Euthanasia: Hell's Last Sacrament

by Robert C. Cetrulo

I suggest that future historians might caption the last half of the 20th century in the United States as "The Flight From Responsibility." In the 1960s "no-fault insurance" was developed — the concept being that you would be paid for your own personal injuries in an automobile accident, regardless of who was to blame, whether you were drunk, etc. You were "entitled," regardless of responsibility.

At about the same time there developed the concept of "no-fault divorce," wherein marriage was treated simply as a contract from which one may walk away, at one's unilateral choice — without regard to responsibility.

And then we came to accept "no-fault sex," i.e., abortion — no responsibility for the unborn child created by sexual intercourse.

And now we have "no-fault medicine," represented by euthanasia, and assisted suicide, with all of the enabling statutes immunizing physicians from criminal and civil responsibility.

Legal And Moral Metamorphosis

As in all human social situations, acceptance is a process, rather than a single event. The concept of "death with dignity" is not a construct of 1960s America. Its modern genesis was a book written in the 1920s in Germany by a psychiatrist and a law professor, which recommended a "good" death be furnished to pure blood Germans with painful terminal diseases.¹

This eugenic movement was picked up and pioneered in America by Margaret Sanger, founder and patron saint of Planned Parenthood of America and its predecessor, the American Birth Control League ("Birth control — more children from the fit, less from the unfit." "Birth control — to create a race of thoroughbreds." "No man or woman should have the right to become a parent without a permit for parenthood.")²

Eugenics became sufficiently well accepted so as to be applied by the U.S. Supreme Court in Buck v. Bell.³ In that case, the Court upheld a mandatory sterilization statute as applied to the mentally retarded, on the mistaken (but then widely accepted) theory that "three generations of idiots are enough," to quote the indelicate language used. It is significant that the U.S. Supreme Court used that decision as supportive authority for its decision in Roe v. Wade,⁴ which legalized the modern medical holocaust of the slaughter of one million unborn children a year in this nation.

This anti-life movement suffered a temporary setback in the United States by reason of the Nazi experience, which embraced the euthanasia concept. By the end of World War II, the Nazis were doing away with amputees from World War I, and even children who were chronic bed wetters, or who had badly-modeled ears, in this insane search for "perfection."⁵

Definitional Dehumanization

The U.S. Supreme Court in 1973 authorized the killing of a whole class of innocent human beings, the unborn, professing that they were "not persons in the whole sense of the word."⁶ And so we began anew on the slippery slope. If you can destroy a human being because he is too young, then there is no reason why you cannot destroy him because he is too old, unproductive, expensive, etc. Thus began the modern version of the euphemistic game, beginning with the phrase "death with dignity," and leading to the argument "right to die," fueled now also by the cost/care-containment concept in medicine, and the inverted demographic structure of the United States (due to abortion and contraception), with there being fewer and fewer people in the work force to sustain more and more people in the retirement segment of society, undermining Social Security, etc. This year, for example, for the first time in history, people over the age of 60 will outnumber children 14 or younger in industrial countries.⁷

Living Wills

In my 30-year involvement in the Pro-Life movement, I had been totally and unequivocally opposed to Living Wills, as the opening wedge in the euthanasia movement, as unnecessary, capable of mischief, and furnished to us by the same folks who gave us abortion on demand. They have quite properly been called "designer deaths."

My personal metamorphosis to my current belief that we need to prepare and put out there for the Pro-Life public what my good friend law professor Charles Rice of Notre Dame University calls "Please Don't Kill Me Wills," has been dictated by the unfortunate successes of the pro-death forces in our legislatures and courts.

