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01.20.2017

Neurology Today picks ethics paper among 2016 best

An article on Lou Gehrig’s disease patients asking for physician aid in dying has been chosen by the editorial advisory board of  Neurology Today as the leading neuroethics and professionalism paper for 2016.  

Dr. Leo H. Wang, an assistant professor of neurology at the UW School of Medicine, is the first author of the paper. He cares for patients with neuromuscular disorders at UW Medicine. The senior author is Dr. Michael Weiss, UW professor of neurology and director of the neuromuscular disorders division in his department.

The paper, which appeared Oct. 21 in the journal Neurology, is titled, “Death with dignity in Washington patients with amyotrophic lateral sclerosis."  The disorder affects motor neurons and can result in progressive muscle weakness, paralysis and breathing difficulties.

Since 2009, the paper reported, 39 Washington state patients whose illness was terminal have asked for a prescription for lethal medications and 30 of them (77 percent) have used the medications to end their lives.  Their chief reasons were loss of autonomy and dignity, and inability to enjoy activities. Their average age was 65. They passed away without any complications noted.  The authors wrote that the Washington state findings paralleled those of 92 Oregon patients who requested physician-assisted death.

Although the intent of the law is for patients to self-administer the drugs, it was not known, according to the authors, if any patients had help swallowing them from family or friends.  The state laws do not set precise boundaries on assistance.

As other states might join Oregon, Washington, Montana, Vermont, California and Colorado in legalizing physician-assisted death under certain circumstances, neurologist are  increasingly likely to encounter patients with neurodegenerative disorders making this request, the authors wrote. Currently, all states with such legalization allow physicians to decline.  

The authors said that neurologists practicing in jurisdictions where physician-assisted death is legal should understand the stipulations of the law regarding  physicians’ rights and responsibilities.  They suggest that neurologists be prepared for how they would respond. 

Their article was one of 12 papers honored.  Each was in a different aspect of neurology practice or research. 

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