Assisted Suicide of the Medical Profession

David C. Stolinsky, M.D.
March 20, 2006

I regret to say that I just received the latest issue of the New England Journal of Medicine, one of the most influential medical journals. Besides the scientific articles, there were two additional articles. Both articles dealt with assisted suicide. Both articles were written from a legal, not a moral, point of view.

The articles dealt with the recent U.S. Supreme Court decision that upheld Oregon’s assisted suicide law, and forbade the Justice Department to interfere with it. The Oregon law allows doctors to prescribe lethal doses of controlled substances like morphine to patients who request it and are "terminally" ill – that is, expected to die in six months.

To me, the question is whether killing a patient is ethical. To the New England Journal, the question is whether killing a patient is permitted under the federal Controlled Substances Act.

How are these questions to be answered? An ethical question must be answered by reference to ethical standards such as the Hippocratic Oath. This oath has been taken by young physicians for 2400 years. It states:

I will give no deadly medicine to anyone if asked, nor suggest any such counsel.

The two articles I refer to totaled 5539 words. But the words "Hippocratic" or "Oath" are not among them. Nor is there any mention of the position of Catholic, Protestant, Jewish or Muslim theologians on assisted suicide or euthanasia. So much for "multiculturalism," which never was about different cultures, but only about shredding our own culture.

The articles had many references to court decisions and legal sources, but not one reference to any source of ethical wisdom. For the authors and the editors, there was no need to include anything except legal references. For these people, there were no moral questions, only legal ones. And, of course, legal questions are answered by judges.

For example, who decided that persons in a persistent vegetative state can be slowly dehydrated and starved to death? Congress? State legislatures? A vote of the people? The American Medical Association? Religious leaders? You must be joking. It was decided by a 5-4 vote of the U.S. Supreme Court. Five unelected judges with lifetime jobs can tell 298 million Americans what to do. And now nobody has the authority – or the guts – to challenge that decision.

The New England Journal is hardly alone in undermining the foundations of the medical profession. Lancet is a leading British medical journal. Some time ago, it published an article noting with approval the "peaceful" dehydrating and staving to death of a patient "very near" a persistent vegetative state. Very near? That is, the patient was minimally conscious, as Terri Schiavo may have been.

Later, Lancet published an editorial claiming that execution by lethal injection is "barbaric." A week or two of thirst and hunger is "peaceful," but a massive dose of a fast-active sedative is "barbaric." These contradictory claims call into question the validity of the scientific articles in that journal. If the editors can’t recognize conflicting, illogical statements, can we trust what they publish?

Since ancient times, society assigned the task of saving life to physicians. If killing people was required, that task was given to executioners. Now we have confused these opposite roles.

A milestone on the road downhill was the publication in Germany in 1920 of "Permission to Exterminate Life Unworthy of Life." The "unworthy" included the incurably ill, the mentally ill or retarded, deformed children and the comatose. Killing was "healing treatment" to be administered by physicians.

For the first time, killing and healing were mixed together. And physicians’ loyalty was no longer to the individual patient, but to "society" or the state.

Once the Nazis took over, medical graduates no longer took the Hippocratic Oath, but an oath to the health of the state. Most American medical graduates also no longer take the Hippocratic Oath, but a variety of other oaths, of which only 8 percent reject abortion, and only 14 percent reject euthanasia. This is called "progress."

I believe the chief cause of the Hippocratic Oath’s demise is its ban on abortion. But in the Oath, euthanasia and abortion are next to each other. Discarding one prohibition weakened the other. If all human life isn’t sacred, none is. Intermediate positions are weak and are being overrun one by one. Who is worthy to live becomes just a matter of opinion.

The phrase "life unworthy of life" was used by the Nazis, but it originated before anyone heard of Hitler. Nazism was a seed that fell on soil that had already been fertilized by the manure of viewing human beings not as having intrinsic worth because they are created in God’s image, but as having worth only if they are useful to others.

Those who now spread similar manure will not be able to claim innocence if similar seeds sprout. The lesson of history is clear.

The Nazi euthanasia program used drugs, then gas, and was the physical and psychological prelude to the Holocaust. It was opposed so strongly by Catholic and Protestant churches that it was stopped, though it continued unofficially. Sadly, there was no organized opposition by physicians.

Of all professions, medicine had the highest percent of Nazis. When leading doctors support late-term abortion, assisted suicide, euthanasia, and cloning of human embryos, remember not to expect moral leadership from the medical profession. This lesson is also clear.

And now Justice Ginsburg and some of her colleagues on the Supreme Court use foreign law to help them render decisions. We should be grateful that judges did not hold similar ideas during the Nazi era. Otherwise, they might have rendered decisions based on Nazi laws regarding racial persecution or absolute government power. In going outside our Constitution and laws to render decisions, judges are violating their oath of office. Having no regard for their own oath, why should judges respect the physicians’ Oath of Hippocrates?

Once we throw away the rulebook, the referee becomes a dictator.

Check out the court cases that authorized assisted suicide or euthanasia. You’ll find the names Nancy Cruzan, Karen Ann Quinlan and Elizabeth Bouvia. They were women, as were Terri Schiavo and most of the people killed by Dr. Kevorkian. Being disabled is becoming dangerous, but being a disabled woman is more dangerous. That doesn’t trouble most ethicists or judges. Of course, the majority of them are men.

In two articles totaling 5539 words, the New England Journal found no space to mention the Hippocratic Oath or any other source of ethical values. Meanwhile, Lancet describes as "peaceful" the slow death by dehydration and starvation of a minimally conscious patient. But Lancet also describes as "barbaric" the execution of convicted murderers in the same way we put beloved dogs or cats to sleep. On the contrary, someone who starved and dehydrated an animal to death would be jailed. So who really is barbaric?

We devalue the severely disabled, so we feel free to kill them. Then why are we surprised when a Hollywood star devalues the less severely disabled, so he feels free to make jokes about their disability? What did we expect? Those who devalue the disabled deserve to become temporarily disabled themselves, so they can know what it feels like to be devalued.

As I write these words, I look up at the wall and see the copy of the Hippocratic Oath I was given when I graduated from medical school many years ago. It is slightly yellowed with age now, but I can still read it very clearly.

And a question occurs to me: Who, or what, is being assisted to commit suicide? Disabled or ill human beings, of course. But the medical profession itself is also committing suicide. True, the legal profession is rushing to assist us physicians to do so. But we can’t put all the blame on lawyers and judges. They are only assisting in the lethal decision we physicians have made for ourselves.

Terri Schiavo, and those like her, aren’t the only ones slowly dehydrated and starved to death. The medical profession itself is in the same unhappy situation. The process of starvation is already far advanced. But unlike Terri, there is still time to save the profession – if we start right away.

Quick! Start an IV. Begin an infusion of moral principles and ethical values. Restore medicine to its former healthy state of independent professionals dedicated to the wellbeing of individual patients, rather than mere technicians serving the economic interests of their employers or the state.

About 2400 years ago, Hippocrates told physicians to heal and never to kill. About 3200 years ago, the Bible told all of us, "…I have set before you life and death, blessings and curses. Now choose life, so that you and your children may live…" As for me, I’ll take these as my beacons to steer by. Others will check the news daily, so they can be guided by the latest court decision. It’s your choice.

For further information:

"Culture of Death" by Wesley J. Smith

http://www.euthanasia.com/index.html

Dr. Stolinsky writes on political and social issues. He may be contacted at dstol@prodigy.net.

www.stolinsky.com