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Abortion Questions and Answers by Jack Wilke, MD Chapter on Euthanasia |
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| CHAPTER 27 Euthanasia Euthanasia is When the Doctor Kills the Patient But there are different kinds of euthanasia such as active and passive, direct and indirect, voluntary and involuntary. Let's clear up this semantic confusion. All of these qualifications are either the product of confused minds, or a direct attempt to change the meaning of the word euthanasia so that we can accept it: Euthanasia is when the doctor kills the patient. But I don't want the doctor keeping me alive artificially. Why not a law to permit death with dignity? No new laws are needed. No doctor in the U.S. has ever been indicted for allowing a patient to die a natural death. When a patient is surely dying, doctors may and must use their best judgment when deciding whether to continue or discontinue certain therapeutic efforts that have failed to cure the patient, and that may only be serving to postpone dying. The doctor's only obligation, then, is to keep the patient comfortable and allow a peaceful death. Doctors have had the confidence of patients in the past because their total effort has been to cure. If and when doctors begin to practice exterminative medicine and begin to kill, then that absolutely essential factor in the doctor/patient relationship --complete confidence -- will be destroyed. In any case, those who have been in intensive care units, by large majorities, would go back, even if such care gave them only one more month of survival. M. Danis et al., Patients & Family's Preferences for Medical Intensive Care, JAMA, vol. 260, no. 6, Aug. 12, '88, p. 797 What about "Living Wills"? These are misnamed, for they have nothing to do with living and everything to do with dying. Nor are they wills; they are, rather, "death wishes" or "death directives." Right to Life agrees that anyone who wants to can sign one, but totally opposes making them binding by law. Why oppose legally binding "death wishes"? * The Euthanasia Society started the idea, and that should give us pause. * Informed consent just cannot be given in a generic fashion for an unknown problem at a future time. * Legislation is not necessary; we have enough government intervention. * The patient and family can always get another doctor if the present one seems unsatisfactory. * A conscious patient can always refuse treatment. * Many patients change their minds. With a signed document that is legally binding, it may be too late. * What does "terminally ill," or "artificial means," or "heroic measures," or "meaningful," or "reasonable expectation" mean? These definitions change with time and are different in each case. The Euthanasia Society started these wills? Yes. The Euthanasia Society and its Foundation have since changed their names to The Society for the Right to Die, which then changed its name to The Society for Concern for Dying. They all have been headquartered at 250 W. 57th St., New York, NY 10019. On the Euthanasia Society's advisory council as a founding member is Abigail Van Buren, the "Dear Abby" newspaper columnist, who constantly pushes these misnamed "living wills." Before his death, Dr. Alan Guttmacher, head of Planned Parenthood World Population was also a prominent member of the Board of the Euthanasia Society of America. Where does the ACLU stand? In 1977, the American Civil Liberties Union's Board of Directors stated: "Consensual euthanasia involves an act or an omission by a second person, at the request of an individual, for the termination of the latter's life when he or she is either terminally ill or totally and permanently disabled. The ACLU recognizes this form of euthanasia as a legitimate extension of the right of control over one's own body." Euthanasia News, vol. 3, no. 1, Feb. 1977 What of suicide? There is a Hemlock Society in America, and an Exit Society in England to aid people in taking their own lives. What of the courts? The courts are moving the U.S. rapidly down the slippery slope to legal euthanasia. A major step was taken when several courts redefined "treatment" to include food and water. Then they authorized the discontinuation of "treatment" for certain patients. These patients were not in pain, were not dying, but were (permanently?) comatose and being fed through nasogastric tubes. When food and water were stopped, they died. The best easy-to-read, moderately-detailed discussion of this is in three short chapters in: Window on the Future, Ed. by D. Andrusko, Nat'l Right to Life, 1987. Euthanasia is legal in Holland? The Dutch legalized euthanasia through a decision in 1981 of the Rotterdam Criminal Code. The doctors there began to remove food and water from such patients. They soon learned that the patients died slow, painful deaths that were psychologically stressful for the family and the medical personnel, as well as being expensive. "Why torture them? We are killing them. Why not do it quickly and painlessly," they said. And so the Dutch doctors began to use lethal injections (and the judges tolerated the practice). Reports vary because of wide variations in reporting and non-reporting, but in 1986, out of a total of 120,000 deaths, between 5,000 to 20,000 people were killed by doctors. Are the Dutch people accepting it? Some are, others are not. "Documented cases of involuntary active euthanasia have been reported by C.I. Dessaur and C.J.C. Rutenfrans, by myself, and others. K.F. Gunning published his experience with the specialists who, when asked to admit an elderly patient to the hospital, advised the general practitioners to administer lethal injections instead. H.W. Hilhorst, in his extensive study (sponsored by Utrecht University and the Royal Dutch Academy of Science), found that involuntary active euthanasia was being practiced in eight hospitals. "Anxiety is growing among threatened groups. Warnings have been published that elderly patients, out of fear of euthanasia, refuse hospitalization and even refuse to consult doctors. An inquiry among hospital patients showed that many fear their own families may ask for euthanasia without consulting them. The Dutch Patients' Association placed a warning in the press that, in many hospitals, patients are being killed without their will or knowledge, or the knowledge of their families, and advised the patients and their families to carefully inquire on every step in the treatment, and when in doubt, to consult a reliable expert outside the hospital." R. Fenigsen, "Involuntary Euthanasia in Holland," Wall St. Journal., Sept. 30, 1987 J. Willke, How Doctors Kill Patients in Holland, Nat'l Right to Life News, May 23, 1989. J. Bopp et al., Euthanasia in Holland, Issues in Law and Medicine, vol. 4, no. 4, Spring '89 pp. 455-487. Is there an alternative to euthanasia? The real alternative to euthanasia is to provide loving, competent care for the dying. A new concept for the dying arose in England, where institutions called Hospices specialize in compassionate, skilled care of the dying. This concept has spread to Canada and the U.S., where it has been quickly accepted. "Once a patient feels welcome and not a burden to others, once his pain is controlled and other symptoms have been at least reduced to manageable proportions, then the cry for euthanasia disappears. It is not that the question of euthanasia is right or wrong, desirable or repugnant, practical or unworkable. It is just that it is irrelevant. Proper care is the alternative to it and can be made universally available as soon as there is adequate instruction of medical students in a teaching hospital. If we fail in this duty to care, let us not turn to the politicians asking them to extricate us from this mess." R. Lamerton, Care of the Dying Priorty Press Ltd., 1973, p. 99 Why talk about euthanasia in an abortion book? They both directly kill living humans. They both are done for the same reasons. For more information see: Euthanasia Questions and Answers or (brief) Ohio Right To life Following is a brief table of comparion included in Dr Wilke's book:
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