Assisted suicide and euthanasia is a confusing subject. However, this subject will greatly affect future generations as we continue the slide down the slippery slope. Please carefully consider all factors before making a judgment. The following are a list of questions that many have asked on this subject and answers that address these provocative questions.
1. ISN’T A DECISION TO KILL ONESELF A PRIVATE CHOICE ABOUT WHICH SOCIETY HAS NO RIGHT TO BE CONCERNED?
This position assumes that suicide results from competent people making autonomous, rational decisions to die, and then claims that society has no business “interfering” with a freely chosen death decision that harms no one other than the suicidal individual. But according to experts who have studied suicide, this basic assumption is wrong.
A 1974 British study, which involved extensive interviews and examinations of medical records, found that 93% of those studied that committed suicide were mentally ill at the time. A similar St. Louis study, published in 1981, found a mental disorder in 94% of those who committed suicide for reasons other than a settled desire to die, and that they are predominately the victims of mental disorder.
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2. WHAT ABOUT THOSE WHO ARE TERMINALLY ILL?
Contrary to the assumptions of many in the public, a scientific study of people with terminal illness published in the
American Journal of Psychiatry found that fewer than one in four expressed a wish to die, and all of those who did had clinically diagnosable depression. As Richman points out, “effective psychotherapeutic treatment is possible with the terminally ill, and only irrational prejudices prevent the greater resort to such measures.” And suicidologist Dr. David C. Clark observes that depressive episodes in the seriously ill “are not less responsive to medication” than depression in others. Indeed, the suicide rate in persons with terminal illness is only between 2% and 4%. Compassionate counseling and assistance, such as that provided in many hospices, together with medical and psychological care, provide alternatives to assisted suicide among those who have terminal illness.
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3. STILL, SHOULDN’T IT BE THE PERSON’S OWN CHOICE?
Christopher Reeves, famous Hollywood actor who played Superman, admitted to being depressed after his horse riding accident. Because he was depressed, he thought of suicide. Yet, with encouragement and care those thoughts passed.
Almost all of those who attempt suicide do so as a subconscious cry for help, not after a carefully calculated judgment that death would be better than life. A suicide attempt powerfully calls attention to one’s plight. The humane response is to mobilize psychiatric and social service resources to address the problems that led the would-be suicide to such an extreme. Typically, this counseling and assistance is successful. One study of 886 people who were rescued from attempted suicides found that 5 years later less 4% had gone on to kill themselves. Paradoxically, the prospects for a happy life are often greater for those who attempt suicide, but are stopped and helped, than for those with similar problems who never attempt suicide. In the words of academic psychiatrist Dr. Erwin Stengel, “The suicidal attempt is a highly effective though hazardous way of influencing others, and its effects are as a rule…lasting.”
In short, suicidal people should be helped with solving their problems, not helped to die.
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4. WHAT ABOUT THOSE IN UNCONTROLLABLE PAIN?
They are not getting adequate medical care and should be provided up-to-date means of pain control, not killed. Even Dr. Pieter Admiral, leader of the successful movement to legalize direct killing in the Netherlands, has publicly observed that pain is never an adequate justification for euthanasia in light of current medical techniques that can manage pain in virtually all circumstances.
Why then, do so many personal stories of people in hospitals and nursing homes have to cope with unbearable pain? Tragically, pain control techniques that have been perfected at the frontiers of medicine have not become universally known at the clinical level. What we need is better training in those techniques for health care personnel-not the legalization of physician-aided death.
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5. WHAT ABOUT THOSE WITH SEVERE DISABILITIES?
What would this thinking say about our attitude as a society? On the one hand, we tell those who have neither terminal illness nor a disability, “You say you want to be killed, but what you really need is counseling and assistance.” On the other hand, we tell those with disabilities, “We understand why you want to be killed, and we’ll let a doctor kill you”? It would certainly not mean that we were respecting the “choice” of a person with the disability. Instead, we would be discriminatorily denying suicide counseling on the basis of disability. We would be saying to the non-disabled person, “We care too much about you to let you throw you life away.” To the person with the disability we would be saying, “We agree that life with a disability is not worth living.”
Most people with disabilities will tell you that it is not so much their physical or mental impairment itself that makes their lives difficult, as it is the conduct of the non-disabled majority toward them. Denial of access, discrimination in employment, and an attitude of aversion or pity instead of respect are what make life intolerable. True respect for the rights of people with disabilities would dictate action to remove those obstacles, not “help” in committing suicide.
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6. IS THIS REALLY AN IMPORTANT ISSUE?
If you are healthy and relatively happy, you might not think so. However, the National Council on Disability definitely thinks it is. In their position paper, Assisted Suicide: A Disability Perspective, states, “The dangers of permitting physician-assisted suicide are immense. The pressures upon people with disabilities to choose to end their lives…are already prevalent…People with disabilities are among society’s most likely candidates for ending their lives, as society has frequently made it clear that it believes they would be better off dead…Persons with disabilities who are poor or members of racial minorities would likely be in the most jeopardy.”
