Newsweek: Veterinarian Says We Should “Treat People Like Dogs”

health care reform, media coverage, Newsweek, Our News & Commentary Blog, pets, reality check, veterinarian

Out of all the newsweeklies on the market, Newsweek has published some of the most outrageous pieces regarding people with disabilities and euthanasia.  This week’s “My Turn” column by veterinarian Karen Oberthaler isn’t the worst thing they’ve published, but it immediately brought to mind one their “classic” pieces.

Oberthaler’s essay attempts to make a case that humans would be a lot better off if our health care was delivered in the same way that veterinary care is for household pets.  Oberthaler is not your average vet – she’s an oncologist who says “pet owners routinely rack up $10,000 bills” to pay for saving the lives of their pets.

Oberthaler obviously doesn’t practice veterinary medicine in my neighborhood.  I don’t think there are many people in my neighborhood with that much extra money on hand – and very fewer who would dip that far into savings in our middle-class corner of the city to save the life of a household pet.

But someone whose human clientele “routinely” pay large amounts of money to save and extend the lives of their pets might see the following as reasonable, I guess:

When facing the death of a loved one—human or animal—the real challenge is coming to grips with the reality of the situation. Since my approach draws me closer to families, it’s easier to suggest that the best course of treatment may be relieving pain rather than fighting a disease. Owners are less likely to fear that you’re giving up on their beloved pet if they trust you. When I’m asked about performing tests, and I know the results won’t change the outcome, I say so. If your golden retriever’s cancer is too far advanced for surgery, getting a biopsy may be a pricey—and superfluous—exercise.

No family wants to subject its already sick pet to uncomfortable tests or dump thousands of dollars into dead-end diagnostics. So why do we do that to our grandparents?

Oberthaler stops just short of the most obvious comparison in an essay advocating human health care should be more like the care for household vets and doesn’t mention euthanasia – but I’ll bet the majority of readers got there without her help, especially if they are long-time readers of Newsweek.

In 1992, the magazine published a “My Turn” column by Katie Letcher Lyle titled “A Gentle Way to Die.”

Lyle also thought we did better by pets than by some humans.  After first giving a tender account of having her cat euthanized, she moves on to give her view of what she obviously feels is a life not worth living.  “Henry” is a man with intellectual disabilities who has been abused and abandoned by the system for most of his life.  He’s in a group home now and she doesn’t see much joy or purpose in his life:

I know the arguments about the abuses of kindly death, and I know mental incompetents were the Nazis’ first victims. The money is certainly not the point; I believe strongly that one can judge any civilization by how decently it treats its sick, its elderly, its disabled. But money is a reality, and adding up all the institutional, medical and social services, Henry has already cost American taxpayers roughly $1.5 million. But my point is, what does life hold for Henry now? I’ll tell you: either a drugged hell of an existence behind bars; or, more probably, deinstitutionalization, street life, an agonizing death in a filthy alley. It happens to others, everywhere, every day.

I don’t like the conclusion I’m forced to. But is a gentle death for a human being always the worst answer? Laws can be implemented to prevent abuses. It seems patently untrue to me that any life is always preferable to no life. I wish, more than I can say, that there were some place on this earth where Henry could live happily and freely and be loved and understood. But since there isn’t, I find it disgraceful, as well as ironic, that we cannot bring ourselves to treat our fellow humans as humanely as we treat our pets.

The original article described Lyle as some sort of “advocate” for the “handicapped.”  I hope she’s no longer allowed anywhere near people with intellectual disabilities.

****

Getting back to the current “My Turn” essay, I suspect the vets in my neighborhood would tell Oberthaler that a lot of pets they euthanize could be cured, but owners don’t have the money for the treatment.  Others balk issues like amputation of a limb or the loss of vision in an animal – many owners see death of a pet as a better outcome than having to live with a disabled pet.

Some even have reasons that are harder to wrap my head around.  Just about a week ago, a story found its way into my newsfeed that raised a lot of eyebrows:

Dog euthanized to be buried with owner

March 5, 2010 — One man’s last request has animal lovers questioning his state of mind and motives. The Arkansas man asked that his dog be buried alongside him — a dog that was only 2-years-old and perfectly healthy. 

Fifty-four-year-old Donald Ellis was buried last week at Oakland Cemetary in Monticello, Arkansas. But not before he made an unusual request: that his 2-year-old Yorkie “Tom Tom” be buried alongside him.

