On March 24, 1997, in an historic conscience vote, the Australian national Senate overturned the world’s only enacted law permitting the practices of euthanasia and assisted suicide. By a vote of 38 to 34, the Senate passed MP Kevin Andrews’ “Euthanasia Laws Bill,” which prohibits any of Australia’s three territories from passing laws allowing euthanasia. Last December, Australia’s national House of Representatives overwhelmingly passed the Andrews bill by a vote of 88 to 35 (see Update, 12/96:3).
The euthanasia law, “Rights of the Terminally Ill Act,” was passed by the Northern Territory (NT) Parliament in May 1995, but did not take effect until July 1, 1996. Since that time, four people have died under the Act — all with the help of NT euthanasia advocate Dr. Philip Nitschke, his lap-top computer, and his “Deliverance” software program.
Earlier this year, the Andrews repeal bill was the subject of a series of hearings conducted by the Senate Legal and Constitutional Legislation Committee. The committee had been given the task of studying the legal and constitutional implications of the Andrews bill prior to any full Senate floor vote. During the course of the hearings, a record-breaking 12,577 submissions — from every state and territory in Australia as well as from other countries — were presented to the committee for consideration. Of those submissions, 93.3% were in favor the Andrews bill (opposed to the NT euthanasia law), while only 6.4% were against the bill (supported the NT euthanasia law). The remaining 0.3% of the submissions presented unclear positions or other considerations. [Report of the Senate Legal and Constitutional Legislation Committee, “Euthanasia Laws Bill 1996.” Appendix I, “Analysis of Submissions,” March 1997, p. 189]
In its 200-page report issued on 3/6/97, the committee did not make a formal recommendation to the full Senate regarding the Andrews bill. Instead 14 senators from all sides of the political spectrum issued statements advising the Senate of their conclusions and urged that the Andrews bill be passed. The committee majority found there were no adverse constitutional implications associated with the Andrews bill. Moreover, the majority held that the NT euthanasia law was seriously flawed, lacked adequate safeguards, had an “unacceptable impact” on the health of the Aboriginal community, would “fundamentally” alter the doctor/patient relationship, and would ultimately devalue the lives of patients. [Senate Report, “Advice to the Senate,” pp. 115-129. See below for excerpts from the report.]
The Senate Report foreshadowed historic floor votes which, in addition to overturning the NT euthanasia law, rejected a last-ditch amendment to allow Dr. Nitschke to end the lives of two more patients, since they had already qualified for an induced death under the NT euthanasia law. In what was described as a “raw rage” reaction to the Senate votes, Nitschke told reporters that territorial self-government was a joke and then publicly burned copies of the “Territory’s Self-Government Act,” the NT euthanasia law, and the newly passed Andrews bill. [Sydney Morning Herald, 3/29/97] Nitschke also claimed that the two patients (who had finished all the paperwork under the NT euthanasia law) were “betrayed” by the federal Parliament. He announced to reporters that, if all else failed, he might have to break the law and help terminate the two patients’ lives. [Reuter, 3/24/97; The Australian, 3/24/97]
Other euthanasia advocates were pursuing different strategies. Since Australia’s governor-general, Sir William Deane, would have to sign the Andrews bill before it could take effect, emotional letters by and on behalf of Nitschke’s two patients were sent to Sir William asking him to delay signing the measure so that Nitschke could help end the patients’ lives without fear of prosecution. Sir William, however, responded that any signature delay on his part would not be justified since it would be a departure from normal procedures. He signed the Andrews bill on 3/27/97, officially overturning the NT euthanasia law. [The Australian, 3/27/97; Australian AP, 3/27/97; The Age, 3/26/97; Sydney Morning Herald, 3/25/97]
Former Chief Minister Marshall Peron, the architect of the NT euthanasia law, took another tact. He asked NT Director of Public Prosecutions Rex Wild to grant an indemnity from prosecution to those who help end the two patients’ lives. Mr. Wild rejected the request, stating that it would be inappropriate to grant indemnity for “hypothetical future events.” Indemnity, Mr. Wild said, is not “used in anticipation of some theoretical or expected activity to give… carte blanche to a potential offender.” [ABC News, 4/10/97; Australian AP, 4/10/97]
Within one week of the rejection of Peron’s indemnity request, Nitschke announced the death of one of the patients, 56-year-old Esther Wild, after four days in an induced coma. While Nitschke called the patient’s death a tragedy, he claimed that it was perfectly legal to bring about her death by intentionally putting her into an drug coma to relieve her suffering. But the NT coroner’s office has instructed the police to investigate the death and Nitschke’s involvement, citing discrepancies in her death certificate and comments made by Nitschke on ABC’s Four Corners program. Also, according to Paul Rofe, South Australia’s director of public prosecutions, Nitschke made a “technical confession” to Wild’s murder during a speech given at a press club luncheon. Reportedly, Nitschke expressed the intention of ending the patient’s life. Rofe said that Nitschke demonstrated the required elements of murder, namely “a deliberate act, requisite intent, no lawful justification.” [ABC News, 4/17/97, 5/13/97; The Age, 5/13/97, 5/17/97]
But Nitschke remains undaunted. In response to the repeal of the NT euthanasia law, Australia’s “Dr. Death” has invented a new death-hastening, coma-inducing machine. Calling it a “slightly macabre device,” Nitschke said it would work by keeping track of the patient’s state of consciousness and then increasing the drug dose if the patient shows signs of waking. [The Australian, 5/15/97; The Age, 5/13/97]
Excerpts: Australian Senate Report
On the Broad Effect of the Euthanasia Law
“We consider that the Rights of the Terminally Ill Act 1995 represents a fundamental shift in Australia’s ethos and social fabric. It has additional national significance as all Australians, indeed all people, can use the Act. It is therefore not just a matter for the people of the Northern Territory.” [p. 116]