We had successfully resisted in my own State of Kentucky the passage of Living Will statutes until 1998. When the first bill was passed, Pro-Life organizations warned that the death peddlers would return shortly, seeking to legalize the withdrawal of food and water, in addition to "extraordinary means" of life support. It took them only one session. In 1999, they passed such an amendment, and I regret to report to you that it was passed with the support of the Kentucky Conference of Catholic Bishops. And it contained an incredibly expansive net to catch the unwary, i.e., those who thought they were safe by not having a Living Will. It mandated that any patient who is "comatose" (not dying — just "comatose") and who has not executed a Living Will, will have someone else appointed for him to make his decisions, including the withdrawal of food and water. Some have thus suggested that if you are in the hospital today, you need to tie a tag around your toe that says "I am neither comatose, nor a heart donor. I am simply napping!"

Another reason that a Pro-Life Living Will is necessary is the Federal Patient Self-Determination Act, enacted by the Congress in 1991, which requires hospitals and nursing homes to explain to every person newly-admitted, his rights under state Living Will laws. The practical effect of this is to shove under the noses of these infirm and frequently aged people the "designer death" formula of the state statute, that they shall not be furnished extraordinary care, that they shall not be furnished food and water, etc. — and give them to believe that they must have such a document. This vulnerable population is given the impression that they must executive such a document — and many automatically do so, frequently when it would truly be contrary to their wishes, but in default of education and the availability of a better document, they are seduced.

The only way to avoid this canned, boiler-plate death-inducing scheme is to have an alternative Pro-Life document. A massive educational effort, getting such a document into the hands of the public, with the understanding that they need to have this to protect themselves, is imperative.

"Compassionate" Killing

Killing is of course never compassionate. Its advocates don't understand the etymology of the word, "com-passion": "suffering with." It is certainly not "merciful" to cause someone to die from starvation and dehydration. An accurate medical description of the horrors of such a death includes:

". . . various effects from lack of hydration and nutrition, lead in ultimately to death — mouth would dry out and become caked or coated with thick material . . . lips would become parched and cracked . . . tongue would swell and might crack . . . eyes would recede back into their orbits and cheeks would become hollow . . . lining of the nose might crack and cause the nose to bleed . . . skin would hang loose on his body and become dry and scaly . . . urine would become highly concentrated, leading to burning of the bladder . . . lining of his stomach would dry out and he would experience dry heaves and vomiting . . . body temperature would become very high . . . brain cells would dry out, causing convulsions . . . respiratory tract would dry out into thick secretions that would result in plugging his lungs . . . at some point within 5 days to 3 weeks his major organs, including lungs, heart and brain would give out and he would die . . . extremely painful and uncomfortable . . . cruel and violent."⁸

This incredible brutality has led to the argument, embraced even in the prestigious New England Journal of Medicine, contending that the distinction between active and passive euthanasia is philosophically unjustified. If we are killing these people by "omission," painfully, then we should frankly kill them by "commission," painlessly. Stay tuned!

Modern Statutory Approach

Most states have Living Will legislation, as well as health care surrogate (sometimes called "proxy") legislation. Both approaches are fatally flawed. The first involves the patient making health care decisions in writing, in advance of the onset of disease, and before even a diagnosis has been made. Such a decision therefore cannot be well-considered or appropriate to the situation.

The second, i.e., proxy, gives carte blanche to some other person to make that decision for the patient, if the patient becomes comatose or incompetent. Here, of course, there is no application at all of the patient's own wishes, consistent with his own moral philosophy, and no control at all on the part of the patient — "control" being, ironically, the usual selling feature by the pro-death movement.

Combining the best of each of these approaches in one document, while complying with state Living Will statutes, results in legal instruments which articulate a philosophy that will be difficult for the death-dealers to avoid.

Such a Pro-Life directive designates a person you choose (someone on the same moral wavelength as yourself) to have authority in the event you lose decisional capacity, while prescribing the guidelines by which he, your physician, and any other person, are to be bound. Human bodily life is described as "inherently good and not merely instrumental to other goods." Specifically prohibited is anything being done or omitted when such act or omission "would be the direct and primary cause of my death." It directs that the patient "be provided medical care and treatment appropriate to my condition, which offer a reasonable hope of benefit without excessive pain and do not pose a severe threat to my life."

