Blast From the Past – 2009 Musings on Final Exit Network, Zealotry and Groupthink

assisted suicide, final exit network, Frontline, Georgia, groupthink, homicide, murder, Our News & Commentary Blog

Editor’s note: This is a post I wrote about the Final Exit Network in March of 2009.  It’s very relevant today, given the revelations discussed in yesterday’s post about the Frontline documentary that included a detailed look at the Final Exit Network.  Even back in 2009, I wondered – if the allegations about restraining peoples hands were true – what the likelihood was of “assistance” crossing the line to “murder.”

Of course, now that we know that GBI did, in fact, tape Ted Goodwin describing what he did to restrain people’s hands – even giving a demonstration that can be viewed by everyone, the question becomes more urgent than ever: Have these zealots crossed the line and committed murder – and if so, how often?

(The link to the AJC article below is nonactive, but the article itself should be available for purchase through the AJC site.)

Final Exit Network, Zealotry and Groupthink

March 10, 2009 | posted by Stephen Drake

The latest story from the Atlanta Journal-Constitution centers on Dr. Lawrence Egbert, the “medical director” of Final Exit Network (FEN). According to the AJC, Egbert’s own words describe him as some sort of Bizarro-world version of Will Rogers, who said “I never met a man I didn’t like.”

In the Bizarro world of Egbert and company, it runs like this: “I (almost) never saw a suicide plea from someone who didn’t deserve to die.”

From the article:

As medical director and co-founder of the Georgia-based Final Exit Network, Egbert in the past four years approved the applications of people who wanted to die because they were diagnosed with terminal cancer.

He approved the applications of people who wanted to die because their bodies were wasting away with ALS or multiple sclerosis.

He approved the applications of people who had not been diagnosed as terminally ill but whose quality of life, in their mind, was no longer worth living.

Egbert, an 81-year-old Baltimore anesthesiologist and teacher affiliated with the Johns Hopkins University School of Medicine, said in an interview Friday that there were times when he rejected people who wanted to die, “but not very frequently.”

Of course, the allegations from the Georgia Bureau of Investigation go beyond simply providing information and “being there.”:

The GBI says the group has a pattern of assisting people in suicides in which a “hood” is lowered over the person’s face, and the person breathes helium until losing consciousness. Death can take 10 or 20 minutes longer.

The GBI alleges that the group breaks state law by holding the hands of the person to prevent struggle or removal of the hood.

There’s no word yet as to whether or not the GBI has this on tape, which is a common practice in “sting” operations.

Friends and sympathizers reject the notion that members of FEN could ever have actively prevented someone from taking the “exit bag” off.

Yet, out of at least 200 (Egbert admits to this) suicides, there apparently hasn’t been one single case in which a person changed their mind – rejecting the feeling of suffocation and claustrophobia. Not one. If there had been one, that person would have needed immediate medical attention. There would be no time to get rid of evidence – paraphernalia, fingerprints, etc. before the paramedics arrived. There sure would be a lot of unpleasant questions to deal with – and possibly a civil suit by the family if brain damage occurred.

But that is pretty cynical and self-serving motivation. It’s easy enough for those of us who don’t think much of the ethics of pro-euthanasia/assisted suicide activists to believe members of FEN would slide from “assistance” to “murder.”

But most people probably don’t feel that way. It’s unthinkable, many would say, that intelligent and ethical people could let their behavior lapse so badly.

Guess what. It’s not unthinkable at all. In fact there’s a name for the phenomenon in which intelligent and ethical individuals – as members of a tightly knit group – can do stupid and unethical things.

It’s called groupthink – originally studied and defined by psychologist Irving Janis. It’s a fascinating and complex topic, with some real-world examples.

Janis identified eight symptoms that put a group of individuals at risk for falling into groupthink:

  1. Illusions of invulnerability creating excessive optimism and encouraging risk taking.
  2. Rationalising warnings that might challenge the group’s assumptions.
  3. Unquestioned belief in the morality of the group, causing members to ignore the consequences of their actions.
  4. Stereotyping those who are opposed to the group as weak, evil, disfigured, impotent, or stupid.
  5. Direct pressure to conform placed on any member who questions the group, couched in terms of “disloyalty”.
  6. Self censorship of ideas that deviate from the apparent group consensus.
  7. Illusions of unanimity among group members, silence is viewed as agreement.
  8. Mindguards — self-appointed members who shield the group from dissenting information.

