrat, amid stiff opposition, signaling that the effort had failed for a third time. Senator Young realized that the bill did not have enough support to clear the Senate Judicial Proceedings Committee.