Other people's lives: reflections on medicine, ethics, and euthanasia.

Author:Fenigsen, Richard

Part Two: Medicine Versus Euthanasia

Chapter XXIX. The Shaping of Public Opinion

In Holland, the opinion polls conducted in the last three decades have shown an increasing acceptance of euthanasia by the public: in 1986, 76 to 77 percent of the respondents supported euthanasia (whether voluntary or involuntary), (538) in 2001 the percentage rose to 82. (539) The consolidation of the present overwhelming majority must be seen as a remarkable phenomenon in the very diversified Dutch society where so many religious denominations coexist and no less than eleven political parties compete in the elections.

One of the influences that has contributed to creating those exceptionally high percentages in favor of euthanasia was the way the polls were conducted. With social acceptance of euthanasia known to be on the rise, asking solely the positively construed questions of the type "Do you agree with ...," as all the questionnaires did, was bound to elicit many quick and less than thoroughly considered affirmative answers. The results could be different had the questionnaires been drawn up in a way that would induce the respondents to consider both the pros and cons of euthanasia. (540)

The selective information supplied to the Dutch public was of utmost importance in shaping opinion on the issue of euthanasia. In the last thirty years a great number of books, monographs, official documents, press reports and scientific papers on the subject have been published in Holland, and symposia have been exceedingly frequent. Among those thousands of publications and telecasts a few were open-minded on the issue of euthanasia, most favored it, and discussed euthanasia as an established practice beyond any dispute. From 1982 to 1985, 166 items concerning euthanasia were published in a large circulation moderate Dutch daily, Brabants Dagblad; only two of these opposed euthanasia. Of the eleven existing TV corporations, only one telecasts programs allowing the opponents of euthanasia to explain their point of view. The Dutch opponents of euthanasia who wish to state their views in print do so in small bulletins read only by themselves or in little known periodicals. As a rule publishers reject manuscripts that oppose euthanasia. The very well researched critical history of the euthanasia movement written by Dr. Issac van der Sluis was rejected by eight publishers and finally printed by the author at his own expense. My book opposing euthanasia had been rejected by four publishers before Van Loghum Slaterus in Deventer decided to publish it. The Dutch press, usually eager to pick up every piece of news on euthanasia, did not report that the European Committee of Medical Ethics and the World Medical Association condemned Dutch euthanasia.

How does the situation in America compare with that in Holland? Of course the U.S. is much less accepting of euthanasia, there is no national consensus on the issue (yet), and the resistance to euthanasia is more powerful than in Holland. But similar developments have begun.

The Dutch advocates of euthanasia emphasize that making the issue debatable was the first step on their way to victory. (541) In the United States euthanasia became debatable long ago. The next step to follow, according to the Dutch, is the stroomversnelling, "the rapids." This is now beginning in the United States. Key media are approached and easily won. It is in the nature of the media to seize upon genuine news. "Thou shall not kill" was news 3,500 year ago, it isn't any more. Legal, logically justified, morally approved killing is news. Printable matter is supplied in abundance by the pro-euthanasia movement. There is little opposition from the other side: the opponents of euthanasia still put too much confidence in the stability of traditional values, and they find it awkward to expound publicly the truths that in their view are self-evident.

The intervention of courts has become an important factor, helping to persuade the public that allowing, hastening, even causing death is a matter of justice. Doctors are told by judges when to stop treating their patients, and some of them have been ordered to act against their professional judgment. Of course we all have to live under the law. However, we should realize that law and medicine are governed by different principles and defend different values. Law and medicine are two great achievements of our civilization. We should try to prevent the one from overwhelming and destroying the other.

Test cases of mercy killing are boldly publicized. Terrible examples that strike the imagination, such as the man paralyzed from his neck down who somehow managed to set his own bed afire, are cited to convince the reader of the necessity of euthanasia. We know that it is improper to use uncommon cases to promote a change that would affect millions of people and society as a whole, but this kind of argumentation helps shape public opinion.