On Illusory “Safeguards”
“Indeed many witnesses supporting euthanasia told the Committee they personally would relax the ‘stringent requirements’ of the Rights of the Terminally Ill Act 1995, which include a final 48 hour cooling off period. As the Labor Premier of New South Wales, Hon. Bob Carr MLA, told the New South Wales Parliament on October 6, 1996: ‘I wonder whether we as a Legislature are confident in making a value judgment about what the cooling off period should be for the taking of a human life. The legislative cooling off period for a person who has bought a set of encyclopedias from a door-to-door salesperson is 10 days. Are we happy to have a 48-hour cooling off period for the taking of a human life?'” [p. 124]
On the Value of Human Life
“As soon as we allow another person to be involved in the death of a fellow human being we must have come to the conclusion that the life is not worth living. The concept of a life not worth living and justifying the involvement of a third party in taking that life challenges to the very core our notions of civilisation. As soon as such a concept takes hold within the psyche of our nation we will demean the value we place on human life.” [pp. 123-124]
On the “Right” to Die
“The Rights of the Terminally Ill Act 1995 does not so much change the law for the patient as it changes the law for the third party (the doctor). What is currently illegal for the doctor will become legal…. Ultimately, a new right is given to doctors to terminate the lives of those who are suicidal and terminally ill. To describe this as providing a ‘right to die’ defies logic.” [pp. 124-125]
On Dying with Dignity
“With very few exceptions, pro-euthanasia submissions which dealt with the term ‘dignity’ described particular physical circumstances and described living or dying in such circumstances as necessarily involving a loss of dignity…. A disturbing equation is thus drawn between having ‘dignity’ and being ‘without disability’…. Any notion that those who choose the path of natural death or those who choose to live with disabilities are in some way taking the less dignified path should be abhorrent to any caring society. Unfortunately, the attitude from certain quarters that dying with dignity demands that life ends before such circumstances begin carries a message which only serves to devalue those who live in such circumstances.” [pp. 125-126]
On Legalizing a “Common Practice”
“Whether euthanasia is a ‘common practice’ is widely disputed. Even if it were it would not of itself provide a justification. Indeed, if it is widely practiced, although it is against the law, it highlights the real concerns of many opponents of euthanasia who argue that the illegal excesses of a minority of doctors will simply become commensurately worse with pro-euthanasia legislation.” [pp. 127-128]
On Leadership and Polls
“The view that Australia is a pluralist society with diverging values within its citizenry is no justification to uproot a foundation stone of our notions of civilisation and the value we place on human life. There are occasions where the legislature is called upon to provide leadership. Both sides of the debate acknowledge that, whilst opinion polls are important as a guide to the legislature, polls of themselves cannot be the ultimate basis for or against legislation.” [p. 128]
On the Distinction between Foregoing Treatment & Euthanasia
“We join with the long established view that there are strong intuitive moral and clinical distinctions between stopping futile treatment and giving a lethal injection. To try to equate the two is disingenuous…. Physician assisted suicide or euthanasia has one purpose — to kill the patient. Those who blur these concepts seek to establish that legalised euthanasia is only a small step for a legislature to take. It needs to be recognised that the step taken by the Northern Territory is this: to move from a situation where no citizen may intentionally take the life of another citizen, to a regime where certain citizens are given a full legal sanction and Parliamentary endorsement to intentionally take the lives of certain other citizens. This by any objective represents a major shift.” [p. 128]
The above excerpts are taken from the Senate Legal and Constitutional Legislation Committee Report, “Euthanasia Laws Bill 1996,” released in March 1997. These comments are contained in the “Advice to the Senate” section, a position statement signed by the majority of Senate Committee members.
The Oregon House of Representatives has voted 32 to 26 to return a measure legalizing physician-assisted suicide back to the voters for reconsideration in November. HB 2954 passed the House on 5/13/97 after a three-hour heated debate, and now heads to the Senate, where the debate over the prospect of repealing Measure 16 will continue.
Measure 16, which passed in 1994 by the narrow margin of 51% to 49%, makes it legal for doctors to intentionally prescribe lethal drugs for the purpose of ending certain patients’ lives. The measure, also known as the Oregon Death with Dignity Act, has yet to go into effect, having been held up by a constitutional court challenge. But in February, the 9th U.S. Circuit Court of Appeals ruled 3 to 0 to dismiss that lawsuit (Lee v. Oregon), finding that the plaintiffs (terminally-ill patients, doctors, and other care-givers) lacked standing. According to the justices, the plaintiffs failed to show that Measure 16 posed an immediate threat to them. By so ruling, the appeals court reversed U.S. District Judge Michael Hogan, who ruled that Measure 16’s supposed safeguards are inadequate and deny the terminally ill the protections (from being pressured or assisted to end their lives) that other Oregonians have under the state’s anti-assisted suicide law. Hogan also issued a permanent injunction barring Measure 16 from taking effect. [The Oregonian, 2/28/97:1A; LA Times, 2/28/97; AP, 2/27/97; also see Updates, 9-10/95:1, 5-6/96:3]
While the 9th Circuit’s dismissal of Lee v. Oregon is being appealed, the prospect of Measure 16’s being enacted by judicial fiat has caused concerned legislators to take a closer look at the measure and at new information which surfaced after the 1994 election. During the campaign, right-to-diers portrayed Measure 16 and its prescription-only method of death as providing patients with a humane, painless, and dignified death. It was only after Measure 16 passed that advocates admitted that the initiative contained major flaws.
