Updated

The California Medical Association on Wednesday dropped its three-decade opposition to physician-assisted suicide, possibly paving the way for already-introduced legislation that would make the practice legal for terminally ill patients in the state.

The CMA said its change to neutral on the issue marked the first by a state medical association. It comes amid renewed debate over doctor-assisted suicide following the death of brain cancer patient Brittany Maynard last fall.

The American Medical Association remains opposed to doctors participating in assisted suicide, saying in a policy statement on its website that doing so was fundamentally incompatible with a doctor's role as a healer, would be difficult to control and posed "serious societal risks."

After Maynard was diagnosed as terminally ill at 29, she moved from California to Oregon, where physician-assisted suicide is legal, and died there because California forbids the practice. The Oregon Medical Association has never opposed physician-assisted suicide.

Two California lawmakers in January introduced SB-128, the End of Life Option Act, to legalize assisted suicide in the most populous U.S. state. That legislation has since passed a key panel in the state senate.

California Medical Association spokeswoman Molly Weedn said a "shift in the conversation" on the issue by both the American public and doctors prompted a debate within the organization.

The neutral position the CMA took "allows physicians to determine between themselves and patients whether they want to participate in the End of Life Option Act" and also gave the group input into the legislation, she said

For example, Weedn said, it was key for the CMA that doctors not be required to participate in assisted suicide or refer patients to a colleague who does.

Critics of the California legislature's bill said they remained "steadfast in opposition" despite CMA's shift.

"Our coalition continues to oppose this deeply flawed legislation because of the dangers it poses to those living with disabilities or in vulnerable circumstances, particularly in a state as ethnically and economically diverse as California," said Catherine Campisi, former director of the California Department of Rehabilitation and supporter of Californians Against Assisted Suicide, in a statement.

"Assisted suicide is inherently dangerous to those who are expensive to care for or who lack access to proper medical care, and rather than open up that Pandora's box, we ought to be exploring how to expand hospice and palliative care to address the needs of those terminally ill," she said.