CONSERVATIVES AND DOCTOR ASSISTED SUICIDE

By Bill Sizemore

October 8, 2005

NewsWithViews.com

As I begin this column on the morning of October 5, 2005, the emotionally charged issue of doctor assisted suicide is being argued before the U.S. Supreme Court in a case challenging whether the U.S. government has the authority to prohibit doctors in Oregon from prescribing lethal doses of pain killers to mentally competent patients with terminal diseases. The Oregon law allowing doctors to write such prescriptions was approved by voters in 1994 and again in 1998.

Let me state for the record that I voted against both measures and would again, if I had the opportunity. However, I am not so sure the federal government ought to win the case the high court is hearing today, even though part of me hopes it does. Part of me believes that Oregonians have the right to pass a law like this one, even if it’s a bad law. Part of me believes that the decision a person makes when faced with a prolonged and painful death is none of my business.

However, there is a substantive basis for concluding that Oregon’s law is a bad one and also a conservative basis for concluding the entire matter is none of the federal government’s business. There are also reasons to question whether suicide in the face of certain death is truly suicide in the traditional sense of the word. You can judge that for yourself when you consider a couple of examples I offer later on.

As a starting point, let’s clear up one bit of misinformation regarding the popularity of the Oregon law. The local and national media routinely refer to Oregon’s law as a “Doctor Assisted Suicide” law, perhaps because that’s exactly what it is. Reporters routinely state that in 1998 Oregon’s Doctor Assisted Suicide law passed overwhelmingly by a margin of 61 percent to 39 percent. There is a problem with such reporting. It is a gross misrepresentation of the facts.

Even though the words “Doctor Assisted Suicide” are commonly used to describe the Oregon law, those words did not appear in the description of the measure that was printed on the ballot. Interestingly, in pre-election polling, when the word “suicide” was inserted into the ballot title, the measure lost 20 percent of its support and failed by as large a percentage as it actually passed by on election day. Oregon’s attorney general flatly refused to use the word “suicide” in the ballot title, because he thought the word would prejudice voters against the measure. In other words, he sugar coated the pill to make it easier for voters to swallow.

It is significant that Oregonians voted to allow doctors to prescribe lethal doses of pain killers to terminally ill patients, but would not have done so if they had been told that the purpose of the prescription was for doctors to help people commit suicide. Those not familiar with the importance of ballot titles may not know that the vast majority of voters do not vote on the text of ballot measures, but vote on the description of the measure that is printed on the ballot. Changing even slightly how an issue is described can change the outcome of the election by a substantial margin.

The issue before the U.S. Supreme Court today will probably be decided not on any kind of moral basis, but on the question of states’ rights. The court probably will decide whether a single state can authorize the use of a controlled substance for a purpose not consistent with federal drug laws. Conservatives ought to wonder where the federal government finds the constitutional authority to decide the medical practices of the several states. As much as I dislike Doctor Assisted Suicide, I am not sure the federal government ought to decide the issue. The court did that with Roe v Wade, and look at the mess that followed.

Most conservatives agree that Roe v. Wade was wrongly decided and that an activist court created out of thin air a right to abortion and inserted that new right into the U.S. Constitution by implication. It seems to follow that if the court was wrong to create such a right in Roe, it would be wrong now to overrule the laws of a state that has passed an ill-advised law regarding doctor assisted suicide? Does a state not have the right to adopt a bad law, as long as that law is not unconstitutional?

I should state as an aside that for obvious reasons such logic does not necessarily apply to the issue of abortion. One can argue that from its inception there has been a prohibition against abortion in the U.S. Constitution, because the Constitution guarantees the protection of innocent human life. If the right to life is applied to a legally viable fetus, then the unborn baby has a constitutional right to protection from an abortionist and even from its own mother.

The legal question with abortion has never been whether a baby has a right to protection, but rather when does the fetus become a distinct human life. The only way a court can say that abortion is not a violation of a baby’s constitutional right to life is to decide in the face of common sense and a ton of scientific evidence that the unborn child is not yet a human being, to declare it a “non-person”.

Doctor assisted suicide, however, presents an entirely different legal question, because the person committing suicide is not directly harming another person. He is deciding whether to end his own life, not someone else’s.

For moral and religious reasons, I am personally opposed to suicide. However, I must confess that the more I have contemplated this issue the more it seems that there may be times when suicide is not really suicide. There may be certain limited times when in fact suicide makes sense, at least to the person contemplating it. That statement may sound outlandish, coming from a Christian conservative, but let me explain.

Some victims on 9/11 chose to leap hundreds of feet to their death rather than burn in the flames engulfing the top floors of the World Trade Centers towers. Could anyone authoritatively condemn such a choice? A terrible death was certain and eminent. All the jumpers did was choose the less painful way of dying. Religious or not, you or I might have made the same choice. Is such a choice really suicide?

In several wars throughout human history, including in modern times, it has been the practice of some combatants to capture enemies for the sole purpose of subjecting them to extended, sadistic torture. Prisoners at times have been subjected to some of the most unimaginable atrocities, including having their arms or legs cut off, being skinned alive, or roasted slowly over a fire. Women captives have been repeatedly raped and then brutally tortured. Would it be considered suicide for a person to kill him or her self when capture was inevitable, and torture and death certain? I don’t know the answer to that question, but it would be hard to condemn such a choice with any degree of conviction.