In December, only two months after voters went to the polls, Derek Humphry (co-founder of the Hemlock Society and supporter/fundraiser for Measure 16) wrote to the New York Times that “…the Oregon law, which forbids injections, could be disastrous.” According to Humphry, “25% of assisted suicides fail, which casts doubts on the effectiveness of the new Oregon law.” “The new Oregon way to die will only work,” Humphry wrote, “if in every instance a doctor is standing by to administer the coup de grâce if necessary.” For Humphry, the “coup de grâce” meant the “lethal injection” or “a plastic bag.” [NY Times, 12/3/94:14]
Humphry based his assessment, in part, on a study by Dutch euthanasia advocate Dr. Pieter Admiraal which found that 1 in 4 patients who self-administer medication to end their lives experience lingering deaths that can take hours or even days. In an article published in The Oregonian, Admiraal said such deaths are “very troubling to the family” and “very difficult to hear,” since the patient “will have difficulty breathing.” [The Oregonian, 12/4/94:1] Admiraal also commented that those witnessing the agonizing scene could be tempted to use a plastic bag to suffocate the patient. “Is that acceptable in a civilized world? In my opinion, no,” he said. [AP, 12/3/94]
Other information on the evolution of Measure 16 was also revealed after the election, information which indicated that the measure was intentionally vague yet carefully worded to fool voters, and strategically intended as a foot-in-the-door to full-blown, active euthanasia. Another Oregonian article, entitled “Write to Die,” described how Measure 16 evolved from death by lethal injection to prescription-only because proponents felt that voters and doctors were not yet ready to approve active euthanasia. Soothing-sounding, euphemistic phrases — like “death with dignity” and “to die with dignity” — were used to mask the dark reality of the measure. [The Oregonian, 12/18/94:A1]
Now supporters of HB 2954 want to give Oregon citizens a chance to cast a more informed vote this coming November. “This is probably one of the most important measures we will ever deal with,” said Rep. Ron Sunseri, the bill’s sponsor. “It deals with life and death. If there is ever a law people need to consider with deliberation, this is it.” But Rep. Cynthia Wooten asked, “What message are we sending? That the voters don’t know what they’re doing? That they’re stupid?” Rep. Bryan Johnston said the reason for sending Measure 16 back to the voters is simple: “This is a bad law.”
But Rep. George Eighmey opposed referring the measure back to the voters, and instead proposed amendments to fix the flaws in Measure 16, including an added informed consent notice where the patient acknowledges that death by prescription drugs could take three or more hours. His proposal failed in the House by a vote of 34 to 24. [The Oregonian, 5/14/97:A1; The Statesman Journal, 5/14/97:1A]
State legislators, though, haven’t been the only ones grappling with Measure 16. Just two weeks before the House voted to refer the measure back to the people, the Oregon Medical Association reversed it’s earlier neutral stand and voted 121 to 1 to oppose Measure 16.
The Sunday Oregonian Editorial
Death without dignity
Legislature should give voters a chance to repeal an assisted-suicide measure that’s too flawed to fix
Even if Measure 16 were a model of craftsmanship and Solomonic wisdom, we would still favor sending the 1994 physician-assisted suicide law back to voters for reconsideration. The reason is simple: Measure 16, even if it were flawless, is different from any other measure we’ve encountered. Ever.
Not only does it concern the most basic questions of life and death, but it also establishes a global precedent. Measure 16 makes explicitly legal what has been deemed illegal, if not immoral, around the world. This is not the kind of decision voters should make in the context of an election that, aside from the general run of candidates, featured 19 other ballot measures. In 1994, recall, physician-assisted suicide vied for voters’ attention with such topics as gay rights, public employee benefits and crime-and-corrections policies.
This alone would argue for revisiting the issue, but there’s an equally potent reason: Measure 16 is not a perfect measure — even by the standards of right-to-die champions.
Indeed, even the right-to-die folks now acknowledge some of Measure 16’s problems, since they’re now asking the Legislature to make changes in the law. Among other things, they want to beef up the law’s informed-consent provision and require labeling on all Measure 16 prescriptions.
That won’t take care of the act’s gravest deficiency, because the Legislature would really have to alter Measure 16 beyond all recognition to do that. The problem is this: Measure 16 allows doctors to prescribe life-ending pills to terminally ill patients, but those pills — the 60 to 100 you must keep in your body to induce death — fail in up to 25 percent of the cases. The result can be vomiting, convulsions, brain impairment, kidney damage, comas and lingering deaths.
As Measure 16’s advocates acknowledged after the 1994 election, their Death with Dignity Act is not as neat and tidy as taking a pill and falling into a blissful final rest.
In the Netherlands, physician-assisted suicides are not done all that much because of this. Doctors there can end these special agonies with lethal injections. Indeed, Dutch doctors practice euthanasia 10 times more often than doctor-assisted suicides. But Measure 16 itself bars doctors from administering lethal injections. What would happen to Oregonians whose pills fail?
The measure’s sponsors could have included a lethal injection or euthanasia provision. Sponsors did just that in the failed initiatives in California and Washington. But the Oregon sponsors didn’t. Why? Because Oregon voters would have probably spurned a measure that gave doctors the power to administer lethal injections.
And with good reason. The experience in the Netherlands makes clear that voluntary euthanasia can turn into involuntary euthanasia. That’s the weight of two studies done for the Dutch government. More than 27 percent of Dutch physicians have engaged in involuntary euthanasia — terminating the lives of patients without the patient’s consent.
