Update 037: Volume 20, Number 3 (2006)

ITF lawyers testify at Congressional hearing

On May 25, 2006, the U.S. Senate Judiciary Subcommittee on the Constitution, Civil Rights and Property Rights conducted a hearing on “The Consequences of Legalized Assisted Suicide [PAS] and Euthanasia.” In the U.S., only Oregon has legalized PAS. No state has legalized euthanasia.

Senator Sam Brownback (R-KS), chairman of the subcommittee, convened the hearing to explore the “unintended consequences and slippery slope” associated with PAS and euthanasia. “Their legalization in the U.S.,” he said, “could actually create a financial incentive for insurance companies to encourage premature ending the lives of those who need long-term care.” [AP, 5/25/06]

But Senator Ron Wyden (D-OR) countered Brownback’s concerns by stating that his home state of Oregon had not legalized PAS “precipitously” and “the safeguards appear to have worked quite well in preventing potential abuses.” He vowed to “strongly oppose” any federal effort to “overturn or nullify” Oregon’s PAS law. [Note: Unless otherwise cited, all witness statements are taken from their written testimony or from the Senate subcommittee.]


In addition to Wyden, there were eight witnesses invited to present testimony before the subcommittee. Those defending Oregon’s PAS law were Ann Jackson, executive director of the Oregon Hospice Association; attorney Kathryn Tucker, director of legal affairs for the PAS advocacy group Compassion & Choices (C&C, formerly Compassion in Dying and the Hemlock Society); and Julie McMurchie, whose mother died under the PAS law.

Those opposed to PAS and euthanasia were International Task Force (ITF) executive director and attorney Rita Marker; ITF attorney Wesley J. Smith, senior fellow at the Discovery Institute; disability advocate and attorney Diane Coleman, president of Not Dead Yet; Jonathan Imbody, senior policy analyst for the Christian Medical Association (CMA), and Hendrick Reitsema, a Dutch citizen whose grandfather was terminally sedated while being starved and dehydrated to death, all without his consent.


Hospice CEO Ann Jackson wrote in her testimony, “It no longer matters whether assisted dying is right or wrong because it is a legal option in Oregon.” She added that “autonomy and control—not uncontrolled symptoms—are the reasons people use a prescription [of lethal drugs].” “Oregon’s hospices agree,” she wrote, “that it’s much easier to have open and honest conversations about end-of-life care when all end-of-life options are on the table.” Assisted-suicide is one of those options.

While C&C’s Kathryn Tucker appeared to agree with Jackson that autonomy and control issues were the reasons for PAS deaths in Oregon (not unrelieved pain and suffering), she still used the emotionally-charged pain argument as justification for PAS legalization. It was the argument most responsible for Oregon’s law passing in the first place. “[A] fraction of dying patients,” she wrote, “will confront a dying process so prolonged and marked by such extreme suffering and deterioration, that they determine that hastening impending death is the least worst alternative.” “Passage of such [PAS] laws would harm no one,” she concluded, “and would benefit both the relatively few patients in extremis who would make use of them….”

Tucker claimed, “More than eight years of experience in the state of Oregon has demonstrated that risks to patients are not realized when a carefully drafted law is in place.”

But ITF’s Rita Marker and Wesley J. Smith both debunked Tucker’s contention in their individual testimony. Marker pointed out that “the experience in Oregon contradicts the effectiveness of safeguards, making it clear that their protective nature is a mere illusion.” C&C, she wrote, “facilitates most of Oregon’s assisted suicides,” and if a patient’s own doctor determines that the patient is not eligible for PAS and refuses to write the lethal prescription, the patient (or the patient’s family) is usually referred to C&C for one of their doctors who will. Smith called the practice pure “doctor shopping” and “rank ‘Kevorkianism.’” [Smith’s Blog , 5/26/06]

Marker pointed out that the data gleaned from Oregon’s PAS experience is highly questionable due to the fact that it is based on doctors’ self-reporting their PAS cases to the state. Smith also questioned the PAS statistics, saying the self-reporting doctors “are about as likely to tell the state they violate the law as they are to tell the IRS they cheated on their taxes.” [AP, 5/25/06]

