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Death on Demand

The assisted-suicide movement sheds its fig leaf.

12:00 AM, Jul 5, 2007 • By WESLEY J. SMITH
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The United States: We saw a similar phenomenon in America's reaction to the decade-long assisted suicide campaign of Jack Kevorkian. Not only were the majority of Kevorkian's "patients" not terminally ill (most were disabled)--but several were not even sick. For example, Marjorie Wantz, Kevorkian's second assisted suicide who died on October 23, 1991, complained about severe pelvic pain. Her autopsy revealed that nothing was wrong physically. It turned out that she had been hospitalized previously for mental problems. In 1996 Rebecca Badger went to Kevorkian complaining of having multiple sclerosis. Her autopsy proved that she was disease free. It was later reported that she had been depressed and addicted to pain pills. Despite these and other such cases of his assisting the depressed to kill themselves, Kevorkian remained publicly popular until he was finally jailed in 1999 after he videotaped himself murdering Lou Gehrig's patient Thomas Youk by lethal injection.

Oregon: Advocates for legalizing assisted suicide frequently tout Oregon's law as proving that assisted suicide can be restricted to the terminally ill. In actuality, little is known about what is happening in the state because it gets information about these practices almost exclusively through self-reporting by participating doctors.

Even so, the curtain was pulled back briefly when a peer-reviewed article in the June 2005 American Journal of Psychiatry appeared describing a potential assisted suicide of a psychotic man that was disturbingly similar to what is happening in the Netherlands and Switzerland. After cancer patient Michael J. Freeland received a lethal prescription, he had to be hospitalized for mental illness. Despite being delusional, his psychiatrist permitted him to keep the fatal overdose, in the doctor's words, "safely at home"--even though this same doctor advised a court that Freeland would "remain vulnerable to periods of delirium" and would "be susceptible to periods of confusion and impaired judgment." (Freeland died naturally nearly two years after receiving his lethal prescription--meaning he was also not terminally ill as defined by Oregon's law when he was prescribed the lethal overdose in the first place.) Needless to say, nothing was done to remedy this apparent breach of law.

THE NATURAL TRAJECTORY of assisted suicide advocacy leads to such ever-widening expansions of killable categories: from the terminally ill, to the disabled and chronically ill, to the "tired of life" elderly, and eventually to the mentally ill. Appel understands this and approves. He writes:

Contemporary psychiatry aims to prevent suicide, yet the principles favoring legal assisted suicide lead logically to the extension of these rights to some mentally ill patients. But now that several Western nations and one U.S. state have liberalized their laws, it seems reasonable to question the policies that universally deny such basic opportunities to the mentally ill.

With the truth now clearly in view, the time has come to have real debate about the so-called right to die. This debate should not pretend that the practice will be limited and rare and it should fully address the societal implications of transforming assisted suicide into a mere medical treatment.

So, let's argue openly and frankly about the wisdom of permitting near death-on-demand as a method of ending serious and persistent suffering. Let's discuss whether "choice" and "individual autonomy" requires that we permit licensed and regulated euthanasia clinics to serve anyone who has made an irrevocable decision to die.

Indeed, let's argue whether or not society owes a duty of prevention to the self-destructive who are not acting on mere impulse. But finally, let's stop pretending that assisted suicide legalization would be just a tiny alteration in public policy restricted only to the terminally ill. That clearly isn't true.

Wesley J. Smith is a senior fellow at the Discovery Institute, an attorney for the International Task Force on Euthanasia and Assisted Suicide, and a special consultant to the Center for Bioethics and Culture. His blog Secondhand Smoke can be found at