Imagine that you have lung cancer. It has been in remission, but your latest test is bad news: The cancer returned and is likely to be terminal.

Still, there is some hope.  Chemotherapy could extend your life, if not save it. You ask to begin treatment.  But you soon receive more devastating news: A letter from the government informs you that the cost of chemotherapy is deemed an unjustified expense for the limited extra time it would likely provide. However, the government is not without compassion. You are informed that whenever you are ready, it will gladly pay for your assisted suicide.

Think that's an alarmist scenario to scare you away from supporting "death with dignity?"  Wrong.  That is exactly what happened last year to two cancer patients in Oregon, where assisted suicide is legal. 

Barbara Wagner had recurrent lung cancer and Randy Stroup, prostate cancer. Both were on Medicaid, the state's health insurance plan for the poor that, like some NHS services, is rationed.  The state denied both treatment for their cancer, but told each it would pay for their assisted suicide. "It dropped my chin to the floor," Stroup told the media. "[How could they] not pay for medication that would help my life, and yet offer to pay to end my life?" (Wagner eventually received free medication from the drug manufacturer.  She has since died.  Stroup's denial of chemotherapy was reversed on appeal after his story hit the media.)

Despite Wagner and Stroup's cases, advocates continue to insist that Oregon proves assisted suicide can be legalized with no abuses.  But the more one learns about the actual experience in Oregon, the shakier such soothing assurances become.

A study published in the Journal of Internal Medicine last year, for example, found that doctors in Oregon write lethal prescriptions for patients who are not experiencing significant symptoms and that assisted suicide practice has had little do with any inability to alleviate pain—the fear of which is a chief selling point for legalization.  From the report:

Family members described loved ones" who pursue PAD ["physician assisted death," a euphemism for assisted suicide] as individuals for whom being independent and in control is important, who anticipate the negative aspects of dying, and who believe the impending loss of self, abilities, and quality of life will be intolerable.  They fear becoming a burden to others, yet want to die at home. Concerns about what may be experienced in the future, including physical symptoms, were substantially more powerful reasons than what they experienced at the time of the request.

When a scared and depressed patient asks for poison pills and their doctor's response is to pull out the lethal prescription pad, it confirms the patient's worst fears about the future—that they are a burden, that they are less worth loving, that they will be allowed to die in agony.  Hospice is geared to address such important existential concerns.  But effective hospice care is undermined when a badly needed mental health intervention is easily avoided or short circuited via a state sanctioned physician-prescribed overdose of lethal pills.

But don't the guidelines protect depressed people in Oregon?  Hardly.  Not only does the law not require treatment when depression is suspected, but very few terminal patients who ask for assisted suicide are referred for psychiatric consultations. Indeed, in 2007 not one patient who received a lethal prescription was referred by the prescribing doctors for a mental health evaluation beforehand.

Moreover, as Dr. Kathleen Foley, perhaps America's foremost palliative care physician, and psychiatrist Herbert Hendin, an expert on suicide prevention, wrote in a scathing expose' of Oregon assisted suicide published in the Michigan Law Review, physician are able "to assist in suicide without inquiring into the source of the medical, psychological, social and existential concerns that usually underlie requests for assisted suicide, even though this type of inquiring produces the kind of discussion that often leads to relief for patients and makes assisted suicide seem unnecessary."

Foley and Hendin provide actual case histories in their very detailed paper that demonstrate the tissue paper strength of Oregon's protective guidelines.  For example, "Joan" was dying of Lou Gehrig's disease and asked for a lethal prescription. The doctor sent her for a psychological evaluation "to cover my ass."  The evaluation—if you can call it that—was conducted by phone with the family repeating the questions to the patient, and, it is worth noting, laughing about them. Foley and Hendin conclude: "Based on these test results, the psychologist [who, it is worth reiterating, never met the patient] concluded that whatever depression Joan had was directly related to her terminal illness, which he considered a completely normal response."

That is hardly careful medical practice. And yet despite the clear problems in Oregon, Washington State has legalized assisted suicide and a trial judge in Montana declared that dying "with dignity" is a fundamental state constitutional right.

