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Welcome to the Hotel Euthanasia
With the words, “In the end, I was left to reflect on what I would want in the face of my own death. I do not know what I would do if I were dying in prolonged and excruciating pain. I am certain, however, that it would be a comfort to be able to consider the options afforded by this bill. And I wouldn’t deny that right to others,” Governor Brown of California signed into law provisions that will allow terminally ill patients to kill themselves with the assistance of a physician.
There is so much wrong here it is hard to know where to begin.
Most importantly, the arguments in favor of physician-assisted killing use rights language to place a heavy thumb on the scale balancing personal interests with community and social good in favor of the needs of a handful of individuals. In doing this real harm is done to society and thousands of vulnerable citizens are put in harm’s way.
One need only to look briefly at the recent videotapes from Planned Parenthood to realize, regardless of one’s position on abortion, that a high level of coarseness about the value of human life can become endemic when the struggle with moral implications of terminating a potential life have ceased. The same callousness, over time, will now be ushered in at the end of life with the enactment of a law that allows this type of killing.
The CDC reports that in 2008, one in 10 elders had reported emotional, physical, or sexual mistreatment, or potential neglect, in that year. In a society that does such a poor job of protecting its vulnerable, it is naive to think that even the protections embedded in the California law will be sufficient to prevent coercion and misuse of assisted death. The idea that the elderly, the poor, the disabled, and the socially isolated will have their agency protected to freely choose not to suicide is fantasy – California dreaming on a grand scale.
The emotions experienced when a terminal diagnosis is made are complex, variable, and confusing. Fear often becomes a predominant emotion, and this, by definition, makes the terminally ill vulnerable, easily exploited, and subject to pressure from family or other interested parties – including the state. If one believes for a second that the medical profession can be trusted to be effective watchdogs over all of this, I suggest revisiting the Planned Parenthood videos.
Contemporary palliative medicine and hospice care can, with very rare exceptions, manage pain and suffering associated with impending death. Fears can be relieved and dignity of the dying supported, with compassionate interventions by doctors, nurses (especially nurses), social workers, psychologists and spiritual counsellors.
What is needed is assistance to the dying that protects their dignity and mitigates their fears in the form of more and better palliative and hospice care – not assisted dying in the form of active killing.
Published in General, Healthcare, Law, Science & Technology
What is needed is assistance to the dying that protects their dignity and mitigates their fears in the form of more and better palliative and hospice care – not assisted dying in the form of active killing.
What Dr. O’Neill says.
My best friend (age 56) is back in school to become a social worker, hoping to work in end of life care.
My best friend (age 56) is back in school to become a social worker, hoping to work in end of life care.
Awesome. Sending encouragement and thanks his/her way
The state must have so much control over our lives that it governs when and how we take our final breaths. No thanks, I choose my own ending.
The state must have so much control over our lives that it governs when and how we take our final breaths. No thanks, I choose my own ending.
My politics run in very libertarian directions too. There are times, however, when the most vulnerable need protection so that they can choose their own ending as well – free from coercion. This, in my view, is one of them.
California has now made depression a capital crime.
Seawriter
Suppose you have Mr. X. No savings, no insurance, no family Willing to support him. Hospice isn’t available (he is homeless). He has cancer that gives him a life expectancy of 6 months. What are his options?
I am so angry about this I am spitting nails. And Brown couches it all in concern for the poor, sick and dying. All he cares about is saving California money in caring for people who really need care. There will soon be a great deal of blood on his hands. I wrote letters to him begging him not to sign this bill.
Since CA is a direct democracy state, I wonder if we could get this on the ballot? What do you think Doc? People need to know that this is about coercion and killing, not compassion. Everything you say is exactly right. I would be going door to door and making calls to convince people of the horrors of this if we could get a repeal on the ballot.
How does he have no insurance? I thought Obamacare was supposed to take care of that? [being sarcastic in general, not directed at F-18, of course Mr. X has no insurance even after, or perhaps because of, Obamacare]
That aside, hard cases make bad law. Law has to be generally applicable with special provision made for outliers.
What concerns me personally is the palliative care part. Because of the damn war on drugs will adequate pain medication be available? Or will the physician refuse to prescribe it because he or she doesn’t want the DEA breathing down their necks?
Everyone who is entitled to Medicare is entitled to the Medicare hospice benefit. The issue is less ability to pay for hospice care, it is the availability of hospice beds. The National Hospice and Palliative Care Organization http://www.nhpco.org is a good source of additional information on the issue you raise
You are so right Doctor. We all here know you can never trust the state (I don’t just mean California) but now we can’t trust our doctors and nurses, and the others in the medical profession.
I posted a piece on this issue last week: http://ricochet.com/the-tao-of-ow-pain-and-its-management/ You are correct in identifying a problem but a more sophisticated understanding of pain (acute, vs chronic, vs terminal) can help policy makers sort this out a bit
Almost anything is open to abuse. The fact that something is open to abuse is not a good argument for restricting my right to it. I can think of a number of diseases that would cause me to choose an alternative. I have qualms about the direct assistance of suicide, but my doctor having the ability to prescribe to me for my choosing, life-ending drugs, should be between me and my doctor. The state has no business in it.
“Most importantly, the arguments in favor of physician-assisted killing use rights language to place a heavy thumb on the scale balancing personal interests with community and social good in favor of the needs of a handful of individuals. In doing this real harm is done to society….”
I’ve seen many assertions from conservatives that allowing suicide degrades the “respect for life” which in turn will rot the nebulous “society”, “the common good” or “the community”. I’m on the edge about this, because it makes some sense to me, but nothing I’ve seen from conservatives amounts to a solid argument establishing this claim. A good argument would contain the building blocks of fact, and the connective tissue of logic. This seems to be another fuzzy, collectivist fear: an unsupported fear that if we leave individuals free, it will be very bad for the collective.
