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Death with Dignity and Other Euphemisms

October 27, AD 2012 16 Comments

Our society is very fond of euphemisms. We like to wrap up difficult ideas and realities with words that make us feel warm and fuzzy, or at least distract us from the real meaning behind the word or phrase we are using. Phrases like pass awayfriendly fire, and letting someone go, litter our vocabulary. We don’t even notice that we are stepping back from the truth when we use phrases like this because it is so common.

In Massachusetts, the Death with Dignity Act will be on the ballots on November 6th as Question 2. If passed, it would allow doctors in the state of Massachusetts to prescribe a lethal dose of prescription sleeping pills for people who are terminally ill and want to take their life.If you do not live in Massachusetts, The Hemlock Society or, excuse me again with the euphemisms, the organization now known as Compassion and Choices, is working to ensure that referendums like this will be coming to a state near you.

Unfortunately, many Massachusetts voters plan to vote for the ballot initiative. This is not surprising, as we live in a society where moral relativism is the norm and people find it odd to suggest that it is possible to find common moral ground in a pluralistic society. However, whether or not you think a person has a right to kill himself or not, the question is whether the state should be involved in assisting someone to commit suicide. Even if you support a person’s right to end their life, it is clear that simply from a logical and practical standpoint, suicide is not something we want to become socially acceptable and, in this case, encouraged by our government.

Why?

Let’s look at Oregon, where physician assisted suicide has been legal since 1997. While the suicide rate was on the decline in the state in the 90s, almost fifteen years later Oregon has a suicide rate that is 35% higher than the national average and it keeps climbing. There were 566 suicides in 2008, 641 in 2009, and 670 in 2010. Is it possible that saying suicide is a permissible and socially acceptable way to end one’s life for one reason helps make suicide overall a more accepted and widely used solution to all of life’s problems?

Which leads to another question: what is the criteria that would allow someone to end their life and how do we know this criteria will not expand, and the methods change until we have slid down the slippery slope of assisted suicide to euthanasia? Is it such a leap from helping people to commit suicide to giving doctors or the government the power to decide when people’s lives have lost value or are no longer worth the financial cost? Sound paranoid? Disability rights groups don’t think so. And neither do the people in Oregon who received letters from their government insurance telling them they would not pay for costly drugs to lengthen their life but they would be willing to pay for them to kill themselves.

There is also the problem of people killing themselves because they feel pressured to do so. 4% of those who have participated in state sponsored suicide in Oregon gave financial reasons as their primary purpose for killing themselves. We are one of the richest countries in the world and our government is helping citizens to kill themselves because they are a financial burden for their families. What kind of message does this send to our society about the value and dignity of human life?

Others will no doubt receive a misdiagnosis, the doctor may tell a patient they have very little time to live when in reality they have many years left. People will certainly die under the misconception that they have very little time to live and in the stress and sadness of what they do not know is a misdiagnosis, they will choose to die rather than live.

The practical arguments against assisted suicide go on and on.

But, aside from all of the very serious practical issues that laws like these can give rise to in a society, for me there is a more fundamental point of concern at hand.

Pope Benedict XVI wrote in his encyclical Spe Salvi:

To suffer with the other and for others; to suffer for the sake of truth and justice; to suffer out of love and in order to become a person who truly loves – these are fundamental elements of humanity, and to abandon them would destroy man himself.

Of course, it is part of our duty as Christians to alleviate suffering in the world and to combat injustice. However, our modern society takes this truth and runs too far, wanting to eliminate any kind of physical and psychological pain at any cost. We lose sight of what is ethical in the blind scramble to avoid pain. Abortion is acceptable because we cannot force a woman to endure the suffering of bringing a baby to term. Assisted suicide is acceptable because we must not allow anyone to go through the pain of losing autonomy or enduring chronic pain. In saying this, I am not diminishing the pain that people experience in these situations, I am simply saying that as a society, we cannot compromise what we know to be right and wrong to take away another’s pain – no matter how much we would like to.

