The following is Part 1 of a 6 part article. Originally published in The Canadian Messenger of the Sacred Heart, Toronto, in 1980, reprinted here with permission.
Part One: Active euthanasia, passive euthanasia, voluntary euthanasia
Dr. Cicely Saunders, medical director of St. Christopher’s Hospice in England, is considered a pioneer in the hospice or palliative care movement, aimed at helping people live their final days in dignity. This is done by keeping them free from pain and loneliness and helping them prepare for death. In her own words, Dr. Saunders “has been involved with care and research and teaching in the needs of patients with advanced cancer, and a few neurological diseases, and, to a lesser extent, with those of the frail elderly.
“When someone asks for euthanasia…we will find it almost in every case that someone, or society as a whole, has failed that person. To suggest that such an act should be legalized, is to offer a negative and dangerous answer to the problem which can be, and is being, solved by better means.” Dr. Saunders points out in a recent article. In the same article in World Medicine, September 20, 1978, she recalls a particular visitor to the hospice. “In 1961 I took Dr. Leonard Colebrook, then chairman of the Voluntary Euthanasia Society, round St. Joseph’s Hospice. He wrote to me afterward: ‘I still feel there would be little or no problem of euthanasia if all the terminal disease folks could end their lives in that atmosphere you have done so much to create – but alas that can hardly be for many a long year.'”
The hospice movement is quietly spreading throughout the world, a living testament to the belief in the sanctity of life. At the same time, the euthanasia movement has surface with a force and acceptance which has surprised many. On the one hand we have the sanctity of life groups who believe that life is precious because it is a gift from God, and on the other hand we have the quality of life advocates who claim that some lives are devoid of value and it would be better for them and for society if these people were dead.
The Living Will or Mercy Will is the main vehicle for the promotion of euthanasia. Right to Die bills have been introduced in many states in the United States, in some provinces in Canada, and in many countries of the world. In Ontario the Law reform Commission is studying the subject. Interestingly, neither the Living Will nor the Right to Die bills mention the word euthanasia.
One cannot help but notice the promotion of euthanasia today and the promotion of abortion (pre-natal or fetal euthanasia) a few years ago. As we unfold the drama of what promises to be the most shocking and catastrophic movement to hit Western society, these parallels will become apparent.
The use of slogans and euphemisms has an important part in the promotion of euthanasia. “Reforming the law” suggests that things will be made better, “freedom to choose” in this instance is called the ultimate freedom; “Living wills” really are death wills; Natural Death (Act) means killing, which is certainly not natural death; “death with dignity” suggests that biological death is undignified, a concept hard to accept under any circumstances. “Mercy Wills” suggests compassion but involve killing.
“Right to Die” suggests that death is a human right whereas death is a natural, universal consequence of life. It is not a right bestowed on us by our fellowman. We are all going to die – we are born to die. What is being promoted here is the right to kill. This promotion involves not only death for those who choose it, but death for those who can’t speak for themselves.
It is imperative, if one is to be involved in the euthanasia debate, to have precise understanding of the terminology which is being used and which should or should not be used. Because of the confusion of these terms there is a wide chasm between the layman’s understanding of the situation and what is being promoted.
Patients have rights! Good medical practice recognizes that every patient has the right to refuse treatment. This right is upheld by the courts. A patient can sue his doctor for assault if the doctor insists on treatment which the patient does not want. To refuse a particular treatment is not euthanasia.
Doctors have obligations to patients. No doctor wants to prolong the dying process; courts have accepted this concept. A doctor treating a disease is not obligated to continue a particular treatment when the disease does not respond to that particular treatment. (But neither should he abandon his patient.) To discontinue such treatment in the face of death, or at any time, is the standard procedure in any good hospital. This is not euthanasia. This is good medicine. “This is quite different from pulling a plug” with the intention fo causing a patient’s death.
The problem arises when some people misname this legitimate discontinuing of a particular treatment as passive euthanasia. Euthanasia societies want to enshrine this standard orthodox practice in Right to Die legislation as the wedge, or Trojan Horse, to proceed with active euthanasia.
What is euthanasia? Euthanasia is a Greek word which originally meant good death. This is something we would all hope for. Today, the word has been corrupted to mean the deliberate killing of our fellow human beings. This is medical homicide, this is murder. The New World dictionary says euthanasia is an act or method of causing death painlessly so as to end suffering. There are several categories of euthanasia, but they all involve killing – induced death, not natural death. The intention is to seek the death of the patient.
This is the killing by omission. Already practiced in some hospitals today, it is a far cry from the concept of a good or easy death connected with the original meaning of euthanasia. From January 1971 to June 1972, the Yale-New Haven Hospital allowed 43 infants to die by withholding food and medical assistance. This is post-natal euthanasia or infanticide. The Sick Children’s Hospital in Toronto allowed 27 severely retarded infants to die over a twenty-year period. These and other hospitals have allowed these babies to die a slow, painful death. These babies are often sedated so that the staff will not hear them cry out. Such practices are carried out, in hospitals, with parental approval. If parents, on their own initiative, starved their offspring and left them to die they would be charged with child abuse or murder. Because it is done with medical approval, the law turns it’s head, ignoring these abandoned, neglected children.
Passive euthanasia is a cruel failure to help those in desperate need and it often results in a painful death for the innocent and defenseless. This is contrary to the Galen Principle (above all do no harm) and the Judeo-Christian Commandment (Thou shalt not kill.) It is the antithesis of the message in eth Good Samaritan parable where mercy was shown to those in need. Passive euthanasia has been called calculated benign neglect. The callous treatment by those who have practiced this type of euthanasia has become an argument for active euthanasia.
This is intentional killing: murder by commission, either with consent (voluntary) or without consent (involuntary), by direct administration of a lethal drug or procedure. This is medical murder. It is against the law, but some doctors claim it is practiced today. “Euthanasia or mercy killing may be described as the bringing out of a gentle and easy death in the case of an incurable disease. It is contrary to the law, yet euthanasia is practiced extensively by many doctors.” (Dr. T. D. Marshall, Canadian Family Physician, June 1975).
This statement may be an exaggeration, but another doctor, writing on the same subject, recently said: “…when is life expendable? If a man or a woman is no longer useful, if he or she is incapable of language, self-care, etc., (just as useless and helpless as a baby) why should he or she not be extinguished? Is that an unfair way of posing the question?” (Dr. J. Arthur Boorman, Canadian Medical Journal, August 18, 1979). Dr. Boorman goes on to say, “…That, to my mind, is the operative word, caring: when the end is near, a too-large injection of morphine to relieve pain could be fatal, but it would not be wrong if it was an expression of caring.
Active euthanasia is the ultimate aim of Euthanasia Societies. The target groups are those whose life has been designated as “devoid of value” or “meaningless.” These are the unwanted, the insane, the helplessly ill, the terminally ill, the handicapped, and the elderly. The motives may be compassionate, but the result is always the same – death for the patient. Some doctors are pushing for a change in the law on euthanasia on the grounds that it is already being practiced. To leave the law as it is, is to encourage disrespect for the law, they say.
Voluntary Euthanasia (suicide)
This is often chosen when a patient is in a state of depression. It is recognized by many as a call for help. Assisted suicide is dependent on doctors, friends, or family to assist in the killing. Suggestions have been made that death pills, or demise pills should be left within the reach of suicide-prone patients. The suggestion has also been made that prisoners should be allowed to opt for voluntary euthanasia (suicide) rather than live out their sentence behind bars. Why? Freedom of choice! – of all things!