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Debate over physician- assisted suicide raises questions about how we die \\ By Livia Gershon S ince 1995, when the issue first came to it, the Massachusetts Medical Society (MMS) has opposed legally allowing terminal- ly ill patients to get a prescription to end their lives at a time of their choosing. It's taken that position each time the issue has come up in the state Legislature, and when it went to voters as a ballot question in 2012. This year, the group is bringing the question to its members again, surveying doctors across the state to see whether they want to change that position. This follows a lawsuit filed against the Massachusetts Attorney General by a Falmouth cancer patient, who is a physician, and his doctor, for legalized physician-assisted suicide. Attorney General Maura Healey has asked a judge to dismiss the case, saying it should be decided in the Legislature. "As we looked at it, we discovered it was incredi- bly complex," said Dr. James Gessner, president of the MMS. The group needs to make sure to reach a repre- sentative sample, including not just people who have strong feelings one way or the other, but the many physicians who are ambivalent about it. The survey will ask about terminology as well. Gessner said members need to think hard about verbiage: Some people worry that "physician-assist- ed suicide" evokes an image of patients with depres- sion or other mental health problems. Others don't like the phrase "medical aid in dying," because that could describe services doctors have always provid- ed to ease suffering in patients' final days. Gessner said the question is a tricky one for doc- tors, whose first promise is to do no harm, and who can rarely be sure of how long a patient has left to live or what their quality of life will be at the end. Yet focusing too much on the specifics of a pro- posed Massachusetts law—which has been intro- duced into the Legislature again this year—risks missing the big picture around end-of-life care, Gessner said. THE MEANING OF DIGNITY P H O T O S / N A T H A N F I S K E Michael Adams received hospice care at his home in Pepperell until his death from terminal cancer in March. Adams, pictured with his Rottweiler, Zeus, said hospice care kept him comfortable, but he believed medical aid in dying should be an option for the terminally ill. 20 HEALTH • Spring 2017