But follow on to the article, and you find that, after a somewhat misleading first paragraph, the recommendation is a very limited one.
One of the country's leading experts on medical ethics today calls for doctors to be able to end the lives of some terminally ill patients "swiftly, humanely and without guilt" - even if they have not given consent.That is, when all the reviews by doctors, relatives, maybe courts, have taken place and a feeding tube is removed from a person in a persistent vegetative state, the doctor is saying that it wold be more humane to hasten the death that is inevitable, rather than allowing it to occur via starvation. And during the starvation, the patient continues to experience whatever conditions may have entered into the decision in the first place: intractable pain, paralysis.Len Doyal, emeritus professor of medical ethics at Queen Mary, University of London, takes the euthanasia debate into new and highly contentious territory. He says doctors should recognise that they are already killing patients when they remove feeding tubes from those whose lives are judged to be no longer worth living. Some will suffer a "slow and distressing death" as a result.
I live in the only one of the United States that has legalized "assisted suicide." This began as an initiative on the Oregon ballot in 1994 which was approved; critics sent it back to the ballot in 1997, and it was approved by a larger majority than in the first election. Beginning promptly in 2001 the Bush Justice Dept. tried to get the law overturned, failing miserably--before a federal judge in 2002 and finally before the US Supreme Court in 2005. The Supreme Court did indeed agree to review the law, and agreed 6-3 that Oregon doctors could not be prosecuted under a Federal drug law, for prescriptions requested by patients for the purpose of suicide.
The requirements are sensible but not oppressive:
The patient must meet certain criteria to be able to request to participate in physician-assisted suicide. Then, the following steps must be fulfilled: 1) the patient must make two oral requests to the attending physician, separated by at least 15 days; 2) the patient must provide a written request to the attending physician, signed in the presence of two witnesses, at least one of whom is not related to the patient; 3) the attending physician and a consulting physician must confirm the patient's diagnosis and prognosis; 4) the attending physician and a consulting physician must determine whether the patient is capable of making and communicating health care decisions for him/herself; 5) if either physician believes the patient's judgment is impaired by a psychiatric or psychological disorder (such as depression), the patient must be referred for a psychological examination; 6) the attending physician must inform the patient of feasible alternatives to assisted suicide including comfort care, hospice care, and pain control; 7) the attending physician must request, but may not require, the patient to notify their next-of-kin of the prescription request. A patient can rescind a request at any time and in any manner. The attending physician will also offer the patient an opportunity to rescind his/her request at the end of the 15-day waiting period following the initial request to participate.People like Coulter predicted all kinds of extreme consequences of this law: hundreds of unbalanced people, including out-of-staters, would seek to end their lives; people would do so as a result of pressure from their inheritance-hungry heirs or lazy doctors, and so on. On average, about 30 individuals take their lives each year under this law; a greater number go through the procedure to receive the necessary drugs, but do not use them. I think this last fact speaks clearly to what is involved, what human need is being met: the need for some sense of control when facing a potentially long and agonizing death. And it speaks to people using this control with deliberation. Having the option, pills in the cabinet, the individual then makes his or her own decision as each day goes by; if their personal threshold of unbearable-ness is not reached, the pills stay where they are. With so few cases each year,the state can review them, and has found no instances of undue pressure, unprofessional behavior, or the other lurid scenarios predicted.
The example of the Netherlands is always brought up in discussions of this subject. There, use of euthanasia has gone further: according to a British Medical Journal report in 2000, "one in five cases of euthanasia occurred without the patient's explicit request" (Perhaps patients brain-dead or otherwise incapable of cognition or communication), and another study found (1997) that of a "sample of 31 [Dutch] neonatologists, 14 (45%) reported having at least once administered drugs with the explicit intention of ending life", to newborns with untreatable and terminal conditions involving severe pain. What discussion there was between the physicians and the parents, we do not know, and many would see that as irrelevant, regarding assisted suicide and euthanasia as wrong in any foreseeable situation. When those remarks are made, I think of someone who spoke up during the second time the Oregon measure was voted on. This person said, with great feeling, that the opponents of the bill would change their minds if they had ever had to listen to a loved one in pain unresponsive to drugs, facing inevitable death, but living on for day after day of torture.
On the subject of pain, it is said that the Oregon Assisted Suicide Act has had the effect of improving the pain relief offered to those with chronic and terminal conditions. It is certainly high time for that--and we have still far to go. The War on Drugs mentality has stood between hundreds of thousands of suffering individuals and effective pain relief, because doctors fear to attract legal attention, or agree with the puritanical demand that even the dying cannot be given a drug otherwise considered illegal. In this way, perhaps, the puritans among us feel that we sinners can get a preview of the torments of hell, and thus come to Jesus before we expire. As far as the Netherlands/"slippery slope" argument, it seems to me that the "slope" is in this case composed of the attitudes of the populace. Netherlanders support euthanasia as provided for in their laws, though when doctors begin to act on their own beyond the law that is something for their courts, and their legislators, to review and decide upon. Again, those decisions will probably reflect public attitudes. The Dutch populace is relatively small, with a long history of independent thinking. The US has a much larger population, one also given to independence and testing new ideas, but possessing some strong base principles. I can't see ideologue legislators, or even the "activist courts" so beloved of the Conservatives, imposing on Americans some nightmare of euthanasia totally foreign to our wishes, to our culture. If anything of this nature happens in our country, it will be courtesy of the HMOs, seeking to cut their expenses. After all, according to a couple of my doctors, it's the HMOs who demand that physicians spend time on the phone trying to justify, to clerks, their patients' need for particular medical procedures. This is where principle gives way in our country--not when challenged by opposing principle, but when challenged by money.
