A Matter of (Quality) Life or Death
The title of Nat Hentoff’s article “The Death Brigade” (FI, October/November 2008) is emotionally charged. I am a retired Oregon physician. The Oregon Death with Dignity Act has proven to be one of the best-crafted laws ever devised. None of the worries predicted by those against the law has come true. Hentoff brings up depression, but the law has nothing to do with depression! You don’t need a psychiatrist to determine that someone has less than six months to live. Only a small number of people avail themselves of the law. Many get the medicine but never take it. However, they have the comfort of knowing that they are in control, and if things get too bad they always have an escape.
Hentoff brought up the cost. The medicine used is an old medicine and probably costs less than $20. Many cancer drugs cost in the thousands. The cost of medical care is irrelevant to the issue. As a physician, I saw many terminally ill patients, some of whom asked to have their deaths expedited. Pain can be helped but not always completely. However, there is no treatment for the misery often associated with a terminal illness. Why anyone would want to force another week or two or month or two of misery on anyone when they want out is a mystery to me. We treat our pets better than that.
Hentoff uses the term “culture of death,” which reminds me of what the anti-abortionists say. Without a law like Oregon’s, people resort to firearms, carbon monoxide, or often ineffective self-medication. (Sounds like pre-legal abortion.) It is a matter of individual choice. Don’t force your beliefs on other people!
As a clinical psychologist who specializes in end-of-life issues, I must take issue with Nat Hentoff’s recent article. I certainly respect his right to live to the last moment of his possible life and am relieved for him that he has recovered from severe depression, but he should become acquainted with illnesses other than his own.
For instance, Huntington’s Disease, which affected Woody Guthrie, the famous liberal folksinger and composer, is an awful illness that combines the worst of dementia and amyotrophic lateral sclerosis and has no end but a devastating, degrading death. Those so unfortunate to inherit this disease might well look forward to ending their lives before the many years of nothingness that lie in their future.
I think the elderly absolutely have the right to hasten their own deaths if they are suffering from intolerable pain or irreversible, deteriorating illness. We should establish that right even if many do not want to take advantage of it.
When we passed the civil rights laws, it did not mandate that all must vote, only that there be no impediments to their right to vote. I think this is the civil right of the twenty-first century that we should recognize and not diminish in any way.
Jerry Dincin, PhD
Highland Park, Illinois
I was surprised to see another article depicting Nat Hentoff’s misunderstanding of the reasons why multiple terminally ill patients agree with what my neurosurgery mentor observed: “These patients are not afraid they’ll die; they’re afraid they won’t die.” As most physicians are convinced, America’s “death with dignity” movement is devoted primarily to irreversibly comatose, vegetative, injured, or ill patients who fervently long to end their misery, not to depressed, alert patients or to those whose conditions have good chances of recovery or significant long-term improvement. Both “believers” and “nonbelievers” may claim correctly that false hope supersedes no hope at all, as victims of American slavery and other forms of inhumanity confirm, but physicians should avoid creating false hope—except for some children, mentally ill adults, and those whose emotional state would be worsened by facts for surrogates. Patients whose misery induces a longing for death would hardly agree with the “ungrateful dissenter to the brigade of death helpers,” the self-describing words of Mr. Hentoff.
Regarding SUTENT (sunitinib malate), a kinase inhibitor approved by the Food and Drug Administration in 2006 for treating kidney cancers, the patient in England with renal carcinoma that Mr. Hentoff mentioned may or may not have had surgery, the tumor may or may not have been advanced with metastases, and associated problems such as hypertension, cardiac dysrhythmias, or other maladies that SUTENT aggravates may or may not have been present. Together with the fact that five-year survival rates, both with and without nephrectomy, are only 5 percent, these major SUTENT side-effects are likely to have influenced the decision of Britain’s national health system in which the physician mandates, “to cure sometimes, to relieve often, to comfort always,” have not been abandoned by the medical profession.