Not Dead Yet’s Diane Coleman presented the reality of PAS from a disability rights perspective. “The Oregon Death with Dignity Act authorizes and empowers physicians to discriminate in their response to a patient’s… wish to die based on the patient’s disability,” she said. “This should be viewed as a violation of the Americans with Disabilities Act, which prohibits such discrimination.” Furthermore, she concluded, “[R]egardless of our abilities or disabilities, none of us should feel that we have to die to have dignity, that we have to die to be relieved of pain, or that we should die to stop burdening our families or society.”

Three witnesses—CMA’s Jonathan Imbody, Hendrick Reitsema, and Smith—addressed the ever-expanding boundaries of Dutch euthanasia and PAS practices. “The slippery slope is not theoretical,” Imbody wrote. “And it can happen anywhere.”

House of Lords blocks assisted-suicide bill;
ethical debates rage

After more than seven hours of heated debate—during which 90 individual members of Britain’s upper parliamentary house presented impassioned pro and con arguments—the “Assisted Dying for the Terminally Ill Bill” was officially blocked from passage for the third year. On May 12, 2006, the House of Lords voted 148 to 100 to delay the second reading of the assisted-suicide bill for six months, effectively killing any chance of it passing before the end of this session of Parliament. The bill’s sponsor, Lord Joel Joffe, has vowed to reintroduce it in the next session. [London Times, 5/12/06; The Independent, 5/13/06; The Guardian, 5/13/06]

Prior versions of Joffe’s bill would have legalized voluntary euthanasia, giving doctors legal immunity if they directly killed a patient who requested death, as well as physician-assisted suicide (PAS), allowing doctors to provide patients with lethal drugs to end their own lives. Joffe opted to go with a PAS-only bill this session because, he said, “[T]here is more support for a law which requires the patient to take the final act.” [British Medical Journal, 11/1/05]

The opposition

But support for his new bill, patterned after Oregon’s PAS law, was still hard to come by. While the British Medical Association changed its century-long policy opposing euthanasia and assisted suicide to a position of neutrality, other medical groups, including the Royal College of Physicians, the Royal College of Psychiatrists, the Royal College of GPs, the Royal College of Nurses, the Royal College of Anesthetists, and the Association for Palliative Medicine, reaffirmed their opposition. [London Times, 5/11/06]

Care NOT Killing, a new opposition alliance of over 32 human rights, healthcare, palliative care, and various religious groups, was formed to fight Joffe’s bill and any future attempts to legalize induced death practices. [Care NOT Killing, press release, 5/8/06] A British chapter of the American disability rights group Not Dead Yet (NDY) was also formed “to make the voice of disabled people heard.” According to spokesperson Jane Campbell, Joffe’s bill “failed to get the endorsement of a single organization of disabled people.” “The very people the bill is intended to help, the terminally ill and disabled,” she wrote, “are frightened by what it seeks to achieve.” [Campbell, “Stop trying to kill us off,” The Guardian, 5/9/06]

The debate

A significant majority of the House of Lords members who testified opposed Joffe’s bill for a broad array of reasons. Responding to Joffe’s earlier statement that the bill does not permit euthanasia [Transcript, House of Lords Debate, 5/12/06, Column 1186. Hereafter cited “Debate.”], Lord Alexander Carlile, a Liberal Democrat and seasoned criminal attorney, stated, “[D]espite protestations to the contrary, everyone in your Lordships’ House knows that those who are moving this Bill have the clear intention of it leading to voluntary euthanasia. That has always been the aim and it remains the aim now.” [Debate, Col. 1191]

Baroness Ilora Finlay, a professor of palliative medicine in both the UK and the Netherlands, told her fellow peers, “The public needs to know that 94 percent of palliative medicine specialists in the UK oppose this Bill.” Countering Joffe’s claim that “palliative care has flourished” in Oregon since PAS was legalized [Debate, Col. 1187], the Baroness said, “Palliative care in Oregon does not fulfill the quality specialist criteria of the UK.” “I was not impressed by what I saw when I went to Oregon as a member of the [House of Lords’] Select Committee,” she explained. “Our palliative care has led the world, and the world is watching this debate.” [Debate, Col. 1202]