Granted, the Legislature or Measure 16’s sponsors could fix the flaw by adding a lethal injection provision. But they would be fixing a flaw with another, fatal, flaw. We can guess that the lethal injection allowance would complicate Measure 16’s electoral prospects. We know from the Netherlands that the lethal injection provision robs patients of individual autonomy and personal choice.
We have no illusions about what opponents of doctor-assisted suicide are up to in focusing on Measure 16’s practical problems and asking for a second vote. They’re not interested in solving these problems. Never were. They’re bent on repealing Measure 16.
Well, so are we. We hold now, as we held in 1994, that this physician-assisted suicide measure is a grotesquely wrongheaded license to kill. It also seems to us that Measure 16’s practical problems are inextricably linked with Measure 16’s moral problems. You have one because you have the other. That happens when you get into the killing business.
Repealing Measure 16 won’t solve the all-too-real problems of death and dying. Better pain-management will help, and the Measure 16 debate has spurred Oregon’s medical community forward in this area. So will greater access to hospice care, and the reconsideration bill’s sponsor, Republican Rep. Ron Sunseri of Gresham, says he has won pledges for more hospice-care funds from legislative leaders. But assisted suicide will exacerbate, not eliminate, Oregonians’ end-of-life dilemmas.
Before Oregon crosses this great medical and moral divide, the Legislature should give Oregonians another chance to stop short.
The above editorial originally appeared in the The Sunday Oregonian, May 11, 1997, and is reprinted here with permission.
On 4/27/97, at it’s House of Delegates conference, the Oregon Medical Association (OMA) voted overwhelmingly to oppose Oregon’s Measure 16. The vote, 121 to 1, passed a resolution reversing the OMA’s three-year neutral stand on the law, which the OMA now condemns as “seriously flawed.” [The Oregonian, 4/28/97:1; Statesman Journal, 4/28/97] Largely as a result of research presented by Physicians for Compassionate Care, an organization opposed to assisted suicide, the OMA was faced with data indicating just how flawed and deceptive Measure 16 really was. “We have searched through publications to find facts, many of them drawn from pro-euthanasia literature,” explained Portland physician N. Gregory Hamilton. “This information was not available in 1994,” he added. [Register-Guard (Eugene, OR), 5/6/97:13A]
According to James Kronenberg, the OMA’s associate executive director, Measure 16 “is a risky proposition that puts the poor, the disenfranchised and the vulnerable at risk. It is also unreliable in achieving its goal.” He said what most affected the doctors’ decision to denounce the measure “was the data on the failed suicides from the Netherlands.” But Peter Goodwin, M.D., chairman of Oregon Right to Die, said that argument was misleading. When a patient survives a lethal prescription, Goodwin said, “that’s not a failure, that is simply a medical procedure for which a complication has developed.” [American Medical News, 5/12/97:3]
Exactly one week after the OMA changed its position on Measure 16, the Michigan State Medical Society (MSMS) also changed its policy on physician-assisted suicide, passing a resolution stating, “Physician assisted suicide is fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control and would pose serious societal risks.” Approximately 400 delegates representing 12,000 physicians approved the policy change by a voice vote. Since 1993, MSMS has held a neutral position on the issue. But MSMS’ newly-elected president, Dr. Peter Duhamel, said that the opposed stance was “probably due to the persistent actions of Dr. Kevorkian and the fact that the medical society has been perceived in the past as not taking a very strong stand on the issue.” [Detroit Free Press, 5/5/97; UPI, 5/5/97; AP, 5/5/97]
With the policy changes in Oregon and Michigan, only the medical society in Rhode Island remains neutral on the issue of physician-assisted suicide.
In April 1997, the U.S. Congress took a preemptive step by passing a new law banning the federal government from funding the practices of assisted suicide and euthanasia. The bill, “Assisted Suicide Funding Restriction Act of 1997” (H.R. 1003), had bipartisan support, with the House passing it by the overwhelming vote of 398 to 6, followed a week later by the Senate’s unanimous vote of 99 to 0. President Bill Clinton signed the bill into law on 4/30/97.
