The Death Helpers Brigade

Nat Hentoff

To some readers of Free Inquiry, this atheist’s most controversial columns have examined the growing culture of death—for example, my questioning of who will decide when our quality of life is defined by doctors and hospitals as so irreversibly dismal that termination will be a kindness to us.

In this culture, doctor-assisted suicide has become the law in one state, Oregon. As of this writing, a similar proposal, having passed the California Assembly on May 28, may well be approved by the state’s senate.

Having years ago experienced cyclical clinical depression, I’ve been in that bottomless black hole. During that period, I devoted much of my time to trying to figure how to lay my hands on the quickest and surest way to commit suicide. Since you’re reading me now, obviously I didn’t succeed—thanks to the assistance of a doctor who was an expert in pharmaceutical ways of lifting me out of the black hole. It was a long process, and, had doctor-assisted suicide been legal in New York, I would not have had the patience to still be here.

I found it telling that in a 2007 report on the supervision of its law, the Oregon Department of Health disclosed that not one of the people involved in doctor-assisted suicide was examined by a doctor qualified to recognize clinical depression or any mental illness.

A further dimension of the mindset of the Oregon bureaucracy that administers compassion in dying is the experience of Barbara Wagner, who has lung cancer. When her oncologist prescribed a medication to slow the growth of her cancer, she was informed that she was not covered for that life-assistance because “Treatment of advanced cancer that is meant to prolong life, or change the course of the disease, is not a covered benefit of the Oregon Health Plan.” She would, of course, be covered if she chose doctor-assisted suicide.

Explaining this decision, Dr. Walter Shaffer, medical director of the state’s Division of Medical Assistance Programs, which administers the Oregon Health Plan, wrote: “We can’t cover everything for everyone. We try to come up with policies that provide the most good for the most people”—a form of utilitarianism that somehow bypasses Oregonians who prefer to slow the growth of their cancers.

Continuing his principled defense of not covering Wagner’s medication, Dr. Shaffer noted that the list of priorities the state brought to its rationing of health care reflected “some desire on the part of the framers of this list not to cover treatments that are futile—or where the potential benefit to the patient is minimal in relation to the expense of providing the care.” After all, how much is the life of someone with cancer worth?

It is clear then why doctor-assisted suicide is covered by the plan—once that treatment is implemented, there is no further cost to the state.

This compassionate concern for Oregon’s taxpayers is not limited to Wagner’s case. As reported by the Associated Press, “Healthcare practitioners have observed a sizable shift in policy in the way recurrent cancer is treated in the state. Increasingly, say local oncologists, sufferers of recurrent cancer are not receiving coverage for chemotherapy. They are always, however, eligible for state-funded assisted suicide.”

There is, however, a happy ending for Wagner. The company that manufactures the medication that will slow the growth of her cancer has told her it will provide the medication without cost.

If we ever have state-run and financed universal health-care in the United States, here’s a cautionary note on the vital need to avoid certain practices of England’s national health system. Wesley Smith, whose blog (wesleyjsmith.com/blog) monitors the international advance of the culture of death, reported a London Daily Mail story on June 28: “A cancer patient [in England] killed himself a day after being told he had been refused a wonder drug by his local primary care trust. Terminally-ill Albert Baxter, 75, committed suicide hours after learning he had been turned down for a drug which could have prolonged his life and shrunk his tumour.”

Mr. Baxter, all too aware of his diminishing quality of life, nonetheless tried to exercise his autonomy as a free citizen with free will: “The cancer sufferer offered to pay for the drug, only to be told he would have to foot the bill for his entire treatment which he could not afford. The pensioner, who was diagnosed with renal cancer in January 2007, had been told by his oncologist, Dr. Fiona McKinna, that the drug Sutent was his only hope. . . . His partner of 30 years, Barrie Curryer, a retired nurse . . . said: ‘What really upset him was that he worked all his life and paid into the health system and was refused treatment.’”

Well, Baxter was terminal, wasn’t he? What did he expect when his government—responsible for paying the costs of treating so many people who are not yet terminal—decided that Mr. Baxter was not worth the expense? It’s a democratically elected government, isn’t it?

A final word from the late Mr. Baxter’s partner. Curryer told the London Daily Mail: “He was told [the drug] would not cure him but would give him a better quality of life. . . . He said, ‘Nobody is doing anything for me, they’re just letting me die.’”

Meanwhile, in ultracompassionate Holland, which provides assisted suicide for the depressed, a story in the British Medical Journal reports that “a group of doctors and researchers has made its detailed advice on committing suicide available to the general public [through] The Foundation for Scientific Research into Careful Suicide.” Even where there is legal doctor-assisted suicide, a sufferer who can’t qualify for it from the state can obtain this book, presumably by ordering it from Holland, and learn to practice “autoeuthanasia.”

When I was in a clinical depression, I would have made sure to get that book. And you would have been spared this ungrateful dissenter to the brigade of death helpers who may soon succeed in passing a doctor-assisted suicide bill in California, maybe with more states to follow.

Nat Hentoff

Nat Hentoff is a United Media syndicated columnist, a senior fellow at the Cato Institute, and the author of, among other books Living the Bill of Rights (University of California Press, 1999) and The War on the Bill of Rights and the Gathering Resistance (Seven Stories Press, 2004). His latest book is At the Jazz Band Ball: Sixty Years on the Jazz Scene (University of California Press, 2010).


To some readers of Free Inquiry, this atheist’s most controversial columns have examined the growing culture of death—for example, my questioning of who will decide when our quality of life is defined by doctors and hospitals as so irreversibly dismal that termination will be a kindness to us. In this culture, doctor-assisted suicide has become …

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