Challenges Ahead
Assisted Suicide

THE KEY TO VICTORY MODELED

By Wesley Smith

As a new century and millennium loom before us, the struggle over legalizing assisted suicide is taking center stage. The stakes could not be higher.

The manner in which the nation ultimately decides this crucial legal and moral issue will tell much of the tale about our culture's remaining commitment to the sanctity/equality of life ethic; will define for our posterity society's cultural attitudes toward elderly, disabled, and dying people; and will determine the continuing commitment of medicine to the do no harm ethical ideal embodied in the Hippocratic Oath.

Indeed, it is not an overstatement to assert that assisted suicide is the coming cultural bellwether issue: win this struggle and our nation will be headed sharply away from the medical culture of death. Lose, and we will likely be engulfed by it.

The End of the Beginning
The jailing of Jack Kevorkian in the Fall of 1999, brought down the curtain on the opening act in the struggle over legalizing assisted suicide and euthanasia. The era of Kevorkian began with the fear that his successes meant that assisted suicide could not be stopped. It ended on a far more optimistic note, with Kevorkian jailed and much of the wind taken temporarily out of the death culture's sails. Unfortunately, the larger struggle has only just begun.

Kevorkian's reign of anarchy and death lasted nine years, a time in which he claims to have "helped" kill approximately 130 disabled, depressed, or ill people. Who in 1989 would have believed that a bizarre, unemployed pathologist who advocated harvesting organs from condemned prisoners and experimenting upon them medically during their executions would rise to become the world's most (in)famous M.D., a hero to many, feted at Time's 75th Anniversary Gala where actor Tom Cruise rushed up to shake his hand? And having achieved such notoriety, who would have guessed that he would so quickly become the "forgotten man" as he serves out his 10-25-year sentence for murder?

The Kevorkian death circus was the most visible aspect of the struggle over assisted suicide, but not necessarily the most important. Of greater concern has been the unremitting attempt to legalize and legitimize assisted suicide/euthanasia as a bona fide medical procedure. The effort began in earnest in 1988, with a failed effort by euthanasia enthusiasts to place a legalization proposal on the California ballot. Thereafter, in quick succession followed a series of important events that provided both good news and bad for people who believe in the sanctity/equality of human life.

On the positive side: Voters refused to legalize assisted suicide or euthanasia in ballot initiatives in Washington (1991), California (1992), and Michigan (1998). In June 1997, the United States Supreme Court refused unanimously to declare an assisted suicide Roe v. Wade, and upheld the right of states to ban assisted suicide. A few months later, the Supreme Court of Florida declared that the state's law barring assisted suicide did not violate Florida's constitution. Between 1994 and the present, six states outlawed assisted suicide either by criminal statute and/or under civil law that had not prohibited the act before: Louisiana, Virginia, Iowa, Rhode Island, Michigan, and Maryland.

But there was also significant bad news. In 1994, Oregon voters legalized assisted suicide, permitting doctors to intentionally help kill dying patients and creating a dangerous beachhead for the medical culture of death from which euthanasia advocates are mounting a national campaign. The media and, more insidiously, Hollywood, repeatedly depicted assisted suicide as a "last resort," compassionate "choice" in facile news reporting and melodramatic movies and television shows that almost unfailingly cast assisted suicide in a highly positive light.

Belgium appears on the verge of legalizing a very liberal euthanasia law. South Africa may follow suit. Canada's ruling party supports legalization. Here in the United States, Maine voters will decide next November whether to follow Oregon's lead.

The debate itself is now entering a new, more sophisticated phase. While some leading proponents of euthanasia, such as Hemlock Society co-founder Derek Humphry, still extol suicide machines and how-to-commit-suicide videos, the movement is quietly metamorphosing.

With the assistance of well-heeled financiers such as George Soros and the Gerbode Foundation of San Francisco, Compassion in Dying has metastasized from a local Washington group formed to help terminally ill people kill themselves into a national organization, the Compassion in Dying Federation (CIDF). CIDF is working very hard to depict itself [falsely] as a mainstream medical reform movement by distancing itself from the death- obsessed assisted suicide advocacy approaches of times past and by advocating improved pain control and end of life care in addition to legalizing medicalized killing. Toward this end, CIDF is affiliating itself with sophisticated and upscale advocates such as the recently named member of the CIDF board of directors, the internationally influential bioethicist Thomas Beauchamp of Georgetown University.

