"Assisted Suicide and the Corruption of Palliative Care"

I have a piece up on today’s First Things daily about assisted suicide and how it corrupts palliative care. From my column:

For the past two decades, euthanasia/assisted-suicide ideologues have worked overtime to conflate palliative care—the medical alleviation of pain and other distressing symptoms of serious illness—with intentionally ending the life of the patient. The movement’s first target was the hospice, a specialized form of care for the dying created forty years ago in the United Kingdom by the late, great medical humanitarian Dame Cicely Saunders. Determined to treat what she called the “total pain” of dying patients, Saunders’ great innovation was to bring a multidisciplinary team to the task of ensuring that their physical pain, existential suffering, spiritual needs, and mental health are all properly attended.

Saunders believed that suicide prevention, when needed, is an essential part of the package, crucial to fulfilling a hospice’s call to value the lives and intrinsic dignity of each patient until the moment of natural death...But assisted-suicide advocates wish to transform hospice into “hemlock” (as one advocate once put it), a facilitator of suicide rather than a preventer.

I note that assisted suicide make much of the fact that about 86% of Oregon assisted suicides were of patients in hospice, and argue that means more is needed to assure a “good death.” I see it differently:

But there is another way to look at it. What advocates don’t mention—and this is an issue about which the state bureaucrats seem utterly indifferent—is that most of Oregon’s assisted suicides were facilitated in some way by people affiliated with the assisted-suicide advocacy group Compassion and Choices (formerly the Hemlock Society)... This means that the patients in the hospice who committed assisted suicide under Oregon’s law most likely did not receive suicide prevention—either because the hospice team was not alerted to their patient’s suicidal desire or perhaps the Oregon law has effectively short-circuited the prevention response by hospice professionals. In other words, rather than showing the need to expand hospice “services,” Oregon demonstrates how assisted suicide actually interferes with the proper delivery of hospice services—at least as the hospice was envisioned by Saunders.

The discussion then turns to the attempts, discussed here previously at SHS, to subvert palliative sedation into backdoor assisted suicide, with particular attention to the California bill I have mentioned previously:

The effect of the bill would be insidious. If AB 2747 becomes law, doctors would be required to facilitate death by dehydration on demand for terminally ill patients—and this “treatment” would not be reserved only for those at the very end of life, since the bill defines terminal illness as having one year or less to live. Moreover, if the doctor believes that palliative sedation is medically unnecessary and/or believes it to be ethically wrong under the circumstances, he or she would still be legally required to be complicit in the patient’s dehydration death under the requirement that refusing doctors refer a requesting patient to another doctor willing to go along.

Assisted suicide ideologues—who tend to be well tailored elites—are ever about the task of subverting important ethical principles and blurring crucial definitions and distinctions in pursuit of their death agenda. But they aren’t the ones who get hurt.