Deathly Quiet:

The Subtle, Stealthy Advance of Euthanasia

By Brian Johnston, NRLC Western Regional Director

The first of this month, April 1, 2002, marked the official legalization of euthanasia in the Netherlands. With the enactment of the Euthanasia and Assisted Suicide Control Act, doctors who "terminate" their patients may do so according to statute. But it is widely known that for the last 20 years Dutch physicians have been routinely dispatching their patients with impunity. Therein lie both a lesson and a warning for us.

We are well aware that the euthanasia movement seeks to change the laws that currently protect the medically and emotionally vulnerable, but often their methods are to first skirt and violate those laws long before they change them. And that is exactly what is happening in the United States today.

Throughout the United States, physicians who support euthanasia are routinely utilizing a special form of "terminal sedation," not as a means of pain control, but with the explicit intention of causing death frequently for incompetent patients who have never asked to die. This is routinely being used on patients who are not in immediate danger of dying, but are in other ways considered "incurable" or "hopeless." (See, for example, the case of Robert Wendland in California. NRL News, June 2001, p. 1.)

Essential to this approach is the mandatory withdrawal of hydration. It is a form of non-voluntary euthanasia that is particularly difficult to monitor. David Orentlicher, a pro- euthanasia physician, stated in the New England Journal of Medicine, "Terminal sedation seems consistent with accepted practices however terminal sedation is tantamount to euthanasia, or a kind of slow euthanasia." (NEJM, Vol. 337, No. 17:1237)

Orentlicher, a physician/"ethicist"/advocate, has made a point of traveling the nation instructing sympathetic physicians not to bother with the law or attempts to change it. Euthanasia can safely be practiced under the guise of terminal sedation. "Just do it," he told the California Conference on Physician Assisted Suicide.

Similarly, Robert Brody, chair of the Ethics Department at the University of California San Francisco Medical Center (and a board member of the pro-euthanasia group Compassion in Dying), instructs his student physicians that "terminal sedation" is an acceptable and appropriate form of "near euthanasia."

But Dr. Rex Greene, a California oncologist and advocate for the medically vulnerable, is alarmed at the hijacking of aggressive sedation.

"The insistence that hydration be removed is not valid. It is very rare that its provision is burdensome," he says. "In fact I have routinely found that adequate hydration is necessary to alleviate terminal delirium. Insisting that hydration be withdrawn as a form of treatment belies their real intention, which is to kill."

The significance of this ongoing practice should not be lost on those who seek to maintain legal protection for the vulnerable. This gradual acceptance of intentional killing was the cornerstone of the Dutch program, and is an essential tool of euthanasia advocates.

Public opinion

Meanwhile, in the western states, Compassion in Dying is in the midst of a public relations campaign to "expand choice at the end of life." The group is targeting churches, community groups, media outlets, and the elderly community.

In California the Hewlett Foundation has funded a think tank that seeks to blend the concept of physician-assisted suicide with end of life care. Other states are also seeing clever, indirect appeals for "compassion" using the emotions and good intentions of uninformed citizens. Pro-life citizens should be aware of, and monitor, these projects.

In Oregon, while Attorney General John Ashcroft has sought to prevent the use of federally controlled substances to kill, the " safeguards" in the law itself are being routinely ignored. Reports abound of "suicide"/killings of people with non-terminal disabilities, and "doctor shopping" when an attending physician refuses to agree that killing is warranted.

In Hawaii, Governor Benjamin Cayetano has personally proposed legalization of physician-assisted suicide, and the bill quickly raced through the lower house. Action awaits in the state Senate. (See story, page 25.)

Last election cycle the citizens of Maine turned back a ballot proposal on physician-assisted suicide. But we need to bear in mind that the margin (barely more than 1%) was extremely close.

There is one piece of good news. An ABCNews/Beliefnet survey conducted by telephone March 13-17, among a random national sample of 1,021 adults, found a plurality of Americans now oppose the legalization of assisting suicide, 48% to 40%. (There was a 3% margin of error; the exact wording of question not released.)

Our work is cut out for us. We need to remember "changing of the law" is only the end game for euthanasia advocates. As in the Netherlands, we must recognize that they are quietly moving ahead with their agenda. Shrouded in subtlety, the euthanasia movement is continuing to advance its agenda.

Talk about it now. Alert others. Remember, the goal of the euthanasia movement is to make changing the law a mere formality.