'Right' or Duty to Die? Depends on Who You Ask
'Right' or Duty to Die? Depends on Who You Ask
Euthanasia debate pits sick and elderly against young, healthy voters who think they need 'assistance' in suicide
by Richard Doerflinger
As the U.S. Supreme Court prepares to hand down some time next year its first ruling ever on physician-assisted suicide, the battle lines seem clear.
On one side are those who believe in the freedom of suffering, terminally ill patients to end their lives with a physician's help. Opposing them are Catholics and others who believe that defense of the sanctity of life outweighs this new demand for "freedom."
Yet, when Bishop Anthony M. Pilla spoke on this issue recently as president of the National Conference of Catholic Bishops, he observed that the issue is not so simple. A serious question can be raised as to whose "freedom" would really be served by legalizing assisted suicide.
"Remarkably," he said, "few have noticed that frail, elderly and terminally ill people oppose assisted suicide more than other Americans.
"The assisted-suicide agenda is moving forward chiefly with vocal support from the young, the able-bodied and the affluent, who may even think their parents and grandparents share their enthusiasm. They are wrong."
Far from "imposing" their values on others, he said, Catholics who oppose assisted suicide "are standing with those who are vulnerable and marginalized, those who often lack a voice in our nation's policies and are at serious risk of having some demeaning 'values' imposed on them from the outside."
As Bishop Pilla issued his remarks at the U.S. bishops' annual meeting in Washington last month, a cardinal often described as the country's pre-eminent Catholic leader was preaching the same message by his words and actions.
As one of his last public acts before succumbing to pancreatic cancer, Cardinal Joseph L. Bernardin of Chicago wrote an unprecedented personal letter to the justices of the Supreme Court urging them not to create any "right" to assisted suicide.
"I am at the end of my earthly life," wrote Cardinal Bernardin in his Nov. 7 letter. "There is much that I have contemplated these last few months of my illness, but as one who is dying I have especially come to appreciate the gift of life."
He warned the justices that "creating a new 'right' to assisted suicide will endanger society and send a false signal that a less then 'perfect' fife is not worth living."
In fact, Cardinal Bernardin's concerns are shared by many other terminally ill patients. In the June 29 issue of the British medical journal The Lancet, a team led by Dr. Ezekiel Emanuel of Boston reports that cancer patients experiencing "significant pain" are far more opposed to euthanasia and assisted suicide than the general public.
Emanuel found little difference of opinion on this issue between cancer patients overall and the general public. But the patients who support assisted suicide for cases of "unremitting pain" are not those in pain, but those diagnosed with clinical depression. The patients actually dealing with pain here and now have a different view.
Emanuel concludes that "having pain does not predispose a person to desire or take actions to end his or her life.... Indeed, oncology patients in pain may be suspicious that if euthanasia or physician-assisted suicide are legalized, the medical-care system may not focus sufficient resources on provision of pain relief and palliative care."
A new study in the Oct. 28 issue of Archives of Internal Medicine confirms these findings, and adds a more ominous note.
Here, researchers at Duke University Medical Center found that frail elderly patients receiving treatment at a geriatrics clinic overwhelmingly oppose legalizing physician-assisted suicide in their home state, with only 34 percent in favor.
Support is even lower among patients who are poor, less educated and experiencing cognitive impairment or a low "quality of life."
But 56 percent of the younger, healthy relatives bringing the elderly patients in for treatment favor legalization-and they often wrongly assume that the patients would favor it, too.
In short, the people most directly affected by policies on assisted suicide are most opposed to it, but their own relatives are often ignorant of this fact. Those younger relatives are the very people who would likely be making "proxy" decisions on euthanasia for elderly incompetent patients, if the Supreme Court establishes a constitutional "right to die."
"These findings are provocative and of great concern," said lead investigator Harold Koenig of Duke University, "because the frail elderly, poorly educated and demented members of our society have little power to influence public policy that may directly affect them."
This phenomenon is not restricted to the seriously ill. One opinion poll after another has shown that the more vulnerable and marginalized members of our society-the elderly, the poor and members of racial minorities-are more opposed to assisted suicide than other Americans.
When the Hemlock Society polled Americans in 1993 on this issue, it was surprised to find that voters aged 18-29 were much more likely than seniors to support the group's agenda.
The Hemlock Society's own newsletter commented that "the younger the person, the more likely he or she is to favor this legislation" allowing assisted suicide -a finding "somewhat at odds with how Hemlock views its membership," since it sees itself as a champion of seniors' freedom to die.
A poll published in the April 4 Washington Post found 50 percent support nationwide for legalizing assisted suicide for the terminally ill. In this poll, voters aged 35 to 44 supported Legalization, 57 percent to 33 percent.
But these numbers were almost reversed among voters aged 65 and older, who opposed legalization 54 percent to 38 percent. A majority also opposed assisted suicide among those with annual incomes below $15,000 (54 percent) and among black Americana (70 percent).
Support for the "right-to-die" agenda is strongest among affluent, college-educated white males with no religious affiliation. These young, healthy men may find it difficult to imagine that a life of illness, disability or suffering has real value.
Many of them undoubtedly want assisted suicide to be available for themselves if they face a lingering dying process in the future.
But they may also see it as a humane solution for patients who are now seriously ill-and for the families who feel burdened by those patients.
This struggle between the generations on assisted suicide comes at a time when new questions are being raised about the future of Medicare, Social Security and other programs in an aging U.S. population.
Some commentators have begun openly blaming American seniors for the nation's social and economic problems. Writing in The New York Times Magazine May 19, for example, economist Lester Thurow charged seniors with "destroying government finances" and "threatening the investments that all societies need to make to have a successful future."
It is frightening to think that such scapegoating of seniors could catch on with younger voters, increasing their enthusiasm for frail elderly patients' "right" to die.
These considerations are surely relevant to the Supreme Court's effort to sort out a just solution to the dilemma of assisted suicide. Federal courts often see themselves as defending endangered or unpopular individuals, protecting helpless minorities against oppression by a powerful majority.
Many vulnerable seniors would welcome the courts' help in fending off a "duty to die" that is all too popular among some of their children and grandchildren.
Doerflinger is associate director for policy development at the U.S. bishops' Secretariat for Pro-Life Activities
This article was taken from the December 15, 1996 issue of Our Sunday Visitor. To subscribe write Our Sunday Visitor, Inc, 200 Noll Plaza, Huntington, In 46750.
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