Baroness Nicola Jane Chapman reflected on the bill from a disability perspective. She was born with osteogenesis imperfecta and has suffered over 600 bone fractures with residual bone pain. Her pain is now under control, but she said, “I dread to think what decisions I might have made if a Bill like this had been passed previously.” Speaking on behalf of the disabled, she added, “We are afraid of the consequences of this bill.” [Debate, Col. 1205]

Baroness Elizabeth Symons told the story of a young man with an advanced case of the most virulent kind of leukemia, at whose bedside she sat “every day and most nights.” She said the man, who was told he only had weeks to live, fulfilled the criteria for PAS in Joffe’s bill. His pain was “excruciating” and his “mental anquish was constant and acute.” “Fourteen years later,” she told the peers, “I am happy to say that he is thriving, and I am so glad that [Joffe’s] Bill… was not on the statute book. I fervently hope that it never will be.” [Debate, Col. 1223]

Both the Archbishop of Canterbury, Rowan Williams, and Lord Rodney Elton touched on the danger of legalizing PAS with the country’s health service under “severe financial pressure.” [Debate, Col. 1197] Elton, formerly a minister in the Dept. of Health and Social Security, said that “ultimately policy is driven by money.” “The stark fact is that palliative care is expensive and the lethal pill is cheap,” he added, “and the generators of policy… will be steered in a critical part by that financial consideration.” [Debate, Cols. 1213-1214] The Archbishop also talked about Joffe’s bill having “implications for everyone—for the suicidal teenager as well as the dying 80 year-old.” [Debate, Col. 1198]

Britain’s slippery slope

Many of those who testified either affirmed or denied the existence of an ethical “slippery slope,” as evidenced by the Dutch experience with ever broadening categories of patients deemed eligible for medicalized killing. While Joffe and his supporters emphatically denied that PAS would inevitably lead to full blown euthanasia, an article which appeared after the House of Lords’ debate in the British journal Clinical Ethics, clearly demonstrates how the slippery slope logic works.

In the article, Dr. Len Doyal—described in the British press as a leading UK expert on medical ethics, a former member of the British Medical Association’s ethics committee, and a Joffe bill supporter—called for the legalization of not just PAS and voluntary euthanasia, but also non-voluntary euthanasia for those not capable of asking for it.

“If competent patients who are terminally ill should be legally able to choose assisted death because they believe that their lives are no longer worth living,” he wrote, “then should it not be possible for clinicians in partnership with families to make similar decisions on behalf of those who cannot competently choose for themselves? Because patients in a permanent vegetative state lack the capacity to experience anything, the same question can be asked about them.” Furthermore, he argued, given the “national shortage of expert palliative care for competent patients…, what would be the moral point in expending such valuable resources on severely incompetent patients whose best interest will be served by a quick and painless death?”

Doyal based his argument on the fact that presently doctors can legally remove life-sustaining treatment, such as food and water, from incompetent patients. “Once it is recognized that withdrawal of life-sustaining treatment from severely incompetent patients is a form of killing,” he wrote, “it will be apparent that clinicians are already taking the lives of such patients through the consequences of decisions that they make about whether or not patients will benefit from further life.” These patients, he said, “should not be forced to die slow and distressing deaths because of the potential distress that the legalization of both [voluntary and non-voluntary euthanasia] might have on patients or doctors in the future.” [Len Doyal, Guest Editorial, Clinical Ethics, 2006, no. 1, pp. 65-67]

Doyal is not the first to use the removal of food and fluids as a rationale for euthanasia. In 1984, during her speech at the World Federation of Right to Die Societies Conference in France, Monash University professor Helga Kuhse said that once people recognize how painful death by starvation and dehydration is, they will accept the lethal injection “in the patient’s best interest.” [Rita Marker, Deadly Compassion, NY: Wm. Morrow & Co., 1993, pp.94 & 267]

Vermont PAS bill dies in committee;
California’s is still pending

Vermont’s Democrat-controlled legislature dealt assisted-suicide advocates a serious blow on May 3, 2006, when the House Human Services Committee voted down HB 168, an Oregon-style bill which would have legalized physician-assisted suicide in that state. The measure failed to get the majority vote it needed to pass out of the committee. Vermont has been persistently targeted by PAS advocates who desperately need another state to follow Oregon’s lead.

