Killing Is Not Compassion

I call heaven and earth to witness against you this day, that I have set before you life and death, blessing and curse; therefore choose life, that you and your descendants may live, loving the LORD your God, obeying his voice, and cleaving to him . . . (Deuteronomy 30:19-20)

True Crime Story?

    Imagine you’re reading a book, or watching a film.  In this story a caregiver, a trusted figure, secretly puts a sleep-inducing drug in the coffee of an unsuspecting person under her care.  Once the victim is no longer conscious, the perpetrator tries to administer a more powerful drug, a lethal drug.  The victim (who had previously expressed to her care provider a desire to continue living) wakes up and fights back.  The caregiver calls upon accomplices (from the victim’s own family, no less!) to restrain her, and forcibly administers the deadly injection. Sounds like a crime thriller, doesn’t it?  But wait, there’s more . . . here the story changes from a crime thriller into a Kafkaesque dystopian nightmare. The deed comes to the attention of the authorities, who conclude that the killer should indeed go to trial . . . but not to punish her wicked crime.  Rather, despite conceding the lurid details above, they conclude that she “acted in good faith”, and seek a trial in order to establish a legal precedent that other health care providers may likewise kill unknowing, and even unwilling, persons without fear of punishment.

Healer, or killer? (detail from painting by Mikhail V. Nesterov)

    As you may have guessed, the scenario above is in fact a true story, which recently took place in the Netherlands, as detailed in this article from LifeNews.com. The only major detail left out of my retelling, and the only thing (at least in the minds of the Dutch Review Committee that investigated the case) that makes what appears to be an act of unspeakable wickedness into a “good faith” medical procedure, is the fact that the victim was suffering from dementia.  As more and more places are following the Netherlands along the path of the legalized killing of the old, infirm, and, increasingly, those who are simply unhappy, it would be wise to take a look at cases like this to see what lies ahead.

In the Eyes of the Law

Prof. Theo Boer (Daily Mail photo)

    The case above is a chilling illustration of how, once we cross the line of giving legal sanction to the direct taking of innocent life, we unleash a force beyond our control, in which the “logic” of death overwhelms supposedly rational considerations.  Let’s start with what Dutch law provides for, and see how it compares to what actually happened in the situation above.  Theo Boer, a professor of Health Care Ethics at Kampen Theological Seminary in the Netherlands recently published an article in the British Catholic Medical Quarterly explaining why he no longer favors the pioneering Dutch law allowing physician assisted suicide. We’ll get to his reasons in a moment; first I’d like to take a look at his summary of the law in question.  Pr. Boer explains that, according to Dutch law:  

-1. “First, there should be a request from the patient” - There was no such request, and in fact, according to an article in the UK’s Daily Mail,

. . . the patient said several times ‘I don’t want to die’ in the days before she was put to death, and that the doctor had not spoken to her about what was planned because she did not want to cause unnecessary extra distress. She also did not tell her about what was in her coffee as it was also likely to cause further disruptions to the planned euthanasia process.

-2.  “there should be unbearable suffering without prospect of improvement” - The daily Mail tells us that “she often exhibited signs of fear and anger, and would wander around the building at nights. The nursing home senior doctor was of the opinion that she was suffering intolerably”, but  adds that “she was no longer in a position where she could confirm that the time was now right for the euthanasia to go ahead”. In other words, in the subjective judgment of outside observers her life was no longer “worth living”; other facts in the case indicate that the person living that life didn’t concur in that judgment.

-3. “the doctor should inform the patient of his situation” - demonstrably no.

-4. “doctor and patient together should have come to the conclusion that there is no acceptable alternative” - again, manifestly not.

-5. “the doctor should have consulted a colleague” - it is unclear from the Daily Mail article whether the “senior doctor” is the same who administered the lethal injection, but it is likely that more than one doctor on the staff participated in discussing the case.  If so, this is the one point on which the doctor unambiguously complied with the actual requirements of the law.

-6. “The assisted dying should take place in a medically sound manner” - well . . .

. . . secretly drugging a patient, then forcibly injecting her as she fights for her life doesn’t fit my standard of sound medical manner, but others may have a different opinion. In any case, the attending physician incontestably violated provisions 1,3, and 4 of the law, arguably number 2 and, if one is to take a civilized view, number 6 as well.  Setting aside for the moment the morality of any such law (I’ll get to that), the doctor euthanizing this patient blatantly flouted most of the specific provisions of the law. How in this world is it possible that the Review Committee would not only bless the doctor’s efforts, but would also be so confident that the courts would agree?

Gospel of Life

    To answer that question, I suggest we go back to St. John Paul II’s Encyclical Evangelium Vitae (The Gospel of Life), published in 1995, six years before the passage of the Dutch assisted suicide law.  St. John Paul, in speaking of both legalized abortion and legal euthanasia, wrote (my bold):

The end result of this is tragic: not only is the fact of the destruction of so many human lives still to be born or in their final stage extremely grave and disturbing, but no less grave and disturbing is the fact that conscience itself, darkened as it were by such widespread conditioning, is finding it increasingly difficult to distinguish between good and evil in what concerns the basic value of human life. (Evangelium Vitae 5)

St. John Paul II

In other words, not only are the acts themselves immoral and unjust, but they tend to corrupt the moral understanding of society as a whole, and consequently the morals of everyone in it.  Why should we expect anyone to honor the specific provisions of man’s laws if we no longer recognize the legitimacy of the moral law, God’s Law, itself?