(Can anyone direct me to a solid argument?)
What I never hear from conservatives on this topic is reverence for the right to life — the foundational right of all others — of the individual contemplating suicide. Because of their collectivist fear, they seem to jettison their usual support of individual rights. An immediate corollary of the individual’s right to his own life is his right to end that life. This doesn’t imply that physicians should help them, so maybe the CA law is bad in that respect. But, do conservatives at least accept a person’s right to end his own life?
Owen and David–the problem is that the state cannot keep its nose out of this because the people most affected are generally getting their medical care on the state dime. And David, nothing these days is between you and your doctor. There are any number of controls on what your doctor can do. Make no mistake, the state wants to save money on giving people care. That is exactly what has happened in Oregon. People are denied care who want it because the state thinks they should choose suicide. In addition, family members can easily put pressure on older people to end their own lives because they do not want their inheritance spent on prolonging a life. The implications of this are endlessly insidious. In the Scandinavian countries that have adopted this, people soon start to think that it is OK to kill even children, or depressed teens. Because once humans think they are gods, all bets are off. They only respect the lives they personally value. So don’t make the mistake of thinking that this ends up being individuals making choices about their own lives. It is everyone else making choices about who lives and dies.
so freedom for all has to be restricted because it might be abused by some.
No, humans must respect life because we are not wise enough to control life and death. This is not about individual freedom. It cannot and will not be about that because there are just too many outside influences thinking they have the wisdom to make these choices for someone else. It is all the someone elses that it is foolish to think can be controlled and expected to respect the wishes of the individual. Do you think for a minute that a young pregnant woman who goes to PP is told all the options and given genuine choices? Nope. They try to convince her that abortion is best and then they sell her baby’s body parts for profit. The same will happen here. Death will become about the bottom line for many, many people. No man or woman is an island, much as you libertarians wish this were the case.
Two excellent articles on this at The Federalist today:
http://thefederalist.com/2015/10/06/my-mom-just-died-of-brain-cancer-heres-why-she-opposed-assisted-suicide/
http://thefederalist.com/2015/10/06/our-deepening-love-affair-with-death/
This trend has already gone too far.
Five years ago Hospice providers in southern CT set up to dehydrate my uncle to death. He had not been near death but was precarious. They had his wife of 55 years give him morphine, valium, atropine until he was unresponsive. She was directed, if he showed any pain, to give more valium. This is a recipe for pulmonary, renal and eventually cardiac failure.
Coming to visit him I was astonished to find this combination and undertook to fluid resuscitate him, he did respond and lived another week.
The complaint I filed with the CT dept of MD licensing was followed up and no wrongdoing was found.
I don’t mind an old man dying but I object to medical therapy that deliberately hastens death, especially in the absence of personal and family consent.
Primum non nocere
We are unworthy of making our own decisions, therefore we must let others make them for us….
The point is that this isn’t how human life works. We are influenced by others, for better or worse. You are, I am. This law just gives a state stamp of approval on influencing people to choose to die. It puts the state in the business of death. You are kidding yourself if you think suicide is always, or even usually, an individual decision. It is not. Now, I certainly respect people’s choice to refuse extraordinary measures to keep them alive. That’s what hospice care is all about. When my father was dying, he and my Mom made the choice to take help from hospice in managing pain and other problems. He went off all other medication that had kept him alive for many years. He told us many times in his final days that he was ready to go. We were lovingly there for him every step of the way, but also told him that it was up to God when he was finally taken. It didn’t take long, but we were not going to hasten that process. Our job was to love him and care for him. I’m deeply grateful that I, my Mom and siblings had that time with my father. By taking him off his medications and bringing in hospice we were respecting his request, but we were not going to kill our father with a lethal injection because that is not how you respect life. Those days were difficult, but I learned a lot about my Dad in his final days, and I’m grateful I could give him loving service.
Thank you for this great post!
Anyone paying attention to the way assisted suicide laws have gone in Belgium and The Netherlands knows how quickly “right to die” becomes “duty to die.”
Best way to dehumanize society: promote abortion and euthanasia.
Best way to humanize society: ensure that every human life is surrounded by care in its most vulnerable and “useless” stages.
The question that should be asked is euthanasia really for the dying or is it really to comfort and reduce the suffering of the living.
We have become like the Spartans. A child or the elderly that were no longer able to contribute to Sparta were taken out to the wilderness to die.
I’m reminded of the deputies that were assigned to Terry Schiavo’s room to ensure that she did not receive a drop of water, much less food to ensure her court ordered death. I wore a badge at one time, but if I had been ordered to her room that badge would have been on my supervisors desk and I would have walked out the door of the precinct without any regrets.
The Dutch currently support assisted suicide laws by around 90 percent.
Amen!
Gov. Brown disgusts me.
And this makes duty to die laws morally right?
What percentage of Southerners supported slavery laws in 1850? (Not secession, slavery laws.) I believe it was comparable.
Seawriter
its indicative that people are satisfied with how the law is being implemented, that it isn’t being abused.
Right, just like the Southerners felt about slavery in 1850. They were satisfied with how the law was being implemented, and were ready to tar-and-feather any gol-dern abolitionist who claimed it was being abused.
Seawriter
Uh–I’d say that’s begging the question. The whole issue we have been discussing is the morality of euthanasia. So public satisfaction with slavery or communism or Nazis or PP killing babies tells us what is moral?
you are correct, poll numbers showing greater support for assisted suicide and complaints about abuses that might happen with assisted suicide is begging the question of morality.
http://www.pewresearch.org/fact-tank/2015/10/05/california-legalizes-assisted-suicide-amid-growing-support-for-such-laws/ft_15-10-05_assistedsuicide_support/