Ellis’ sister Marilyn McDaniel told reporters the family wanted to fulfill her brother’s desire, so they took the Yorkie to the vet and had it euthanized.

According to McDaniel, Ellis said he wanted the dog to go with him because no one would love him like he did. 

BTW, the vet in the story hated putting the dog down, but was afraid that if he refused the dog would be killed in a way that wasn’t as humane as the death he could provide.

That’s the reality of health care for our pets.  We pay what we feel we can afford for the results that meet our satisfaction.  If it costs too much or we don’t like what the outcome would be, we choose a “merciful” death instead.  Not that we tell ourselves and our friends that’s how we make those decisions – like Mr. Ellis who made sure his dog didn’t outlive him – we tell everyone it’s all about love.  –Stephen Drake

Georgia: Grand Jury Indicts Four Members of Final Exit Network on Multiple Counts

assisted suicide, crime and punishment, final exit network, Our News & Commentary Blog

I missed this when the news hit yesterday, but things aren’t looking great for the members of the Final Exit Network (FEN).

Here’s the gist of the news, from the second paragraph of the story from the Atlanta Journal-Constitution:

An indictment returned Tuesday charges the Final Exit Network along with co-founder Thomas “Ted” Goodwin, 64, of Kennesaw and Punta Gorda, Fla.; Claire Blehr, 77, of Atlanta; and Dr. Lawrence Egbert, 82,  and Nicholas Alec Sheridan, 61, of Baltimore with violating Georgia’s RICO Act, assisting a suicide and tampering with evidence. The four are to be arraigned in Forsyth Superior Court on April 1.

More here about the investigation leading to the charges:

Once an investigation was opened, a GBI agent, posing as a Dawson County man dying of pancreatic cancer, applied for the Final Exit Network’s help.

According to the charges, Goodwin walked the undercover agent through the steps that would have killed him. Goodwin allegedly demonstrated how he would hold down the agent’s hands to prohibit him from removing the “exit bag.” That is when other agents came in and arrested Goodwin, according to the GBI.

As I suggested in the beginning of this entry, 2010 isn’t looking to be a great year for the FEN.   It’s even mentioned in the AJC article here:

In January, Wye Hale-Row pleaded guilty to assisting a Phoenix woman, who killed herself in 2007. Hale-Row was one of four Final Exit Network members indicted following the death of Jana Van Voorhis. The cases against the three other defendants are still pending.

Van Voorhis was found dead in her home on April 15, 2007 and an autopsy showed she died from helium asphyxiation. However, authorities say Van Voorhis was not terminally ill at the time and suffered from mental-health issues and depression.

This, of course, doesn’t tell the whole story.  As reported earlier on this blog, Hale-Rowe – a prominent activist in the Hemlock Society and general assisted suicide advocacy for decades – agreed to testify against the other FEN members in Arizona as part of her plea agreement.

I’m sure the FEN is putting on a good show of bravado right now.  But the plea agreement and promise to testify from Hale-Rowe alone should have them all pretty worried by now.  And then there’s the issue of their “training manual,” which may be entered into evidence into one or both trials.  I hear there’s some stuff in the manual that might not play real well with a jury.  –Stephen Drake

Jacob Appel: Bad Medical Historian, Questionable Ethicist or Just a “Spin Doctor?”

bioethics, euthanasia, infanticide, jacob appel, media coverage, medical decisionmaking, Netherlands, Our News & Commentary Blog, research, unethical ethicists

As a left-handed tribute to “bioethicist and medical historian” Jacob M. Appel, I have titled this blog entry as a question, leading uninformed readers to think maybe I will seriously analyze an issue with two or more sides.  In fact, as readers of this blog know, I have a definite viewpoint and people come to this blog reading the content with that in mind.

However, when readers of the Huffington Post come across an entry by “bioethicist and medical historian” Jacob M. Appel, titled in the form of a question, they might be inclined to think they are going to get expert, honest and unbiased analysis.  Since most readers of the Huffington Post aren’t any more inclined to critical thinking than attendees at a Tea Party event, most readers might miss that while Appel may be an “expert,” they don’t get any analysis, let alone unbiased and honest analysis.

The source of this mini-rant is an essay posted by Appel on Huffington Post:

Should Children Have A Right to Die?

First off, the essay is about killing children rather than “letting them die.”

Second, the essay is about why we should allow children to be killed, rather than an analysis of the pros and cons.  The title is subterfuge.

