B121-DES72
Euthanasia: Viva!
Copyright © by Dan Schneider, 11/28/03
I’ve found
that people tend to hate you more when they fairly lose an argument to you,
rather than when they feel you’ve somehow cheated. Bizarre, you may think. But
chew on this- you’re presumed ‘duplicity’ gives the losing party an
‘out’ to not deal with their own failure(s) because you, after all, ‘did not
play by the rules’. Therefore, they lost not because they were bad at something,
but because they ‘wuz robbed’. Of course, this is the essence of the
rationalization process by which all of us are to some degree guilty of at
various times in our lives. Still, I find this particularly noticeable when
dealing with a zealot- be they a tree hugger, an anti-abortion nut, a religiot,
or some obsessed fan. Topics that almost always entail this sort of
rationalizing are religion, abortion, euthanasia, eugenics, homosexuality, &
a handful of others.
20 years ago
my dad died from 2 forms of cancer- leukemia (blood cancer), & lymphoma
(lymph cancer). It was about 3 years from diagnosis till death, & the man
withered especially away in the last month or so. About 2 weeks before death my
dad was sent home as terminal. Fortunately, he went quickly. But, had he not,
& had my dad asked me to put a pillow over his face at the end I would have.
Cancer victims, along with AIDS sufferers & people with Alzheimer’s
Disease, are the most likely folk to need euthanasia. There are, of course,
groups like the Hemlock Society that promote euthanasia as a civil
liberties issue, & they are on firm legal & ethical ground- BUT, never
underestimate the political process’s ability to bastardize common sense- if
such a thing can exist in a world filled with dunces.
Here is a
summary of the Hemlock Society’s beliefs:
+ that every hopelessly ill, mentally competent American should have
access to the full range of end-of-life choices, including the option of
hastening one's death to end unbearable suffering.
+ that people should not have to suffer needlessly when they die.
+ that all religious faiths should be respected, but that no one should
be allowed to impose their beliefs about end-of-life choice on others.
+ that the
hopelessly ill have the right to choose quick, gentle, certain death in the
presence of their loves ones.
+ that physicians should be allowed to help a hopelessly ill patient
achieve a peaceful, dignified death if that's what their patient wants.
+ that the law should always be followed, but that where the law doesn't
permit physician aid in dying, it should be changed.
+ that maintaining control over how we die is just as important as
maintaining control over how we live.
+ that no government has the right to tell us how we die.+ that
depriving someone of choice and dignity in the final chapters of life is morally
and ethically wrong
In the last
quarter century or so the topic of euthanasia has been dominated by 2 figures-
both frail in appearance, but 1 of whom was a vegetable & the other a
spitfire. I mean, of course, Karen Ann Quinlan & Dr. Jack Kevorkian. Both of
these individuals simultaneously boosted & kyboshed the saner voices
pleading for euthanasia as a right. Not heard of this pair? Here’s a primer on
both- 1st up is KAQ.
KAQ (born
3/29/54) was a pretty, vivacious 21 year old New Jersey coed who went out
partying 1 night with some friends on 4/15/75. Coaxed in to shedding her ‘good
girl’ image KAQ mixed her imbibing of booze with too many tranquilizers. She
collapsed & was rushed to a hospital- Newton Memorial Hospital in Newton,
New Jersey. Doctors pumped her stomach, saved her life (or what was left of it),
but she had been deprived of oxygen too long before the paramedics arrived.
She suffered massive brain damage & slipped into a coma. The official
state term for her condition was called a ‘persistent vegetative state’.
KAQ’s state was defined in the courts this way:
‘….the result of extensive and irreparable brain damage brought on by the total loss of cognitive functions. There is no sapient behavior, no awareness of self or surroundings. In addition to being totally unconscious, Karen was unable to breathe properly. At times, she did not breathe at all. Because of this, doctors inserted a respirator tube into her trachea through an opening in her throat. The respirator forced air through the tube into her lungs and assisted her ventilation process in essentially two ways. If she breathed on her own, the respirator simply increased the volume of air which reached her lungs; if she did not breathe at all the respirator took over that function entirely.’