David S. Summers, MD
Neurologist and American Academy of Neurology senior member
A Never-ending Fight
Barack Obama’s infatuation with faith-based funding is problematic indeed (“Flocking to Faith,” Katha Pollitt and “Obama on Faith-Based Funding,” FI, October/November 2008). There are other troubling areas, but his succumbing to such infringement of church-state separation takes the cake.
Undoubtedly, this dilemma is more consequential to those not afflicted with religious superstition, but in reality it should affect all who honor the separation of church and state, particularly since it is favorable to religion also.
And yet Obama is the only choice. There are signs he is amenable to collective influence, and no doubt his honesty and decency far outweigh the counterfeit in office. But whether Obama has the fortitude to confront the corporate minions, and in fact fulfill his promise of change, he might be on a better footing if he had not acquiesced to faith-based farcicality in the first place.
But now he is the one. That he clean house and open the door to a more humane and prosperous future may be totally dependent on progressive collective action. This must now be the fully intended purpose of all forward-looking Americans—after, of course, all the McCainiacs have been put out to pasture.
William R. Lamppa
Practice What You Preach
In “Changing Tennessee Jury Oaths without Going to Court,” (FI, October/November 2008), Michael Swanson discusses swearing religious oaths on the Bible. But the very Bible on which believers place their hands quotes Jesus as saying:
But I say unto you, Swear not at all; neither by heaven; for it is God’s throne: Nor by the earth; for it is his footstool: neither by Jerusalem; for it is the city of the great King. Neither shalt thou swear by thy head, because thou canst not make one hair white or black. But let your communication be, Yea, yea; Nay, nay: for whatsoever is more than these cometh of evil. [Matthew 5:34–37]
According to Jesus, swearing an oath “cometh of evil.” Why don’t believers object on these grounds?
Frank D. Kirschner
Lending a Helping Hand
I enjoyed Peter Singer’s account of his debate with Dinesh D’Souza at Biola University (“God and Suffering, Again,” FI, October/November 2008), but there are a few points I think Singer could have included in his debate. If we are to God as ants are to us, then why does this god demand our attention and worship? I don’t know of too many people who demand attention and worship from ants. Another good question
takes aim at the idea common among believers that it is only belief in God that gives our existence ultimate meaning. If God gives your existence meaning, then what gives God’s existence meaning? When I ask this question of believers I either get no answer at all, answers that make no real sense, or answers that resort to the “God has ways/motives man was not meant to know” or “God’s mind is not knowable by man” variety. If the nature of God’s mind or motives is an inscrutable mystery but you claim that “He” gives your existence meaning, how can you really say anything at all about the ultimate meaning of your existence, other than that you really have no idea?
Another dilemma arises when questioning why God needs humans to worship him or do “The Lord’s work” for him. “God doesn’t need us; we need God” is a common response. So God created us needlessly? Why would God bother to create something he has no need for? If God has no need for us what does that say about God as a source of ultimate meaning and purpose? Is God just a way of begging the entire question of meaning and avoiding facing tough existential issues head-on?
Spreading the Good Word
Ronald A. Lindsay states in his article “Of Golden Geese and Sacred Cows” (FI, October/November 2008) that “our goal is not to convert the majority of Americans—or the world generally—to humanism.” I strongly disagree! Then he says we “simply need enough committed humanists to form a critical mass.” What??
Obviously, we do need to convert as many people as we can by educating and challenging them to think rationally. The above-mentioned “critical mass” will not just magically appear through wishful thinking. Furthermore, we do need to target the majority of people in order to get a fraction to join together in a secular movement. Every one of us, including scientists, need to speak up whenever and wherever delusional ideas are presented as if they were fact.
Port Townsend, Washington
Ronald A. Lindsay responds:
I do not believe there is any substantive disagreement between me and Ms. Bettanny. I definitely agree that we should try to convey our message to as many people as possible, whether or not we think they might be persuaded to become humanists. My point was that although our message should be widely disseminated, we need to be realistic about our goals. It is unrealistic, I believe, to expect that we can convert the majority of Americans to humanism, nor do we need to do so to accomplish our objectives.