After years of operating without any consequences, it’s easy to see how FEN members could have developed a feedling of invulnerability. Anyone who has lurked on Derek Humphry’s (Humphry is an advisor to FEN) email list or engaged the most zealous euthanasia supporters has encountered the symptoms covered in numbers 2-4 firsthand. Number 5 has played out on Derek Humphry’s email list several times – most notably when one member suggested that Jack Kevorkian’s activities in assisted suicide might have been reckless and irresponsible. Seeing that kind of thing play out makes it quite possible that there is at least some degree of self-censorship going on within the movement to avoid the dogpiling that occurred in the Kevorkian episode. That, of course, leads to the illusion of unanimity. While it’s impossible to know if there were “mindguards” in FEN itself, Humphry is pretty careful in handpicking information sent out to his list, highlighting news items that reinforce the “rightness” of his cause and framing the opponents as opportunists and/or religious zealots.

So, even starting from the highly questionable assumption that FEN members are moral and ethical people, they operate in a world that is geared toward the erosion of those aspects of their character in favor of group cohesion, loyalty and self-preservation.

PBS Airs Frontline “The Suicide Plan” – Video Tape Exposes Final Exit Network’s Big Lie

assisted suicide, final exit network, Frontline, Georgia, murder, Our News & Commentary Blog, zealotry

Well, I spent a significant amount of time today going through the video and painstakingly transcribing key quotes, only to find out a little bit later that the Frontline site has posted a transcript.  If you heard a heavy sigh late this afternoon, that was me – I was too tired for the more usual stream of colorful language I’d use in situations like this.

There will probably be a third look in the next few days, but today I want to focus on what, to me, was the single most striking set of statements and revelations that emerged in the documentary.

When the news of arrests of members of the Final  Exit Network (FEN) in Georgia made the news in February, 2009 – there was a disturbing allegation in addition to assisting/facilitating the suicide of John Celmer, a man who had gone through tough cancer treatments, but was cancer-free at the time of his death.  The following is an excerpt posted in the NDY blog taken from an article in the Atlanta Journal Constitution – an article that is now only available through a pay wall.

The death had been planned for months, authorities say. Two helium tanks were purchased, along with an “exit bag,” or hood to be placed over the suicidal man’s head.

Thomas “Ted” Goodwin, 63, formerly of Kennesaw, and Claire Blehr, 76, of Atlanta, would observe the death of the man they were told suffered from pancreatic cancer. In truth, the man was a Georgia Bureau of Investigation agent conducting a sting operation at a residence in Dawson County.

On Wednesday, authorities say, Goodwin walked the undercover agent through the steps that would have killed him. He demonstrated how he would hold down the undercover agent’s hands to prohibit him from removing the “exit bag.” (Emphasis added)

At that point, other agents moved in and arrested Goodwin, said GBI spokesman John Bankhead. He, Blehr and two men in Maryland were taken into custody on charges they helped John Celmer, 58, of Cumming, commit suicide by the same method last June.

Celmer’s family found his death to be suspicious. They contacted the Cumming Police Department, which led to the GBI’s involvement.

Bankhead said agents found evidence in Celmer’s house linking him to the Final Exit Network, a Marietta-based volunteer organization —- of which Goodwin is president —- supposedly dedicated to serving individuals who are suffering from an incurable illness or intolerable pain.

This is how FEN broke into the national consciousness.  By far, the most damning allegation made was the claim that Ted Goodwin told the GBI agent that Goodwin would hold his hands down to prevent him from removing the “exit bag.”  In various news stories the allegation almost always referred to an “affidavit” filed by the GBI agent in the sting operation.  As much as I tracked the coverage – I never saw any reference to a recording.  Eventually in the press, that put the framing in terms of the word of a “persecuting officer” against a harmless old man just trying to help people.