While assisted suicide and euthanasia are already illegal, supporters of the new law said that the measure was necessary in the event that the U.S. Supreme Court rules in favor of a constitutionally-protected “right” to die or in case Oregon’s Measure 16 legalizing physician-assisted suicide ever takes effect. Oregon’s Medicaid director has already gone on record stating that physician-assisted suicide would be covered under that part of the taxpayer-financed plan called “comfort care.” [Statesman Journal, 12/6/94:1A]
“We want to stop it before it even starts,” said H.R. 1003 co-sponsor Rep. Kit Bond (R-MO). “The Congress must intervene to say that [assisted suicide] is not our interest or intention and we will prohibit the use of federal money for that purpose,” co-sponsor Sen. Byron Dorgan (D-ND) said. Chief sponsor Sen. John Ashcroft (R-MO) explained, “We should not hook up Dr. Kevorkian to the United States treasury,” while Sen. Joseph Biden (D-DE) said, “Physician-assisted suicide is the most dangerous slippery slope, in my view, that a nation can embark on.” Biden also told reporters, “Under no circumstances should the federal government be paying physicians to help people kill themselves.” [AP, 4/10/97, 4/11/97′ 4/16/97; Washington Post, 4/11/97:A20; Reuter, 4/11/97; UPI, 4/16/97]
The new law bans the use of federal funding “to provide any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing the death of any individual, such as by assisted suicide, euthanasia, or mercy killing.” [H.R. 1003, Sec. 3(a)(1)] The funding restriction applies to all federal health care programs, including Medicare; Medicaid; Title XX; Public Health Service; Indian Health Care; Veterans Medical Care; all military, Peace Corps, and prison health care systems; Federal Employees Health Benefits Program; and programs for disability assistance. [H.R. 1003, Sec. 3(d)(1-2)] Additionally, the law prohibits the use of federal money by advocacy groups “asserting or advocating a legal right to cause, or to assist in causing the suicide, euthanasia, or mercy killing of any individual.” [H.R. 1003, Sec. 5(a)(3)]
As President Clinton signed the bill into law, he stated,
“This is appropriate legislation. Over the years, I have clearly expressed my personal opposition to assisted suicide, and I continue to believe that assisted suicide is wrong. While I have deep sympathy for those who suffer greatly from incurable illness, I believe that to endorse assisted suicide would set us on a disturbing and perhaps dangerous path. This legislation will ensure that taxpayer dollars will not be used to subsidize or promote assisted suicide.” [White House Press Release, Statement by the President, 4/30/97]
Sometime in the very near future, the U.S. Supreme Court will hand down its decision in two assisted-suicide cases (Washington v. Glucksberg and Vacco v. Quill). At issue before the Court is whether there is anything in the U.S. Constitution that would prohibit states from having laws against assisted suicide. It is expected that the Court will find that states do have the right to prohibit assisted suicide.
However, another case (Krischer v. McIver) — this one before the Florida Supreme Court — is also due to be decided this summer. Florida is one of only five states in the country with a specific right to privacy provision in its constitution, and the case now pending is based on the state, not the federal constitution. This means that — even if the U.S. Supreme Court decides that states can ban assisted suicide — the Florida Supreme Court could still declare the assisted-suicide law unconstitutional under the state constitution.
On May 8, the Florida Supreme Court heard oral arguments in the case which is an appeal of the January 31, 1997 decision by Florida Circuit Judge S. Joseph Davis in which Davis gave specific approval for a physician, Dr. Cecil McIver, to assist in the death of Charles Hall, an AIDS patient. In his opinion, Davis declared that a lethal prescription is “medical treatment” and said that Florida’s law against assisted suicide violates the state constitution’s right to privacy provision. (See Update, 1-2/97:6)
Arguing before the Florida Supreme Court, ACLU attorney and assisted-suicide advocate Robert Rivas portrayed laws against assisted suicide as state imposed suffering. He claimed that assisted suicide should be just another medical treatment. And he played down the significance of legalizing assisted suicide.
According to Rivas, the case is about whether a person “has the right to instruct the State of Florida to let him alone and get out of his dying process” or whether the person must be forced into “dying in a state-approved script.”
He claimed that a law against assisted suicide affects doctor-patient communication because it “makes it illegal in Florida to candidly discuss if the physician is going to help a patient across the River Styx a little sooner.” And he claimed that permitting assisted suicide would merely allow a person “to control a few details of how death takes place.” But, in response to questions from the justices, he revealed what these “few details” could include.
For example, when asked if a doctor would have to be the one to provide assisted suicide, Rivas said that the state could determine that there could be a “group of people who, after doctors have signed off, would carry it out.” He said there would not be any restriction of the method of death, only that the “physician is to ensure instantaneous and painless death.”
Although he didn’t elaborate on what qualifications would be required for the “group of people” who would serve as ushers to the grave or how physicians would ensure that this group would deliver death in an instantaneous and painless manner, he did draw the line on using shotguns as an acceptable medical treatment.
When asked if it would be permissible to shoot a friend if asked to do so, Rivas answered, “It’s murder to kill somebody at their request. It’s just murder.”
In response to a question about there being any difference between writing a prescription for a fatal drug overdose and giving a lethal injection, Rivas acknowledged that he didn’t see any significant difference and said any determination of the matter could be left to a future court case.
Throughout his argument, Rivas was careful to frame the issue as one which deals with an individual’s right to receive medical treatment which would induce death. He rejected the fact that, if the Florida law is found unconstitutional, the person who causes the death of another — not the dead person — would be the recipient of the right to assist in death without penalty.
Parker Thompson, arguing on behalf of the state, pointed out that in reality Florida’s law prohibits someone from engaging in assisted suicide. Changing that will give rights to the one who assists — which, in the case before the court, would be Dr. McIver, not Charles Hall.
He also noted that, if the court were to determine that lethal drugs constitute medical treatment available under Florida’s right to privacy, it would not be limited to competent, terminally-ill adults. He pointed out that previous Florida decisions regarding the right to privacy and medical treatment clearly permit medical treatment decisions to be made on behalf of children and the incompetent. “Providing drugs to end a patient’s life,” said Thompson, “is not medical treatment.”
It is now up to the Florida Supreme Court to decide whether the crime of assisted suicide will be judicially transformed into a “medical treatment” which, as Rivas claims, is only a matter of a “few details of how death takes place” or whether Florida will be permitted to protect its residents from those who would provide poison in the name of compassion.
George Delury, a former editor of the World Almanac who said he helped his disabled wife, Myrna Lebov, commit suicide by providing her with a lethal drink of drugs and honey, has now admitted that he actually suffocated her with a plastic bag.
In an e-mail message sent over the right-to-die Internet mailing list, Delury wrote, “The potion she drank tasted awful, but she did slip peacefully into sleep and later, wiht [sic] the help of a plastic bag I applied, into death.” [Delury, Right-to-Die Electronic Mailing List, 4/29/97] Delury also discusses his use of a plastic bag to end his wife’s life in his new book, What If She Wants to Die, which is due to be released this summer.