It short-circuits the pro-euthanasia concept being developed, referred to as "futile care," pointing out that "while certain treatments may be futile in combating or curing a disease, treatment or care which sustains life is not futile." It insists that "pain relief and basic nursing care, specifically including food and fluids, are to be provided, as well as ordinary nursing and medical care appropriate to my condition."

There is no panacea in this complicated field. Many years ago I recall listening to that marvelous Christian (convert), Malcolm Muggeridge, who indicated that his prayer was that in his final days he would "be delivered into the hands of a Christian physician." Unfortunately, in this post-Christian era in the United States, and with the degeneration of legal, medical and moral standards, the defense strategem needs to be a little more complicated.

Powers Of Attorney

Most everyone is familiar with the concept that you can execute a document giving authority to another person to make decisions for you. For people of advanced years, the use of a Durable Power of Attorney is recommended. This gives that authority to a person who shares your moral values. One can add therein the health care decision guidelines described above. The authority granted to the attorney-in-fact by the Durable Power of Attorney continues even after the principal becomes disabled, because this document contains an additional paragraph stating that "This Power of Attorney shall not become ineffective upon my disability." This guarantees continuity of decision-making authority in the person in whom you have trust — but limited also by the guidelines you have specified. The Durable Power of Attorney avoids the intervention of a court-appointed guardian, who may or may not follow your wishes.

For those who are young and in good health and do not need to have another presently take care of their affairs, a Springing Power of Attorney is recommended, giving the same authority and the same health care decision guidelines, but postponing the effectiveness of that grant of authority until such time as disability arises, which can be confirmed by the affidavit of the treating physician.

Traditional Religious Principles

The genesis of these principles can be found in the Catholic Catechism, Sections 2276 to 2279; Pope John Paul II's October 21, 1985 Address to the Pontifical Academy of Sciences; the January 1985 Guidelines on Life Sustaining Treatment by the National Conference of Catholic Bishops Committee for Pro-Life Activities; and the May 5, 1980 Declaration on Euthanasia by the Sacred Congregation for the Doctrine of the Faith.

Pro-Life Lawyers

Pro-Life lawyers are essential. "Pro-Life lawyer" is not an oxymoron. They do exist. I sometimes have to remind my non-lawyer friends that attorneys have some great patron saints: Thomas More, Robert Bellarmine, Robert Ives, Francis DeSales, etc. Their spiritual sons and daughters do exist still today. It is crucial that you proceed to a carefully-selected Pro-Life lawyer, and make sure that he is on the same moral wavelength as yourself. Then, he can apply these Christian principles to the statutes of the state in which you live, and produce protective and principled Pro-Life documents.

Brain Death And Organ Donation

The length and subject matter of this article makes impossible a thorough discussion of this topic. One needs to be sensitized, however, to the reality of the tension that exists between Judeo-Christian principles of maintaining life, on the one hand, and the demand for organs, on the other hand.

According to bioethics expert Gilbert Meilaender, cessation of heart and lung activity was the traditional criterion for determining when death occurs; but, in 1968 a committee at Harvard Medical School recommended cessation of all brain activity as a criterion. This change allowed doctors to take organs from people whose heart and lungs were kept going artificially, a process essential to protect the conditions of the organs.

Most people would be shocked at some of the "protocols" (procedures) established at some hospitals for the harvesting of organs. One requires the injection of morphine! Why, if the patient is already dead? Three quarters of the hospitals surveyed permitted doctors to take organs from patients who are not even brain dead!

Some of these shocking facts were highlighted on a 60 Minutes documentary on CBS on April 13, 1997, "Not Quite Dead ." In one case, the records demonstrated that the heartbeat of the patient shot up during the time when the organs were being cut out. In another, it acknowledged that death didn't occur until vital organs were removed.

