AAHPM Delegation Successful in Garnering Support
Wendy Chill
During its November 2024 Interim Meeting, the American Medical Association (AMA) House of Delegates (HOD) approved two reports that serve to recognize palliative care as an essential service and add language related to the provision of palliative care to the Medical Code of Ethics. These reports recognize the value of palliative care by the AMA and provide a starting point for additional advocacy in order to increase access to necessary services.
The AMA HOD is the legislative and policy-making body of the AMA. Medical specialty and state medical societies are represented at the HOD. Each society is allotted delegates who meet twice per year to establish policy on health, medical, professional, and governance matters as well as the principles within which the AMA’s business activities are conducted. During HOD meetings, a series of resolutions and reports are offered and considered, and every specialty and state medical society represented votes to approve, defeat, or amend these items.
AAHPM currently has delegates who attend these meetings each year. The current delegation is Chad Kollas, MD FAAHPM, Ruth Thomson, DO MBA FAAHPM, and Ana Leech, MD FAAHPM. There are also additional AAHPM members who attend the AMA HOD meetings, formally serving as delegates for other organizations, which increases the number of physicians in the HOD who advocate on behalf of hospice and palliative care. Those members include Kyle Edmonds, MD FAAHPM, Toluwalase Ajayi, MD FAAP FAAHPM, Holly Yang, MD FAAHPM, and Karl Steinberg, MD CMD.
New Palliative Care Policy at AMA
During the November 2024 Interim Meeting, there were two reports that specifically addressed palliative care. An AMA Board of Trustees report, “Expanding Palliative Care,” recognizes palliative care as a human right and provides for a comprehensive definition. This new AMA policy also states that palliative care is “the comprehensive management and coordination of care for pain and other distressing symptoms, including physical, psychological, intellectual, social, psychosocial, spiritual and the existential consequences of a serious illness, which improves the quality of life of patients and their families or caregivers and that generalist and subspecialist palliative care evaluation and treatments are patient-centered and family-oriented, emphasizing shared decision-making according to the needs, values, beliefs and cultures of the patient and their family or chosen family.”
A second report from the Council on Ethical and Judicial Affairs, “Expanding Access to Palliative Care,” amends the Code of Medical Ethics to include an opinion on palliative care and states that “physicians have clinical ethical responsibilities to address the pain and suffering occasioned by illness and injury and to respect their patients as whole persons.…These duties require physicians to assure the provision of effective palliative care whenever a patient is experiencing serious, chronic, complex or critical illness, regardless of prognosis.” This policy now also states that physicians should “advocate that palliative care be accessible for all patients, as necessary, for the management of symptoms and suffering occasioned by any serious illness or condition, at any stage, and at any age throughout the course of illness.”
“Passage of these policies by the AMA is a great step forward in the field of palliative care,” Dr. Kollas explained. “It is rare that additions to the Code of Medical Ethics pass on the initial try, so this emphatically affirms the HOD’s respect and support for our specialty.”
The AAHPM delegation worked to make edits to the initial drafts of these reports so that they discussed the importance and appropriate use of palliative care by physicians. The delegation also had multiple conversations with other medical specialty and state societies in order to garner the necessary support for these reports to ensure passage.
These new AMA policies are an initial step in broader advocacy efforts to expand access to palliative care. The AMA, in conjunction with AAHPM, will work with state medical societies and other medical specialty societies to ensure that individuals in all areas of the country, including those historically underserved, will be able to access necessary services.
Wendy Chill is AAHPM’s director of health policy and government relations. For more information or questions about the Academy’s advocacy efforts, email [email protected].