Almost immediately, Ted Goodwin and other members of FEN denied that anyone held anyone’s hands down; some people claimed they just touched people’s hands while others said they never touched the individual whose suicide would be witnessed at all.

This is a still-active link to a news story published in March 2009 gives an example of a typical denial by Ted Goodwin:

GBI has said network members were instructed to buy two new helium tanks and a hood, known as an “exit bag.” In court papers, investigators said the group’s guides would hold down its members’ hands to prevent them from removing the hood — a charge Goodwin vehemently denied.

“We do not hold hands down. We do not cause them to suffer,” he said. “And this will be proven in a court of law — I promise you.” (Emphasis added.)

What we know now – thanks to Frontline – is that Ted Goodwin lied.  Repeatedly.

For the first time ever, the GBI tape of the sting was shown.  Below is the transcript:

NARRATOR: An agent posing as a man dying of pancreatic cancer had applied to Final Exit Network for help.

GBI AGENT: —expecting a visit from Ted Goodwin of Final Exit Network. The purpose of this visit is to provide assistance in committing suicide.

PENNY PENN: The undercover sting showed what the rest of the— the facts intimated.

GBI AGENT: Want something to drink, Ted?

TED GOODWIN: I just had some water—

PENNY PENN: It was consistent with the training materials. But we actually had the players, the defendants themselves, going through this.

TED GOODWIN: You’re going to have that hood on, and you’re going to be looking at me, probably. And you’re going to be breathing. It feels and smells just like air.

PENNY PENN: You know, I think then that a jury could believe that this is actually how it would happen with other people.

TED GOODWIN: About half the people have the tremor in their arms. So their arms come up. And that’s just muscle reaction. I’m going to make sure your arms don’t tear a hole in that bag. I’m going to hold your arms down.

PENNY PENN: The holding of the hands, though, became something much more sinister and also legally significant than just, you know, the idea that there is this other person, you know, who’s putting their hand on top of that person just to have, you know, some human contact. Here it was that they were actually keeping the person’s hands down or the arms down so that they couldn’t remove the bag.

GBI AGENT: I’m just wondering how you would hold my hands down if I were having involuntary spasms.

TED GOODWIN: Like that.

GBI AGENT: You can do it.

TED GOODWIN: I can do that. Trust me.

NARRATOR: As soon as physical contact was made, agents arrested Ted Goodwin.

The tape is striking – in the last part, Goodwin gives a demonstration of how he would hold the agent’s arms down as the agent is down on the bed.  The agent looks like he’s struggling to get his hands up – Goodwin is successful in holding them down.

It gets worse, though.  In an earlier exchange with Lawrence Egbert, ex “medical director” of FEN, there’s this disturbing exchange:

Dr. LAWRENCE EGBERT: The point of no return is when a patient pulls it down, and that’s made very clear to them. And I often will say, “Once you pull it down, you’ve made the decision. If you pull— full of helium and you pull this down over your head, you’ll be unconscious between 30 and 60 seconds, and unless you have a very vigorous, strong heart, dead within 8 to 10 minutes.”

When a person dies, then we— we’ll take the bag off. And after we’ve sat for a few minutes that way, if the relatives are there, we’ll ask them explicitly to wait a couple of hours so the body will cool, so that somebody won’t try and resuscitate. If they try and resuscitate right away, they can get a heart— the heart’s very tough and the brain is not so tough. So the heart will start up again. And I’ve seen a person like that, where the heart started up beautifully, normally, but the brain was totally dead. And that, we do— that is the ultimate of disasters.

Frustratingly, the interviewer doesn’t ask for a clarification of what Egbert means when he “makes it clear” that pulling the bag down is the “point of no return.”  Does he mean that he won’t let him take the bag off at that point?  It’s open for interpretation, with that at the top of my personal list.

So take these elements:

  • A bunch of secretive suicide-assisting zealots;
  • A “protocol” that included – at one time at least – holding people’s hands down to prevent them from “accidentally” removing or tearing the helium-filled plastic bag;
  • At least one FEN member who informed “clients” that pulling the hood over their head was the “point of no return;
  • And a great concern by Lawrence Egbert that the “ultimate” disaster is the person being resuscitated with a beating heart but a brain that’s dead (I suspect he’d apply that to any brain damage – it’s pretty clear he doesn’t care much about medical accuracy when working in this field.