Prior to his wife’s death on 7/4/95, Delury kept a computer diary entitled, “Countdown: A Daily Log of Myrna’s Mental State and View toward Death.” While Delury told authorities that Myrna, who had multiple sclerosis, wanted to die and that he helped her only out of love for her, the diary revealed the dark side of Delury’s motivation. According to the computer log, Delury saw his wife as a burden who was “sucking my life out of [me] like a vampire and nobody cares.” Referring to Myrna, he wrote, “…I no longer believe in you.” [Diary entries for 3/27/95, p. 7] He also has admitted that he cashed Myrna’s lump-sum $50,000 disability check against her wishes because he anticipated her death and figured the money would pay off his debts and allow him to live more comfortably. (See also, Updates, 11-12/95:3, 3/96:7, 5-6/96:11.)
Delury became somewhat of a celebrity spokesman for the right-to-die movement after he was given a six-month jail sentence as part of a plea bargain agreement which reduced the charge against him to attempted manslaughter. Because he has already served his time, authorities said that he cannot be charged again even though he is now admitting that he suffocated Myrna. Wayne Braison of the Manhattan District Attorney’s office said, “The prosecutor is aware of the e-mails, but double jeopardy would apply.” However, N.Y. State Attorney General Dennis Vacco, who is opposed to assisted suicide, reportedly is launching an investigation to see if Delury will profit from his forthcoming book about Myrna’s death. If so, that could violate New York’s Son of Sam Law, which prohibits anyone from profiting from a crime they committed.
“From a legal standpoint, as far as double jeopardy, there’s nothing that can be done, but now we’re talking about something that is not in the court of law, but in the court of public opinion,” said IAETF Executive Director Rita Marker. “George Delury has held himself out as a caring person. In fact, what happened was not sweet violins in the background, but she was smothered.” [Forward (New York), 5/9/97:1]
Ionia County prepares for Kevorkian trial
Michigan Circuit Court Judge Charles Miel has ordered that jury selection in the fourth trial of Jack Kevorkian begin on June 10th in Ionia County. Kevorkian faces four felony counts in the 8/30/96 death of Loretta Peabody, 54, who had multiple sclerosis. Peabody’s death had originally been thought to be from natural causes, and her body was cremated. But when authorities confiscated a video tape showing Kevorkian conferring with Peabody and her husband in their Ionia County home shortly before her death, prosecutor Raymond Voet obtained a grand jury indictment of Kevorkian and his assistant, Janet Good, former head of the MI Hemlock Society. Felony charges against Good, who reportedly has terminal cancer, have been dropped. [UPI, 2/19/97; Detroit Free Press, 5/8/97. See also Updates, 10-11/96:1; 1-2/97:8]
Over protests from Kevorkian’s attorneys, Judge Miel ruled that the video tape — as well as Kevorkian’s suicide machine and other items confiscate by police — was legally obtained and could be admitted as evidence by the prosecution in the forthcoming trial. The judge, however, said he will not allow the full video tape showing three other Kevorkian victims to be entered into evidence, only the parts of the video dealing with Peabody. Voet is appealing that ruling to the MI Court of Appeals. [Detroit News, 5/17/97; 5/20/97]
Voet is also looking into the swift remarriage of Peabody’s husband only three months after her death. Voet voiced his concern that Joseph Peabody was having an affair prior to his wife’s death — a relationship which may have played a role in Loretta Peabody’s seeking Kevorkian’s help in dying. [Detroit News, 5/16/97]
Kevorkian burns state’s “cease & desist” order, secretive deaths continue
When the Michigan Dept. of Consumer and Industry Services, the agency responsible for licensing medical professionals, issued a “cease and desist order” warning Kevorkian that if he aids in anymore suicides he will face a 4-year felony charge and a $2,000 fine for practicing medicine without a license, Kevorkian held a news conference and burned the order. It was the state’s contention that “by his own statements” Kevorkian has acknowledged making diagnoses and prognoses of patients’ conditions and, as such, is practicing medicine without a license. Geoffrey Fieger, Kevorkian’s attorney, called the order “tyrannical” and “unacceptable.” Kevorkian labelled it “fascistic.” [Detroit News, 4/4/97, 4/5/97]
But others might simply call it “useless,” with Kevorkian in an apparent stealth mode. Bodies are now secretly abandoned in motel rooms; anonymous callers have to alert unsuspecting desk clerks; and nothing is left in the rooms to indicate what really happened — except for a note instructing authorities to contact Fieger, who then claims that he represents the corpse’s family. There’s no evidence, no proof that Kevorkian was even there. Since last reported in the Update, there have been five such deaths:
- Helen Livengood, 59, of Richmond, VA, died 3/6/97 — had chronic arthritis.
- Albert “Buddy” Miley, 41, of Warminster, PA, died 3/19/97 — was quadriplegic as the result of a high school football injury and an inspirational role model for local high school students.
- Jeanette Knowles, 75, of Norfolk, NE, died 3/24/97 — had ALS (Lou Gehrig’s disease).
- Heidi Aseltine, 27, of Indianapolis, IN, died 4/9/97 — had AIDS, her death occurred 5 days after the state issued Kevorkian’s “cease & desist order.”
- Delouise Bacher, 63, of Arvada, CO, died 5/4/97 — had multiple sclerosis.
Recent “bad press” for Dr. Death
Some recent articles have been less than flattering to Jack Kevorkian. Here are three examples.