Over the last decade, advocates have repeatedly attempted to legalize PAS in various parts of the country, but in every case their bill or ballot initiative has been defeated. This latest Vermont bill was hotly debated over the course of the 2005-2006 legislative session. According to Dr. Robert Orr of the Vermont Alliance for Ethical Healthcare (VAEH), local PAS proponents got hundreds of thousands of dollars from out-of-state advocates, hired a field director and professional lobbyists, conducted an expensive opinion poll, and got very favorable media coverage. Yet, despite all that, a dedicated, broad-based opposition coalition—including medical, disability rights, and suicide prevention groups— prevailed. [VAEH Newsletter, no. 38, 6/6/06]

Now only California has a PAS measure still pending. AB 651, another Oregon law clone, is scheduled to be heard in the Senate Judiciary Committee on June 27. If approved, it would then need to pass a Senate floor vote. If it passes the liberal Senate, it would proceed to the Assembly, where strong opposition stopped it last year. It’s deadline for passing both houses is August 31.

Note: After this edition of the Update went to press, California’s assisted-suicide bill was defeated in the Senate Judiciary Committee. For more information, see: California.

Swiss cabinet backs assisted suicide

Swiss Justice Minister Christoph Blocher announced on May 31, 2006, that his cabinet has decided that there is no need to change the country’s law on assisted suicide. The Swiss Parliament had requested that the government study whether the current law, prohibiting euthanasia but tolerating assisted suicide if the assister is well intentioned, should exert tougher controls on the practice.

Many in parliament have been concerned with the fact that Switzerland has developed a reputation for “death tourism.” The Zurich assisted-suicide advocacy group Dignitas has been responsible for the deaths of over 450 people since it began in 1998, mostly foreigners. The cabinet’s decision to leave the law as is was met with strong criticism from three of the four political parties in parliament, all of whom said that the cabinet ignored parliament’s wishes.

The cabinet based its decision on a justice ministry report that said that strong rules on assisted suicide would not be practical because each case is different. They unanimously refused to outlaw the practice.

Blocher told reporters that they had no plans to monitor Swiss right-to-die groups because to do so would add to the government’s bureaucracy and would legitimize these organizations. The only control the cabinet plans to consider is whether to make assisted-suicide drugs more difficult to obtain. The final decision on this will be made by the end of the year. The Radical Party has indicated that it will file a parliamentary motion to force the government to reconsider the issue. [Swissinfo, 5/31/06]

Residents object to Dignitas’ body bags

Residents of a Zurich apartment complex are gathering signatures to evict Dignitas, the assisted-suicide provider group that uses a fourth-floor flat as the place to end people’s lives. Describing it as a “house of horrors,” Gloria Sonny, a six-year resident of the complex, said, “This is meant to be a residential flat, but some days you’d think it was a morgue.”

For many residents, the worst part is seeing these suicidal people in the halls and elevator on their way up to the apartment to die. “The look in their eyes haunts me,” Sonny explained, “particularly if they are young.” For other occupants, seeing the corpses in body bags propped up in the corner of the communal three-person elevator is the most disturbing. Since the elevator isn’t big enough for a coffin, Dignitas uses a body bag to bring the corpse down to a waiting hearse. “Almost every day the bodies of people… are taken down in the lift,” Sonny said. Kelvin Leneveu, another resident added, “It’s very creepy. The floors are thin and when we hear movements upstairs, we know that means they’re up there, and someone’s going to die.” [British Medical Journal, 6/3/06; Daily Telegraph, 6/4/06]