To top it off, Ted Goodwin states that it’s his duty to “prevent a botched suicide.” He appears unconcerned about maybe killing someone who changed their mind about suicide at the last moment.

And that’s exactly what all of these factors are a recipe for.  This group claims that no one has ever changed their mind at the last minute.  Given that they claim a body count in the hundreds, that is literally unbelievable.  It’s far more likely they don’t give anyone a chance to reconsider at the last minute.  And, if true, you end up with something that isn’t suicide at all – and “assistance” has become something even uglier – murder.

Below is an embedded video of  “chapter 7” from this Frontline show – it contains most of the material alluded to in this post.

 

Watch The Suicide Plan on PBS. See more from FRONTLINE.

 

PBS Airs Frontline “The Suicide Plan” – Immediate Reactions and Impressions

assisted suicide, Compassion & Choices, documentary, final exit network, Frontline, media, media coverage, Our News & Commentary Blog

On Tuesday, November 14, PBS aired the Frontline segment “The Suicide Plan” – which focused on the “assisted suicide underground.”

It’s hard for me to judge how this show would have struck the average viewer.  I know I need to force myself to review the show for a deeper reaction than I can offer right now, a few minutes after midnight.  The upside is that the show is fresh in memory – the downside is that I’m tired and don’t have the time or energy to go back through the show for more detailed comments.

First of all, almost the first half hour of this 90-minute show was taken up with the personal stories of three individuals,  two of whom had facilitated suicides as individuals, and a seriously ill woman who was planning to commit suicide with the help, advice and guidance of advisors from Compassion and Choices, the largest assisted suicide organization in the US with a respectable reputation.

Told only by the people involved, the stories are meant to evoke sympathy for the friends and family members who have facilitated the suicides of others – and we’re not encouraged to wonder if there’s more to the story than the obviously self-serving accounts of those involved.  Nor are we encouraged to question to the veracity of claims made by Barbara Coombs-Lee of Compassion and Choices that their “counseling” program – “helping people” commit suicide in the 48 states that have not legalized assisted suicide – is strictly limited to people who are terminally ill and that it’s all tightly controlled.

The near-total avoidance of the word “suicide” by the narrator is also a tip-off that the sympathies of the film makers are squarely in the pro-assisted suicide camp.

Nevertheless, a few things that should chill some viewers were shown.  One of the most important revelations involved the Georgia Bureau of Investigation (GBI) ‘sting’ operation with the Final Exit Network (FEN), in which a GBI agent posed as a man who claimed to be dying of cancer.

In the accounts of the sting, references were made to the GBI affidavit that claimed then-president of the Final Exit Network Ted Goodwin told the agent that as an “exit guide” he would “hold his hands down” to prevent his hands from “inadvertently” ripping the helium-filled plastic bag off.  In interview after interview, FEN members denied allegations that they held people’s hands down.

It turns out it was true.  The GBI videotaped it.  It’s unfortunate the videotape has gone unmentioned in all the previous coverage of the Georgia case.

It’s getting late and I think I’ll let it rest here.  I’ll review the show tomorrow and write more about what the show revealed – intentionally or not.

One final thought, though.  This show was – correctly – run with a warning about mature content, etc. in the beginning.

So what genius at PBS labeled this show as falling under the genre “Parent Picks” in the TV listings.  It’s shown in the screenshot below:

 

Have a good night.  I think I’m exhausted enough to sleep now.  More later.

RELEASE: Massachusetts Disability Rights Activists Relieved That Voters Defeated Assisted Suicide Initiative

assisted suicide, Ballot Question 2, disability activists, disability rights advocates, Massachusetts, Our News & Commentary Blog, Second Thoughts

Massachusetts Disability Rights Activists Relieved That Voters Defeated Assisted Suicide Initiative

Massachusetts disability rights activists from the group Second Thoughts breathed a sigh of relief Tuesday night as voters appear to have closely defeated Question 2, which would have legalized assisted suicide in the state. National Not Dead Yet applauds Second Thoughts leadership in the Massachusetts efforts to clarify the dangers in the initiative.

