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Obviously, America 1997 is not Germany 1941. Americans have a practical
sense of justice that favors the weak and the little guy. But if
we want to keep it that way, we shouldn't assume that merely knowing
about a past tragedy prevents us from repeating it. We need to learn
from history. And in reflecting on physician-assisted suicide, the
first lesson for our lawmakers is that any killing motivated by
a distorted sense of mercy -- no matter how many reasonable and
honeyed words endorse it -- leads to killing that has nothing at
all to do with the best interests of those killed.
Let's examine a few simple facts.
First, every one of us fears the image of a pain wracked, dying
patient stripped of dignity and trapped in a suffering body. But
today, no one needs to suffer excruciating pain in a terminal illness.
Modern pain suppression drugs can ensure the comfort of persons
even in the final stages of dying. Hospice care, focused on ensuring
a natural death with comfort and dignity, is increasingly available.
It's true that some doctors under-prescribe pain management or seek
to artificially prolong life beyond reasonable hope of recovery.
But that's an issue of training. Patients have the right to decline
extraordinary means of treatment. They also have a right to be free
of mind numbing pain. Both these goals can be accomplished without
killing them.
Second, terminally ill persons seeking doctor-assisted suicide
usually struggle with depression, guilt, anger and loss of meaning.
They need to be reassured that their lives and their suffering have
purpose. They don't need to be helped toward the exit. We should
also remember that in helping the terminally ill to kill themselves,
we're colluding not only in their dehumanization, but our own. Moreover,
the notion that suffering is always evil and should be avoided at
all costs is a very peculiar idea. Six thousand years of Judaeo-Christian
wisdom show that suffering can be -- and often is -- redemptive,
both for the person who suffers and for family and friends. In any
case, isn't it odd to try to eliminate suffering by killing those
who suffer?
Third, the Hippocratic Oath has very good reasons for binding physicians
to "do no harm." Doctors wield enormous power over their patients.
And that power quickly corrupts the profession unless it is held
rigorously in check. That's one of the reasons the American Medical
Association has rightly, and so strongly, opposed physician-assisted
suicide.
The alternative is immensely dangerous. The doctors who killed
their patients in Nazi Germany may be written off as the product
of a special, terrible time. But what about the doctors in the Netherlands
-- right now, today -- who admit to killing patients without their
approval?
Physician-assisted suicide among the Dutch has been quietly tolerated
for some time. But no one was prepared for the number of Dutch doctors
who have taken it beyond that, proactively dispatching the terminally
ill without their knowledge. The point is: The logic behind doctor-assisted
suicide naturally expands. Can anyone honestly argue that physician-assisted
suicide will limit itself to voluntary candidates in an era of ruthless
medical cost efficiency? Can anyone be naive enough to believe that?
And do we really want a society where patients aren't sure they
can trust their physicians?
One final point. The U.S. Supreme Court upheld state bans against
physician-assisted suicide in Washington and New York earlier this
summer. That's very good news. But these positive decisions need
to be reflected in legislation at the state level, and the debate
will be bruising. What we lack in too much of today's discussion
about doctor-assisted suicide is the presence of God. Yet God, in
the view of the great majority of Americans, is the Author of life
and its only true owner. Life is God's gift, and He alone is its
Lord. However wounded or attenuated it may seem, life is precious.
Every life is sacred from conception to natural death. We rarely
understand life. We certainly don't own it. But if this sad century
has taught us anything, it's that we have no right to dispose of
it -- however good the alibi.
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