Monday, June 6, 2011

Assisted Suicide

Ross DoubtThat (my spelling)
Wrote this for the NYT this morning, I reproduce it here in it's entirety.
The comments it produced follow.(Selected by me)

The Link:

Dr. Kevorkian’s Victims

The case for assisted suicide seems to depend on human sympathy — on the impulse toward mercy, the desire to ease what seems like pointless pain and suffering. Why shouldn’t the terminally ill meet death on their own terms, rather than at the end of prolonged agonies? Why shouldn’t the dying depart this earth with dignity, instead of enduring the inexorable stripping away of their physical and mental faculties?

Such are the sentiments that made Jack Kevorkian, who died last week of natural causes, a hero to many millions of Americans. Though he was tried repeatedly and finally convicted of second-degree murder, the former pathologist’s career as “Dr. Death” (he said he assisted at more than 130 suicides) was widely regarded as a form of humanitarianism rather than a criminal enterprise.

But if such sentiments are understandable, they are morally perilous as well. We do not generally praise doctors who help dispatch their terminally ill patients, as Kevorkian repeatedly and unashamedly did. Even when death is inevitable and inevitably painful, it is not considered merciful to prescribe an overdose to a cancer victim against her will, or to gently smother a sleeping Alzheimer’s patient.

The difference, of course, is that Kevorkian’s clients asked for it. That free choice is what separates assisted suicide from murder, his defenders would insist.

But this means that the moral case for assisted suicide depends much more on our respect for people’s own desire to die than on our sympathy for their devastating medical conditions. If participating in a suicide is legally and ethically acceptable, in other words, it can’t just be because cancer is brutal and dementia is dehumanizing. It can only be because there’s a right to suicide.

And once we allow that such a right exists, the arguments for confining it to the dying seem arbitrary at best. We are all dying, day by day: do the terminally ill really occupy a completely different moral category from the rest? A cancer patient’s suffering isn’t necessarily more unbearable than the more indefinite agony of someone living with multiple sclerosis or quadriplegia or manic depression. And not every unbearable agony is medical: if a man losing a battle with Parkinson’s disease can claim the relief of physician-assisted suicide, then why not a devastated widower, or a parent who has lost her only child?

This isn’t a hypothetical slippery slope. Jack Kevorkian spent his career putting this dark, expansive logic into practice. He didn’t just provide death to the dying; he helped anyone whose suffering seemed sufficient to warrant his deadly assistance. When The Detroit Free Press investigated his “practice” in 1997, it found that 60 percent of those he assisted weren’t actually terminally ill. In several cases, autopsies revealed “no anatomical evidence of disease.”

This record was ignored or glossed over by his admirers. (So were the roots of his interest in euthanasia: Kevorkian was obsessed with human experimentation, and pined for a day when both assisted suicides and executions could be accompanied by vivisection.) After his release from prison in 2007, he was treated like a civil rights revolutionary rather a killer — with fawning interviews on “60 Minutes,” $50,000 speaking engagements, and a hagiographic HBO biopic starring Al Pacino.

Fortunately, the revolution Kevorkian envisioned hasn’t yet succeeded. Despite decades of agitation, only three states allow some form of physician-assisted suicide. The Supreme Court, in a unanimous 1997 decision, declined to invent a constitutional right to die. There is no American equivalent of the kind of suicide clinics that have sprung up in Switzerland, providing painless poisons to a steady flow of people from around the globe.

Writing in The Atlantic three years ago, Bruce Falconer profiled one such clinic: Dignitas, founded by a former journalist named Ludwig Minelli, which charges around $6,000 for its ministrations. Like Kevorkian, Minelli sees himself as a crusader for what he calls “the last human right.” And like Kevorkian, he sees no reason why this right — “a marvelous possibility given to a human being,” as he describes it — should be confined to the dying. (A study in The Journal of Medical Ethics suggested that 21 percent of the people whom Dignitas helps to commit suicide are not terminally ill.)

But unlike Kevorkian, Minelli has been free to help kill the suicidal without fear of prosecution. In the last 15 years, more than 1,000 people have made their final exit under his supervision, eased into eternity by a glass of sodium pentobarbital.

Were Minelli operating in the United States, he might well have as many apologists and admirers as the late Dr. Death. But it should make us proud of our country that he would likely find himself in prison, where murderers belong.
Selected comments:
Karen Garcia
New Paltz, NY
June 5th, 2011
11:04 pm
Have you ever noticed that conservatives and some religions are only concerned with people during their nine months in the womb and then again when they are drawing their last breaths? Those trying to deny health care to poor people in our current nihilistic political climate have no right to criticize assisted suicide when they themselves are indirectly contributing to assisted homicide through enforced medical neglect. Fifty million Americans currently lack health insurance, and with the burgeoning unemployment crisis, that number will only grow.

Ross Douthat seems to think anybody feeling the slightest physical or emotional pain will run to the suicide clinics should they ever become legalized. He sure doesn't seem to have much confidence in the resilience of human beings. To compare a terminally ill person with a bereaved person is just plain silly. Some grieving people kill themselves, but most do not. They know life goes on. For the terminally ill, life does not go on.

Maybe if we had universal health coverage, more people would stay alive and not want to kill themselves due to a disease that was never treated due to lack of money. How about it, Russ? Sounds like a humane plan to me.

Marie Burns
Fort Myers, Florida
June 5th, 2011
11:04 pm
Ross, probably hundreds of doctor-assisted suicides occur every day in the U.S. People like me who have living wills volunteer to let medical professionals let us go.

I have personally witnessed two such decisions within my own family. The doctors were not only aware of what was going on, they helped both the dying patient & the family through the wrenching ordeal. No, the doctors didn't -- as far as I know -- administer any drugs to shorten the patients' lives. But they honored the patients' wishes to go when they were ready. These were rational decisions made by fearless people who were fortunate to have brave, caring doctors.

Most people have heard some version of, "I don't know how she did it, but Granny stayed alive till Uncle Fred could get here." Or "After Paula died, Jim just didn't want to go on." We don't have much control over when we die, but in the normal course of dying, we do have some. People who don't want medical personnel messing up that normal course or do want doctors to help that course along should indeed have the option.

Perhaps when you are older you'll better understand the process of dying. It's a bit flip to write, "We're all dying every day." Most people your age have no idea what that means. And I'm glad of that.

The Constant Weader at
Susan L.
New York, NY
June 6th, 2011
12:13 am
I feel the same way about assisted suicide as I feel about abortion: If you don't like it, don't do it - but don't you dare tell me what I can (or can't) do with *my* body! If I had the horrible misfortune to have a terminal illness and I was unwilling to continue suffering needlessly, I just hope I'd have the ability to decide when I'd had enough. I also find it quite ironic that right-wingers are only too eager to tell the rest of us what we should or shouldn't do - in myriad aspects of our lives - and yet otherwise they have a totally hands-off attitude when it comes to things we desperately need (like taxes to pay for pesky little things such as police officers, firefighters, teachers, healthcare and a whole host of other critical things that are part of a First World society).

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