Wednesday, January 25, 1995, Section: EDITORIAL, St. Louis Post-Dispatch

by Nancy Valko, RN
Have polls replaced consciences? Can right and wrong be put to a vote? On Nov. 8, Oregon voters approved, by a margin of 51 percent to 49 percent, the legalization of lethal overdoses for the terminally ill. Ballot Measure 16 (or M-16 as some in Oregon are beginning to call it) immunizes doctors from prosecution if they prescribe lethal overdoses for people expected to live six months or less.

Immediately, a state task force was formed to devise regulations to make the new law work. According to Jono Hildner, acting administrator of the state health division, members of the task force are state bureaucrats, hospital representatives, lawyers and doctors who were chosen to avoid debate about the ultimate wisdom or morality of the law. “It’s not our purpose to debate whether it’s good law or bad law,” he said. “It is the law.”

But substituting legalities for ethics does not necessarily make things simpler. Already, some disturbing facts are beginning to emerge. Cheryl K. Smith, an attorney who helped draft Measure 16, has admitted that “in about 20 percent of cases deaths will take up to four days to occur. Most of the time it will work, but the death won’t be spontaneous. It will be long and drawn out, which means families will have to be educated about this. Otherwise, they’ll have some emotional trauma watching loved ones take two, three and four days to die.”

Derek Humphry, founder of the Hemlock Society, which proposed this measure, is already dissatisfied with the law and has written: “The new Oregon way to die will only work if, in every instance, a doctor is standing by to administer the coup de grace (lethal injection) if necessary.”

Already, some euthanasia supporters are using the same arguments used in the Nancy Cruzan case to argue that the suicide “benefit” must necessarily be extended to people who cannot speak for themselves. Others point to the suffering of the chronically disabled as equivalent to the suffering of the terminally ill in an attempt to include that group in so-called death-with-dignity laws.

Also alarming is the fact that, earlier this year, Oregon obtained a waiver from the Clinton administration to begin rationing health care for the poor under Medicaid, but ironically, lethal overdoses would now be covered by the state health-care plan under “comfort care” according to the chairman of the Oregon Health Services Commission.

Therefore, you could be denied treatment you might want under Medicaid if you were terminally ill, but you would have your medicalized suicide covered by Medicaid!

Even the supposed safeguards are causing consternation in many quarters as common sense collides with Measure 16. For example, even though studies have shown that 95 percent of all suicide victims have a diagnosable mental disorder at the time of their suicide, psychological examinations are not mandatory. That is left up to the doctor’s discretion even though disorders such as depression are notoriously underdiagnosed, especially in the elderly and terminally ill.

Also, according to Measure 16, families need not be notified of the death decision of a loved one until after death has occurred. Can you imagine how you would feel if you were denied even a final moment with your mother (much less a chance to convince her of the folly of suicide) by being purposely left in the dark?

Actually, the only real safeguard in Measure 16 turns out to be not for the patient, but instead for health-care providers who will be, in the words of the measure, “immune from civil, criminal liability for good-faith compliance.” And, as one doctor has said, if doctors are allowed to kill their patients, “who will care about a little paperwork?”

A medical person is really not required for suicide. For example, a running car and a closed garage are notoriously “successful” in causing death. Medical people are only necessary to add a patina of respectability.

Euthanasia supporters attempt to reassure the public that very few people would take advantage of legalized suicide. If that is true, then why should we change our laws, our standards for health-care professionals, even our suicide prevention programs to accommodate these few people who insist that we approve their actions? Must we now accommodate every person’s desires no matter what the consequences might be for society?

As a full-time cancer nurse, I know how vulnerable people with terminal illnesses can be. I know how cancer patients worry about the cost of their care and about being a burden to their families. But I also know that a dignified and meaningful death cannot be achieved by doctors and nurses killing their patients.

There really is a difference between allowing inevitable death and actually causing death. It is ironic that when we have so many ways to help and support the terminally ill and their families, euthanasia supporters insist that only a lethal overdose at the hands of a doctor will satisfy their desire for a “good death.”

Thankfully, the Oregon law is on hold as judges determine its constitutionality. But the larger question remains: Can a society dispense with its most basic principle that innocent people cannot be legally and privately killed without dissolving into a kind of moral anarchy on life and death issues?

Unfortunately, if some of us are willing to risk legalizing euthanasia and the rest of us are intimidated into a silent “tolerance,” we all will have to live (or die) with the answer to that question.

Publication Details, Copyright © 1997 Post Dispatch and Pulitzer Technologies Inc. Published here with Nancy Valko’s permission.


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