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7. OPPONENTS OF LEGALIZING ASSISTING SUICIDE SAY IT WILL LEAD TO INVOLUNTARY EUTHANASIA. AREN’T THESE OVERBLOWN SCARE TACTICS?
Absolutely not. Those who desire to see assisted suicide and euthanasia legalized say there will be strict limitations to guard against abuse of this power to kill. Holland is often pointed to as being a good example of the humane use of euthanasia. The reality tells a different story. A report released by the Dutch government reveals that in 1990, 5,941 of the 11,800-recorded cases of active assisted killing were done without the patient’s consent. Safeguards do not work.
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8. IS EUTHANASIA NEW TO SOCIETY?
The following is from an article in the New York Times dated October 8, 1933. The German Ministry of Justice announced its intention to authorize physicians to end the sufferings of incurable patients.
The proposal stated that, “It shall be made possible for physicians to end the tortures of incurable patients, upon request, in the interest of true humanity…” This was on the eve of the rise of a cruel tyrant, Adolph Hitler, whose inhumane treatment of fellow human beings is legendary.
The real issue of euthanasia is the value of each human life. Traditionally our society has advocated love, compassion and medical intervention to help those who are old, infirm, disabled, or deeply depressed. We are now being conditioned to believe that it is compassionate for a medical doctor to kill a less than “perfect” human. But, when any group of people decide who lives and who dies, based on age, infirmity or mental capacity, the weak and “undesirable” become targets of the strong. Sound familiar?
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9. WHAT ABOUT “WILL TO LIVE” DOCUMENTS?
There is growing evidence that those who do not provide clear directions concerning the life-saving measures they would want are more likely to be denied them than to receive them. Many court cases have been decided in favor of removing all forms of life support. Therefore, it is important that those who do not want to be denied life-saving medical treatment, or even food and fluids, make their views known in some form of advance directive.
Two common advance directives are Living Wills and Durable Powers of Attorney. Living Wills focus on the rejection of life saving medical treatment under certain medical conditions. Durable Powers of Attorney authorize a specified person to make decisions concerning the provision or withholding of life-sustaining measures when the signer is incompetent. Though such laws appear to protect patients’ rights, they have some serious flaws from a pro-life point of view.
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Assisted Suicide: The Forgotten Pro-Life Battle
by Adam MacLeod | Washington, DC | LifeNews.com | 9/29/11 11:56 AM
As the proponents of assisted suicide strive to legalize it in Massachusetts, we should take another look at their arguments and the deceptions therein. The battle over assisted suicide and euthanasia is not over; advocates of assisted suicide are not resting. While earnest and engaged Americans are focused on the economy, an upcoming presidential primary, and impending Supreme Court battles over the health insurance mandate and same-sex marriage, the culture of death continues to advance largely unnoticed along a front that some had supposed was dormant.
Now, from the Bay State, comes news that advocates for assisted suicide have succeeded in bringing before Massachusetts voters a ballot initiative that would permit doctors to help their ill patients kill themselves. The initiative will appear next year. If it succeeds, Massachusetts would join Oregon and Washington in legalizing assisted suicide. Montana remains in limbo after the state high court called into question the enforceability of Montana’s prohibition against assisting suicide, but the legislature earlier this year declined to legalize the practice expressly.
People quite naturally recognize that life is better than death, that the deliberate destruction of life is an evil to be avoided, and that the state has a role to play in preventing suicides. It follows logically from these uncontested (and incontestable) observations that state laws prohibiting euthanasia and assisted suicide are just and efficacious. But, like magicians who use distractions to remove the important object from view, proponents of legalized death have shrouded the inviolability of human life in a mist of confusion. Exposing their ploys is the first step in defeating their efforts to advance the culture of death. Below are three arguments that are likely to be advanced for legalization in Massachusetts. All three are designed to distract and to deceive.
The Alleviation-of-Suffering Ploy
In public, proponents of assisted suicide most commonly characterize assisted suicide as the only hope of relief for “suffering patients” who are afflicted with serious illnesses. This plea is of course designed to appeal to voters’ (rightful, natural) sense of compassion for those unfortunate souls in whose shoes none of us would choose to walk. None of us likes to contemplate what it would be like to be told by a doctor that one has just a few months to live, and that one’s most prominent experience during those final months will be unrelenting pain. And we cannot bring ourselves to judge our neighbor who is forced to face such grim prospects. Who are we to tell the terminally ill patient that she must not end her life a few weeks early, and that she may not avoid the suffering and indignity that attend such horrible illnesses?
Thus, cleverly, assisted suicide proponents use voters’ natural aversion to death and suffering to build support for legalized death. To be against suffering is to be against laws that unnecessarily prolong a life of suffering, the argument runs. To celebrate life is to celebrate what is good and enjoyable in life, not to burden the terminally ill with a dark and unendurable coda.