The title, to be honest, should read something like “Parents should be able to ask doctors to kill their seriously ill and disabled children.”

But the misleading nature of the title only skims the surface of the distortions, omissions and manipulations in the essay by Appel.  They begin with the first sentence:

Advocates for aid-in-dying have largely focused their efforts on the rights of mentally-competent adults to end their lives when and how they wish.

Almost a year ago, this blog featured a post devoted to revealing the history of pro-euthanasia leaders promoting legalized killing of ill and disabled kids in the US and Canada. Maybe “historian” Appel didn’t know about that.

The impetus for Appel’s essay was the publication of a new study published in Archives of Pediatrics & Adolescent Medicine.  From the AP story on the study:

The study was published Monday in the March edition of Archives of Pediatrics & Adolescent Medicine. It was based on interviews with parents of 141 children who had died of cancer and were treated at three hospitals, in Boston and Minnesota.

Among parents studied, 1 in 8, or 13 percent, said they had considered asking about ending their child’s life, and 9 percent said they had that discussion with caregivers. Parents of five children said they explicitly requested euthanasia for their dying children, and parents of three said it was carried out, with morphine.

The lead author of the study is quoted as doubting the interpretation of parents who believe the lives of their children were ended, saying they were probably given sufficient morphine to quell symptoms and that timing of death (imminent anyway) was “coincidental.”

None of those nuances are explored by Appel.  He reasons that since a small percentage of the parents wanted the lives of their kids ended, it should have been legal for doctors to do it. 

What else does Appel do in the course of his essay?

  • Fails to mention that the Netherlands – after lobbying from some medical professionals – has accepted infant euthanasia as a practice.  The first known “beneficiaries” were infants with (nonterminal) spina bifida and hydrocephalus.Where’s a “medical historian” when you need one?
  • Sets up a “straw man” argument citing fears of “nefarious parents,” ignoring the historical reality of the willingness of some doctors in the US to manipulate parents to accepting “nontreatment” leading to death as the best thing to do with infants with spina bifida and hydrocephalus.  It’s an important episode in US medical history – to disability advocates and activists, anyway.  To bioethicists and “medical historians,” – not so much.
  • Engages in his own rhetorical “slippery slope” as he glides through the essay discussing the euthanasia of “terminally ill” kids with cancer, then moves on without effort to include “chronically ill.”  All of it falls under “end of life.”
  • Finally, and probably most egregiously, Appel really should have told his readers that he took a public position on this matter in an article published last year.  And to be totally honest, his position is that the potential suffering of a child or infant should be the determining factor in deciding to kill them – not the consent of parents.

I already knew that intellectual honesty and rigor weren’t required to gain prominence in bioethics circles.  Apparently these traits aren’t held in esteem in the field of medical history, either.  –Stephen Drake

Illinois: Kangaroo Hearing on “Presumed Consent” Organ Donation Bill Scheduled Today

bioethics, brain death, Illinois, kaylee wallace, legislation, organ donation, Our News & Commentary Blog, Ruben Navarro

From the Peoria Journal Star:

Public can weigh in on organ donation bill

Excerpt:

PEORIA —A public hearing is scheduled for 3 p.m. Tuesday in Springfield to receive comment on state Sen. Dale Risinger’s bill to establish a presumed consent policy for organ donation in Illinois.

Sometimes called the opt-out policy, presumed consent has been adopted by many countries and has significantly reduced shortages and waiting time for donated organs. Rather than requiring people to sign up to be a potential organ donor, everyone is considered a potential donor except those who specifically opt out of the program.

Risinger’s bill proposes a presumed consent policy applies for people 18 and older.

“This is an important first step to getting a law in Illinois that helps us have more organ donors. This is just the first step. To get it right, we need public input. The current bill is not in its final form,” said Risinger, R-Peoria.

Risinger’s stated commitment to soliciting public input seems pretty disingenuous.  Outside of a few careful readers of today’s edition of the PJ Star, it’s a pretty good bet that the only people who know about today’s hearing are supporters of the bill. Predictably, the “public input” will reflect overwhelming support for a radical change in organ donation policy, simply because Risinger and his supporters have carefully stage-managed the coming show.  Look how well the PJ Star article is managed – no voice of caution or dissent.  A few phone calls to various bioethics departments would have yielded some.  If you want to know just how radical this change would be, consider that Illinois would be the only state in the country with such a policy.

So why would anyone have a problem with this?  I can only speak for myself – a former Illinois resident, but I’ll give a few basic objections.