Sleeping pill awakens “PVS” patients

When Louis Viljoen’s doctor in South Africa prescribed a sleeping pill for him to calm his restlessness, something unexpected happened. Louis, who had been in a “permanent vegetative state” (PVS) for three years, suddenly awakened 25 minutes after the drug was administered. His mother was there when it happened. For three years, she said, “He hadn’t made a sound, not even a groan. Then that night I heard a noise that sounded like ‘urgh.’” Unsure what the sound meant, she whispered, “Louis?” “Yes,” he replied. “That was his first word,” his mother explained. “I was in such shock, I cried.” [Daily Mirror (UK), 5/31/06]

Louis’ case was one of three such cases reported in the May 2006 issue of the medical journal NeuroRehabilitation. All three cases involved males around 30 years-old who had been in a PVS for at least three years. Two were victims of motor vehicle accidents, the other almost drowned. All were given daily doses of the sleeping medication Zolpidem (brand name Ambien). Each dose aroused the patients in about 20 minutes and lasted for four hours. Then a second dose was given, allowing the patients eight hours of consciousness per day, during which time they could interact with their families and, in one case, play catch with a ball.

One patient had been constantly screaming when unconscious, but after the drug was given stopped screaming and quietly watched TV. When the drug’s effect wore off, each patient returned to an unconscious state. Researchers monitored the patients’ response to the drug for three to six years. They found no long-term side effects and concluded, “Zolpidem appears an effective drug to restore brain function to some patients in the permanent vegetative state.” The Glasgow Coma Scale and Rancho Los Amigos Cognitive test scores for all three men improved with the drug’s use. [NeuroRehabilitation, 5/31/06, pp. 23-28]

South African physician Walley Nel, who co-authored the study, said, “There is a lot of research to be done before we can start using this drug on others, but now we have something we can work on.” “When you think about how many life-support machines have been switched off over the years, it makes you wonder,” he said. [Daily Mirror, 5/31/06]

In response to the study’s findings and to similar reported events from families of patients misdiagnosed as PVS, the Terri Schindler-Schiavo Foundation and the disability rights group Not Dead Yet have independently called for a moratorium on the withdrawal of care from these patients until more definitive data on PVS is gathered. [World Net Daily, 5/25/06; Cybercast News Service, 6/1/06]

The British company ReGen Therapeutics plans to begin clinical trials to further test Zolpidem on 30 coma patients in July. [UPI, 6/1/06]

“We never say no”
Some in the right-to-die movement abandon pretense

By Wesley J. Smith

There is a pretense in contemporary assisted suicide advocacy that goes something like this: “Aid in dying” (as it is euphemistically called) is merely to be a safety valve, a last resort only available to imminently dying patients for whom nothing else can be done to alleviate suffering.

Meanwhile, in the real world, the founder of the Swiss suicide facilitating organization Dignitas is just about done with pretense. The Sunday Times Magazine (London) reported that Dignitas’ founder, Ludwig Minelli, plans to create sort of a Starbucks for suicide: a chain of death centers “to end the lives of people with illnesses and mental conditions such as chronic depression.”

Minelli believes that all suicidal people should be given information about the best way to kill themselves, and, according to the Times story, “if they choose to die, they should be helped to do it properly.” Dignitas admits to having assisted the suicides of many people who were not terminally ill. As Minelli succinctly put it, “We never say no.”

The story about Minelli illuminates a deep ideological belief within the euthanasia movement: that we own our bodies, and thus, determining the time, manner, and method of our own deaths, for whatever reason, is a basic human right.

That is certainly how one of the other superstars of the international euthanasia movement, the Australian physician Phillip Nitschke, sees it. Nitschke travels the world presenting how-to-commit-suicide clinics. Several years ago he was paid thousands of dollars by the Hemlock Society (now merged into the assisted suicide advocacy group Compassion and Choices) to create a suicide concoction made from common household ingredients (a formula he calls the “Peaceful Pill”).