Boston, MA (PRWEB) November 07, 2012

Massachusetts disability rights activists from the group Second Thoughts breathed a sigh of relief Tuesday night as voters defeated Question 2, which would have legalized assisted suicide in the state. Members had gathered at Boston’s Littlest Bar to await the election results. According to the Boston Globe, with 51 percent opposing the initiative and 93 percent of the vote counted, proponents of the measure conceded defeat.

“We changed the nature of the campaign,” said John Kelly, Director of Second Thoughts. “This is the first assisted suicide campaign in which the disability rights perspective has reached so many people.” Kelly, a power wheelchair user since a spinal cord injury in 1984, became a leading spokesperson for the opposition. He debated half a dozen different proponents across the state, squaring off against lead advocate Dr. Marcia Angell three times. Two of those debates are archived on WBUR.

Over the last six weeks of the campaign, support for Question 2 plunged from a high of 68% to a steady 49% throughout last night. “Simply put, Massachusetts had second thoughts, ” Kelly said.

Second Thoughts was formed in December 2011 by Massachusetts disability rights activists, and brought a progressive perspective to a debate so often portrayed as part of the culture war between secular liberals and religious conservatives. The group burnished its progressive credentials, for example, by producing a bumper sticker calling for “Yes on 3/No on 2,” because medical marijuana is also a disability rights issue.

“Assisted suicide proponents tried to paint all opposition as religious and extreme,” said Denise Karuth, Second Thoughts spokesperson for Western Massachusetts. “But progressives changed their minds when they heard, for example that no independent witness was required when the drugs are taken. It’s a recipe for elder abuse.”

“We fight for social justice,” said Eileen Feldman of the Second Thoughts steering committee. “Besides unreliable safeguards, Question 2 stigmatizes conditions that are a normal part of living as disabled for many people. Physical incapacity or incontinence does not take away your dignity.”

The national disability group Not Dead Yet served on the Second Thoughts steering committee. “We applaud the articulate leadership that Second Thoughts provided in efforts to clarify the dangers in the initiative,” said Diane Coleman, Not Dead Yet’s President and CEO.

Second Thoughts now hopes to capitalize on its media exposure by continuing its advocacy on life-and-death healthcare issues, which impact people with disabilities across the age spectrum.

“Question 2 galvanized our community,” said Kelly. “We live on the front lines of our health care system, and our knowledge and experience can improve the system and make it more responsive to people faced with serious chronic and terminal illnesses.”

#

To access the fully formatted press release (pdf version available) please go to PRWeb.

Bioethicist Endorses Mass. Assisted Suicide Bill in a Sloppy and Intellectually Lazy Essay

Art Caplan, assisted suicide, ben mattlin, bioethics, Compassion & Choices, disability rights advocates, final exit network, Massachusetts, Oregon, Our News & Commentary Blog, reality check

Art Caplan has an opinion piece that came out yesterday – and it’s linked from just about every conceivable place on NBC and MSNBC.  It’s an endorsement of the proposed legalization of assisted suicide on the ballot in Massachusetts.  While disappointing, it’s not that big a surprise; Caplan has been sliding toward this unqualified endorsement of legalized assisted suicide for several years.

I’ve long had mixed feelings about Caplan.  He can write some insightful analysis and even show a willingness to break from the ranks of fellow bioethicists as he did in at least two instances – the so-called “Katrina killings” at Memorial Medical Center in New Orleans during Hurricane Katrina and in his criticism of the so-called “Ashley Treatment.”  And, while he’s ended up on the same side as disability activists in some instances, he’s never given us more than a casual mention, at least in anything I’ve read.  I know he reads this blog occasionally, so he gets information on disability rights activism and advocacy from here when he does stop by.

