Life and Death at the Eve of the 21th Century

Euthanasia is, in many ways, a battle of words, of semantics. Accordingly, as we begin this conference, I would like to suggest that we use the proper terminology. Those who favor euthanasia have done a very successful job of confusing the issue. I would suggest that we be very direct. I would not qualify euthanasia, at least when we use that word, by calling it direct or indirect, voluntary, involuntary, non-voluntary, or assisted suicide. I would suggest that we use euthanasia in its direct context, and that is, “euthanasia is when the doctor kills the patient”.

A similar degree of semantic gymnastics is occuring in the titles that the pro-euthanasia organizations give themselves. In the United States, originally, their title was very direct - The Euthanasia Society - but then they found that that did not appeal to people, so they changed their name to The Society for the Right to Die. Perhaps that was even too direct. Now they call themselves The Society for Concern for the Dying. I rather think the United Kingdom’s title of Exit is rather imaginative. They never say when “the doctor kills the patient”.

We do have one society in our country that would appear on the surface to be direct. It is called The Hemlock Society. As we all know, hemlock was the poison taken by Socrates when he committed suicide. His suicide is held up as a very noble deed, and so this society assumed that name and uses it to equate suicide with a very dignified and honorable death. The problem is, those who named that society do not know history or, if they do, the have chosen to ignore it, for in fact, Socrates did not commit suicide in the usual sense of the term. Socrates had committed a grievious crime according to the Greek state and, because of it, he was sentenced to death. He could have recanted; he did not, he stood on his honor. He could have fled; he did not, he stayed. The sentence of death was by poison. He chose to drink this in public. Socrates did drink the hemlock and did die, but it was not suicide. The State had chosen to execute him; he merely accepted the punishment and stood with great dignity for his principles, even to death.

The laws of Athens and Thebes in Greece at the time punished a man who committed suicide by denying him a conventional burial and confiscating his property. That was not done in Socrates’ case. Would we say that a man commits suicide if he walks to the gallows or the electric chair, rather than being forcibly dragged there? I think not. And so with Socrates - his was not suicide. But the euthanasia people hold up the death of this great man as an example of dignifying suicide. They lie. They really should be honest and change the name of their society once more.

Hippocrates, of cource, gave us the basic ethic of medicine - primum non nochre (first, do no harm). The oath written by Hippocrates came down to us through the centuries. It has been ignored, frighteningly, in the last decades. We remember that Hippocrates’ great contribution to medicine was to separate the healing and killing functions of the physician. He said, “Henceforth, a doctor will never kill”. That was grievously abused fifty years ago by the Nazis, but it is just as grievously abused around the world today in abortion and, sadly, here in the Netherlands by euthanasia. The great tragedy is, there are those amoung us who are physicians who have co-operated with this. I am sure there will be times when a nation decides to kill some of its citizens, but if and when that occurs, I would plead with those government officials - do not involve physicians. Hire executioners, for that is what you are doing, but do not destroy the ethic of medicine by involving doctors in the killing.

One obvious thing that must be said, although we all of us here know it, is that we can let death occur. We do let death occur. We should let death occur. When a patient is in the process of dying, a doctor does not have to prolong the dying process. I can look back, including my training, on fifty years of medicine. I remember when we first got pencillin, and so many of the other marvelous therapeutic tools that we have. Without question, there was a time when we, as physicians, using these marvelous, new therapeutic tools, did not know when to quit. I am sure that we kept patients from dying, and in the process often kept them in pain and suffering. The secular media speaks of this constantly, but they should look again, for that really does not happen much anymore. I have spoken in an average of one city a week for the last thirty years or more. I speak to physicians, my colleagues, in cities and countries around the world. The message I receive, consistently now, is that doctors have learned to let patients die. Doctors, with rare exeptions, are compassionate to their patients and we certainly should have learned how to control pain.

But the picture on television is one of an old man who obviously is dying. He is tied down in his bed with tubes into every normal body opening and several artificial ones. This old man is in pain. He wants to be at peace to die, but these evil doctors will not let him die. Now that is the frightening spectre that is held up everywhere by those who would give us euthanasia.

Let me be very clear. Those who would legalize euthanasia in our various nations really are not too concerned about that old gentleman, for he will die and such prolonging of the dying process does not happen very often anymore. We doctors do allow him to die. No, the patients they are concerned about are those who someone else thinks ought to die, but who will not die. There is a term for these patients. We call them “biologically tenacious”. Somebody wants them dead, but they will not die. They are the targets of the euthanasia people.

In most countries the patient threatened is not the one who is being killed most often in the Netherlands. In most countries, the target is the patient in coma, resultant from trauma or stroke. This patient is being fed through a gastrotomy or nasogastric tube. Typically, this patient is not in pain. He is being fed a nutritious milkshake through the tube several times a day, a diet that is cheap. This method of feeding is efficient and clean. This patient will stay alive, unless someone kills him.

The threat in most countries, and it is happening in most, is to remove the feeding tube. We know what happens when you remove food and water. It takes perhaps seven to ten days, and this patient will starve to death, a not very pleasant way to die. Remember, such patients are not dead, the are not dying, they are not terminally ill. You certainly have reason at times to remove other therapies, and, if so, sometimes that patient will then go on to die, but sometimes not. If you remove food and water, however, the patient will always die. If you do remove his feeding tubes, you have killed him.

