I’ll be the first to admit that there are some bioethicists that can and do write with intellectual honesty and engage in rigorous analysis. However, those qualities are not required in order to gain respect in the field of bioethics. I offer Jacob Appel and Peter Singer as Exhibits A and B. (Those appear to be the main examples that have been discussed on this blog. There are plenty of others.)
Now John Carney, President/CEO of the Center for Practical Bioethics has provided a fresh example of the ease with which some bioethicists render judgments that seem to have been reached without checking the facts or simply ignoring facts.
On February 7, the Practical Bioethics Blog published “Thoughts on Final Exit Case” by Mr. Carney. The blog post opens like this:
Before too much is made of the Georgia Supreme Court’s ruling freeing four Final Exit volunteers from criminal charges for assisting a suicide, let’s look at the facts
From there, he proceeds to make 5 numbered points. And, to be fair, numbers 1 through 3 are pretty straightforward if unremarkable observations about the court decision: that the court made a fair call on a badly written law on grounds it violated constitutionally protected free speech.
The last two items are remarkable – but not for very good reasons. In his fourth point, speaking about the overturned Georgia law, he says:
State lawmakers adopted the law in 1994 to prevent Dr. Kevorkian types from advertising their services, an understandable preventive step, but incomplete, especially in light of other recent state laws that have made physician aid in dying legal.
Frankly, I have no clear idea what this sentence means. I have a couple guesses of what Mr. Carney might have meant, but I have to change the sentence to make the meaning clear. For one thing, the phrase “other recent state laws that have made physician aid in dying legal,” makes it sound like there’s been an avalanche of such laws. In fact, there are only two states that have legalized assisted suicide – Oregon and Washington. In Montana, the Supreme Court found that a patient’s consent to assisted suicide qualified as a defense against homicide for the physician doing the aiding. Things are still in limbo in that state, since no doctor has – publicly at least – provided suicide assistance while the legislature in that state still hasn’t passed a statute defining the paramaters of allowable “practice” in regard to assisted suicide. And what does all that have to with what happens in Georgia, anyway?
Carney’s fifth and last point is where he really goes off the rails, though. Here it is:
Finally, Dr. Lawrence Egbert and others in Final Exit Network are not Jack Kevorkian types. The group does not advertise their efforts to take the lives of patients, but only assist the patient in taking her own. Though that may seem like splitting hairs to some, when there is no state law on the books that bans assisted suicide, advertising or publicly advocating for a troublesome and morally objectionable activity does not a criminal make.
This not “splitting hairs” – it’s fiction. First of all Kevorkian also claimed to be just assisting people in taking their own lives – his devices were rigged so that the individual who wanted to die had to operate it. There were just two cases in which Kevorkian admitted doing anything more. The death of Thomas Youk, which he taped and Mike Wallace televised; and an attentive Wesley Smith realized Kevorkian confessed to the direct killing of his first “client,” Janet Good.
Just using information from the January 19 article on Lawrence Egbert in the Washington Post magazine, we learn a few things about Egbert from Egbert:
- Egbert says he’s been “present” for over 100 suicides and “approved” of about 300 suicides. In addition to nonterminally ill people who are “suffering,” he’s also helped or signed off on people with severe depression (or other psychiatric issues, such as Jan Van Voorhis)
- Contrary to claims that they only provide advice and “presence,” Egbert reveals he reuses old “exit bags,” saving people the 60 bucks it would take to order them. This is a direct contradiction of one very consistent claim FEN has made – that those whose suicides they “attend” buy all their own gear. It’s not a minor point – it’s one way they maintain that what they do isn’t “assistance.”
- Egbert claims to have approved of about 95% of applicants. While the claim is just as unverifiable as Egbert’s, Kevorkian always claimed to have “helped” only a small percentage of those who wrote or called him wanting to commit suicide.
So if you go by facts, both the Final Exit Network and Kevorkian had almost identical “eligibility” criteria, except for Egbert’s willingness to facilitate the suicides of people who had depression (Kevorkian’s writings indicate he was warm to the idea, but never admitted to accepting someone who had that as a complaint).
Egbert’s admission that he reuses “exit bags” refutes a claim that the Final Exit Network makes – that they give *only* advice and their physical presence. The reuse of bags is reminiscent of Kevorkian’s “thrifty” ways as well.
Egbert’s “eligibility criteria” are actually more expansive than Kevorkian’s inconsistent standards were.
In conclusion, if you look at a factual comparison, the Final Exit Network is a group of suicide vigilantes who have been lying about at least some of their practices, according to Egbert’s account. If claims were made by ex-president Jerry Dincin in ignorance of what Egbert was actually doing, that’s even more disturbing – it means you have a bunch of zealots eager to “attend” and facilitate the deaths of strangers – and none of them really know what everyone else is doing.
To the extent that there’s a difference in terms of Kevorkian, the zealots are even worse; not even they know what each of them is doing and they are operating almost completely under the radar.
That’s all for this entry. I hope that Mr. Carney and the Center are more rigorous in their analyses regarding other areas than he was in this one. –Stephen Drake
Stephen – I appreciate your response to my blog about Georgia’s Supreme Court decision on Final Exit members. I’ll try to clarify what was unclear on the two final points:
My #4. You are correct in arguing that that there is “no avalanche of laws.” However, the point I was trying to make was this: the 1994 Georgia law at question in this ruling, preceded both the Oregon (1997 enactment of 1994 referendum), and Washington (2008) laws. You are correct in noting that there is no law in Montana; only a court case.