These truths have now been verified by an editorial in Anaesthesia, the journal of the Royal College of Anesthetists, which recommends that an anesthetic be routinely given during operations to remove a person's heart, lung, liver, and pancreas. Without sedation, such operations can bring troubling sights, says Phillip Keep, a consultant anesthetist at the Norfolk and Norwich Hospital: "Almost everyone will say they have felt uneasy about it. Nurses get really, really upset. You stick the knife in and the pulse and blood pressure shoot up. If you don't give anything at all, the patient will start moving and wriggling around and it's impossible to do the operation."

You need to reexamine the concept of your signature on your driver's license, authorizing the donation of organs. Many organs do not survive your death, and their "harvesting" in effect causes your death. You cannot morally give them away before you're finished with them!

For an excellent discussion of this topic, I refer the reader to "Life, Life Support and Death," authored by nine eminent Pro-Life physicians and a Pro-Life lawyer, led by Dr. Paul A. Byrne, M.D., past President of the Catholic Physicians Association of the United States, and available through American Life League, Inc., P.O. Box 1350, Stafford, VA 22555.

Hospice Vs. Assisted Suicide

An early pioneer in the hospice movement (founded in the middle of the 19th Century by the Irish Sisters of Charity) was Dr. Richard Lamerton: "Deep in our common mind and heart, as old as our civilization itself, is the knowledge that hospitality is a duty owed to the weary traveler and to the sick." Dr. Lamerton also demonstrates the unnecessity for euthanasia, assisted suicide, etc. "once a patient feels welcome, and 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 our duty so to care for these patients that they never ask for euthanasia. A patient who is longing to die is not being treated properly."

A modern expert on the subject, Dr. Ira Byock, President of the American Academy of Palliative Medicine, points out in his book Dying Well, that the control of pain ". . . can always be done."

And, of course, individual, intentional termination of innocent human life is always prohibited.⁹

Dutch Experience

From a practical standpoint, the consequence of blurring the line between "healing" and "killing," by the health care professional has resulted in a disastrous slide down the slippery slope.

In the 1970s, the Dutch courts began to tolerate physician-assisted suicide for terminally ill but competent patients. By the early 1980s the medical profession had established guidelines for physicians to perform assisted suicide and euthanasia.

In 1984 the Netherlands Supreme Court accepted physician-assisted suicide and euthanasia not only for terminally ill patients but also for chronically ill or elderly patients whose deaths were not otherwise imminent.

In 1986 the Dutch Medical Association established "guidelines for euthanasia."

In 1990, the official Remmelink Report confirmed that "non-voluntary euthanasia was being widely performed in the Netherlands: 2300 cases of euthanasia at the patient's request, 400 cases of physician-assisted suicide and more than 1000 cases in which physicians terminated patients' lives without their consent. Fourteen percent of the patients who were killed without consent were fully competent and 11% were partially competent. These were patients who could have made their own decisions about whether to live or die but were never given the opportunity to decide for themselves."

This has euphemistically been referred to as "termination of patients without explicit request."

In a landmark book, Deadly Compassion: The Death of Anne Humphry and the Truth About Euthanasia, Rita Marker points out how Humphry was hounded to her suicide by her pro-death husband Derrick Humphry, the founder of the Hemlock Society, and how he indeed killed his first wife, as well as his parents.

As Marker points out, these statistics in Holland demonstrate that in a nation of only 15 million people, with a total death count of 130,000 per year, Dutch physicians deliberately end the lives of 11,800 people each year by administering or providing lethal doses or lethal injections. This accounts for 9% of the total annual deaths in the nation.

This modern downward spiral has predictably and unavoidably proceeded "from assisted suicide to active euthanasia, from terminally ill to chronically ill, from voluntary to non-voluntary, and from physical illness to mental suffering."¹⁰ The camel is never content with only his nose in the tent!