As I’ve said, Caplan produces some excellent analysis at times.  Other times – as in his latest effort – I get the feeling he more or less “phoned it in.”  By that I mean that he provides nothing more than very superficial statements and arguments with few concrete facts.  That’s exactly what he does in his latest, an endorsement of legalized assisted suicide, and it’s little more than a reproduction of the talking points assisted suicide advocates are using right now in Massachusetts.

Here’s an excerpt:

The proposed Massachusetts law is very restricted and contains important safeguards. Experience in other states shows little reason for worry about abuse or misuse.  Instead the more people who are going to die know they can end their lives sooner if they choose, the more many of them fight harder to live.

Even the editorial board of the Oregonian had questions about the glowing reports of the success of the safeguards as they stated in September of 2008 (editorial is unavailable except through paid archives):

On the negative side, Oregon’s physician-assisted suicide program has not been sufficiently transparent. Essentially, a coterie of insiders run the program, with a handful of doctors and others deciding what the public may know. We’re aware of no substantiated abuses, but we’d feel more confident with more sunlight on the program. (Emphasis added.)

Daniel Callahan, President Emeritus of The Hastings Center, shared similar sentiments just yesterday:

I have not said much about the potential abuse of “death with dignity” laws. I have no special reason to believe there are serious abuses in Oregon and Washington, or that there need be any in Massachusetts, but we will never really find out if there is. The potential for abuse that most worries me is the legitimization of suicide, whose numbers are now rising. There are all sorts of reasons for people of all ages without terminal illness to want to get rid of their unhappy lives. They should not think that suicide is an acceptable and rational way to cope. Beyond that, I cannot see any good that can come of legalization of PAS. “Choice,” that all-purpose value word these days, used by the liberal left and the market right, is not a good enough reason to change some deep and valuable traditions of the doctor-patient relationship.

You can read his entire article on The Hastings Center’s “Over 65 Blog.”

Caplan’s sloppiness doesn’t stop with that small item.  Making one of his rare references to disability groups, he makes sure to pair us with the “usual suspects”:

Some disability groups and religious organizations are fighting hard to get a “no” on the “Question 2,” initiative as well.  They believe that the terminally ill who are disabled deserve better palliative care and emotional support rather than a prescription of deadly medicine. They also worry that people may feel compelled or coerced into choosing death because their care is expensive, they see themselves as a burden to others or because relatives are thinking that they do not want to spend the grandchildren’s college tuition to keep grandpop going in a nursing home or ICU. Given the current push to contain medical costs, the biggest fear is that the vulnerable will get the bum’s rush to the hereafter. (Emphasis added.)

A little later he adds this “straw man” version of concerns of opponents of assisted suicide:

The critics are worrying about a shift to mass suicide inspired by heartless doctors and families pressuring dying patients to end it.

As luck would have it, there are several disability-centric related critiques of assisted suicide that have been published lately.  Just today, the NY Times published an op-ed by Ben Mattlin titled “Suicide by Choice? Not So Fast.”  Here’s an excerpt, relating some concerns – the real concerns upon which Caplan built his Straw Man:

I was born with a congenital neuromuscular weakness called spinal muscular atrophy. I’ve never walked or stood or had much use of my hands. Roughly half the babies who exhibit symptoms as I did don’t live past age 2. Not only did I survive, but the progression of my disease slowed dramatically when I was about 6 years old, astounding doctors. Today, at nearly 50, I’m a husband, father, journalist and author.

Yet I’m more fragile now than I was in infancy. No longer able to hold a pencil, I’m writing this with a voice-controlled computer. Every swallow of food, sometimes every breath, can become a battle. And a few years ago, when a surgical blunder put me into a coma from septic shock, the doctors seriously questioned whether it was worth trying to extend my life. My existence seemed pretty tenuous anyway, they figured. They didn’t know about my family, my career, my aspirations.

***

This is but one of many invisible forces of coercion. Others include that certain look of exhaustion in a loved one’s eyes, or the way nurses and friends sigh in your presence while you’re zoned out in a hospital bed. All these can cast a dangerous cloud of depression upon even the most cheery of optimists, a situation clinicians might misread since, to them, it seems perfectly rational.