On 4/24/75 she was transferred to the ICU of St. Claire’s
Hospital in Danville, New Jersey She remained there until 6/9/76. On that day,
she was transferred to the Morris View Nursing Home in Morris Plains, New
Jersey. She would never leave. Her family led an all-out assault to get the
courts to declare their daughter’s ‘right to die’, transforming a comatose
person into a heroine- & later an icon- of the pro-euthanasia movement. In
July of 1975 the family had, in consultation with doctors & the hospital
chaplain, decided to ‘pull the plug’. They signed a hospital release &
the end seemed near, as they say. Not to be. Then the lead doctor reversed
himself- invoking Hippocrates & all- but, oddly, not hypocrisy! The doctor,
however, was wrong, because KAQ was an almost textbook case for the patient with
no hope of recovery, therefore extraordinary means were not required. The doctor
disagreed & forced the family to take legal actions- they decided not to be
rash, but to make a stand. On 9/12/75 her father petitioned the Superior Court
of New Jersey to be appointed guardian of his daughter, with the expressed power
to discontinue all extraordinary means of sustaining the vital processes of his
daughter’s life support machines. Instead, the state appointed a guardian ad
litem & the NJ Attorney General, county attorney, & St. Claire’s
Hospital all lined up against the family’s wishes. The battle was begun!
Here is a
summary from several online sources of what the main issues were:
First, the
common law doctrine of guardianship mandates the Court, as supreme guardian of
all incompetents who appear before it, find that the withdrawal of treatment
administered to Karen Quinlan is the only course of action which will promote
her best interests. It was further argued that the right to refuse treatment is
protected not only at common law but also by the provision of the United States
Constitution. The principal contention of Joseph Quinlan in this regard was that
the right of privacy protected by the Constitution enabled him and his family to
cause the discontinuance of certain life sustaining medical treatment which
Karen was receiving; and it was this argument as will be seen shortly which
eventually was adopted by the New Jersey Supreme Court. The third contention
which was advanced on behalf of Mr. Quinlan was that the denial of this request
would be an impermissible interference with the free exercise of his religion.
The First Amendment to the United States Constitution as applied to the States'
Fourteenth Amendment prohibits the States from interfering with the free
exercise of religious beliefs absent compelling contrary secular [State's]
interests. And, lastly, it was argued that the Eighth Amendment's proscription
against the imposition of cruel and unusual punishment will be violated by the
failure of the Court to grant the prayer of the Quinlan family.
The arguments advanced by the Attorney General for the State of New
Jersey, the county prosecutor, the treating physicians, the hospital and the
guardian ad litem can be summarized as follows. First, the Court lacks the
jurisdiction and power to grant the relief sought by the Quinlan family. Second,
it is never in a person's best interest to elect the suspension of medical
measures where death is a likely concomitant. Third, there is no constitutional
right to die. The State's compelling interest in the preservation of life
invariably overrides individual decisions predicated upon the right of privacy
and upon the guarantees of the First and Eighth Amendments. Fourth, granting of
the Quinlan's request would derogate from prevailing medical standards; and
fifth, withdrawal of treatment would constitute homicide should Karen die.
