The California Medical Association should stand down when it comes to end of life options.

The Supreme Court of Canada recently ruled unanimously that doctors may provide aid-in-dying to patients with “grievous and irremediable” medical conditions. This landmark decision comes on the heels of the introduction by state Sen. Bill Monning, D-Carmel, of the End of Life Option Act that would give a similar right to terminally ill Californians.

Clearly momentum is building for a more humane approach to life’s final chapter, but we still have a long way to go. American medicine is famous for its ability to prolong dying through technological triumph. Patients too often die in the hospital on torturous respirators and feeding tubes – at huge cost. Over $500 billion, or 28 percent, of Medicare expenditures are spent on care during the last six months of life. More important is the avoidable suffering endured by patients and families.

The California Medical Association (CMA) has historically opposed aid-in-dying legislation, on the basis that it runs counter to physicians’ oath to heal. However, multiple surveys – the latest out of Stanford – show that doctors choose a different course when they know they cannot be healed. They make it clear through advanced directives that they don’t want heroic measures. To them, a graceful death is being comfortable and in control. They abjure the awful effects of pointless chemotherapy or being tethered to tubes. They know the choices, they can access whatever care they want, and they mostly opt to go peacefully, without the high-intensity care that they give their own terminal patients.

Furthermore, they have the drugs, and if necessary, they can use them.

The CMA opposed the End of Life Care Notification Bill recently signed into law by Gov. Jerry Brown requiring physicians to give terminally ill patients comprehensive information regarding their options at the time of diagnosis. They claimed that physicians should be able to decide whether such a discussion would emotionally upset patients and thus doctors should be able to convey the information at a time they deem appropriate.

It is difficult to fathom why fear of causing emotional upset trumps patients’ right to know every end-of-life care option, unless it is some misguided patriarchal notion of the patient-physician relationship that doctors would never accept for themselves.

Fortunately, there is evidence that physicians’ attitudes towards aid-in-dying are changing. A recent study found that, for the first time, most doctors favor it (54 percent, up from 46 percent in 2010). One hopes that CMA’s leadership, if not actively supportive of the End of Life Option Act, will at least take a neutral stance and allow its members to vote their conscience. Positive input from patients would help: In the U.S., 70 percent of those polled favor the aid-in-dying option when all viable treatment options are exhausted.

Doctors decide to leave this world when they can no longer be healed: one only hopes they will not stand in the way of our desire to do the same.

SUSAN MEISTER is a Pebble Beach resident and writer.