PHYSICIAN-ASSISTED SUICIDE, PRO AND CONPHYSICIAN-ASSISTED SUICIDE, PRO AND CON
About Assisted Suicide
Secular humanist believers in assisted suicide/ euthanasia routinely dismiss opponents as religious zealots who are driven by a sectarian desire to impose Christianity on society. In this view, people like me care little about the right to personal autonomy and even less about human suffering. Rather, driven by religious fervor, we see ourselves on a “divine” mission to force the extension of each human life for as long as medically possible.
While this ridiculous stereotype might play well to those who see religious fundamentalists lurking under every rock, the most compelling arguments against assisted suicide are entirely secular. Moreover, many of the most effective opponents of the euthanasia agenda aren’t religionists at all. These include medical and hospice professional organizations, advocates for the poor, and most especially, the disability rights movement.
Why do so many secularists oppose assisted suicide? Books could be—and have been—written on the subject. But with space limited in this forum, I will focus briefly on just four: money, abuses, alternatives, and abandonment.
Follow the Money
It takes only about forty dollars for the drugs used in an assisted suicide. But it could take $40,000 (or more) to provide the medical care and mental health support necessary to alleviate an ill or disabled person’s suicidal desire. In a healthcare world dominated by health maintenance organizations (HMOs), where profits come from cutting costs, assisted suicide would ultimately be about money.
Don’t take my word for it. None other than Derek Humphry, founder of the Hemlock Society, argued in his most recent book, Freedom to Die, that “economic reality” is the answer to the oft-asked question about legalizing euthanasia, “Why now?” He writes that assisted suicide could result in the saving of “hundreds of billions of dollars” that “could benefit those patients who not only can be cured but who want to live.”1
Taking that attitude even further, imagine how much more money could be saved—and thus profits made by HMOs—if euthanasia were made available (as many advocates want) to persons with disabilities, to the elderly who are “tired of life,” and to those with permanent cognitive incapacities. Permit the killing of these folk as a “medical treatment,” and Wall Street investors in HMOs would be dancing in the street!
And don’t forget the pressures involving inheritance, life insurance, payment for nursing home care, and the like. Since our values often follow our pocketbooks, a right to die could quickly morph into a duty to end your life for the benefit of society and/or your family.
Guidelines don’t Protect
Euthanasia proponents say that the answer to these and other concerns about abuses is for careful government regulation of assisted suicide. But experience in the Netherlands demonstrates clearly that “protective guidelines” don’t protect against abuse. They merely give the illusion of control.
The Netherlands has permitted euthanasia since 1973 under supposedly rigorous guidelines, including requirements for repeated patient requests and an absence of alternative ways to relieve suffering. These so-called protections are violated with impunity. Indeed, since 1973, Dutch doctors have gone from killing terminally ill people who ask for it, to killing chronically ill people who ask for it, to killing physically well but depressed people who ask for it. (This later category of permissible killing resulted from a Dutch Supreme Court ruling that approved a psychiatrist’s assisting the suicide of a healthy but grieving mother whose two children had died.)2 Moreover, people who have not asked for euthanasia are routinely mercy-killed. According a paper published in the British medical journal The Lancet, doctors kill 8 percent of all infants who die in the Netherlands.3 Repeated Dutch government studies have concluded that doctors there kill approximately one thousand patients each year who have not asked for euthanasia.4 So much for protective guidelines.
What about Oregon, which has legalized assisted suicide? Not much is known about the actual practice of assisted suicide since it is practiced in darkest secrecy. But of the few cases that have come to public attention, almost all included abuses. For example, as reported by The Oregonian, one woman received assisted suicide from her HMO despite being diagnosed by two mental health professionals as having dementia and being under family pressure to end her life.5
Effectively Alleviating Suffering
The assisted suicide debate so dominates news coverage that many people are not even aware of the tremendous breakthroughs that have been made in treating pain and other distressing symptoms of illness and injury. The truth is that no one need ever die in agony. People still do, of course, but that is not because we don’t know how to substantially alleviate suffering. It is because medical professionals just don’t do a good enough job of it, and patients and their families are insufficiently educated about what can be done to demand better care.
This is a national scandal that demands concerted efforts to educate doctors and patients about the tremendous potential for pain control and relief of depression. And it requires laws to remove the chill doctors report feeling from the Drug Enforcement Agency when they prescribe aggressively for pain. Along these lines, when Rhode Island passed a law outlawing assisted suicide while explicitly authorizing the aggressive use of drugs for the treatment of pain, the medical use of morphine shot through the roof.6
Compassion Or Abandonment?
People who support assisted suicide believe they are being compassionate. But are they really?
Imagine having a terminal illness and despairing about becoming a burden to your family, or of being forced to die in agony. You go to your doctors and suggest that perhaps the answer is assisted suicide. The doctor shrugs and says, “Well, it’s your choice.” Wouldn’t that confirm your worst fears about the value of your life, your future prospects for suffering, your concern that you are now a burden on your family?
Assisted suicide is not an answer to the problems it seeks to address; it is to surrender to them. If we wish to remain a truly compassionate society that cares deeply for our ill, disabled, elderly, and dying, we will reject the siren song of killing and focus intently on improving care and suicide prevention to help the suicidal ill and disabled overcome the desire to end their lives.
1. Derek Humphry and Mary Clement, Freedom to Die: People, Politics and the Right-to-Die-Movement (New York: St. Martin’s, 1998), pp. 333–34.
2. See for example, J. Remmelink et al., “Medical Decisions About the End of Life,” in Report of the Committee to Study the Medical Practice Concerning Euthanasia; The Study for the Committee on the Medical Practice Concerning Euthanasia (2 vols., The Hague, 1991). For discussions of subsequent Dutch investigations of euthanasia, see Kathleen Foley and Herbert Hendin (eds.), The Case Against Assisted Suicide: For the Right to End-of-Life Care (Baltimore: John Hopkins, 2002).
3. Agnes van der Heide et al. “Medical End-of-Life Decisions Made for Neonates and Infants in the Netherlands,” The Lancet 350 (July 26, 1997): 251–56.
4. Ibid.5. Erin Hoover Barnett, “Is Mom Capable of Choosing to
Die?” The Oregonian, October 17, 1999.
6. DEA published statistics of morphine use per capita.
Wesley J. Smith is a senior fellow at the Discovery Institute and an attorney and consultant to the International Task Force on Euthanasia and Assisted Suicide. His most recent book (co-authored with Eric M. Chevlen, M.D.) is Power Over Pain: How to Get the Pain Control You Need.