Sunday, October 16, 2005

If I Should Die Before I Wake, I Pray The Lord My Soul To Take

The terrible deaths made possible by modern medical advances necessitate a change in thinking about the ethics of assisted suicide. These days, despite my conservative nature and my firm support for him on most matters, I seem to be disagreeing with President Bush on several fronts: the Terry Schiavo case, illegal immigration, the pouring of money down the drain in New Orleans, and now, assisted suicide. Over 15 years ago, as I watched my mother’s health and body deteriorate and the likelihood of a very painful death process looming, I turned to the Hemlock Society and purchased the book, “Final Exit” by Derek Humphry. The book was a waste of time, giving no usable advice, and my conversations with her doctor and with my own doctor led nowhere. I concluded that in Rhode Island I could not even discuss the subject of giving her a way out if she were in excruciating pain and dying.

Nowadays, doctors assure me that they have the means to provide a pain-free existence to a person whose body is wasting away from cancer or from some other wasting disease. I think this is generally true, but I think also that there are many situations where either the doctors would be unwilling to provide the drugs in the amounts needed, fearing malpractice lawsuits from the family, where the person’s existence is so degrading that just stopping the pain is not enough, or where the drugs just don’t work. The flip side to the wonders of modern medicine is the prospect of a horrible, lingering death, and we do not even have the blessing of “the old man’s friend” anymore. Last year I got a vaccination that protects me from pneumonia for the rest of my life.

In 1994, the state of Oregon, the only state to do so, voted in favor of the Death With Dignity Act, and three years later they voted against repeal. The Oregon law allows terminally ill patients of sound mind who are likely to die within six months to receive lethal doses of pills after conferring with two doctors. A prescription for lethal drugs is then written by the doctor, and the patients administer the drugs themselves. Despite fears that ill people would flock to Oregon for assisted suicide, in the law's first seven years, only 208 people followed through to the end. When John Ashcroft became attorney general in 2001, he issued an edict that doctors who prescribe drugs that are used to commit suicide can be prosecuted under the federal Controlled Substances Act. The state of Oregon and a group of terminally ill patients challenged this Ashcroft directive and won. The case has now reached the U.S. Supreme Court.

The Court began hearing arguments in the case on Oct. 5. Supporters of the assisted suicide law say a favorable high court ruling could lead other states to follow Oregon's lead. It is the first major case that new Chief Justice John Roberts, a conservative jurist just named by President George W. Bush, has heard since his confirmation late last week.

The Bush administration argues - unsuccessfully so far, in two lower court decisions, - that federal drug-control laws bar doctors from prescribing lethal doses. This case really involves two important issues: the right of terminally ill people to end their lives, and the allocation of power between the federal government and the states.

George Eighmey, executive director of Compassion in Dying of Oregon, a group that advises assisted suicide patients in Oregon, said the law offers terminally ill patients a humane way to end their suffering.

"The law is working well, in the sense that the few individuals who do use it are individuals who are strongly independent; well-educated, financially secure and family-oriented," Eighmey said. "These are people who wish to exit on their own terms."

Opponents include some doctors and religious organizations.
"Assisted suicide is a reversal of the proper role of a doctor as a healer, comforter and consoler to an improper role of the physician causing a patient's death," said Dr. Kenneth Stevens of Physicians for Compassionate Care, a leading opposition group.

The U.S. Conference of Catholic Bishops, which has filed briefs in the Supreme Court case, contends that Oregon "is sending a very negative message to sick, elderly and vulnerable patients that their lives are not worth protecting and their suicides are not worth preventing," spokesman Richard Doerflinger said.

M. Charles Bakst, in the Providence Journal on 10/04/05, wrote, “Eli Stutsman, a Portland lawyer who helped write the law, told me this year, ‘The patient decides, and they're making decisions about themselves, and then only in very limited circumstances. There's no allowance in the Oregon law for anybody to make the decision for the patients, and in fact, it's a crime to coerce a patient. It just doesn't happen.’"

There are many activities that are none of the business of the federal government, and traditionally states have had the exclusive right to rule on moral and ethical issues. The Terry Schiavo case showed the wisdom of this philosophy. The federal government should just stay out of the relationship between doctor and patient. I hope no-one I know and love ever needs to have this choice. I hope I never need it, and I would regard each day I could spend with loved ones and friends as precious, no matter what. However, although I don’t think I could do it, I want assisted suicide to be available when that time comes. I also don’t ever again want to read about elderly couples in such dire straights that one kills the other and then themselves with a gun.