What does that have to do with Georgia? I suggest that the 1994 Georgia legislature either intended to outlaw assisted suicide or was acting on social presumption that it was not only abhorrent but illegal and was attempting to outlaw the public advertising of assisting in the act. But the law fell short. Limiting its law to public advertisement against assisted suicide, notwithstanding the denial of free speech, only served to complicate the matter for the 2012 Georgia Supreme Court because by then Oregon and Washington laws were on the books. You may disagree with that interpretation, but since the practice is now legal in the US, I can only surmise that the 94 law outlawing public advertising of assisted suicide intended to limit its exposure to Kevorkian types because the understanding at the time, was nobody would stand for the practice in Georgia. What the Georgia legislature needs to do is pass a law declaring assisted suicide illegal. I don’t think that’s a bad thing. I was just trying to point out that the court’s ruling isn’t judicial activism in this case.
My #5. I’m not certain you were able to be on the January 23 online forum with Dr. Egbert, following the Washington Post article, but the session was instructive. It is clear that you are passionate in your defense of disabled persons, advocating for their protection. I applaud you for that advocacy. While arguing for that position, I still don’t believe that it is fair to characterize Dr. Egbert as bad as or worse than Dr. K. You acknowledge that Dr. K killed people. Jack Kevorkian was convicted of second degree murder. This is the second acquittal for Dr. Egbert. Fact, not fiction.
The online forum was revealing for me because it reinforced the claim that Dr. Egbert is not same as Jack Kevorkian. Permit me to share just a couple of his comments from the forum where he received a number of vigorous challenges. In his response to a resident at Johns Hopkins he stated “I do not assist in suicide. I help people stop their suffering. Lots of physicians are helping their patients stop the (sic) suffering as I am sure you do. I have taught for years at Hopkins and can tell you some of your fellow students have witnessed staff physicians helping their patients hasten the process.” He still teaches there.
In response to the question of depression, he responds, “if you are depressed today, should we not first help you with your depression? Only, let me repeat ONLY when you have thought it over and over with loving guidance made the decision, is it reasonable.”
He admits to being a Unitarian Quaker and that the Unitarian Universalist Association approved in its 1988 General Assembly “the right to end our lives with physician help.” You may disagree vehemently with Dr. Egbert’s position. I disagree with him too. I just find it difficult to put him in the same box as a convicted murderer. His acquittals took place in Georgia and Arizona; not states with liberal leaning courts. We must all work to protect the rights of the disabled, as you have dedicated your life to doing. However, we also need to listen closely to what prompts him and others like him to advocate for those who suffer. And then do something about ending their suffering before they ever think to call Dr. Egbert and his “vigilantes”.
JOHN G. CARNEY
President and CEO
Center for Practical Bioethics
To John Carney –
Your long “clarification” of point #4 makes some sense, but the fact that it takes that long to lay it out means that it was a muddle as written. It’s also redundant, since you’d already made that point elsewhere. In fact, I’m hard-pressed to find anyone who calls this “judicial activism” or a “bad decision” in the sense that the ruling doesn’t make sense. It’s also clear from what you’ve written here that you don’t have a clue as to what we’ve written or how we viewed this decision. We saw it coming once the real nature of the statute came to light – it was a mess and most people I know would have been shocked to see the law upheld.
Per #5
Two of the questions Egbert answered was mine. One involved zealotry and the difference in the claimed approval rates between him and Kevorkian. He evaded addressing the difference in approval rates and ignored the comment I made about his approval of someone taking Chantix altogether – Chantix can result in chemically induced suicidal ideation. Two other questions were also from people opposing assisted suicide for nonreligious reasons – an elder law attorney and another NDYer.
You clearly don’t understand the nature of our advocacy at all. It’s not about “protection” but “equal protection.” (e.g. Suicides seen as preventable tragedies for *all* and not just the young, healthy and nondisabled.)
We “know” that Kevorkian directly killed two people because he showed us one on film and he admitted to another one after many years of lying about it. All we have is Egbert’s word that he only advised and was present. We already know from his account that he and Final Exit Network have lied about every one of their clients buying their own equipment.
Your info on Egbert and his relation to Johns Hopkins are incorrect. He is still listed as faculty, but no longer allowed to teach courses.
The claim that he doesn’t assist in suicide but helps stop suffering is *exactly* the same claim that Kevorkian made.
Remember, too, that Kevorkian had three acquittals, one mistrial and then a conviction.
The only thing that Egbert and FEN advocates for those who suffer is suicide. I know that from my experience with someone who probably still plans to kill themselves with their help. I won’t go into detail, but until this person talked to us, the issues of better pain management, support at home, etc. NEVER CAME UP. They don’t discuss what a person might need to want to live.
Frankly, at the end, I read your refusal to see Egbert as a dangerous zealot as nothing more than classist. You can’t believe that a UU (not exactly known for having low-income congregations) and someone with Johns Hopkins could possibly be anything like Kevorkian. What you’re saying – to me – is that you can’t see him that way because he’s too close to what you see in the mirror and what you see in terms of colleagues when you go to work.
You are entitled to your opinion but not your own facts – and your position is one in which I’d think you’d rather issue statements based on factual information rather than your own emotional biases.