So this is the most tragic element of this trend of thought in our society that is evident in initiatives like this. When we lose a sense of our humanity, we begin to lose a sense of what makes us more fully human. God, in His infinite wisdom, chose to make the evil of suffering, a vehicle for grace, beauty and transformation in our lives. If we, as a society, do all that we can to avoid suffering, we may avoid pain but we also avoid the opportunity to grow more deeply in the school of love. Some might think this is useless if a person’s life is going to end anyway, but so much transformation can happen in one minute, one hour, one day. We never know what we are cutting short by choosing the hour of our death.

So, let us fight this culture of death. Let us be prophets of the dignity and beauty of human life in all of its stages, the beginning and the very end.

Please spread the word about this ballot initiative in Massachusetts.  If you know any MA voters, please share information with them. Visit this site set up by the Massachusetts Catholic Conference. Also – discuss with friends and family because we can count on initiatives like this coming to other states. And most importantly, please pray that this law is not passed in the state of Massachusetts this November.

UPDATE 11/2012: Thanks be to God, this initiative in MA was narrowly defeated in the recent election. Please continue to pray for this issue and for the people who choose to take their lives when diagnosed with a terminal illness.

About the Author:

Sr. Theresa Noble is a novice, aka nun in training, with a religious congregation of sisters in the US. She left her job in California with eBay to follow God four years ago. She currently lives in a convent in Boston where she prays, evangelizes, bakes bread and blogs at Pursued by Truth (http://pursuedbytruth.blogspot.com/).

  • I live in Massachusetts, also. I wholeheartedly support Question 2. I have cared for and still care for a disabled 27 year old son…non-verbal, non-mobile and pretty much non everything. I do this 24/7 for the past 15 years so I have a keen insight into life-death realities unlike most people.
    I have studied Question 2 and know most of the opponents well like NDY (Not Dead Yet), badcripple.blogspot.com and Second Thoughts of MA. Your arguments are a study in epistemoligcal solipsism. The disability opponent groups also focus on the slippery slope.
    So a few points are important to note: (1) most disabled people, the huge majority, would not meet the criteria for terminally ill within six months; (2) there are many safeguards built into the MA ballot initiative (3) no evidence exists to support the slippery slope argument (4) 2-3% of intractable pain in terminal illness does not respond to medications, (5) evidence from Oregon and Washington is clear…people who get the seconal do not always use it. They use it when pain, indignity, etc. is real and relentless and they KNOW the end is days away.
    Advanced directives which provide for withholding water and food are simply cruel ways to end life. Modern technology extends life quite beyond what nature intended. I do not know how often you faced almost dying with someone, but many times it is not dignified, by any stretch of the imagination.
    Question 2 simply allows for a “good death” and helps a dying person avoid a “bad death”. Ever witness a “bad death”? Even a God, who is loving and merciful, would be appalled by a bad death.
    The concept which I must reject is that of “redemptive suffering.” Spend a day in my house and explain to my son how his suffering redeems anyone or anything …epistemological solipsism. Quite an unsound concept. “Extraordinary claims require extraordinary proofs.” (Hitchens)
    I am happy I live in Massachusetts because the ballot initiative will pass overwhelmingly. I an equally happy that since the days od the criminal Bernie Law, the archdiocese of Boston is recognized as a meaningless bureaucracy devoid of influence. Check out my blog a look at “both sides” of the issue:

    http://healingandempowerment.blogspot.com/2012/10/yes-on-question-2-ma-death-with-dignity.html

    • Ted Seeber

      I am in Oregon. I have experienced death in friends and family.

      I cannot describe choking down 9 grams of poison as a “good death”, as my mother in law chose to.

      I cannot describe my cousin, who shot himself, as a “good death”, not within the law, but encouraged by it.

      I can describe my grandmother, who struggled with dementia at the end yet stayed moral, as a “good death”.

      A good death has more to do with courage than it does with giving up.

      • Ted,

        I have thought about your comment many times since reading it and I just want to let you know that I am keeping you in prayer, as well as the souls of your cousin and mother.

        Until reading your comment, I had not considered the pain that family members must experience at the death of someone they love. It is hard when someone you love dies, it must be much harder to see them kill themselves rather than embracing the natural death process, even if it is terribly painful. Assisted suicide has many victims, and it is not just the people who choose to kill themselves.

        Keeping you in prayer.

        Peace to you,

        Sr. Theresa

  • Hi Phil,

    I was actually wondering if you would comment on this and was hoping that we might finally find some common ground as this is an issue that most disability rights groups are in opposition to. Almost every major disability rights organization in the United States officially oppose assisted suicide.