This is a classic example of a slippery slope. Why should we allow that patient to lie in pain for one or two weeks, as he or she slowly starves and dehydrates to death. Why not a simple, quick, lethal injection? With this there is less pain, less expense and less emotional stress to those around the patient.

At least the folks here in the Netherlands have that logic behind them, for the Dutch have taken a fatal step. They should have known better. We need only recall the Nazi experience. That killing did not start with Jews or gypsies. The killing started with severely retarded children and with hopelessly insane adults. But it only took five years for that to change. In the end they were killing children who were bed-wetters and World War I amputee veterans.

You see, we have never placed a price on human life. Its value has been beyond calculation. It is sacred. The Nazis put a price tag on human life. Those who were useless eaters were not worth keeping alive. The Dutch have done the same thing and, sadly, some of this is happening without publicity in other countries. Abortion is another analogy. It was first allowed only for the most difficult cases - the baby conceived in assault rape, the child who was malformed. But now we have abortion on demand in most nations at the request of the woman. You see, we really cannot afford to place a price tag on human life and say that this particular life is not worth living, no matter how burdensome that life may seem at this time. Because, once we agree that human life has only a relative value, and do place a price tag on it, then it is only a matter of time until that price tag is marked down, the price is reduced. This is the slippery slope.

I am sure at this conference nuch will be said about the Dutch experience, and we will hear from other countries. I would simply remind us all that an attitude that someone walking the streets in good health may have toward euthanasia is one opinion. But place that person on their back in the nursing home, and then ask them about euthanasia, and you may get an entirely different answer.

The Dutch experience has taught us that attempts to limit those who may be euthanized is a futile effort. We have heard from your polititians here, and we have seen in our own journals and heard on lecture platforms opinions that tell us that only the most serious cases will be affected. The Dutch guidelines are that this must be a voluntary request by the patient. But over half of the Dutch people killed did not ask to be killed. You have told us that this request must be long considered, not impulsive, and this condition has been ignored.

We have been told that the patient must also have unbearable pain. I have a good aswer for that. If someone tells me that their loved one is in pain, and their pain is not being controlled, my answer is, “Get another doctor”. If your doctor does not know how to control pain, get one who does. Pain can be controlled. Controlling organic pain is easy. The difficult pain is emotional and psychological.

Euthanasia must be done only with consultation - no problem; both doctors get paid. And you have a phrase here - force majeur (there is no other answer to this problem). That is a word that is not used in many other nations. The answer to that is, “Nonsense, there always is another answer”.

And so the Netherlands has taught us much. As this nation continues the downward spiral of degeneracy and of killing your own loved ones, we have become more and more convinced that this is not a good idea.

Euthanasia and abortion have much in common. As a matter of fact, in many ways they are exactly the same, merely at different times in a person’s life. Every reason that has been given throughout the world to justify abortion can be used to justify euthanasia. Let us look at them.

Usefulness: The unborn baby will be burden, but so will this patient, if he continues to live.

Wantedness: The baby is unwanted, but so is this old man.

Degree of perfection: The baby to be born will be severely handicapped, but this child with motor-neuron disease or your aging mother after a stroke, will also be handicapped.

Age: Prior to birth, the baby is too young, but after a certain age, the man is too old.

Intelligence: The fetal baby is not yet conscious. The nursing home patient is no longer really very conscious anymore.

Place of residence: The fetal baby lives in the womb; the older patient in a nursing home.

“Meaningful life”: The U.S. decision legalizing abortion, Roe v. Wade, said that the fetus “does not yet have a meaningful life”. How easy it is for a doctor to say that the patient no longer has meaningful life.

Cost: She is too poor; she cannot afford to have this child. He is too poor; he cannot afford to care for his aging mother any longer.

Numbers: That family has too many children already. This nation has too many old people already.

Marital status: The young woman is unmarried. The old lady is widowed.

Let me quot from Richard Lammerton’s Care of the Dying. This was written twenty years ago. It remains the real answer to euthanasia.

“Once a patient feels welcome and is not a burden to others, once his pain is controlled and other symptoms have been at least reduced to manageable proportions, then the cry for euthanasia disappears. It is not that the question of euthanasia is right or wrong, desirable or repugnant, practical or unworkable; it is just that it is irrelevant. Proper care is the alternative to it. If we fail in this duty to care, let us not turn to the politicians and ask them to extricate us from this mess.”

Let me conclude with a comment by Pastor Richard John Neuhaus. It relates to both abortion and euthanasia.

“ . . . So long as we have the gift of life, we must protect the gift of life. So long as it is threatened, so long must it be defended. This is the time to brace ourselves for the long term. We are today laying the foundations for the Pro-life Movement of the Twenty-first century. Pray that the foundations are firm, for we have not yet seen the full fury of the storm that is upon us. . . . But we have not the right to despair. We have not the right and we have not the reason to despair if we understand that our entire struggle is premised not upon a victory to be achieved, but a victory that has been achieved. If we understand that, far from despair we have right and reason to rejoice that we are called to such a time as this, a time of testing, a time of truth. The encroaching culture of death shall not prevail, for we know, ‘The Light shineth in the darkness, and the darkness shall not overcome it’. The darkness will never overcome that Light.”

John C. Willke, M.D. - President

International Right to Life Federation