Kevorkian

What You Need to Know Now That the District of Columbia Has Become the Seventh Jurisdiction in US to Legalize Assisted Suicide

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Despite emails and other efforts to encourage the US Congress to exercise its legal authority to stop the Washington D.C. assisted suicide law, the expected congressional action was not completed within the 30 legislative days required.

However, there may be hope on the horizon according to a  February 18, 2017 Washington Times article that said “Congress can still neutralize the Death with Dignity Act by cutting off its funding through the appropriations process.”

What went wrong with the process of nullifying the assisted suicide law in time?  No one seems to know.

But one thing we do know is that Compassion and Choices, the well-funded assisted suicide activist organization, will continue its relentless fight over and over again in every state without an assisted suicide law and in the courts to make assisted suicide legal throughout the US. But even that is not the final goal.

Ominously, we are now seeing assisted suicide leaders like influential lawyer Kathryn Tucker even criticizing the so-called “safeguards” in assisted suicide laws  as “burdens and restrictions”. She now argues that  assisted suicide should be “normalized within the practice of medicine”.

WHAT WE NEED TO KNOW AND DO NOW

We cannot just depend on lobbying our politicians and legislatures to fight assisted suicide only when such bills are introduced in states legislatures or as public initiative votes. We must constantly reinforce our message that every life is worthy of respect and care, not medical termination.

But we must also understand that the assisted suicide/euthanasia movement has had decades of experience in shaping and publicizing its lethal message through carefully crafted steps to convince the public that physician-assisted suicide must be legalized to prevent or end suffering.

As I wrote in my 2013 article “Then and Now: The Descent of Ethics”, the assisted suicide/euthanasia movement has been very busy in the last several decades. I included a short history of the movement that people should know:

The 1970s brought the invention of “living wills” and the Euthanasia Society of America changed its name to the Society for the Right to Die. The so-called “right to die” movement received a real boost when the parents of Karen Quinlan, a 21-year-old woman considered “vegetative” after a probable drug overdose, “won” the right to remove her ventilator with the support of many prominent Catholic theologians. Karen continued to live 10 more years with a feeding tube, much to the surprise and dismay of some ethicists. Shortly after the Quinlan case, California passed the first “living will” law.

Originally, “living wills” only covered refusal of life-sustaining treatment for imminently dying people. There was some suspicion about this allegedly innocuous document and, here in Missouri, “living will” legislation only passed when “right to die” advocates agreed to a provision exempting food and water from the kinds of treatment to be refused.

But, it wasn’t long before the parents of Missouri’s Nancy Cruzan, who was also said to be in a “vegetative” state, “won” the right to withdraw her feeding tube despite her not being terminally ill or even having a “living will.” The case was appealed to the US Supreme Court, which upheld Missouri law requiring “clear and convincing evidence” that Nancy Cruzan would want her feeding tube removed, but, in the end, a local judge allowed the feeding tube to be removed. Shortly after Nancy’s slow death from dehydration, Senators John Danforth and Patrick Moynihan proposed the Patient Self-Determination Act (never voted upon but became law under budget reconciliation), which required all institutions to offer all patients information on “living wills” and other advance directives. Since then, such directives evolved to include not only the so-called “vegetative” state and feeding tubes but virtually any other condition a person specifies as worse than death and any medical care considered life-sustaining when that person is deemed unable to communicate.

But this “choice” is becoming an illusion. In 1999, Texas became the first state to pass a medical futility law to allow doctors and/or medical committees to  override advance directives and patient or family decisions to continue life-sustaining treatment on the basis that doctors and/or medical committees know best when to stop treatment.

In the 1990s, Jack Kevorkian went public with his self-built “suicide machines”  and the “right to die” debate took yet another direction. By the end of the decade, Oregon became the first state to allow physician-assisted suicide. At first, the law was portrayed as necessary for terminally ill people to die with allegedly unrelievable pain. Within a short time, though, it was reported that “according to their physicians, the patients requested assistance with suicide because of concern about loss of autonomy and control of bodily functions, not because of concern about inadequate control of pain or financial loss.”

Other states eventually followed Oregon but efforts to pass assisted suicide laws often failed in other states so Compassion and Choices (the former Hemlock Society) promoted palliative/terminal sedation and VSED (voluntary stopping of eating and drinking) as a legal alternative to assisted suicide in states without such laws.

Compassion and Choices has found much success in working with sympathetic news outlets and pollsters to encourage the public and even medical professionals to support assisted suicide.

Even TV’s popular Dr. Phil McGraw hosted a 2012 segment featuring a Canadian woman who wanted her adult disabled children to die by lethal injection. Ironically, the mother, along with former Kevorkian lawyer Geoffrey Feiger, argued that removing their feeding tubes was an “inhumane” way to end the lives of the adult children. Tragically, when the studio audience was polled, 90% were in favor of lethal injections for the disabled adults. Disability organizations protested after the show, writing that “By conveying social acceptance and approval of active euthanasia of individuals with disabilities by their family members, the segment threatens their very lives”.