The family lost & the case went to the New Jersey Supreme Court. After going all the way to the Supreme Court KAQ’s family won the right for their daughter to be removed from life support systems. This was on 3/31/76, & here is the legal rationale for their decision:
The court
based its decision on the constitutional right of privacy enunciated primarily
in the United States Supreme Court cases of Griswald v Connecticut and Roe
v Wade. The Court in Griswald found the unwritten constitutional right of
privacy to exist in that the number of specific guarantees of the Bill of Rights
formed by emanations from those guarantees that helped give them life and
substance. According to the New Jersey Supreme Court, this right is broad enough
to encompass a patient's decision to decline medical treatment under certain
circumstances in much the same way as it is broad enough to encompass a woman's
decision to terminate pregnancy under certain circumstances. While stressing
that such a right is not absolute and, therefore, can give way before a
compelling state interest, the Court denied the possibility of such a compelling
interest in the instant circumstances. Reasoning that the State's interest
weakens and the right of individual privacy becomes stronger as the degree of
bodily invasion increases and the prognosis dims, the Court concluded that in
Karen's circumstances the degree of bodily invasion was so great and her
prognosis so dim that her right to privacy clearly outweighed any arguable State
interest. The Court went on to point out that the right of privacy would be
illusory in the case of an incompetent like Karen unless it could be exercised
by someone on her behalf by those closest to her. If Karen's guardian and family
acting as they believe Karen would have acted, chose to terminate treatment the
Court felt that such a decision should be accepted by society the majority of
whose members would have made the same decision themselves.
In reaching
its conclusions, the Court also considered the proper role to be played by those
allegedly prevailing medical standards which it had been argued constituted a
bar to the withdrawal of treatment. While the doctors on the case had appealed
to those standards in refusing to honor the Quinlan's request, the Court found a
certain ambiguity in the attitude of the medical profession toward such
standards. In addition to the view put forward on behalf of the treating
physicians, it found another approach - one which refused to treat the hopeless
and dying as if they were curable. The justices concluded that the standards
relied on by the treating physicians were neither so consistent nor so rational
that they could prevail over the interest and desires of the patient as seen by
her father and guardian nor could such standards control the Court in its
response to the case with declaratory relief established by Joseph Quinlan.
Finally, in addressing itself to the question of possible homicide, the
Court concluded that there is a valid distinction between withdrawing life
support systems in cases such as Karen's and the infliction of deadly harm
either on one's self or another. It saw a difference between Karen's situation
and the unlawful killing which is condemned in statutory law. The court denied
that the death following upon the withdrawal of treatment would be homicidal. It
would be rather the result of previously existing natural causes not from the
withdrawal of treatment; and, even if it were considered homicide, it could not
be unlawful if done pursuant to the exercise of an explicitly recognized
constitutional right.
Both the
state & the hospital were legally forced to comply. Then- in a twist no one
foresaw- KAQ continued to breathe after life support was removed in late May of
1976, after doctors supportive of the family pronounced life support was vital
to her remaining alive. Without it, they chimed in unison, the girl would
suffocate within a few minutes. Egg was all over the faces of the doctors, &
KAQ then became a heroine to Radical Christians who saw her ‘will to live’
as a sign that God was on their side, &, yeah, also KAQ’s. Once a poster
girl for the Left, KAQ now became an icon for the Right. Her parents &
doctors were portrayed as heartless, evil, & mad scientists. Any attempts to
secure KAQ’s ‘right to starve to death’ were politically untenable. For
nearly a decade more KAQ lived, vegetatively in her nursing home, before finally
dying of malnutrition & pneumonia on 6/11/85. The family bore their pain
& could not move on for over a decade. Rather than just being able to
consent to a shot that would euthanize their daughter- a ‘right’ even their
comatose cat or dog would have- the family was forced to not only suffer, but be
humiliated & excoriated, rather than sympathized & empathized with.
The most
enduring aspect of the KAQ case, however, was that ‘living wills’ came to
the fore in the mid 1980s. This allowed people to state that they preferred no
extreme measure be taken to save or prolong their life if a doctor assents to
the severity of that person’s medical condition. The reason for this
ascendancy was because not long before her overdose she had on 3 occasions
stated that if she were in a hopeless medical condition she would not want her
life prolonged by extraordinary medical measures. It was this seemingly sidebar
issue in the euthanasia debate that would a few years later lead to the rise of
the movement’s poster boy: Dr. Jack Kevorkian, the latter day John Brown, the
man everyone opined about! Before I join in opining, let me best summarize some
of Dr. Jack’s more noted moments in service to the movement. Again, this info
has been called from over a dozen online sites that either excoriate or praise
him:
May 28, 1928
Jack Kevorkian is born in Pontiac, Michigan, the son of Armenian immigrants.