    There is a clear pattern to the way this corruption works in concrete instances, which we can see in the legal history of contraception and abortion over the past century: The rare, extreme case is offered as an exception to a ban on something that had previously been considered intrinsically wrong; once the line has been breached, however, there is no longer any reason in principle to deny to others what was at first permitted to only a few.  If it’s not wrong for married couples experiencing certain difficulties to use contraception, why should it be wrong for others? If it’s not murder for one woman to abort her baby, how can it be so for another? We have now seen the same thing happen here in the United States with marijuana laws: first only “medical” marijuana for people with glaucoma and other conditions, but followed in short order by the general lifting of restrictions.  We should expect that, once rare “hard cases” have been used to legitimize legal euthanasia, the killing will become increasingly more commonplace, and “acceptable” in an ever wider range of situations.

It Can’t Happen Here . . . Can It?

    Pr. Boers details how this exact thing has happened in the Netherlands with assisted suicide and direct euthanasia.  The law was proposed to apply to people who were suffering late-stage terminal illness and suffering extreme pain.  Before very many years, those people became the exception to the rule:

. . . what was once considered a last resort, now becomes a default mode of dying for an increasing number of people. The unbearable character of the suffering is lesser described in terms of physical suffering and more in terms of ‘meaningless waiting’.

    In fact, most of the people requesting euthanasia aren’t dying at all:

Whereas in the first years hardly any patients with psychiatric illnesses or dementia appear in reports, these numbers are now sharply on the rise. Cases have been reported in which a large part of the suffering consisted in age related complaints. Loneliness occurs in 50 out of the last 500 cases that I reviewed before stepping back. Many of these patients could have lived for months, others for years or even decades. We have seen a number of ground breaking cases: ‘euthanasia for two’, for example couples in which the caregiver gets cancer and his partner chooses to die the same day and the same way; euthanasia in blindness; euthanasia for a man with autism who fears retirement; assisted dying for a mother of two suffering from tinnitus. Undeniably, assisted dying for one group of patients leads to demands from others.

    Similar results are reported in Oregon, the first US state to legalize assisted suicide, and in other states that have followed since.  There, the most common reason given is the abstract, amorphous "loss of autonomy" (see chart below). Less than a third cite pain (and not all of those are actually experiencing pain: for some it is only fear of possible pain). In fact, the most common factor among those seeking assisted suicide is not pain or terminal illness but depression, a treatable, non-fatal condition.  Studies conducted in both the United States and the UK indicate that over 90% of those seeking assisted suicide are suffering from mental problems. Nevertheless most of these people receive no psychiatric assistance prior to their death.   In fact, we have seen in the United States, and Pr. Boer reports the same in the Netherlands, that the doctors who preside over these deaths often have no professional relationship at all with their patients, and sometimes don’t even know them.

The Law as a Teacher

    The idea that “The Law is a Teacher” is an old one, going back at least to St. Paul’s letter to the Galatians.  So what does a law permitting killing people because they are old or sick teach us?  Surely it sends the message that human life is not sacrosanct, but instead something that can be disposed of when it becomes difficult . . . and if difficult lives are expendable, then why not inconvenient lives?  And where do we go from there?  St. John Paul explains that:

It is a problem which exists at the cultural, social and political level, where it reveals its more sinister and disturbing aspect in the tendency, ever more widely shared, to interpret the above crimes against life as legitimate expressions of individual freedom, to be acknowledged and protected as actual rights.  (Evangelium Vitae 18)

    Pr. Boer, in language strikingly like that in the passage above, confirms that such has in fact been the case in the Netherlands, saying that “there is a shift in public opinion. Whereas in the beginning assisted dying was seen as a last resort, public opinion is shifting towards considering it a right” (my italics).  Boer goes even further, however, adding:

. . . public opinion is shifting towards considering it a right, with a corresponding duty on doctors to act. A law that is now in the making obliges doctors who refuse to actively refer their patients to a ‘willing’ colleague.

The Culture of Death

Dance of Death by Venne Adriaen Pietersz

   We can expect the pressure on doctors to participate in killing to grow more intense in jurisdictions that have legalized euthanasia.  The idea of such killing as a legitimate good likewise puts pressure on family members to seek it for loved ones who may be unable to ask for it themselves (which may have been a factor in the Dutch case discussed above), and also on those who are themselves suffering to “spare” their relatives the trouble of caring for them.  This very concern is among the most cited reasons given by those asking for assisted suicide or euthanasia.  And so we see the corrupting power of sin: doctors, who have dedicated themselves to healing, are increasingly compelled to do the opposite and kill; close family members see themselves in mortal conflict with those whom they love . . . and killing off grandma becomes little more exceptional than "putting to sleep" the family dog.

    That’s the future that’s in store for us if we continue down the path of killing as a remedy for suffering, old age, and mere ennui.  We can look forward to more and more people implicated in ever greater acts of injustice, and ever wider waves of corruption spreading throughout society as a whole.  As we can see from events in the Netherlands this is no longer conjecture, but, in many places, a reality, a reality famously described by St. John Paul II as a "culture of death"  (Evangelium Vitae 12). The people who are relentlessly pushing Death as the solution to a myriad of problems will try to paint killing as “compassionate”, but the truth is very different. Killing is not Compassion.