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