Like Minelli, Nitschke is straightforward about his goals. In a 2001 interview, National Review Online asked him who should qualify for the Peaceful Pill. He responded:

My personal position is that if we believe that there is a right to life, then we must accept that people have a right to dispose of that life whenever they want… So all people qualify, not just those with the training, knowledge, or resources to find out how to “give away” their life. And someone needs to provide this knowledge, training, or resource necessary to anyone who wants it, including the depressed, the elderly bereaved, [and] the troubled teen.

Nitschke and Minelli’s position has a large constituency among euthanasia believers. Indeed, over the years, the movement has left many telltale signs that assisted suicide is not intended ultimately to be restricted to the imminently dying.

Take the “Zurich Declaration,” issued at the 1998 bi-annual convention of the World Federation of Right to Die Societies. (The WFRD is an umbrella group made up of 37 national euthanasia advocacy organizations, including Compassion and Choices and Hemlock founder Derek Humphry’s Euthanasia Research and Guidance Organization, or ERGO.) It states:

We believe that we have a major responsibility for ensuring that it becomes legally possible for all competent adults, suffering severe and enduring distress, to receive medical help to die, if this is their persistent, voluntary and rational request. We note that such medical assistance is already permitted in The Netherlands, Switzerland and Oregon, USA.

It should also be noted that one need not be dying or even sick to experience “severe and enduring distress.”

Support for a broad and liberal access to suicide extends far beyond activists in the euthanasia movement. It has been embraced by some people in the mental health professions, where a concept known as “rational suicide” is being promoted in professional journals, books, and at symposia.

Typical of this genre is a 1998 article by James W. Werth published in the journal Crisis, with the ironic title, “Using Rational Suicide as an Intervention to Prevent Irrational Suicide.” Werth urges that mental health professionals should not always save the lives of suicidal patients, but instead, should non-judgmentally facilitate the suicidal person’s decision making process. If the professional agrees that the desire to die is rational, then the suicide should be permitted, or perhaps even assisted.

To qualify for a rational suicide, the patient would have to demonstrate to the mental health professional that he has a “hopeless condition,” which Werth defines as, “terminal illnesses, severe physical and/or psychological pain, physically or mentally debilitating and/or deteriorating conditions, or qualify of life no longer acceptable to the individual.” This is circular thinking. By definition, if one is suicidal, he has a quality of life that he believes is no longer acceptable.

Not surprisingly, assisted rational suicide is already permitted in the Netherlands where the Dutch Supreme Court approved a psychiatrist’s facilitating the death of a distraught woman who wanted to die because her children were dead.

Similar suicide-friendly attitudes are often expressed among mainstream bioethicists—and not just by Princeton’s Peter Singer. For example, the University of Utah’s Margaret Pabst Battin suggests that “suicide can be rationally chosen,” to “avoid pain and suffering in terminal illnesses,” as a “self-sacrifice for altruistic reasons,” or in cases of “suicides of honor and principle.” Along these same lines, Julian Savulescu, an up-and-comer in the international bioethics community, argues that respect for human freedom demands that society permit the suicides of competent persons—even when they are expressing an “unjustified desire to die.”

“Some freedoms are worth the cost of innocent life,” Savulescu wrote in a chapter for the book Assisted Suicide. “The freedom to finish one’s life when and how one chooses is, it seems to me, about as important as any freedom.”

The right to receive assisted suicide for virtually any reason is especially popular among self-declared “free thinkers” and humanists. Thus, Tom Flynn, the editor of Free Inquiry, the house organ for the Council for Secular Humanism, wrote in the Spring 2003 issue, that the belief in human liberty must include an unfettered right to die. “While suicide has never been exactly popular, a new assault on our right to suicide is brewing. It’s something secular humanists ought to resist.” Why? Because Flynn (and other humanists) believe fervently that a right to suicide is a crucial element of human liberty:

What’s really in play here is the old dogma that individuals don’t own their own lives. Physician-assisted suicide is but part of the issue. If we trust our fellow humans to choose their occupations, their significant others, their political persuasions, and their stances on religion, we should also defend their right to dispose of their most valuable possessions—their lives—even if disposing of life is precisely the choice they make.

