Doctors lack sufficient training in the treatment of patients who are dying, according to a report accepted by the Washington State Medical Association.

The 43-page report, drafted by the End of Life Task Force and approved Saturday without dissent, said the most critical shortcomings are in communication and easing pain.

The document said many doctors “fail to communicate clearly with dying patients, undertreat their pain and ignore or override their end-of-life decisions - just the opposite of what patients and their families want.”

The report proposes that third- and fourth-year medical students spend time in hospice programs that would enable them to follow patients through death, including the mourning of friends and family.

More use should be made of hospices, programs where dying people may receive help from social workers, counselors and spiritual advisers, as well as doctors and nurses, the report said.

“We need to build an understanding of what is available in end-of-life care,” association president Dr. Nancy Purcell said.

Sidestepping a highly divisive issue within the medical community, the report took no position on whether doctors should help terminally ill patients end their lives.

The report did say that if assisted suicide is allowed, doctors need clarification of which patients may request death, how physicians should respond and what provisions should be made for those who refuse on grounds of religious belief or conscience.

“If physician-assisted suicide becomes legal, we feel it’s essential that the public have adequate protection,” Purcell said.

The association is on record as opposed to the procedure.