Kill It Before It Breeds

ON TUESDAY, the voters of Washington State defeated Initiative 119, which would have legalized what proponents euphemistically termed "aid-in-dying." That means legalized euthanasia.

Supporters of Initiative 119--led by the Hemlock Society, a national organization which advocates the complete legalization of all euthanasia and suicide--argued that "aid-in-dying" would allow people to control the most important personal decision possible, whether to live or die. They said that, because doctors' traditional role is to decrease the suffering and increase the well-being of their patients, allowing doctors to end suffering through ending their patients' lives is a natural extension of this role.

Let us be thankful that the voters thought twice before voting "Yes." Euthanasia, no matter what compassionate rhetoric it comes cloaked in, is a fundamentally dangerous practice. Also being considered in California, Oregon and Florida, euthanasia would destroy the trust of the doctor-patient relationship. More importantly, it would open the door to a subjective standard of the value of life which would destroy the very foundations of human liberty--personal autonomy--by giving doctors the right to kill patients at their own discretion.

WASHINGTON STATE already has laws on the books that allow patients or their authorized proxies to refuse life-sustaining treatment, except in the case of nutrition and hydration, which cannot be withheld. Proponents of Initiative 119 argued that this law fails the test of compassion. In its place, they wanted this:

"This initiative expands the right of adult persons with terminal conditions to have their wishes, expressed in a written directive, regarding life respected. It amends current law to:

"Expand the definition of terminal condition to include irreversible coma and persistent vegetative state which will result in death in six months;

"Specify which life-sustaining procedures may be withdrawn;

"Permit adult persons with terminal conditions to request and receive aid-in-dying from their physicians, facilitating death."

"...aid-in-dying... facilitating death." What benevolent, even compassionate little phrases these seem. Proponents of Initiative 119 and similar proposals count on the emotional weight that arguments in favor of personal autonomy carry in our society.

Suffering patients, euthanasia advocates say, should not be forced to continue their lives in extreme pain and suffering. Doctors are healers and comforters, they say, so they should be allowed to ease the pain of their patients by terminating their pain in the most final fashion.

Medical technology has prolonged our lives, but it cannot improve their quality, the argument continues. To counteract the negative effects of technological prolongation of life, doctors should now be able to end a patient's life peacefully, to stem the agony of an illness artificially prolonged by life support systems and other technology.

This argument, however, ignores the definition of a doctor. Professor Leon Kass, M.D., of the University of Chicago, notes that euthanasia "would change the meaning of being a physician from being a healer to that of being an annihilator." He reminds us that the role of the physician has been that of a person who benefits "the sick by the activity of healing."

The healing aspect of meidicine has indeed been perverted by misuse of technology, Kass says. But he maintains that it is misleading to argue that euthanasia is a solution to the problems which medical technology has caused.

To address the real problems of technology, Kass says, physicians need to return to the ideal of caring and healing, instead of acting as medical technicians obsessed with sustaining life at any cost. Life itself is not the ultimate value. The ultimate value which physicians must hold is that of healing, actually making sick people feel better. With the overuse of technology, doctors have changed from healers, or life-affirmers, to life-prolongers.

But with euthanasia, they would become life-destroyers.

ONCE THE DOCTOR'S role changes to that of a life-destroyer, Washington State's Physicians Against 119 say, patients will no longer be able to trust doctors to act in their best interest. Euthanasia may start out as a benevolent impulse, but it soon becomes a calculating and inhuman procedure.

Initiative 119 would have provided few safeguards against doctors killing patients who were depressed, mentally ill or completely incapable of deciding whether to allow their doctor to kill them. Although it states that only the mentally competent will be allowed to choose euthanasia, no procedure for determination of mental competency is set by the initiative. Nor could doctors involved in euthanasia cases be sued by family members for wrongful death.

Finally, as The Los Angeles Times noted recently, Washington's law would have allowed any two physicians to determine whether euthanasia is warranted, conjuring up the bizarre spectre of unemployed dermatologists setting up killing centers for cancer patients. Because of such a lack of safeguards, euthanasia will soon be extended to groups proponents claim the law protects.

PROPONENTS of Initiative 119 have dismissed these and other arguments against legalizing euthanasia as unrealistic "slippery slope" arguments. Hemlock Society spokespeople have said over and over again that their law attempts to increase the options for the individual, not to make it possible for doctors to murder their patients with impunity.

They are either lying or terrifically ignorant of the only Western country in which euthanasia is widely practiced. Holland has had semi-legal euthanasia for about 20 years and has more safeguards than the Washington law would have had. The picture for patients in Holland grows uglier by the day.

A recent Dutch Government Study says that of 2300 cases of euthanasia in 1990 doctors performed 1200 without the consent of the patients. But other studies suggest that the government study vastly underestimates the number of deaths. Those in favor of euthanasia say the number of euthanasia cases may be more like 4000. One study, done by a researcher at the University of Virginia, estimates the number at between 5000 and 20,000.

Most ominously, Kass notes that another study, done by a Dutch proponent of euthanasia, discovered that last year 8750 patients died from withdrawal of treatment without the knowledge or consent of their families. And that there were 8100 additional cases in which patients died from an overdose of morphine, 61 percent of which occurred, strangely enough, without the patient's knowledge or consent.

Clearly, something is wrong with allowing doctors to perform "aid-in-dying." At least in the Dutch case, the quasi-legalization of euthanasia has led to a slippery slope. There are few reasons to believe that American doctors would be less tempted to play God with their patients than the Dutch.

We can only hope that when voters or legislators in California or Oregon or Florida must decide whether to legalize the medicalized murder of euthanasia they will follow the lead of the voters in Washington. If they do otherwise, there is little hope that the killing will stop with those who wish to end their lives peacefully.