1952
Graduates from University of Michigan medical school with a specialty in
pathology.
1956
Publishes journal article, "The Fundus Oculi and the Determination of
Death," discussing his efforts to photograph the eyes of dying patients, a
practice that earned him the nickname "Doctor Death."
December 1958
Presents paper at meeting in Washington, D.C., advocating medical
experimentation on consenting convicts during executions. Embarrassed,
University of Michigan officials ask Kevorkian to leave his residency there.
1961
Publishes article in The American Journal of Clinical Pathology detailing
his experiments on transfusing blood from cadavers to live patients.
1970
Becomes chief pathologist at Saratoga General Hospital in Detroit.
Late 1970s
Quits pathology career, travels to California, and invests life savings in
directing and producing a feature movie based on Handel's "Messiah."
With no distributor, the movie flops.
1980s
Publishes numerous articles in the obscure German journal Medicine and Law outlining
his ideas on euthanasia and ethics.
1987
Advertises in Detroit papers as a "physician consultant" for
"death counseling."
1988
Kevorkian's article, "The Last Fearsome Taboo: Medical Aspects of Planned
Death," is published in Medicine and Law. In it, he outlines his
proposed system of planned deaths in suicide clinics, including medical
experimentation on patients.
1989
Using $30 worth of scrap parts scrounged from garage sales and hardware stores,
Kevorkian builds his "suicide machine" at the kitchen table of his
Royal Oak, Michigan, apartment.
June 4, 1990
Kevorkian is present at the death of Janet Adkins, a 54-year-old Portland,
Oregon, woman with Alzheimer's disease. Her death using the "suicide
machine" occurs in Kevorkian's 1968 Volkswagen van in Groveland Oaks Park
near Holly, Michigan.
June 8, 1990
An Oakland County Circuit Court Judge enjoins Kevorkian from aiding in any
suicides.
December 12,
1990
District Court Judge Gerald McNally dismisses murder charge against Kevorkian in
death of Adkins.
October 23,
1991
Kevorkian attends the deaths of Marjorie Wantz, a 58-year-old Sodus, Michigan,
woman with pelvic pain, and Sherry Miller, a 43-year-old Roseville, Michigan,
woman with multiple sclerosis. The deaths occur at a rented state park cabin
near Lake Orion, Michigan. Wantz dies from the suicide machine's lethal drugs,
Miller from carbon monoxide poisoning inhaled through a face mask.
November 20,
1991
The state Board of Medicine summarily revokes Kevorkian's license to practice
medicine in Michigan.
May 15, 1992
Susan Williams, a 52-year-old woman with multiple sclerosis, dies from carbon
monoxide poisoning in her home in Clawson, Michigan.
July 21, 1992
Oakland County Circuit Court Judge David Breck dismisses charges against
Kevorkian in deaths of Miller and Wantz. Oakland County Prosecutor Richard
Thompson appeals.
September 26,
1992
Lois Hawes, 52, a Warren, Michigan, woman with lung and brain cancer, dies from
carbon monoxide poisoning at the home of Kevorkian's assistant Neal Nicol in
Waterford Township, Michigan.
November 23,
1992
Catherine Andreyev of Moon Township, Pennsylvania, dies in Nicol's home. She was
45 and had cancer. Hers is the first of 10 deaths Kevorkian attends over the
next three months; all die from inhaling carbon monoxide.
December 3,
1992
The Michigan
Legislature passes a ban on assisted suicide to take effect on March 30, 1993.
February 15,
1993
Hugh Gale, a 70-year-old man with emphysema and congestive heart disease, dies
in his Roseville home. Prosecutors investigate after Right-to-Life advocates
find papers that show Kevorkian altered his account of Gale's death, deleting a
reference to a request by Gale to halt the procedure.