Horrific hospital scenes are depicted, and the language used, those "people slumped in wheelchairs," "decaying bodies," "patients hooked on machines," is such as to evoke not sympathy but revulsion, and the feeling that the world should be rid of such abominations.

Unconscious persons, who stay alive are called "biologically tenacious," as if they were not people whom we cherish, whose illness pains us, but noxious creatures resistant to insecticides. The lives of newborns and of people with substantial disabilities are verbally abused and devalued. Their very humanity is questioned so as to make euthanasia an imperative. They are termed "monsters," "post-human beings," and we are asked if they are "still persons, or only things"? (542)

An insidious attack is directed at people who do their best to help fellow humans in distress. Not the death and disease but doctors and their machines are depicted as the enemies of mankind.

The right to die is forcefully emphasized, as if dying were indeed a right and not a sad necessity. The theme of dignity is widely exploited. We are told that to be assisted by medical technology entails loss of dignity, as if the dignity of honest, caring, courageous people, our parents and spouses, could somehow be drained out of them through medical devices. And we are told that the way to die in dignity is to let yourself be killed by a professional.

A special, soothing language is used to make it easier for the public to accept euthanasia. Documents intended to hasten death are given the name of "Living Wills" and killing patients with injections is called "Aid in Dying." The term "euthanasia" is carefully avoided, and "physician-assisted suicide" is substituted, though there is no moral difference between the two, and the factual difference is negligible. (543)

In Holland, doctors unimpressed by the quasi-legalization, and all the rhetoric in praise of voluntary euthanasia, go on exterminating children with disabilities (544) and sick elderly people who never asked for death. (545) Similar exterminatory practices, though on a smaller scale, occur in the United States (546) along with the movement in favor of assisted suicide. Indeed, two different currents mix and intertwine in the euthanasia movement: the libertarian and the exterminatory. Watching this alliance of the honest and sincere with the ruthless and fanatical, I have little doubt who will use whom and whose agenda will prevail. The striving of libertarians for expanded rights and unlimited freedom of the individual will produce the opposite: compulsion to die, denial of the right to live, and replacement of human community we know by a new Killing Society.

Chapter XXX. The Society That Has Embraced Euthanasia (547)

In the last three decades euthanasia has become one of the main issues, and the most discussed issue in Dutch public life, politics, and national conscience. Euthanasia is supported by all major Dutch political parties and by a majority of Dutch Catholics, Protestants, and agnostics and has found a way to express and unify important and disparate social moods and tendencies.

The anti-intellectual and anti-technological rebellion in the years after World War II, and the triumphant technological society's certitude that all problems (including death) can and must be solved, met and intertwined in the movement in favor of euthanasia. The movement was begun by people who believe in abolition of all taboos and joined by those observant of the new taboos protecting autonomy and selfishness. The movement in favor of euthanasia succeeded in unifying at the same time the modern abhorrence of death, disease, dependence, and disfigurement, and the new national fascination with death.

People intent on improving the human race by extermination of weaklings form an important current in the movement in favor of euthanasia. They mute their rhetoric to conform with the official platform, but when euthanasia is considered for infants with disabilities, and people who are mentally retarded or demented, or the policy of allowing certain groups to die out is promoted, the supporters of extermination reveal their presence in an unmistakable way.

The supporters of free choice and "the right to die" form an even more important current. This group includes both libertarian intellectuals who proclaim the individual's unlimited right to self-determination and people who simply are afraid of suffering, feel that they have the right to escape it, and want to have the means. The libertarians have shaped the present official platform of the movement.

Active euthanasia has been openly practiced in the Netherlands for over thirty years, a time probably too short to expose all the changes it brings about in society, but long enough to reveal some of the consequences. Indeed, the practice of euthanasia has perceptibly affected the position of the individual in relation to society, society's very nature and purpose, law, government, judicial system, the practice of medicine...

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