Euthanasia or assisted suicide would not only be available to people who are terminally ill. This popular misconception is what this essay seeks to correct. There is considerable confusion on this point, perhaps further complicated by statements in the media.
There are two problems here – the definition of “terminal” and the changes that have already taken place to extend euthanasia or assisted suicide to those who aren’t “terminally ill.
There are many definitions for the word “terminal.” For example, Jack Kevorkian who participated in the deaths of more than 130 people before he was convicted of murder said that a terminal illness was “any disease that curtails life even for a day.”(Dr. Death) Dutch psychiatrist Dr. Boudewijn Chabot who provided a fatal dose of drugs to a depressed, but physically healthy, woman, stated that “persistently suicidal patients are, indeed, terminal.”(CQ) Oregon’s assisted suicide law defines “terminal” as a condition which will “within reasonable medical judgment, produce death within six months.”(Oregon) A prognosis of six month to live is also the basis upon which patients qualify for hospice coverage under Medicare.(Cys)
However, federal officials note that about 10% of patients live longer than the anticipated six-month life expectancy.(Id.) The use of a six-month prognosis to qualify a patient for assisted suicide or euthanasia was challenged in the World Federation of Right to Die Societies’ newsletter as well:
“The six-month standard “not only calls on doctors to make an unreliable prediction, but prescribes a pointless time limit: The longer the life expectancy the greater the patient’s suffering. The e…
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…a for Rational Suicide: A Survey of Psychotherapists,” 25 Suicide and Life Threatening Behavior, (1995), p. 238. (Emphasis added.)
“Zurich Declaration on Assisted Dying,” signed on October 14, 1998 at the 12th International Conference of the World Federation of Right to Die Societies, held on October 12-15, 1998 in Zurich, Switzerland. For the full text, see Zurich Declaration. Among the signers were Richard MacDonald, M.D., Medical Director of the Hemlock Society; Australian physician Philip Nitschke; and British Dr. Michael Irwin of the United Kingdom.
“Dignity in Dying Bill 2001,” South Australian Parliament, introduced on March 14, 2001 by Australian Democrats state deputy leader Sandra Kanck. [Extract from Hansard, Legislative Council, 14 March 2001. accessed at http:www.democrats.org.au/sa/parlt/autumn2001/0314_e.htm on May 29, 2001.]
Doctor-Assisted Suicide and the Hospitals’ Bottom Line
Euthanasia and the Hospitals’ Bottom Line
An important factor in debates over health care and treatment strategies is the issue of cost. It is tremendously expensive to provide the state-of-the-art care that the modern hospital offers. Concerns about where the money will come from to care for elderly citizens appear to be making the case for “mercy killing” even more compelling. Under financial pressure, hospitals are exercising their right to deny such expensive healthcare to the aged or seriously ill.
We reserve the right to refuse service: Most people have seen these signs at restaurants and retail shops. But now, metaphorically, some hospitals are hanging such notices over their entryways by promulgating “futile care” protocols that grant doctors the right to say no to wanted life-extending medical treatment to patients whose lives they consider lacking in sufficient quality to justify the cost of care.
Unnoticed by the mainstream press, a disturbing study published in the Fall 2000 issue of the Cambridge Quarterly of Health Care Ethics reveals how far the futile-care movement, in reality the opening salvo in a planned campaign among medical elites to impose health-care rationing upon us, has already advanced. The authors reviewed futility policies currently in effect in 26 California hospitals. Of these, only one policy provided that “doctors should act to support the patient’s life” when life-extending care is wanted. All but two of the hospital policies defined circumstances in which treatments should be considered nonobligatory even if requested by the patient or patient representative. In other words, 24 of the 26 hospitals permit doctors to unilaterally deny wanted life-supporting care.
How is such medical abandonment justified? Advocates of futile-care theory cleverly shift the focus away from the physiological effect provided to the patient and toward whether the patient has the “potential for appreciating the benefit of the treatment.” Thus, the Cambridge Quarterly reports that 12 of the 26 hospitals surveyed prohibit treating people diagnosed with permanent unconsciousness (other than comfort care) based on these patients’ supposed inability to know they are being treated. Never mind that several medical studies demonstrate that this condition is often wrongly diagnosed (40 percent misdiagnosis according to one British report). And never mind that such patients sometimes awaken unexpectedly, as recent headlines attest.
What is most disturbing is that these policies, if enforced, would prevent profoundly brain-damaged and dementia patients from receiving tube-supplied food and water because such care is considered medical treatment.