Suicidal Transcendencies

Four weeks ago, one of the seminal — and most headline-commanding — figures in the modern personal freedoms debate was released from prison to little more than a ripple in the Big Media, it seemed. Of course, I’m talking about Jack Kevorkian, M.D., the man who claims to have assisted 130 or more people in shuffling off their mortal coils.

Frankly, this lack of airtime floors me. In the heyday of his influence — just about all of the ‘90s before his imprisonment in 1999 — “Dr. Death” was everywhere. On magazine covers, on major news and interview shows, on the radio, in newspaper headlines, church sermons and editorials…

Now he’s out again. And even though Kevorkian has claimed — in one of the few quotes that has circulated since his release — to believe and to be working tirelessly for all the same things as before he was locked up, nobody in the mainstream media seems to care.

That’s because he isn’t killing anybody this time.

Think about that, folks. I don’t know about you, but this shows me more clearly than any example I’ve ever seen that despite their somber, self-serving posturing, issue-packaging and slick prime-time producing, all the media really want to talk about is killing…

Not freedom. Not the role of government. Not doctor-patient ethics. Not religion or politics or policy. All of these things are just ploys to keep bringing the discussion back to the only aspect of the story that really matters to them: The MURDER part.

There can be no other explanation here, can there? I mean, Kevorkian is still the marquis champion of aggressive human euthanasia (assisted suicide, self-determination, whatever) out there. And other than the inevitable Larry King interview and a 60 Minutes recap of their own story from 1998, the issue has largely faded from the public dialogue…

That’s a shame — because the “right to die” debate is one we ought to be having.

Doctor-Assisted Screw-icide?

In just two months, I’ll be in Africa, on a dangerous-game safari. And before I go, I want to say this for the record:

If some old “dagga boy” Cape Buffalo should do a flamenco number on my spine and render me a vegetable, I’d like nothing more than for some merciful soul to come visit me in the quad ward and pull the plug on my life-support machine. I’m sure thousands of animal rights wackos would more than gladly volunteer to do this.

However — and as much as it may surprise some of you to hear a liberty advocate like me say it — I should NOT be able to authorize my doctor to do me in artificially with drugs or anything else (called aggressive euthanasia — simply “pulling the plug” is passive euthanasia, and legal in most places).

At least not unless it’s under a set of very strict and well-defined legal parameters that no one’s even thinking about yet. The potential for abuses is just too great. Here’s what I mean…

Aggressive euthanasia as estate planning: It isn’t hard to imagine scenarios in which aged parents who aren’t really terminally ill or in unlivable pain might choose, were it legal, to have a doctor put them down years before their numbers would’ve come up…

Think about it: Mom’s lonely and miserable after the death of her spouse, and guilt-ridden at being a burden to her kids, who can’t afford live-in care or a suitable assisted-living facility. Think she wouldn’t be tempted to punch her own clock if it were legal?

What about the other extreme? Pop’s a rich widower, but is shelling out money to a “retirement community” that he feels would be better spent on his grandkids’ college tuition. Think a certain kind of father wouldn’t play up the old arthritis pain to get a doc to sign off on the Big Adios — so his kids and grandkids can have it on Easy Street instead of some over-priced, glorified nursing home revamping their feng-shui?

Beyond this, is it really so unbelievable to think that the looming presence of an immediate inheritance — or simply an end to years of tedious in-home care — might spur some less-than-scrupulous children to try and influence Mom or Dad toward suicide? And might not this be especially easy if they’re dealing with someone of less-than-sound mind (like an Alzheimer’s patient) who’s trusting them to help make decisions?

Aggressive euthanasia as revenge/bargaining chip: Legalizing doctor-assisted suicide opens the door to all kinds of motivations for offing oneself that have nothing to do with pain or incapacity…

Let’s say Biff (55 and in the midst of a midlife crisis) and Buffy (49 and past her prime) go through a bitter divorce after he catches HIV from a Haitian prostitute (15 and well past his prime). Part of her settlement was that she remains the beneficiary of his term life insurance policy, which extends until his 80th birthday — and which looks all but certain to pay off now that he’s fighting a terminal disease. Except in the case of suicide, which nullifies payout.

So what’s to stop Biff from having his doctor drug him to death when the pain starts to get bad just to screw her out of her payoff (he’s mad because she spilled the beans about the Haitian boy to all his country club buddies)? Conversely, what’s to stop Buffy from leveraging this possibility to better her up-front take in divorce court?

Aggressive euthanasia as malpractice shield: People trust their doctors, but I wonder if doctors can be trusted not to start telling people when it’s “time to go,” especially when their livelihoods may be at stake…

Let’s say a doctor has diagnosed an elderly patient’s degenerative disease as something incurable, like multiple sclerosis. But after years of pain management and treatment that continues until the patient is wheelchair-bound and inquiring about physician-assisted suicide, the doctor discovers that it was really an advancing case of treatable Lyme Disease that has been causing his patient’s degeneration (confusion between these two conditions happens regularly — look it up).

All “code of ethics” talk aside, don’t you think some doctors in this situation might subtly counsel their patients toward a decision that’ll take the evidence of such misdiagnoses to the grave instead of the state’s medical board?

In my opinion, the power to legally prescribe death is a conflict of interest of the most fundamental sort for doctors. Do we really want to give them this card to play?

Aggressive euthanasia as cost-cutting tool: Few medical decisions happen for anyone these days without the involvement of insurance companies, but it’s scary when people’s lives become nothing more than line-items on a balance sheet…

Think Nationwide (who’s “on your side”) and other big health insurance carriers aren’t licking their chops in anticipation of the day when physician-assisted suicide becomes the law of the land? Think about how insurance companies remain profitable: By taking in more money in premiums than they shell out in covered expenditures…

Now, I’m no bean-counter, but it’s got to be far cheaper to put someone to sleep than it is to shell out for months worth of long-term hospital care for terminal conditions — or years’ worth for cases of paralysis. What happens when insurance carriers become involved in this type of decision?

And here’s another little twist: Will companies start offering discounted up-front premiums to people who sign a contract that they’ll commit legal suicide if they become terminally ill or paralyzed?

Let’s say that such an insured becomes paralyzed days after a stem-cell breakthrough in paralysis treatment is discovered and reported in the media as being 2-3 years away from mass availability. Would this patient — who has signed, in exchange for lower lifelong premiums, a contract consenting to die in the event of paralysis — have the right to wait for the new treatment on the insurance company’s dime? Or would The Suits have the right to come in and pull the plug to save the cost of sustaining their insured?

I’m telling you, there are a lot of angles to consider in this debate — things people just aren’t grappling with…

Bottom Line on the End of the Line

In a perfect world, it’s a no-brainer to me that those so inclined should have the right of self-determination. To me, ending one’s life on terms of one’s own choosing is the ultimate expression of personal liberty…

But we don’t live in a perfect world. And as usual, I believe that the likely root of any evils in the administration of this ultimate freedom, were it to become legal and common on a grand scale, would be HUMAN in origin, not moral or religious or anything else.

And until we, as a society, have really thought the physician-assisted suicide matter through — considering every possible scenario and enacting ironclad legal safeguards against every possible abuse — I just don’t see how it could ever become the law of the land…

Not that it shouldn’t be in a “free” country.

Jim Amrhein
Freedoms Editor, Whiskey & Gunpowder

June 27, 2007