There are even ongoing discussions in bioethics suggesting that some people might have an ethical obligation to commit suicide. Thus, in a 1997 cover story in the prestigious bioethics journal the Hastings Center Report, philosopher John Hardwig argued that there is not only a right, but also a “duty to die”:

A duty to die is more likely when continuing to live will impose significant burdens—emotional burdens, extensive caregiving, destruction of life plans, and yes, financial hardship—on your family and loved ones. This is the fundamental insight underlying a duty to die.

A duty to die becomes greater as you grow older. As we age, we will be giving up less by giving up our lives . . . To have reached the age of say, seventy-five or eighty years without being ready to die is itself a moral failing, the sign of a life out of touch with life’s basic realities.

Bioethicist Battin has also supported the concept of an eventual duty to die for those living in rich countries, not just to spare burdening our loved ones but to promote world egalitarianism. Thus, she wrote in a book chapter called “Global Life Expectancies and the Duty to Die” that the time may come when we will have the moral obligation to “conserve health care resources by forgoing treatment or directly ending [our] life” toward promoting “health prospects and life expectancies” that are more equal around the globe.

Despite this thickening atmosphere of suicide permissiveness, most assisted suicide advocates in this country continue to insist that “all” they want is for the terminally ill to have access to hastened death.

For some, clearly, this is a mere political tactic. The ultimate goal is a much broader death license. Others may actually mean for the initial terminal illness limitation to be permanent, believing that “restricted” assisted suicide, once accepted widely, would not spread to ever widening swaths of acceptable killing (as it has in the Netherlands).

Which camp one decides best represents the overall euthanasia movement doesn’t really matter. Once assisted suicide is accepted in law and culture, the premises of radical autonomy and allowing killing to alleviate human suffering would conjoin, unleashing the irresistible power of logic that would push us inexorably toward the humanist nirvana of death on demand.

Wesley J. Smith is an attorney for the International Task Force on Euthanasia and Assisted Suicide, a senior fellow at the Discovery Institute, and a special consultant to the Center for Bioethics and Culture. His website is wesleyjsmith.com. The above article is reprinted with the author’s permission and originally appeared in the Weekly Standard, 4/27/06.

News notes . . .

· The world renowned Cambridge University physicist Stephen Hawking recently spoke about life and hope at a Hong Kong University of Science and Technology press conference. Hawking, 64, who has ALS (Lou Gehrig’s disease), is unable to move or speak, but uses a computerized voice synthesizer to verbally communicate. One question posed to Hawking mentioned Bun Tsai, a local paralyzed accident victim who wants euthanasia legally available to him. Hawking was then asked how he copes with the frustrations of his condition, to which he replied: “The victim should have the right to end his life, if he wants. But I think it would be a great mistake. However bad life may seem, there is always something you can do, and succeed at. While there’s life, there is hope.” [People’s Daily, 6/14/06]

· Minnesota neurologist and bioethicist Ronald Cranford, 65, who referred to himself as Dr. Humane Death, died of kidney cancer on May 31 in a hospice near Minneapolis. [Minneapolis Star-Tribune, 5/31/06] Cranford made a career of testifying in major “right-to-die” cases always in support of withholding or withdrawing treatment from cognitively disabled patients. It was his testimony in favor of removing tube-supplied food and fluids from non-dying patients, such as Nancy Beth Cruzan, Christine Bussalachi, Robert Wendland, and Terri Schiavo, that earned him almost hero status in some bioethical circles. While on the stand in the Cruzan hearing, Cranford said that he would consider even spoon-feeding Nancy to be “medical treatment,” and to spoon-feed her “would be totally inconsistent” with what was wanted, namely her death. [Cruzan v. Harmon, 760 S.W.2d 408 (Mo. 1988) (No. CV 384-9P), Transcript, p. 283] University of Pennsylvania bioethicist Arthur Caplan described Cranford as “a defender of free choice and families’ wishes” and that he “thought it was pointless and futile—not a good use of society’s resources—to sustain a person who would not recover.” [NY Times, 6/3/06]

