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Last Rights

You can have the ‘right to die’—once you surrender all the others

Nov 12, 2012, Vol. 18, No. 09 • By SAM SCHULMAN
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There is a libertarian case to be argued that free people in a free state should have the freedom to kill themselves—perhaps even to hire others to kill them as a private enterprise. Legislation need be necessary only to protect their “assistants” from liability suits (and good luck getting that one past the trial lawyers). At another frequency of the political spectrum, members of the human rights community might come to promote the right to die as the crowning glory of a whole pyramid of other rights. But the right to die, as it exists today in several states and European countries, has not come about because citizens demanded the right to die, or demanded complete personal autonomy. Citizens of the Benelux countries, Oregon, and Washington have been granted the right to die only within a euthanasia regime which efficiently strips from patients every other right they already possess. Doctors, hospitals, and even family members may euthanize a patient with fewer restrictions than the most modest municipality places on a landlord who wants to evict a nonpaying tenant.

A new book by the political scientist Howard Ball, At Liberty to Die, makes very plain the Pickwickian nature of the “right to die.” For him, any law in the United States that prohibits assisted suicide or euthanasia is unconstitutional. The liberties we have now under the two Due Process amendments extend to every American the right to choose “to die with dignity—with the passive assistance of a physician—rather than live in great pain or live a quality-less life.” But making euthanasia and assisted suicide legal, as they are in Oregon and Washington, involves the complete abrogation of due process for the patient, whether he has given an indication that he wishes to die or is no longer in a position to manifest his objection. There is no impartial authority who will consider whether an elderly patient really wants to die, apart from the assurances of his care-takers and heirs.

In Oregon and Washington, very few are killed by their personal physicians. And even the best doctors are not perhaps good judges of a patient’s desire to die. Consider the testimony of Dr. Joris Slaets, professor of geriatric medicine at the University Medical Center Groningen, who declared in an op-ed in a major Dutch newspaper that he thinks people nowadays die too late in life. Dr. Slaets likes to discuss end-of-life issues with his patients, and he asks them about their “goals” for their remaining years. He estimates his patients’ vitality and life expectancy before he decides whether they are worthy of further therapy. Dr. Slaets and his Dutch colleagues are judge, jury, and often executioner—something short of due process. Aleid Truijens, a columnist for the newspaper de Volkskrant, which published Slaet’s op-ed, noted his aggravation at failing to dissuade an 80-year-old woman from heart surgery (which was successful). “Was the woman in his example not vital enough for him? Did her plans for the rest of her life not satisfy him?”

When it comes to matters like property and money, the law is far more protective of the interests of the elderly than “right to die” laws are of their life. According to Seattle attorney Margaret K. Dore, her state’s probate law frowns when a witness to a will receives a gift from the estate. The statute presumes that the heir has used “duress, menace, fraud, or undue influence,” and requires the heir to rebut this presumption. Yet when someone signs the papers requesting a fatal dose to end his life, Oregon and Washington welcome an heir as one of the two necessary witnesses. An heir may represent the patient throughout the process, pick up the dose from the pharmacy, and, without any requirement for suspervision, administer it at a time of his convenience (sometimes a year later) to his or her loved one. If anyone objects, well, doctors, family members, and others are protected by a good faith clause in the Oregon and Washington euthanasia statutes.

In the Netherlands, the law is written in such a way that 23 percent of Dutch doctors feel they needn’t even report euthanasias they have undertaken, according to a major new study in the Lancet—and of course no Dutch doctor has ever been prosecuted for death without request or consent. In Flemish Belgium, 32 percent of euthanasias take place without request or consent or notice to relatives.  Whether or not it’s true that it’s difficult for a rich man to enter into the kingdom of heaven, the New York Times was horrified to find that those Oregonians richly endowed with worldly goods turn out to be the most attractive candidates for euthanasia. Why do so many people support the “right to die” for rich parents and relatives? Perhaps it’s because that’s where the money is.

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