Hastings Center Rep.: Organized Obfuscation: Advocacy for Physician-Assisted Suicide.

• Author: Callahan, Daniel
• Position: Abstracts

An ancient but evergreen practice with controversial political and ethical issues is to manipulate ideas and language, spinning them to serve one's ends. An example is the physician-assisted suicide debate regarding the ballot initiative in the State of Washington. The advocates for physician-assisted suicide made use of a favorite method from the spin tool box, that of obfuscation, defined in dictionaries as an effort to render something unclear, evasive, or confusing. I believe that in recent years, many advocates of euthanasia and physician-assisted suicide have used organized obfuscation as a political tactic, and the Washington initiative is no exception.

The seeds of this interpretation were planted in the author's mind in the late 1980s. In the January-February 1989 issue, the Hastings Center Report published an article by a Dutch cardiologist, Richard Fenigsen, titled "A Case Against Dutch Euthanasia." The article seemed extreme in its accusations, the only available footnotes were in Dutch, and there was no good way of independently verifying his critique. In brief, he charged that there were far more instances of euthanasia than reported, that regulations promulgated by Dutch courts to control the practice were widely ignored, and that euthanasia without informed consent of patients was common.

The journal was almost instantly assaulted with a remarkable (and obviously orchestrated) deluge of complaints from Dutch health authorities and organizations, as well as euthanasia advocacy groups. Their message was uniform and unsparing: the Report should not have published such an irresponsible article, filled with unverifiable charges and baseless accusations and displaying a gross misunderstanding of the practice of euthanasia in the Netherlands.

As it turned out, Fenigsen was proved right. In a series of confidential interviews with physicians and an examination of death certificates, three government-sponsored surveys in 1990, 1995, and 2001 found that approximately two percent of all Dutch deaths (3,500 or so) came from euthanasia and physician-assisted suicide, about 1,000 of which were without the patient's explicit request. Fewer than forty-five percent were reported as required by law.

But the apologists of spin did not give up. Yes, those figures were probably correct, they seemed to say, but they did not mean what they seemed to mean. Foreigners (Americans)just don't understand that the Dutch doctor-patient relationship is far...