· Oregon’s Department of Human Services (ODHS) has developed a new statewide suicide prevention program because the state’s suicide rate for people over 65 is well above the national rate and has been for over a decade. “This is an important issue that will only get worse as our population ages,” noted Dr. Mel Kohn, Oregon’s chief epidemiologist. One of the contributors to the elder suicide problem according to the ODHS is the “high prevalence of mood disorders among older adults, particularly those with certain chronic health conditions.” [ODHS, Press Release, 5/16/06] Commenting on Oregon’s apparent inability to “connect the dots,” ITF’s Wesley J. Smith said, “Amid the wringing hands, no one seems to get that the state itself, by legalizing physician-assisted suicide, sends an insidious message that suicide is fine and dandy in some cases. Despairing people, particularly with health issues, get that point and may think, if it’s okay for the cancer patient, why not for me?” [Smith’s Blog, www.wesleyjsmith.com, 5/16/06] Assisted suicide was voted in over a decade ago, the same length of time that Oregon’s elder suicide rate has been high.

· Ireland’s Director of Public Prosecutions (DPP) has officially ordered the extradition of Reverend George Exoo, an American right-to-die advocate, for criminal prosecution in the 2002 assisted-suicide death of Rosemary Toole Gilhooley, 49. Gilhooley, who was physically healthy but severely depressed, died using a plastic “Exit Bag” secured tightly around her neck, with a tube from a helium canister inserted so she could breathe in concentrated, lethal levels of the gas. It was a classic assisted-suicide scene, straight off the pages of the suicide manual Final Exit by euthanasia guru Derek Humphry, who reportedly had sold her a copy of the book. Exoo and his live-in companion Thomas McGurrin ran a death assistance organization called “Compassionate Chaplaincy” out of their West Virginia home. They traveled to Dublin at Gilhooley’s expense and were present when she took her life. Aiding and abetting a suicide is illegal under Ireland’s Criminal Law (Suicide) Act of 1993 and carries a 14-year prison sentence. An Irish spokesman said that the correct extradition papers are currently in the hands of American legal authorities. [Irish Times, 4/20/06; Irish News, 4/20/06]

· When it comes to euthanasia, what the Netherlands legalizes, Belgium is soon to do the same. The Dutch formally enacted their permissive euthanasia law in April 2002. Just under six months later, neighboring Belgium followed suit. Recently, within weeks of the Dutch establishing a committee to oversee the approved practice of “baby euthanasia,” the Belgian Flemish Socialist Party, a member of the country’s coalition government, proposed the expansion of its euthanasia law to give children under 18 the right to choose a medically-induced death and to give the parents of younger children and babies the right to choose such a death for their child. [Guardian (London), 4/6/06; Sunday Times (London), 3/5/06]

· Homeless and illegal immigrants in the Netherlands are being denied needed hospital care because they are uninsured, according to two Rotterdam doctors who have been treating over 20 uninsured patients a week for a variety of conditions, some serious. In an article in the Dutch medical journal Medisch Contact, the doctors wrote that it is “unacceptable” that “medical help for some patients in our country has declined to a third world level.” Last January, a new national health insurance system took effect, and hospitals are objecting to the costs and responsibilities that come with uninsured poor patients. [British Medical Journal, 6/3/06] In a country where euthanasia is legal, inexpensive, and accepted medical practice, the temptation for an easy solution to a costly problem could be disastrous.

· A study, published in the medical journal Archives of Internal Medicine, found that surrogates designated by patients in advance healthcare directives to make treatment decisions for them, as well as next-of-kin decision makers, “incorrectly predict patients’ end-of-life treatment preferences in one third of cases.” Researchers concluded that, while their data “call into question the ability of surrogates to predict patients’ treatment preferences,” the “surrogates are more accurate than physicians” in predicting the treatment decisions patients would make. “Therefore,” they wrote, “in the absence of alternative methods, current reliance on surrogates may be defended as the best available method for implementing the substituted judgment standard. Further studies should consider whether there are other ways to improve surrogate accuracy.” [Shalowitz et al., “The Accuracy of Surrogate Decision Makers,” Archives of Internal Medicine, 3/13/06, pp. 493-497]