Tuesday, June 8, 2010

The Crime of Assisted Suicide

By Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Barbara Coombs Lee, president of the assisted suicide lobbying group, Compassion & Choices, has posted a response to the arraignment of nurse William Melchert-Dinkel (47) on two counts of aiding suicide. According to the criminal complaint, Melchert-Dinkel trolled the internet, posing as a young woman, encouraging dozens of people to kill themselves. The specific charges arise out of the deaths of 23 year old Mark Drybrough and 18 year old, Nadia Kajouji.

Coombs Lee’s post on Compassion & Choices’ blog is titled: "The Real Crime of Assisted Suicide." She states that reporters have been calling Compassion & Choices for comment, "perhaps with the expectation that we would not condemn the alleged behavior." Coombs Lee, however, and rightfully so, condemns the alleged conduct of Melchert-Dinkel.

Coombs Lee’s post is, nonetheless, not up front about the role of her organization. First and foremost, Compassion & Choices also encourages suicide, which she euphemistically terms "aid in dying." Coombs Lee further states that "aid in dying" is something "different" than suicide, in part, because she claims it is limited to people who are dying anyway. She states: "Aid in Dying . . . changes only the timing of the imminent death in a minor way." She also claims that "aid in dying" promotes patient "self-determination." This is not only wordplay, but malarky.

Last week a Connecticut court further agreed that "aid in dying" is in fact assisted suicide by another name. In the Blick case, Compassion & Choices argued that the Connecticut law that prohibits assisted suicide does not prohibit "aid in dying" because "aid in dying" is not suicide. The court concluded that the definition proposed by Compassion & Choices is identical to the definition of assisted suicide and therefore it is prohibited by the assisted suicide law. 

In other words, "aid in dying" is simply another name for assisted suicide.

Compassion & Choices has recently, at least twice, proposed expanded "aid in dying" laws, which would apply to non-dying people. In New Hampshire, where an assisted suicide law was defeated in January, her organization proposed a definition of "terminal condition" so broad that it would have included otherwise healthy people with disabilities. See here: http://notdeadyetnewscommentary.blogspot.com/2009/01/new-hampshire-poised-to-redefine.html.

Similarly, in Montana, Compassion & Choices’ definition of a "terminally ill adult patient" would have applied to an 18 year old who is insulin dependant or a young adult with stable HIV/AIDS. http://www.euthanasiaprevention.on.ca/ConnMemo02.pdf

Compassion & Choices’ broad definitions of "terminal" are also significant in terms of healthcare delivery. This is because once patients are labelled "terminal," an easy justification can be made that their treatment or coverage be denied in favour of someone "more deserving." In Oregon, where assisted suicide is legal, this has already happened, with the most well-known case involving Barbara Wagner. Wagner, who had cancer, wanted the chance to live offered by the drug, Tarceva. The Oregon Health Plan, however, denied coverage and offered to pay for "aid in dying." Wagner did not see this "option" as a celebration of her "self-determination." She said: "I'm not ready, I'm not ready to die."

In November 2008, Coombs Lee commented on the Wagner case. In an Orgonian editorial, she defended the Oregon Health Plan, argued against Wagner’s choice to try Tarceva and argued for a public policy change to discourage patients from seeking cures. Coombs Lee stated:
"The burning health policy question is whether we inadvertently encourage patients to act against their own self interest, chase an unattainable dream of cure, and foreclose the path of acceptance that curative care has been exhausted and the time for comfort care is at hand. Such encouragement serves neither patients, families, nor the public."

So much for patient "self-determination." Moreover, if Compassion & Choices’s broad definitions of "terminal" would be adopted, would the next "Barbara Wagners" include 18 year olds dependant on insulin or young adults with HIV/AIDS? This is a fair question.

Part of the shock expressed with Melchert-Dinkel’s conduct concerns his alleged use of deception to hide his true identity and agenda. Compassion & Choices, deceptively named as if it were a promoter of individual choice, has a similar attribute.

Legal assisted suicide, whatever its name, is not about patient self-determination. It is about enabling physicians or other people and institutions such as health plans to pressure others to an early death or even to cause that death. This is the "crime" of assisted suicide.


Deborah Chevalier said...

It is sad that society has reached a point whereby we feel it is our right to decide who should live and who should die.

Those who are sick or disabled should have a right to live in comfort. What is the point of all our medical advances if we do not even provide that much to those who need it?

WMD himself has described his actions as 'legal murder'. Surely that is what it is and should be seen as nothing less. I'm certain Barbara Coombs realizes that also, although she will never admit it. She has her own agenda and compassion I do not believe is a part of it.

Perhaps the greatest crime is simply that there is such a law as 'assisted suicide' which although no less then murder does not carry the same punishment and is often even excused by society. It is time we see it for the vile action that it is and punish it accordingly.

Ann Neumann said...


Most of us are rather accustomed to your advocacy that every dying person be put through whatever possible treatment there is, however experimental, that you have issue with patients making their own health care decisions or dying naturally, that you contest whatever definition it is that will help you scare the elderly and terminal and disabled into thinking the great "culture of death" is out to kill them. (I'd love to hear the motivation you ascribe to this group of "killers." There's an odd tendency on the right to paint opponents not as simple opponents but as forces of some great conspiracy....)

I've also learned from reading here that patient autonomy scares those who wish to impose a moral and ethical standard - of their own definition - on the medical system and the state's laws. Or rather, ultimately on patients who are working to achieve informed consent. It's a paternalistic need to "protect," to enforce that you know better, to assert your judgement on those who face death. I get all this strategy of yours. And I commend your sad effectiveness.

But to pull out the Barbara Wagner story and use it to somehow prove that the folks at C&C or anyone who believes in the DwD laws in Oregon and Washington wanted to save a buck is even beyond you; an incredibly irresponsible distortion of a story that you have apparently not researched.

Wagner thought - was encouraged to believe - that an experimental, miracle drug was going to save her life. It couldn't. The tragedy of the Wagner case is that society, her doctors, her family and you ("pro-life" media) who made so much of her sad story failed to prepare her for immanent death. Convinced her and manipulated her story to convince others that we have a duty to pursue every possible, ineffective medical procedure or drug, to die in the fight, to make no peace with death because we will defeat it.

Yes, yes, "do not go gentle" and "pray for a miracle" and "you can fight this" and "God doesn't give you more than you can handle" is all a fine story for the dying (or perhaps the living) but it didn't help Wagner accept that she was going to die. Death comes; it is not shameful to die; patients who are dying have the right to make their own medical decisions - including the decision to not rely on medical prolongation of death.

I don't care how often you claim to take the high road on this one, redefine things, make supporters of aid in dying out to be "killers" and death-hungry evil-doers.... You write me back after you've become a hospice volunteer or spent some time in facilities with the dying and you know intimately what happens in those hospital beds, when you understand that medicine is an inexact science, that supporters of aid in dying are as compassionate as you think you are, that the definition of death has changed over the past forty years and that we struggle today to redefine it in the face of leaping technology, when you realize that monolithic answers mean nothing to individuals, -- then tell me what great ethical superiority you are espousing.