by Richard Doerflinger
February 25, 2000
The image of physician-assisted suicide providing a "humane and dignified death" has suffered major setbacks lately. The credibility of the "right to die" movement may not recover.
The first blow landed when the Oregon Health Division on February 23 issued its second annual report on implementation of the state's "Death with Dignity Act." State officials said there were 27 reported cases of legal physician-assisted suicide in 1999 – up from 16 in 1998. And while overdoses of powerful federally controlled substances were used in all cases, three of those patients took over eleven hours to die – with one patient taking 26 hours.
The second blow came from an article in the Oregon newsweekly Brainstorm (www.brainstormnw.com), revealing a "botched" assisted suicide in December that failed to kill the patient. The man lingered and suffered terribly after taking the lethal dose, leading his wife ultimately to call 911. Medical technicians saved him, and he died later of natural causes in a nursing facility. It turns out that suicide advocacy groups in Oregon have known of the case for some time but refused to acknowledge it publicly, and it was completely missed by Oregon's official "reporting" system. In a live radio interview February 23, one Oregon "right to die" leader fiercely denied knowing about the case – until his debating opponent produced a tape of his own voice discussing the case at a local seminar on assisted suicide.
The third and most deadly blow against the facade of Oregon's law came from the February 24 New England Journal of Medicine. There, Dutch experts reveal that 18% of physician-assisted suicides in that country produce "complications" such as nausea and vomiting or fail to work as expected, prompting doctors to kill their patients more directly by lethal injection. (Such direct killing by physicians is not allowed by the Oregon law.)
An accompanying editorial by Dr. Sherwin Nuland, American author of the bestseller How We Die, notes that this figure may be only the tip of the iceberg: Ten percent of Dutch physicians refused to discuss their cases in the survey, and the cases left unreported are likely to be the ones in which "patients experienced the worst complications."
Dr. Nuland observes: "This is information that will come as a shock to the many members of the public -- including legislators and even some physicians -- who have never considered that the procedures involved in physician-assisted suicide and euthanasia might sometimes add to the suffering they are meant to alleviate and might also preclude the tranquil death being sought."
The Dutch data have a broader significance, besides showing that "quick and easy" assisted suicide is not what it is cracked up to be. Those data were available in a Dutch-language manuscript in 1997. In that year, pro-life Oregonians trying to repeal the Oregon Death with Dignity Act used the data to argue that the Oregon law would lead to lingering and inhumane deaths. But Oregon television stations, including all three major network affiliates, refused to air the ads using this information, calling them "misleading" (The Oregonian, Oct. 8, 1997). And suicide advocates aired their own TV ads saying that "politicians and the Catholic Church" were trying to mislead the public. "The truth is, you could look forever and you won't find that [Dutch] study -- because it doesn't exist," said the right-to-die ad. "It's simply not true" (The Oregonian, Oct. 15, 1997). Oregonians believed the latter ad, and voted to keep the assisted suicide law.
But the study did exist, and it is now clear which side had its facts straight. The Oregon law is based on misinformation -- and the people of Oregon are paying for it with their lives.
In light of the data on inhumane deaths by suicide, Dr. Nuland notes that two paths now lie before our society. We must turn away from the assisted suicide agenda -- or we must provide "thorough training in techniques" for killing patients, "with the attention to detail that all aspects of medical practice demand." Nuland favors the latter, and we can easily see where this leads: Doctors standing ready with syringes to finish off patients whose suicides begin to go "bad"; medical schools and residency programs feeling pressure to train doctors in how to kill their patients most efficiently ( a pressure many of them have tragically not felt when it comes to training doctors in better pain control); Catholic medical schools being chided by accreditation agencies for falling below the "standard of care" because they don't teach killing methods.
As the U.S. Senate prepares to debate the Pain Relief Promotion Act, which would clarify the law to prevent use of federally regulated drugs for assisted suicide, it must choose one path or the other. Is assisted suicide part of "medical practice"? If it is, the federal government will no doubt be drawn into efforts to make sure it is done "right" -- so no patient gets away alive.
The other issue raised by these new revelations is the credibility of a "right to die" movement that has misrepresented the facts and suppressed the truth to promote its agenda. As that movement declared in its own 1997 ad, "any campaign not based on the truth is fundamentally and fatally flawed." By that standard, the campaign for government approval of assisted suicide has a lot of explaining to do.
(Mr. Doerflinger is Associate Director for Policy Development at the Secretariat for Pro-Life Activities, National Conference of Catholic Bishops.)