CIDF's long-term plan is obvious: sell itself to the media and general public as the "reasonable middle ground" between the Kevorkian/Derek Humphry "extremes" on one hand and pro- life/religionist opponents of assisted suicide on the other.

Meeting the Challenge
How should the pro-life movement react to these events and prepare for the coming struggle? I humbly suggest the following:

Follow the coalition modeled in Michigan. In 1997, Oregon voters reaffirmed by a 60-40% vote their 1994 51-49% decision to legalize assisted suicide. Yet, only one year later, Michigan voters stopped the assisted suicide juggernaut cold by rejecting assisted suicide by an overwhelming vote of 71-29%. Why the difference?

Part of it had to do with differing demographics between the two states, but it must also be remembered that Michigan was the state that refused to stop Jack Kevorkian for nine years. The more fundamental reason for success in Michigan, in my opinion, was the diverse alliance of strange political bedfellows that came together to defeat assisted suicide.

The outcome in Michigan showed that coalition politics is the way to future success: disability rights activists, medical and hospice professionals, and advocates for the poor who are generally secular and not necessarily pro-life, working closely with committed pro-life activists, Catholics, and evangelicals. It worked beautifully. People who either distrusted the pro-life movement or who were antithetical to religion felt comfortable voting against assisted suicide. This coalition must be expanded in coming years to include other groups that tend not to see eye to eye with the pro-life movement.

Argue Case In Secular Terms: Many in the pro-life movement approach their advocacy from a religious perspective and are comfortable in that milieu. Please rest assured, I am not arguing that pro-lifers should ever compromise their own religious values or faith-based commitment to their cause. However, I am convinced that arguing against assisted suicide on the basis that "only God can take a life" is a prescription for failure in today's cultural environment. Thus, to be effective beyond the pro-life and religious communities, pro-lifers must be willing to argue the case against assisted suicide fluently and convincingly from a purely secular basis.

Learn the Facts: Proponents of assisted suicide often argue that the only basis for opposing their death agenda is religious. In truth, the secular case against assisted suicide and euthanasia is utterly overwhelming. But it takes time and effort to learn enough facts to convincingly "connect the dots."

Give Greater Priority to Opposing Assisted Suicide: The struggle over assisted suicide has not galvanized the nation. Indeed, it is a subject that most people avoid the way they do writing a will or planning their own funeral. This is not cause for complacency, however. The pro-assisted suicide forces are energetic and indomitable, often able to spin defeat into a seeming victory - - as they did with their U.S. Supreme Court trouncing.

On the other hand, it has been my experience that some in the pro-life movement are less willing to commit themselves as energetically to resisting assisted suicide as they do to abortion. There are several reasons for this, all understandable.

But in a cultural and political milieu in which most people are generally indifferent to the outcome, the side with the most energy will win. That means all of us who are part of the anti- assisted suicide alliance will have to redouble our efforts in the coming years just to stay in place, while actually rolling back the culture of death will take a heroic effort.

Each reader of these words who wants physicians to do a better job of treating pain and who opposes assisted suicide should write or call their United States senators without delay and urge that they vote yes on the Pain Relief Promotion Act and vote for cloture to prevent Senators Ted Kennedy and Ron Wyden from derailing this important bill with their threatened filibuster.

Proponents of assisted suicide believe ardently that they represent the future. I am convinced that they are wrong. They must be. Assisted suicide is bad medicine and even worse public policy. But naysaying alone is not enough. It is the moral responsibility of each and every one of us who know why that is true to work energetically to convince the rest of the country. This is no small task. It is not a message people necessarily want to hear.

But if we want our children to live in a country in which elderly, disabled, and dying people are as welcome at the table of life as are the young, healthy, and vital among us, we have no choice but to roll up our sleeves and get energetically about the task at hand.

Wesley J. Smith is an attorney whose writings have appeared frequently in National Right to Life News. His next book, Culture of Death: The Destruction of Medical Ethics in America, will be published later this year by Encounter Books.