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At 7:34 AM, Anonymous steve said...

I am in favor of letting terminally ill and suffering people end their lives. One could argue (at least in some cases) that it is not suicide. Often, the elimination of the drugs or life support that is preventing NATURAL death would allow said NATURAL death to occur. So often, it is not providing death but providing the avoidance of death-prevention.

Further, just because we CAN prolong life indefinitely does not always make this a good thing. We have our elderly on all these medications...some on 10-15 different medications! They allow them to breathe and be classified as live, but I'm not sure it always allows them to "live".

I have one other point. I know it is a court and as such must always engage in the specific legalities of an issue....but it always bugs me when the ruling on the subject is not addressing the subject. Case in point - argueing in an assisted suicide case that it is illegal (read wrong) because of the technicality of a federal drug control law. If the issue is right to death, just deal with that...or kick it out as a non-legal issue.

At 6:59 PM, Blogger Roy B. said...

Steve's last point is a good one. Let's just embrace the issue and not dress it in false propositions that beg the very question. The question should be, "Is there any compelling Federal interest in regulating physician assisted suicide?" Not, "Does assisted suicide violate federal drug control law?"

Or, for those who believe (as I) that there really are certain fundamental individual rights that the government cannot regulate away(and I consider the right of a terminally ill patient to die with dignity to be one of those rights) then it is difficult to see how any federal law can be rationally constued to interfere with that right.

It is interesting that part of the origins of Roe v. Wade was an earlier case (Griswold v. Conn.) where the the Supreme Court held that there was no compelling governmental interest in regulating the physician/patient relationship in the area of birth control. The court ruled that the dialog between doctor and patient on that subject was part of a fundamental "right to privacy" that the govenment must stay out of. How is it possible to view the right of a terminally ill person differently?


At 8:15 PM, Anonymous Anonymous said...

The problem I see, would be the path we would most likely follow if the "right to die" expands. First of all I must say that I've been on my "Deathbed" 15 times in my life so I can speak from experience of facing death.

I'm concerned that at some point in time, that the government might begin to make the decision of whose life is worth keeping and not keeping. If anyone has worked with the mentally retarded one can experience a tremendous "love" yet some in society would prefer to eliminate that "burden". Hitler conducted many "experiments" with the retarded.

The slippery slope can be shown at the other end of the life issue. Very few people realize that the infamous "Roe vs. Wade" had companion case, "Doe vs. Bolton" that was ruled on the very same day. Roe legalized abortion up to the 9th month. Doe vs. Bolton allowed it for ANY Reason up to the 9th month. Those reasons have included SEX SELECTION and other issues.

The point is the slope that started in 1973 is continuously moving down even with other issues of embryonic stem cell research.

Getting back to the key issue, I'm confident that within 20 years of any significant change in the "End of Life" issue, that very soon we would see cases of people who might not have made decisions before hand, might have a Judge make that decision for them.

Keep the Faith

If we look at the expansion of the "other Life issue" of abortion, a very small percentage of

At 6:45 AM, Blogger Sharon said...

Anyone can end their own life at any time, why does the government have to be involved at all? Why do doctors have to be involved? Doctors are supposed to save lives not end lives. I have heard that 98% of doctors refuse to perform abortions for the same reason. Why do we always have to get government involved in our very private decisions? I am not against people who decide to end their own suffering or help a loved one do the same. That is a personal choice. I just don't want government interference. These decisions should remain private. Once you start trying to regulate who can and cannot have the right to die, you are in trouble. A judge should not decide whether I can die. A judge is just some stranger in a black robe. And some of their recent decisions on the Supreme Court have shown they are not of sound mind. Sharon

At 6:58 AM, Anonymous steve said...

anonymous makes a good point on the "slippery slope" arguements, but I still stand by my earlier statements.
Generically speaking, I think it's reasonable to come to common sense decisions "within reason" without having to address every slippery slope or extremist arguement.
An example I would offer is that I think it reasonable that individuals should have gun ownership rights. But I think it unreasonable to assume or argue that legalization of handguns leads to or entitles ownership of nuclear weapons.

At 12:36 PM, Anonymous steve said...