    The National Council on Disability (NCD) Position Paper on Assisted Suicide states that: “The dangers of permitting physician-assisted suicide are immense. The pressures upon people with disabilities to choose to end their lives, and the insidious appropriation by others of the right to make that choice for them are already prevalent and will continue to increase as managed health care and limitations upon health care resources precipitate increased ‘rationing’ of health care services and health care financing.”

    There are also many concerns about this initiative that even if you were in agreement theoretically, there are serious reasons to oppose it.

    Here are some:

    – Expected Survival less than 6 months: A physician must diagnose a person as having a terminal condition with 6 months or less to live, opening the dangers of assisted suicide to many who are not terminally ill. Experience in Oregon and Washington shows that many people who appeared qualified within the defined time span, but declined assisted suicide, lived months or years beyond the doctor’s estimate, or even survived to recover from their disease. One study found that 17% of people outlive their prognosis, some by many years. (This is one reason why the MA Medical Society is in opposition to this law: http://www.massmed.org/AM/Template.cfm?Section=MMS_Advocacy&TEMPLATE=/CM/HTMLDisplay.cfm&CONTENTID=76836)

    – Lack of Mental Health Screening: The proposed law does not require an independent mental health evaluation of persons requesting lethal prescription medication (two physicians must agree that a patient qualifies for assisted suicide, but there is no requirement for either of them to be psychologists or psychiatrists).

    – Continuity of Care: The proposed law does not include any requirement to investigate cases where physicians who have known a patient over time have found the patient ineligible for the criteria for assisted suicide. Physicians new to such cases who agree to assist in suicide are protected under the proposed law if they simply claim they acted in “good faith” — a standard so low as to make any purported safeguards unenforceable.

    – Advances in palliative care and hospice medicine have made great strides in the last two decades. Yet the proposed law offers suicide as a resolution to suffering without any requirement that all avenues of palliative treatment be exhausted to alleviate a patient’s suffering before suicide intervention.

    Phil, I know that you and most people who want to support this initiative want to do so out of compassion. But true compassion protects the most vulnerable in our society and laws like this do not protect the elderly, the weak, and the disabled, but open them up to many abuses and social pressure to take their lives when they have become burdensome to others.

  • Allow me to comment on your objections to Question 2:
    (1) Many disability groups oppose #2. Why? They use the slippery slope argument…today the terminally ill, tomorrow the disabled, the severely disabled. Let me respond as a disability advocate: I find it insulting that the groups would even attempt to equate disability with terminal illness.. The overwhelming proportion of the disabled live long, long lives and productive lives. This leads to the “slippery slope.” tomorrow heralds involuntary euthanasia. The slippery slope argument is a philosophical fallacy, From the Nizkor Project:

    “The Slippery Slope is a fallacy in which a person asserts that some event must inevitably follow from another without any argument for the inevitability of the event in question. In most cases, there are a series of steps or gradations between one event and the one in question and no reason is given as to why the intervening steps or gradations will simply be bypassed. This “argument” has the following form:

    Event X has occurred (or will or might occur).
    Therefore event Y will inevitably happen.
    This sort of “reasoning” is fallacious because there is no reason to believe that one event must inevitably follow from another without an argument for such a claim. This is especially clear in cases in which there is a significant number of steps or gradations between one event and another.” Since the late 90’s in Oregon and later Washington there is NO EVIDENCE of the slippery slope.

    (2) Survival rates: Of course, survival rate are at times wrong. Six months can be many years or even total remission. Evidence shows that people who have a script for the seconol do not use it right away….they use it when the suffering is unremitting and intractable. Some change their minds when the pain is tolerable…the initiative provides an option in case, that’s all.

    (3)Lack of mental health screening: Three requests for a script to your physician; review by a second physician. Request in writing. Both physicians confirm diagnosis, prognosis and mental competency to make a decision. If either doc doubts competency, they can refer to a shrink or deny a script. What more of a screening do you want?

    (4)Continuity of care…three requests one in writing…two physicians confirm all requirements. This is a fabricated argument.