Exploiting the natural fear of suffering most people have has also led to a growing acceptance of the premise that it can even be noble to choose death instead of becoming a burden on family members or a drain on society. It is up to us to combat this attitude of despair by  not only educating ourselves and others about the facts and dangers of assisted suicide but also by offering hope and support to those of us most at risk.

Pain and “Choice”

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It was 1969 and I was fresh out of nursing school when I was assigned to a patient I will call “Jenny” who was thirty two years old and imminently dying of cancer. She was curled up in her bed, sobbing in pain and even moaned “just kill me.” The small dose of Demerol I injected into her almost non-existent buttocks every four hours “as needed” was not helping. I reassured Jenny that I was immediately calling the doctor and we would get her more comfortable.

However, I was shocked when the doctor said no to increasing or changing her medication. He said that he didn’t want her to get addicted! I told him exactly what Jenny said and also that she was obviously very close to death so addiction would not be a problem. The doctor repeated his no and hung up on me.

I went to my head nurse and told her what happened but she told me I had to follow the doctor’s order. Eventually, I went up the chain of command to the assistant director of nursing and finally the Chief of the Medical Staff. The verdict came down and I was threatened with immediate termination if I gave the next dose of Demerol even a few minutes early.

I refused to abandon Jenny so for the next two days before she died, I spent my time after my shift sitting with her for hours until she fell asleep. I gave her whatever food or drink she wanted. I stroked her back, held her hand and told stories and jokes. I asked her about her life. I did everything I could think of to distract her from her pain and make her feel better. It seemed to help, although not enough for me. I cried for Jenny all the way home.

And I was angry. I resolved that I would never watch a patient needlessly suffer like that again.

So I educated myself by reading everything I could about pain medicine and side effects. I also pestered doctors who were great at pain control to teach me about the management, precautions and rationale of effective pain management. I used that knowledge to advocate and help manage my patients’ pain as well as educating others.

I was delighted to see pain management become a major priority in healthcare and even called “the fifth vital sign” to be evaluated on every patient. I saw new developments like nerve blocks, new drugs and regimens to control pain and other techniques evolve as well as other measures to control symptoms like nausea, breathlessness and anxiety. Now we also have nutritional, psychological and other support for people with terminal illnesses and their families.

Best of all was that I never again saw another patient suffer like Jenny despite my working in areas such as ICU, oncology (cancer) and hospice.

TWENTY-FOUR YEARS LATER

When my oldest daughter was 14, she attended a public high school where the science teacher unexpectedly started praising the infamous Dr. Jack Kevorkian and his public campaign for legalized assisted suicide and euthanasia.  Kevorkian’s first reported victim was Janet Adkins, a 54 year old woman with Alzheimer’s in no reported physical pain who was hooked up to a  “death machine” in the back of a rusty van. Mrs. Adkins was just the first of as many as 130 Kevorkian victims, many if not most of whom were later found to have no terminal illness. Kevorkian escaped prosecution-even after he harvested a victim’s organs and offered them for transplant-until the TV show 60 Minutes aired Kevorkian’s videotape showing him giving a lethal injection to a man with ALS (Lou Gehrig’s disease). Shockingly, Kevorkian served only 8 years in prison before he was paroled and eventually became a media celebrity peddling assisted suicide and euthanasia.

My daughter, who never before showed any interest in my speaking and writing on the topic of assisted suicide, now stood up and peppered her teacher with facts about Kevorkian. The teacher asked her where she learned her information and she answered “From my mom who is a cancer nurse”.

Sarcastically, he responded “So your mother wants to watch people suffer?” My daughter responded “No, my mother just refuses to kill her patients!” End of discussion.

CONCLUSION

But not the end of the story. Tragically, we now have legalized assisted suicide in several states and serious efforts  to expand it to include people without physical pain but with conditions like Alzheimer’s, mental illness or other psychological distress as well as even children.

As Wesley Smith recently and astutely observed :

 Moreover, the statistics from Oregon and elsewhere show that very few people commit assisted suicide due to physical suffering. Rather, the issues are predominately existential, such as fears of being a burden or losing dignity

The public is being duped by groups like Compassion and Choices that campaign for legalized assisted suicide on the alleged basis of strict criteria for mentally competent, terminally ill adults in unbearable physical pain to freely choose physician-assisted suicide with (unenforceable) “safeguards”.

The emerging situation throughout the world is more like Kevorkian’s dream of unfettered and universal access to medical termination of the lives of “expendable” people. How much easier is that when people with expensive mental health problems, serious illnesses or disabilities can be encouraged to “choose” to be killed?