“If Mr. Fieger is so confident that no jury will convict his client, why the furtive actions? Why the secretive behavior? Why the blind-draw scam? Is he afraid public opinion is beginning to sour on Kevorkianism? Such evasiveness is hardly a hallmark of the great moral crusades for social change.” [Editorial, Detroit News, 2/12/97]
In an interview, when confronted with his own contradictory statements that the medical profession is corrupt yet doctors should be the ones to decide when to perform euthanasia, Kevorkian is quoted as saying: “‘It’s simple,’ he bellows. ‘You just control euthanasia. How? You execute doctors who abuse it! Yes, execute them! No trial, no appeal, execution!'” [Charles Laurence, “An appointment with Dr. Death,” Chicago Sun-Times, 4/27/97]
“In 1993, I wrote a book…about Kevorkian. The book, reviewers said, was an evenhanded account…. After the book was published, interviewers would sometimes ask me if Kevorkian was crazy. I would say he was a zealot, not nuts…. I no longer defend Kevorkian’s sanity.” [Michael Betzold, “The Selling of Dr. Death: How a Sharp Lawyer and a Soft Press Made Jack Kevorkian Seem Normal,” The New Republic, 5/26/97:22-28]
I have lived with Amyotrophic Lateral Sclerosis (ALS/Lou Gehrig’s disease) for seven years. On January 8, the Supreme Court heard arguments concerning whether terminally ill people have a constitutional right to physician-assisted suicide. After the two-hour hearing, with its blending of emotion and law, the justices seemed highly skeptical.
I hope so. For as Chicago’s beloved Cardinal Joseph Bernardin wrote to the Supreme Court just before he died: “There can be no such thing as a ‘right to assisted suicide’ because there can be no legal and moral order which tolerates the killing of innocent human life, even if the agent of death is self-administered. Creating a new ‘right’ to assisted suicide will endanger society and send a false signal that a less than ‘perfect’ life is not worth living.”
Euthanasia advocates believe they are doing people like me a favor. They are not. The negative emotions toward the terminally ill and disabled generated by their advocacy is actually at the expense of the “dying” and their families and friends. We often feel disheartened and without self-assurance because of a false picture of what it is like to die created by these enthusiasts who prey on the misinformed.
What we, the terminally ill, need is exactly the opposite — to realize how important our lives are. And our loved ones, friends, and, indeed, society need to help us feel that we are loved and appreciated unconditionally.
Instead, reporting in the media too often makes us feel like token presences, burdens who are better off dead. For example, in a recent ABC “Nightline,” Ted Koppel interviewed a pro-euthanasia supporter with ALS who announced to the world that he was going to take his life on a specific date. He felt he was obligated to do so because of his beliefs and the terminal situation of his disease. I found this act of showboating pretentious and ABC’s presentation of his condition exploitive. Mr. Koppel asked him why he had not yet taken his life and his only answer was… no answer. It was obvious to me that despite what he said, this man really wanted to live. Indeed, the people around him urged him to live. He listened. He did not commit suicide but died a peaceful and natural death with loved ones at his side.
Many pro-euthanasia groups “showcase” people with ALS. They portray us as feeble, unintelligible and dying by slow suffocation. This is absolutely false, and I protest their efforts vehemently. By receiving proper medical care, a terminally ill person can pass away peacefully, pain-free and with dignity. We are not people just waiting for someone to help us end our misery, but to the contrary, we are people reaching out to love… to be loved… wanting to feel life at its best.
Too many people have accepted the presumption that an extermination of some human lives can be just. Are we becoming a society so starved for heroes that we are too quick to embrace the Jack Kevorkians of the world? Where has our sense of community gone? True, terminal illness is frightening, but the majority of us overpower the symptoms and are great contributors to life.
If physician-assisted suicide is legally available, the right to die may become a duty to die. The hopelessly ill may be subtly pressured to get their dying over with — not only by cost-counting providers but by family members concerned about burdensome bills, impatient for an inheritance, exhausted by care-giving or just anxious to spare a loved one further suffering.
In my view, the pro-euthanasia followers’ posture is a great threat to the foundation upon which all life is based, and that is hope. I exhort everyone: Life is worth living, and life is worth receiving. I know. I live it every day.
Robert Salamanca, of Pleasanton, CA, is living intensely with ALS. His article originally appeared in the San Francisco Chronicle, 2/19/97, and is reprinted here with the author’s permission.
Two recent Dutch court cases underscore the fact that, while right-to-die supporters claim otherwise, euthanasia and assisted-suicide safeguards simply do not work. This April, two doctors, both of whom terminated patients’ lives in violation of established euthanasia guidelines, were set free without penalty.
While the practices of euthanasia and assisted suicide are technically illegal in the Netherlands (carrying up to a 12-year jail sentence), doctors are assured that they will not be prosecuted as long as they follow government-approved guidelines — ostensibly formulated to protect patients against abuses. Those guidelines include the requirements that physicians perform euthanasia only on patients who make clear and repeated requests to die, that doctors seek out a second physician’s opinion as to whether the patient’s life should be terminated, and that details of all euthanasia and assisted-suicide deaths must be reported to authorities.