First, the term “presumed consent” is deceptive – as is the term “opt-out.”  In fact, you can’t really talk about “consent” at all with a bill like this, unless you think “imposed consent” makes any kind of sense as a term.

Second, some of us refrain from registering as organ donors because we don’t trust some of the lesser-known, but worrying realities regarding organ donation and attempts to expand the donor pool.

I’ll start off with brain death.  Most people assume that since the state they live in considers them a corpse if they’re declared “brain dead,” then the state also imposes some sort of uniform standards regarding how that determination should be made.

That’s a comforting thought, but it’s not the reality.  In fact, a 2008 article published in the Journal Neurology found wide disparities in how hospitals made determinations of brain death. It’s not surprising considering how the statutes relating to brain death were written (from the article):

In accordance with the Uniform Determination of Death Act, guidelines for brain death determination are developed at an institutional level, potentially leading to variability of practice.

Notice that the autonomy of individual hospitals is treated with a great deal more deference in the UDDA than Risinger and his colleagues believe Illinois citizens should have over their own organs.

In case you’re wondering, there have been a handful of cases made public in which people declared brain dead “miraculously” recovered.  Zack Dunlap’s “miraculous” recovery is the most well-known.  Not so miraculous when you know that some institutions aren’t as rigorous as others at making those determinations.

Maybe medical professionals aren’t all that hung up on whether or not the determination of brain death is accurate or not, anyway.  Over the past several years adoption of the Donation after Cardiac Death protocol has allowed harvesting of organs from individuals within a short (a very short time) after their heart stops beating, usually through removal of a ventilator.  The issues here are too long and complicated to get into, but there are already some pretty troubling stories associated with the protocol that should give any reasonable person pause.  For more information on that, I recommend reading  this link on Ruben Navarro, this one on Kaylee Wallace, and this article by Dick Sobsey on “Schrödinger’s Ethics.”

Does that mean I would never be an organ donor?  No, it doesn’t.  What it does mean is that my family knows that if I am declared “brain dead,” they will demand to know exactly how the determination was made and how that stands up to the standards determined by the American Academy of Neurology.  If the “gold standard” has been met, they can get the organs.

I am not OK with the donation after cardiac death protocol and my family knows this.

See how much there is to discuss?  Wouldn’t it be a great idea if Risinger decided to actually open this bill up to a real debate?  Isn’t the public entitled to something better than what looks like a stacked deck masquerading as an open public dialog?

For more info on this bill, please check out the following link:

Bill status for SB3613 (includes link to full text of legislation)

According to the PJ Star article, testimony can be emailed to Sen. Risinger here.  He says he wants to hear from the public.  –Stephen Drake

Addendum: In my haste, I forgot to thank Nancy Valko for alerting me and others to this bill.  I doubt I would have heard about it without her digging out the information and sending it on.

UK: The Independent – “Disabled people need assistance to live, not die,” by Clair Lewis

advocacy, assisted suicide, clair lewis, crime and punishment, Homicide / 'Mercy Killing', media coverage, Our News & Commentary Blog, United Kingdom

By now, readers of this blog are probably getting familiar with the name and the writing of Clair Lewis.  Today is another chance to read what she has to say about the recent developments in the UK. 

Writing in The Independent, Clair says “Disabled people need assistance to live, not die. “

Here’s the first part of her essay:

There is a saying among disabled people that goes: “If it hurts, we know we’re alive”. Like most humans our natural instinct is not merely to survive but to flourish. For this we need assistance to live, not die. Disabled people suffer so much neglect, isolation, exclusion and discrimination that some volunteer for euthanasia. But this is not the only way to address suffering. What about assistance to live?
When healthy people are suicidal, the usual response is to try to help them live better lives, not provide a solution which encourages them to die. It seems that disabled people are the only people who can be suicidal and mentally competent at the same time. Help offered to people with suicidal feelings is often inadequate. But however strapped for cash the NHS is, the one thing they won’t do is offer to finish the job off properly. 
This is why people like me are so concerned about the Director of Public Prosecution’s new guidelines on assisted suicide. On the surface, they look like an attempt to equalise the legislation – they move the focus on to the motivations of the assistant, widen up who may assist in a suicide and pay particular attention to whether an assistant’s actions were “compassionate”. But what is the definition of compassion?
Read the rest here.  And consider leaving a comment on the site so the paper know the essay was read and appreciated.  –Stephen Drake