February 25,
1993
Michigan Governor John Engler signs the legislation banning assisted suicide. It
makes aiding in a suicide a four-year felony but allows law to expire after a
blue-ribbon commission studies permanent legislation.
April 27, 1993
A California law judge suspends Kevorkian's medical license after a request from
that state's medical board.
August 4, 1993
Thomas Hyde, a 30-year-old Novi, Michigan, man with ALS, is found dead in
Kevorkian's van on Belle Isle, a Detroit park.
September 9,
1993
Hours after a judge orders him to stand trial in Hyde's death, Kevorkian is
present at the death of cancer patient Donald O'Keefe, 73, in Redford Township,
Michigan.
November 5-8,
1993
Kevorkian fasts in Detroit jail after refusing to post $20,000 bond in case
involving Hyde's death.
November 29,
1993
Kevorkian begins fast in Oakland County jail for refusing to post $50,000 bond
after being charged in the October death of Merian Frederick, 72.
December 17,
1993
Kevorkian ends fast and leaves jail after Oakland County Circuit Court Judge
reduces bond to $100 in exchange for his vow not to assist in any more suicides
until state courts resolve the legality of his practice.
January 27,
1994
Circuit Court Judge dismisses charges against Kevorkian in two deaths, becoming
the fifth lower court judge in Michigan to rule that assisted suicide is a
constitutional right.
May 2, 1994
A Detroit jury acquits Kevorkian of charges he violated the state's assisted
suicide ban in the death of Thomas Hyde.
May 10, 1994
The Michigan Court of Appeals strikes down the state's ban on assisted suicide
on the grounds it was enacted unlawfully.
November 8,
1994
Oregon becomes the first state to legalize assisted suicide when voters pass a
tightly restricted Death with Dignity Act. But legal appeals keep the law from
taking effect.
November 26,
1994
Hours after Michigan's ban on assisted suicide expires, 72-year-old Margaret
Garrish dies of carbon monoxide poisoning in her home in Royal Oak. She had
arthritis and osteoporosis. Kevorkian is not present when police arrive.
December 13,
1994
The Michigan Supreme Court upholds the constitutionality of Michigan's 1993-94
ban on assisted suicide and also rules assisted suicide is illegal in Michigan
under common law. The ruling reinstates cases against Kevorkian in four deaths.
June 26, 1995
Kevorkian opens a "suicide clinic" in an office in Springfield
Township, Michigan. Erika Garcellano, a 60-year-old Kansas City, Missouri, woman
with ALS, is the first client. A few days later, the building's owner kicks out
Kevorkian.
September 14,
1995
Kevorkian arrives at the Oakland County Courthouse in Pontiac, Michigan in
homemade stocks with ball and chain. He is ordered to stand trial for assisting
in the 1991 suicides of Sherry Miller and Marjorie Wantz.
October 30,
1995
A group of doctors and other medical experts in Michigan announces its support
of Kevorkian, saying they will draw up a set of guiding principles for the
"merciful, dignified, medically-assisted termination of life."
February 1,
1996
New England Journal of Medicine publishes massive studies of physicians
attitudes towards doctor-assisted suicide in Oregon and Michigan. Studies
demonstrate that a large number of physicians surveyed support, in some
conditions, doctor-assisted suicide.
March 6, 1996
The 9th U.S. Circuit Court of Appeals in San Francisco rules that mentally
competent, terminally ill adults have a constitutional right to aid in dying
from doctors, health care workers and family members. It is the first time a
federal appeals court endorses assisted suicide.
March 8, 1996
A jury acquits Kevorkian in two deaths.
March 20, 1996
Representative Dave Camp (R-MI), introduces a bill in the U.S. House to prohibit
tax-payer funding of assisted suicide.
April 1,1996
Trial begins in Kevorkian's home town of Pontiac in the deaths of Miller and
Wantz. For the start of his third criminal trial, he wears colonial
costume--tights, a white powdered wig, and big buckle shoes--a protest against
the fact that he is being tried under centuries-old common law. He would face a
maximum of five years in prison and a $10, 000 fine if convicted in the Wantz/Miller
deaths. On May 14, 1996 the jury acquitted him.
