In 1990, as I was nursing a mortally ill magazine, I got a call from a literary agent. “I have a great idea for a book. Your dad [a neurologist at the University of Chicago] could do the medical part, and you could write it. The book is called How We Die. Let me explain it.”
I told him not to bother with the explanation—I got it instantly. I saw the book in my mind and understood why it was such a brilliant idea. I phoned my father with the good news about our new family project. An unworldly man, Dad would surely be puzzled by the notion that a book about the physiology of dying would be a bestseller.
Dad surprised me—he was outraged, not puzzled. “Do you know ‘how we die’? Do you have any idea of ‘how we die’?”
“Of course not,” I said, “but that’s why—”
“Well, let me tell you, you’re lucky,” he interrupted. “It’s just . . . awful.” And after a brusque, ironic inquiry about my own health, he got off the phone.
Four years later, How We Die, by Sherwin B. Nuland, M.D., hit the bestseller lists. Dr. Nuland wrote it, he says in the book, for the same reason my father wouldn’t: because he knew dying was awful. But he hoped that by describing exactly the unlovely processes by which disease and euthanasia actually kill us, he would persuade the public that the ideal of “dying with dignity” was an illusion. If readers understood him, they would understand that while “there is often a serenity—even a dignity—in the act of death,” dignity comes “rarely in the process of dying.”
Nuland failed even to slow the frenetic progress of “death with dignity” through our institutions and opinion-makers. As the memory of the Nazi death-experiments wore off, euthanasia became the preoccupation of those understandably gloomy souls who happen to live in a few rain-drenched regions at the northwestern edges of continental land masses (Belgium, the Netherlands, Oregon). Now there is a euthanasia lobby, with distinguished advocates in the great medical journals, departments of bio-ethics, university departments of philosophy, the Department of Health and Human Services, the media. In his Human Exceptionalism blog, Weekly Standard contributor Wesley J. Smith assiduously chronicles the promotion of euthanasia by CBS News, Time magazine, the BBC, and the New York Times. Yes, as an editorial in the New England Journal of Medicine rejoiced this July, “momentum is building for assisted dying.”
The fact that its proponents are selling it in a misleading way to the elderly, the disabled, and the depressed doesn’t prove that physician-assisted suicide is despicable or repugnant. But it is clear that its proponents hope to achieve for euthanasia the status of gay marriage—until recently a novel and provocative idea, with many attractive arguments in its favor, opposition to which has suddenly been transformed into a career-destroying, dinner-party-silencing scandal. Among voters, euthanasia has even more legitimacy than same-sex marriage, which has lost every referendum that put the question to voters. The citizens of Oregon and Washington have made assisted suicide legal in their states, and Massachusetts voters are deciding whether to do so this week.
What is novel about the recent enthusiasts for euthanasia is that they have abandoned the idea of mercy killing: Euthanasia is no longer a humane way to alleviate pain, but a right. They’re prudent in making this change. Euthanasia was once the only alternative to unbearable pain. This is no longer the case, thanks to science and the generosity of taxpayers. Medicine can increasingly deliver mercy without death, with drugs and other therapies. We pay armies of social workers and build armadas of programs to alleviate loneliness and despair. Of course, neither science nor social science is perfect or perfectly deployed, but the tools are there. So it was inevitable that promoters of death-with-dignity would need to find another way to express the nobility of their desire to persuade others (not themselves, usually) to die a few hours, days, weeks, or years sooner than they would in the course of nature.