Just yesterday, The Phoenix – a Boston weekly paper – published a long article by S.I Rosenbaum, titled “Killing with kindness: Why the Death With Dignity Act endangers people with disabilities.”:

I think my opinions about doctor-assisted suicide crystallized the night Mike — my wheelchair-using, ventilator-breathing boyfriend — choked on pineapple juice, passed out, and died.

He was dead for several minutes, on a steel table in the ER. The doctor shocked the pulse back into his heart and dropped him into an induced coma, but it still wasn’t clear whether he would make it. As I stood by his bedside, shaking, one of the nurses touched me on the shoulder.

“Maybe it’s better this way,” she murmured.

I’ll never forget that moment. We’d been watching a movie together a few hours before. We had plans to go clubbing. Maybe it’s better this way?

I’m not a violent person, but I wanted to punch that lady in the face.

When I started going out with Mike, I thought that prejudice against people with disabilities was something we’d left behind along with Jim Crow and sodomy laws. I was shocked, again and again, to find that I was wrong. So wrong. Everyone I met had ideas about what it must be like to date Mike — that we never went out, that we couldn’t have sex, that I must have to take care of him all the time — that were so false as to be laughable. We did laugh at that stuff. We had to. But for every person who came up to us to congratulate Mike on his “bravery” in taking a trip to the mall, there was someone who actually thought he’d be better off dead.

Some of those people were doctors.

I defy anyone to interpret anything in either of those articles as saying there’s a great fear from “heartless doctors.” (There are some outright bastards out there, but that’s not the real issue)  The real issue is the fear of medical professionals wanting to be “compassionate” based on what they believe about our lives.

I can already hear Caplan and others voicing objections – saying that assisted suicide legislation is limited to people who are “terminally ill.”  We’re just being paranoid.

No.  We’re informed.

The organizations pushing legalization of assisted suicide are sophisticated and well-funded.  And, like many advocacy organizations, they are following an incrementalist strategy in terms of their policy goals.  Through polling, focus groups and experience, they’ve developed a vocabulary about these topics that draws a favorable response from the public.  And, for the moment, the more “respectable” groups are sticking to policy that is allegedly limited to people who are “terminally ill.”

But the signs of more expansive “advocacy” are already in evidence.  The assisted suicide vigilante group Final Exit Network (FEN) facilitates the suicides of old, ill and disabled people and makes no secret that they don’t limit their “eligibility” to “terminally ill.”  Think of them as the Tea Party arm of the “Right to Die” movement (and, no, that’s not a compliment).  Their activities and agenda clearly involve people with disabilities.  Recently, Derek Humphry (Hemlock Society co-founder, FEN advisor) sent an email to his “right to die” email list announcing a chapter of FEN was opening in Oregon, where they will do the kind of “underground” assisted suicide the “legit” advocates claimed that the law would prevent.

Meanwhile, the “legitimate” group Compassion and Choices is engaging in a campaign to promote the “death with dignity” of elderly people who are just plain tired of living through “VSED” – voluntarily stopping eating and drinking.  They are successfully enlisting hospice and palliative care professionals to facilitate the process.  Ironically, Caplan recently published an article in The Lancet about the death of a man who had horrible bed sores and refused to let staff move him to try to help the sores heal.  Caplan thought a case like this – which ended in the man’s death – deserved a discussion of the limits of autonomy, the effects on medical professionals, and the effect on patient care over time.  Frankly, I think that the program by C & C is much more deserving of that kind of conversation, as they are actively engaging a growing body of palliative care practioners to become comfortable in playing a role in the deaths of people who are simply old and say they don’t want to live any more.  That is going to have a much more far-reaching range of effects than the one individual who wanted his bed sores left untouched.

But questioning the effect of an effort like C & C’s would mean inviting the retaliation of a large and powerful advocacy group.  That’s probably farther than a certain bioethicist is willing to go.  Maybe he’ll just wait until they’ve pushed agenda and it’s viewed as acceptable by the public and the medical profession.  Then he can write and tell us that it’s all ethically OK – and use their talking points to do it.

h/t to Bill Peace for alerting me to the Over 65 blog and Callahan’s post.