    (5) Palliative care and hospice…not all pain is able to be alleviated by opiates without killing the patient. 2-3% is intractable…the last days and weeks of a “bad death” are bad. Cyclic vomiting, double incontinence, neuropathic pain, severe spasticity, aspiration, lungs filling with fluid choking a person, delerium, hallucination …why should any person endure this for a few weeks? Let those die who want to die…they have many lifetimes ahead of them. Life is illusory and transient.

    I do not support #2 only through a position of compassion, I do so out of righteousness, respect for choice and the golden rule (do unto others….) I want the option should it be necessary!

    Sorry, there is little commmon ground, Sister…

    I apologize for typos ..cataracts and age, ya know!

    • Ted Seeber

      Courage in suffering is the meaning of dignity. Escaping suffering by death is the meaning of the word cowardice. This would be better described as the “Death with cowardice” bill.

  • Phil,

    No argument for a slippery slope? More like no argument you accept, but there are plenty of arguments for it.

    Already unborn children even suspected to have disabilities are killed because the people making the choices for them assume that life with a disability is not a life worth living.

  • “Evidence shows that people who have a script for the seconol do not use it right away….they use it when the suffering is unremitting and intractable.”

    Can you point me to that please? My understanding is that you take it alone, with no doctor around, no hospice evaluation is required, no family members must be notified, and the cause of death is not listed as suicide.

    So, unless the law in other states is more restrictive, how would they know this?

  • Phil,

    A response to your slippery slope response: Almost every major disability rights group sees assisted suicide as a danger to vulnerable people. Are they all wrong? Yes, you are correct, euthanasia is not legal in WA or OR – yet. However, if you look at this in the worldwide context, there are four countries with assisted suicide (plus WA and OR)- three in which euthanasia is legal. I don’t think that is a coincidence – Neither do people with disabilities.

    In the Netherlands where euthanasia is legal, the UN investigated charges that infants with disabilities were being euthanasized in 2001: http://www.unhchr.ch/tbs/doc.nsf/0/dbab71d01e02db11c1256a950041d732?Opendocument – Now doctors in the Netherlands are speakly openly about euthanizing children with disabilities: http://en.wikipedia.org/wiki/Child_euthanasia

    Your arguments for 3, 4 assume that a patient will be able to find a doctor who will write a prescription who is familiar with their case. Only a handful of doctors say that they will write these prescriptions. Doctors are against this initiative. So, people wanting to find this option will likely be talking to doctors who do not know their case and are not familiar with their situation. A psychological test should be required. It is not.

    As for #5 – palliative care – Don’t you think all palliative care options should be required to be used before a person has this option? This law doesn’t even require that the doctor talk to the person about palliative care, let alone try it. As for your comment – “Let those die who want to die…they have many lifetimes ahead of them. Life is illusory and transient.” – this is your opinion, would you bet other people’s lives on what you believe to be true?

    This law has many protections in place for the doctors and very few for the patient. It is extreme, even in a world-wide context, and it will lead to dangers for the weak and vulnerable and social pressure for the elderly to take their lives when they have become a burden. Phil, if you want to protect vulnerable people like your son and believe in the value of their lives, I don’t think this is something that you want to vote for.

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  • Phil,

    “I adamantly oppose selective abortion …”

    Then how can you say there is no evidence to support the slippery slope argument? That is the argument: that people in the medical community will assume that life with a disability is a life not worth living, and they will put pressure on people to kill themselves, or on caregivers to kill those who depend on them. You recognize that it already exists for the unborn. You oppose that kind of thinking.

    Why would you say there is no evidence for the slippery slope argument then? Doesn’t follow.

  • Phil,

    Can you please answer this question?

    You said evidence shows that people who have a script for the seconol do not use it right away, they use it when the suffering is unremitting and intractable.

    What evidence? I’m asking because this is a major concern with the law. If the poison is taken alone, with no doctor around, no hospice evaluation required, no family members required to be notified, and the cause of death is not listed as suicide — then how do they collect evidence that most people who get seconol don’t use it until the suffering is unremitting and intractable?

  • Mack

    The most basic of the commandments is “You shall not kill.” We do not have the moral right to take the life of an innocent person, either of ourself or another. Only God is the author of life.
    The concept of redemptive suffering is part of Christian faith. If life has meaning at all, then suffering has meaning too. In Christ, it does.

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