This is an effective ploy, but it rests upon a bold deception. Assisted suicide is neither necessary, nor actually used, for the alleviation of pain. Indeed, the data show a wide gulf between the public justifications for assisted suicide and its actual use in practice. Oregon was the first state to legalize assisted suicide, implementing its program in 1997. The state’s annual reports consistently reveal that, of those who seek and obtain assistance in suicide, only a small fraction cite “inadequate pain control or concern about it” as a reason for their choice. Indeed, hauntingly, more patients are worried about being a “burden on family, friends/caregivers” than are concerned about pain.
Even these data do not tell the whole story; Oregon lumps those who are in pain with those who are merely concerned that they might be in pain at a future date. But few terminally ill patients need to resort to suicide in order to alleviate actual pain. Tragically, legalization in Oregon appears to have decreased patient access to palliative care. Of the initial 142 cases of assisted suicide in Oregon, only 13% were referred for palliative care consultations, and studies reveal that the quality of palliative care in Oregon has declined since assisted suicide became legal.
A much more common motivation than pain management appears to be simple clinical depression. In 2006, the Royal College of Physicians released a statement revealing that patients who want to die will change their minds–will choose life–after they are treated for depression in 98% to 99% of cases. Two researchers writing in the Michigan Law Review also concluded that when patients are treated by physicians who listen to them, treat their depression, and manage their pain, “their wish to die usually disappears.” In light of these facts, it is striking that only one of the sixty-five assisted suicide patients in Oregon in 2010 was referred for psychiatric evaluation. In 2009, none was referred.
The Unnecessary Prolongation Ploy
A second favorite ploy, related to the first, is to conflate prohibitions against assisted suicide with extreme measures to keep people alive. Though legalization proponents trade on fears of being artificially sustained after one’s time has come, prohibiting assisted suicide is not the same as forcing people to live beyond their time. To affirm that life is always worth defending from attempts to destroy it is not to claim that one should always make efforts to lengthen life.
Nor does respect for human life entail that the terminally ill must bear up stoically under extreme pain. Showing respect for all persons regardless of their condition or circumstances means providing needed medical care, including palliative care, when the terminally ill are in their final weeks and hours. That some forms of palliative care hasten impending death is not a reason to condemn its administration. The purpose of administering palliative care is not to kill but to relieve pain. The physician who administers palliative care is no more culpable than the physician who attempts to save a life by performing a risky surgery.
Medical practice involves risk and, sometimes, death. The line that we must ask a physician not to cross is the line at which he adopts the patient’s death as his purpose. That action is inherently different from performing a risky medical procedure; it makes the physician a different kind of person, one who is unfit to practice medicine and who harms himself as well as others.
The Personal Autonomy Ploy
The most common motivation for assisted suicide patients is a desire for personal autonomy, to control the time and manner of one’s own death. In Oregon, this is the most commonly cited concern of assisted suicide patients, and many scholarly advocates of assisted suicide admit that this is the real justification for legalization. The desire for control is understandable, but suicide is a means of control that causes real harm not just to the person who destroys his own life but also to all those with wh
om he is in community.
Proponents of legalization invoke a radical conception of personal autonomy. The idea is that each individual person makes the value of her own life by choice. When an individual ceases to value her own life, when she no longer prizes those treasures that life enables her to enjoy, she ought to be free to end her life.
People do not make their lives valuable merely by choosing to live. If this were the case, then the lives of small children and senile adults would have no value and would be unworthy of protection in law. As a matter of fact, myriad laws protect human life at various stages of human development, even in states–Oregon and Washington–that permit assisted suicide for the terminally ill. These laws do not discriminate against the very young or the very old, or against those who ascribe the least value to their own lives. States invest resources in suicide prevention and privilege citizens to prevent suicidal acts, by force if necessary. None of these laws provides for weighing the instrumental value of the life being saved.
So even in states that permit assisted suicide, the law reflects our understanding that life has value, regardless of the conditions in which it is lived. Laws preventing suicide preserve the communities of which the suicidal person is a part. The personal autonomy ploy rests upon the deception that suicide affects only the one who commits it, and that this individual alone should have a say in the matter. But suicides are not purely autonomous acts. Just as the family and neighbors of each person recognize the intrinsic value of that person, the family and friends of a suicide realize the irremediable loss that suicide causes.
Suicide should not be inflicted upon anyone. To assist its commission is to do violence to the very fabric of civil society. For the sake of doctors, their sick patients, and the communities in which doctors and patients live, Massachusetts and Montana should strengthen their legal commitments to protect the sick and suffering.
LifeNews.com Note: Adam MacLeod is an Associate Professor at Faulkner University’s Thomas Goode Jones School of Law. This was originally printed at Public Discourse and is reprinted with permission.