Dr. Sippe Schat, 54, did not comply with all the guidelines in April 1996 when he gave a lethal injection to his 72-year-old cancer patient, Dora Brattinga, and then tried to cover up the euthanasia death. Prosecutors in Leeuwarden charged Schat with murder because, they said, he had violated so many of the guidelines that they had to press charges. Schat reportedly had no written documentation that Brattinga had actually asked for euthanasia, he had neglected to get a second doctor’s opinion, and he had falsified the patient’s death certificate stating she had died of natural causes. [AP, 3/25/97]
On 4/8/97, a District Court 3-judge panel ruled that, while prosecutors had failed to prove that Schat had committed murder, the doctor had not followed all the approved euthanasia guidelines in Brattinga’s death. The court handed down a six-month suspended sentence, and Schat was set free. This ruling caused one Associated Press reporter to write that the suspended sentence “underscores how Dutch judges are sympathetic to doctors who practice euthanasia and reluctant to imprison physicians who break the rules.” [Jenifer Chao, “Dutch Euthanasia Doctor Walks Free,” AP, 4/8/97]
Another Dutch physician, A. Makdoembaks, also received a suspended sentence on 4/1/97 for the death of a 75-year-old woman in November 1994. Like Schat, Makdoembaks admitted euthanizing the patient, but the court found that he had not followed the guidelines when he filed an incomplete death report and when he failed to get a second doctor’s opinion before ending the woman’s life. For violating the euthanasia safeguards, Makdoembaks received a three-month suspended sentence. [AP, 4/2/97]
Note: As previously reported in the Update (12/96:4), a recent study published in the New England Journal of Medicine indicates that the majority of Dutch physicians (59%) do not comply with the guideline requirement to report euthanasia and assisted-suicide deaths to the authorities. [van der Wal et al., “Evaluation of the Notification Procedure for Physician-Assisted Death in the Netherlands,” NEJM, 11/28/96:1706] Furthermore, in a companion report, researchers found that 55% of the Dutch doctors interviewed in 1995 indicated that “they had ended a patient’s life without his or her explicit request” or “they had never done so but that they could conceive of a situation in which they would.” [van der Maas et al., “Euthanasia, Physician-Assisted Suicide, and Other Medical Practices Involving the End of Life in the Netherlands, 1990-1995,” NEJM, 11/28/96:1701]
In a ruling that has caught most people off guard, Colombia’s highest court has approved euthanasia for terminally-ill people who have given their consent. On 5/20/97, the Constitutional Court ruled 6 to 3 that a person following strict guidelines cannot be prosecuted for taking another’s life. The Court’s chief magistrate, Antonio Barrera Carbonell, told reporters that soon the court will be issuing a series of guidelines detailing the circumstances under which euthanasia would be legal. “The court ruled in the abstract,” he explained. “Obviously, the ruling has to be understood as a message to the legislative branch to pass laws on the matter.” Sen. Rodrigo Villalba said the court’s decision “took everyone by surprise.” “Congress will have to convene immediately to discuss this because there’s a lot of confusion,” he added.
Ironically, the case before the court was brought by a Bogota lawyer who strongly opposes euthanasia. He filed the case because he wanted the court to make Colombia’s 1980 penal code tougher on mercy killing. Under the existing code the penalty for euthanasia was only six months to three years in jail. But rather than toughen the existing law, the court overturned it in cases where there is expressed consent given by the victim. “This is going to draw conflict. This will be argued. The ethical and moral debate is just beginning,” acknowledged Chief Magistrate Carbonell. “There are a lot of people who believe that sustaining the life of the terminally ill is too costly from the economic point of view, and that applying a penalty [for euthanasia] is wrong,” he said. [The Miami Herald, 5/22/97; AP, 5/21/97; Reuter, 5/20/97]
Wesley J. Smith, legal consultant and a spokesperson for the IAETF, has authored a blockbuster new book entitled, Forced Exit — The Slippery Slope from Assisted Suicide to Legalized Murder. Published by Times Books (Random House) and due to be released on 6/1/97, Forced Exit offers a compelling case against legalizing assisted suicide and euthanasia, while also presenting the reader with viable, humane, and compassionate alternatives. Smith — who, as a consumer advocate, has authored several other books — uses original reporting, exhaustive research, historical analysis, true stories, and extensive interviews to show just how powerful and dangerous the death culture has become. Here’s what some of the experts have to say:
- C. Everett Koop, MD, former surgeon general: “Wesley J. Smith offers a compelling argument against legalizing assisted suicide and clearly explains the devastating effects it would have on an unwary public. Smith has done us all a great service with this important primer.”
- Ralph Nader, consumer advocate: “Forced Exit argues against legally assisted suicide in so many compelling ways. It should drive the terms of debate on this highly charged controversy that is sweeping a country in the grip of rationed care and the plight of millions of uninsured Americans.”
- Ira Byock, MD, president, Amer. Academy of Hospice & Palliative Medicine: “In Forced Exit, Wesley J. Smith clearly and convincingly reveals the disturbing social ills lurking beneath the benign sheep’s clothing of the euthanasia movement. Equally important, Smith shines a bright light on the alternatives to preemptive death….”
- Nat Hentoff, columnist: “Finally, a lucid, comprehensive, and absorbing account of a dangerous movement that will eventually affect us all if assisted suicide is legalized, for it will inexorably lead to lawful euthanasia.”
- Carol J. Gill, Ph.D, president, Chicago Institute of Disability Research: “Wesley Smith maintains a balance between sane, well-grounded observation and deeply felt passion…. The stories, data, and interpretive text are clear and absorbing, resulting in a book that says more than we expect about how to live.”
- Evan J. Kemp, Jr., former chairman, Equal Employment Opportunity Commission: “Poor people with chronic health conditions and those who deviate too far from the norm will be encouraged to ‘choose’ assisted suicide. Forced Exit makes this and other cogent arguments concerning this critical issue of our time.”
Note: Forced Exit will be available in bookstores starting June 1.