German Experience

We need to consider the observation of Dr. Leo Alexander, a psychiatric consultant at the Nazi war trials of physicians at Nuremberg:

Whatever proportions these [German war] crimes finally assumed, it becomes evident to all who investigated them that they had started from small beginnings. These beginnings at first were merely a subtle shift in emphasis in the basic attitude of the physicians. It started with the acceptance of the attitude, basic in the euthanasia movement, that there is such a thing as a life not worthy to be lived. This attitude in its early stages concerned itself merely with the severely and chronically sick. Gradually the sphere grew to include the unproductive, the ideologically unwanted, the racially unwanted and finally all non-Germans. But it is important to realize that the infinitely small wedged-in lever from which this entire trend of mind received its impetus was the attitude toward the non-rehabilitable sick.

Those who argue that assisted suicide can be effectively limited and controlled must confront the naive statement of U.S. Chief Justice Warren Burger expressed in Roe v. Wade in 1973: "Clearly, the court today does not authorize abortion on demand." If Burger were alive today, how would he react to the slaughter of 4,000 babies a day in the United States — 40 million body-count since 1973 — performed for reasons having nothing to do with even the most strained and far-fetched medical argumentation?

The "slippery slope" gets slipperier — and steeper!

The title to this article was taken from the caption to a marvelous article appearing in the Wanderer, by George A. Kendall, one of the finest philosophic and theological analyses of the pro-death movement I have ever read. Some excerpts therefrom follow:

For the Christian, the meaning of life, its value, is love. From this perspective, life is one long process of letting go of self. Not of course the genuine self which God created in love, but of the sovereignty of the ego. It is one long process of giving the self to others and ultimately of surrendering the self to God in love. The process of dying is simply the last stage of this process: the affirmation of God's sovereignty by surrendering oneself, one's life to His love. It is the final letting-go of every egotistical and self-centered attachment in allowing one's self to fall at last into the void. The Christian facing death fears Satan's last efforts to draw him into evil. He receives the last sacraments. The unbeliever, in contrast, faces his Enemy's last attack and chooses suicide. Euthanasia, assisted suicide, self-deliverance, aid in dying must therefore be understood in spiritual terms as Satanic last sacraments of evil, a kind of final right of passage by which the man who has chosen the outer darkness over God's light of love passes through the last threat and finds his rightful place in that eternal darkness.

For the dying patient who needs to make peace with himself, with his loved ones, and with his God, the five last words suggested by Hospice are recommended: "I forgive you — forgive me — thank you — I love you — goodbye." To these must be added: "Pray for me, as I do for you."

Notes

1. Release of Destruction of Life Devoid of Value, Hoche & Binding.

2. Margaret Sanger, Father of Modern Society by Elasah Drogin. New Hope, Kentucky.

3. 47 Supreme Court 485 (1927).

4. 93 Supreme Court 705 (1973).

5. A Sign for Cain by Dr. Frederick Wertham. See also by Fr. Paul Marx, O. S. B., Ph. D., founder of Human Life International Death Without Dignity.

6. Roe v. Wade, supra.

7. Population Research Institute Seminar, featuring insurance industry expert W. Patrick Cunningham, Harvard Research and Asia specialist Dr. Nicholas Eberstadt, and World Magazine journalist Mindy Belz.

8. Paul Brophy v. New England Sinai Hospital, 497 NE2d 626 (Mass. 1986).

9. "One may not do evil, even to accomplish good." Romans 3:8. Cf. The Catholic Catechism, Sections 2280-2283.

10. "Issues in Law and Medicine," Vol. 14, No. 4 (Winter, 1998).

Mr. Robert C. Cetrulo is a practicing attorney in Covington, Ky. and a former U.S. Magistrate-Judge for the Eastern Judicial District of Kentcky. He has taught political science and constitutional law and authored articles published in the Kentucky Law Journal. He has been active in the pro-life movement for 30 years and serves as president of Northern Kentucky Right-to-Life Committee, an uncompromising, 100 percent, pro-life organization. This is Mr. Certulo's first article in HPR.

© Ignatius Press 2001.

This item 4051 digitally provided courtesy of CatholicCulture.org