Oregon has become the model for how assisted suicide is supposed to work.  But it actually demonstrates that the Oregon Trail is a dangerous path.  For those willing to take the time to dig beneath the sloganeering and feel-good propaganda, it is easy to see that legalizing assisted suicide leads to abandonment, bad medical practice, and a disregard for the importance of patients' lives.

For some to prosper must others die?

Soylent Green
Remember in the 70’s when everyone was convinced overpopulation was going to paradoxically destroy life on earth? Soylent Green (film 1973) depicts New York City in 2022. Overpopulation and global warming have left its 40 million inhabitants hungry and grumpy. Running out of resources, the Soylent Corporation concocts Soylent Green, wafers made from the corpses of good citizens who opt for voluntary euthanasia so not to waste limited resources by living out their full lives.

http://en.wikipedia.org/wiki/Soylent_Green

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Logan's Run
Logan’s Run (1976 film) continued to capitalize on the limited resources and overpopulation panic with the story of Logan, a Deep Sleep Operative who is employed by the state to track down and kill anyone over 30 who runs from mandated euthanization at the local Sleepshop. Again, for humanity to live and prosper certain classes of people must die.

http://en.wikipedia.org/wiki/Logan's_Run

University of Chicago Professor, Jean Bethke Elshtain, grapples with the question "Who Counts?"

In a recent interview for Books and Culture Professor Elshtain drew from her book, Sovereignty; God, State and Self in response to questions regarding how we as a culture reason about matters related to human dignity.

When Professor Elshtain was asked about the paradox that most Western democracies expend great resources to provide people with disabilities greater access even as they pursue projects that aim at creating a world where no such persons exist, she pointed out that these opposing ideas are derived from the same historical root.

"If you put a premium on certain kinds of developed capacities--let's say, those who can enact projects of freedom, who have achieved a certain level that we recognize as definitively human--and tethered to that you have philosophies that measure us by our capacity to engage in rational operations, then those who can never maximize their capacity and who lack certain capabilities are going to be a huge problem. You can see that in the social contract literature. John Locke doesn't know what to do with idiots and imbeciles, in the tender language of the day. Where do they belong? They can't sign the contract. They're outside of the rationally interacting universe. Once you set that in play, an ongoing devaluation of certain categories of people takes hold."

Later in the interview Professor Elshtain commented on the observation that the notion of human dignity has "taken a beating lately" as exemplified by Harvard Psychologist, Steven Pinker. Professor Elshtain, citing a discussion at which Pinker was a participant, asserted that Pinker holds an antiquated view of dignity that bears correction.

"If you acknowledge that all human beings have a dignity that must not be assaulted, you're reminded of your common humanity. Human dignity entails a leveling, a moral equality that offends certain sensibilities. If you consider those who have launched assaults on human dignity historically, they've often believed they can only remain lofty if others are a lot lower. But dignity draws us together."

President Obama's executive order permitting funding of embryonic stem cell research is more smoke and mirrors than hope and change

Today President Obama fulfilled another campaign promise and overturned the Bush policy which restricted federal funding on destructive embryonic stem cell research. Surrounded by those who had long rejected the Bush policy as “anti-science”, the President stated his order would lift that restriction and allow the U.S. to lead the world in scientific discovery, which he hoped would possibly, someday, maybe not in our lifetime, lead to cures for sick people.

Sadly, advances in adult stem cell research, including umbilical cord blood stem cells along with new advances in iPSC research remained unmentioned in the President's speech today. And given even in today's news, the story of the little girls who's blindness was treated using her own cord blood stem cells, this executive order continues to obscure the facts and realities of where the real cures and promise are happening now.

Jennifer Lahl, national director of the Center for Bioethics and Culture Network said, “The President missed a huge opportunity today, to send a message to the world, that he really is serious about changing the politics in Washington . While he acknowledged the ethical and moral difference dividing people in these stem cell debates, he could have pointed to the mounting evidence that embryonic stem cell research has not only moral problems but is not necessary if we are serious about cures and treatments for sick patients.”

cbc.org

http://www.cbc-network.org/research_display.php?id=384

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