November 4,
1996
Kevorkian's lawyer announces a previously unreported assisted suicide of a
54-year-old woman. This brings the total number of his assisted suicides, since
1990, to 46.
June 12, 1997
In Kevorkian's fourth trial, a judge declares a mistrial. The case is later
dropped.
June 26, 1997
The U.S. Supreme Court rules unanimously that state governments have the right
to outlaw doctor-assisted suicide. The Court had been asked to decide whether
state laws banning the practice in New York and Washington were
unconstitutional.
November 5,
1997
Oregon residents vote to uphold the state's assisted suicide law, the first of
its kind in the nation. The law allows doctors to prescribe lethal doses of
drugs to terminally ill patients.
March 14, 1998
This day marks Kevorkian's 100th assisted suicide, involving a 66-year-old
Detroit man.
September 1,
1998
Michigan's second law outlawing physician-assisted suicide goes into effect.
November 3,
1998
Michigan voters reject a proposal to legalize physician-assisted suicide for the
terminally ill.
November 22,
1998
CBS's "60 Minutes" airs a videotape showing Kevorkian giving a lethal
injection to Thomas Youk, 52, who suffered from Lou Gehrig's disease. The
broadcast triggers an intense debate within medical, legal and media circles.
November 25,
1998
Michigan charges Kevorkian with first-degree murder, violating the assisted
suicide law and delivering a controlled substance without a license in the death
of Youk. Prosecutors later drop the suicide charge. Kevorkian insists on
defending himself during the trial and threatens to starve himself if he is sent
to jail.
April 13, 1999
Convicted of second-degree murder and delivery of a controlled substance in the
death of Youk, a Michigan judge sentences Kevorkian to 10-25 years in prison. He
would be eligible for parole in six years. Kevorkian plans to appeal.
In short, JK is either 1 of the most notorious serial killers
in world history (130+ deaths), or a demigod of the euthanasia movement. He took
the concept of living wills’ refusal to intervene & turned it on its head,
stating that ‘assisted suicide’ was not only ethical, but a duty. While
there are some niggling problems, the ‘real’ vs. ‘reported’ tallies of
assisted suicides, the claims- right or wrong- that some of the suicides’
changed their minds after turning on the machines, etc., only a fool would argue
that it’s not a total waste of Michigan taxpayer money to jail a
septuagenarian for doing something all but the congenitally narrow-minded see as
a self-evident civil right. Still, JK wastes away, all but forgotten, in jail as
the movement looks for its next hero/heroine, & the public wends from media
sensation to media sensation- the 2000 election, 9/11, Enron, Worldcom, Chandra
Levy, the Afghanistan War, Gulf War 2, Kobe Bryant, Michael Jackson, etc.
Personally, I
do not see this as an issue of civil liberties (although it technically is) as
much as an issue of societal maturation. Were I ever in KAQ’s state let me go
on record stating that my wife (or other heirs) ‘pull the plug’ or ‘stick
in the slow drip’. As for JK, it should be noted how up front, & in the
public eye, he conducted his crusade. He even reeks of humor & wisdom as he
rots in obscurity. Quoth the Doc: ‘I won't live to see it, but this (assisted suicide) will become
accepted in your lifetime. Know why? Do you think Generation X will pay to keep
all you baby boomers alive in nursing homes?’ Compare that honesty with the murderous
anti-abortionists who slink in & out of shadows with stealth. Regardless, I
am pro-euthanasia. I feel that everyone has the right to live their life as they
choose, so long as they do not impose their wills or beliefs on another.
That’s it. Simple. Period. Win or lose, I’m ready for the hate.
[Note- after completing this essay I found out that the Hemlock Society changed its name to the more PC End-Of-Life Choices Organization. Hmmm!]
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