Most of us have seen Western movies where the men, fearing being overrun by a band of attacking renegades, have handed the women a pistol in the middle of the battle and instructed them in no uncertain terms that if worse comes to worse, not to be taken alive. The logic of such advice is almost unquestionable. In such cases, suicide is not so much suicide as choosing the method of your own death.

It is not much of a leap in logic to apply the same logic to doctor assisted suicide. If it made sense for those who leaped to their deaths from the Twin Towers rather than be burned alive or used a bullet to avoid a certain death that would have been preceded by rape and torture, could it not make sense for someone to take a lethal dose of painkillers to avoid the slow painful death that will certainly come, if his or her disease is allowed to run its full course?

This question is not meant to be rhetorical. One’s answer may be different, based on one’s religious or moral views. Personally, if I had a terminal disease, I would not choose suicide. Period. I am confident that the grace of God would be sufficient for me to bear whatever suffering He allowed me to endure. I say that unequivocally. I simply would not consider suicide. I would let God choose the time of my death.

However, should a person who does not have such faith be forced to suffer, because that’s what I would choose to do? Is it any of my business or the government’s business for that matter, if they want to choose the method and timing of their exit?

However, having said that, I do not believe any of this justifies a law authorizing doctors to help their patients kill themselves. A person can make the choice to kill himself and carry out that choice without involving the state. People have been doing that for centuries.

However, whether the state is involved in such an event is an important distinction, because when the state gets involved, when the state officially approves the action, other factors come into play. For one, a very slippery slope is created, and that’s worth contemplating.

Oregon’s law requires that the person who wishes to kill himself has to be mentally competent. Also, his or her doctor cannot inject him with a needle. The patient has to orally take the lethal dose of pills or capsules that is going to cause his body to shut down. Sometimes, that requires a patient to take a lot of pills, perhaps more than a hundred. Some patients throw up enough of the pills that they do not die right away. A few suicides have taken weeks to die.

But the question does not end here, and it won’t. Allowing mentally competent patients to kill themselves with the assistance of a doctor is only a starting point. What about those patients who are not mentally competent?

If you accept the logic that the state should allow doctors to help mentally competent patients end their lives to avoid suffering, then what about those who are not mentally competent and yet are enduring the same kind of pain and suffering? Should they have to suffer simply because they are not mentally competent under the law? Should not the law allow someone else, a judge or a family member, if there is one, to make the decision for them? We do that with other affairs of the mentally incompetent. We allow judges or guardians to make major decisions on their behalf. Why not let someone else decide whether they should suffer or die “quietly”?

But, where does this slope lead us? Without any kind of break in logic, we have gone from allowing mentally competent patients to kill themselves to a government official ordering a doctor to inject a lethal dose of painkillers into some helpless person who is unable to choose for himself. This is indeed a very slippery slope. The next step is too logical to ignore.

Accepting doctor assisted suicide as good public policy opens our minds to unforeseen acts that will suddenly begin to make sense from our new vantage point; things which do not make sense now and might even seem outright barbaric from where we stand today.

For thousands of years, people have been killing themselves to avoid a painful death. Sometimes, doctors, nurses, family members and friends have assisted them, often simply by leaving the means at their disposal. The vast majority of suicides have been by means of a firearm. However, this is a far cry from the government becoming involved in, sanctioning, or even assisting in the killing of its citizens. Such policy leads to no good place.

There will always be those who choose to end their lives for whatever reasons. It is my conclusion that the government need not be and indeed should not be a participant in such decisions. Oregon’s doctor assisted suicide law has been on the books for more than a decade. In the meanwhile, although the issue has been and continues to be hotly debated in other venues, no other state has followed Oregon’s lead. It appears that for now, the virus has been contained.

Until officials in Oregon start applying the law to mentally incompetent citizens and suicide becomes euthanasia, I see no real reason for the federal government to have a say in the matter. Perhaps Oregon will learn from its mistake and repeal its own law. After all, all that would be required for voters to repeal Oregon’s law would be for an honest attorney general to put the words “doctor assisted suicide” in the ballot title.

Finally, one troubling fact about the actual use of Oregon’s doctor assisted suicide law is the reality that several of those who have used it have not been in uncontrollable pain. They have chosen to kill themselves because they didn’t want to be an emotional or financial burden on family members, or have not wanted to suffer the humiliation of having someone wait on them hand and foot at the end, even changing their diapers. There is no way of knowing how many of the 220 plus patients who have used the law thus far felt pressured to end their lives to avoid being a burden on their families.

Personally, I would feel cheated if someone close to me committed suicide to avoid being a burden on me.

Folks, the end of someone’s life is almost always a difficult time, but it can also be one of the richest times, as families pull together and love and compassion are both expressed and received. It is often at the time we are suffering most that we begin to see most clearly, even through the pain and humility of it all, which things matter most in life. That is not a time to miss.