I agree the government should not be involved. However, I think some of the issue here is because some who want help dying cannot do it themselves. Not everyone can do it by themselves.
Remember Dr. Kevorkian? He is still in prison since 1999.
One problem with not havings the feds in our private business however is that we end up with many different and inconsistent state laws...that has potential to be just as bad a the feds making the call!

At 6:23 PM, Anonymous roy b said...

This a response to Sharon's comment "Why do doctors have to be involved at all?"

I was for many years the lawyer for an AIDS Service Organization (in the days before the AZT and protease inhibitors) - so I saw this issue frequently and counseled both terminally ill people and their doctors on this issue.

The terminally ill people I counseled did not fear death. However, they did have a fear of pain, of violent death (jumping or handguns), of "messing up" a suicide attempt, or of making their situation worse and their loved ones suffer more because of the circumstances or mechanics of the suicide or a suicide attempt. They wanted medical advice about how to "do it right" -which meant painlessly, effectively, and with a minumum of debris. These were questions that a doctor - knowlegable about the subject, could answer, and the doctors frequently did answer them.

I considered those discussions to be the most private of physician/patient communications and a place where the government (state or federal) had no role to play. This is an dialog for the physican and the patient - and nobody else.


At 7:13 PM, Blogger RussWilcox said...

Thanks, Roy. I want to add that it is almost impossible for a lay person to find out about and gain access to medications for a sure and painless death. One needs a doctor and a legal structure that allows a doctor to prescribe the proper meds. The Oregon law provides for that along with many safeguards.

At 3:46 AM, Blogger Sharon said...

I still say that whenever you get the government involved in anything, there is hell to pay. There is alway a but or a however in all arguments, that doesn't mean we can't be a resourceful people and solve our own problems. If we had no more laws from henceforth we would be a better nation. Our country is going down the toilet,and alot of it has to do with trying to legislate morality. One person's morality does not equal anothers. We used to be a nation of people who took the bull by the horns and solved our own problems, now we whine about what the government should have done to "save" us. I remember Dr. Kevorkian and he is right where he should be. Imagine wanting to be an angel of death? What a creep. It is too scary to think that legislation could legitimize someone like him who wants to run around helping people die. Makes my skin crawl. Look at our illustious Senators and Reps who enact legislation. Many are slimeballs. I don't want them in charge of my private life. Thanks but no thanks. Sharon

At 10:06 AM, Anonymous steve said...

It surprises me that you go from saying "nation of people who took the bull by the horns and solved our own problems" to next sentence disapproving of Dr death....he was doing just what you suggest, people had a problem - they wanted to die, he was helping them.
True, I would not want this for my profession or sparetime, but he (for whatever reason) was willing. And they locked him up. I applaud him for raising the awareness of this very personal and legitimate issue. I maintain that if someone in terrible shape wants to die, let them die.
But I agree with you that the government could muck up just about anything it touches.

At 6:31 AM, Blogger Sharon said...

I believe the soul of man is totally connected to nature. For me there is a God, and He is in evidence every day in our natural world and everything in nature is interconnected. You only need one fool to mess up this interconnectedness. Dr Kevorkian is such a fool. Technology can be a fool as well. Legislating death and "helping" death occur in any way is not a good idea in my opinion.

At 7:35 AM, Anonymous steve said...

I agree with all you say above except about Kevorkian. He is a hero. He is willing to go to jail on behalf of the cause to allow graceful death.
I commented before on this but I will repeat it. It is not necessarily helping death so much as eliminating the false prolonging of (poor quality) life.
If someone would die without the plug in the wall, and you pull the plug - did YOU kill them or were they really already on deaths' doorstop being prevented entry?
I maintain it was mistaken/misinformed society, big business, the pharmaceutical giants who were preventing and disallowing their NATURAL death.

If I am ever some worthless braindead machine-dependent vegetable, PLEASE for God's sake and mine (and your too by the way), pull the plug!

At 11:36 AM, Blogger Bob Dahl said...


You and I agree completely on this one. If the Supreme Court were to rule against the State of Oregon, it truly would be "legislating from the bench."

Congress could do something about this if they choose, but I don't think there is any enthusiasm for that.

Sliprey slope arguments rarly impress me. As George Will has said, "Life is a slippery slope. Judge a issue on its own merrits."


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