NC Family President John L. Rustin speaks with Wesley Smith, Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism, about the dangers of assisted suicide and the growing success of efforts to legalize it across the United States.
INTRODUCTION: Thanks for joining us this week for Family Policy Matters. Our guest today is Wesley Smith, a lawyer and Senior Fellow with the Discovery Institute’s Center on Human Exceptionalism. He is also a consultant to the Patients Rights Council. We will be talking with Wesley about the dangers of assisted suicide and the growing success of efforts to legalize it across the United States.
Wesley is the author of hundreds of articles and several books, including:
JOHN RUSTIN: As we begin our discussion today Wesley, define for us, if you will, assisted suicide and explain how it differs from euthanasia?
WESLEY SMITH: To me it doesn’t differ morally in the sense that what is being done is the intentional ending of the human life, supposedly to eliminate suffering. In other words, eliminate suffering by eliminating the sufferer. The technical difference is that in ‘assisted suicide,’ as we’re normally using the term, a doctor will prescribe a lethal overdose of barbiturates to kill the patient and the patient takes that overdose themselves. In euthanasia, the final act causing death is done by the doctor, or the nurse practitioner in Canada’s case. But they really are the same thing; It’s just a technicality of who does the final act.
JOHN RUSTIN: To date, a handful of states in the United States have legalized assisted suicide through both elections and also court decisions. Which states have legalized assisted suicide, and are there additional states that are expected to consider it, or to do so in the near future?
WESLEY SMITH: I think it’s important to note that more states have refused to legalize assisted suicide, overwhelmingly, because this agenda is tried in more than half the states every year and most of the time it fails abjectly. However, once in a while, because these people are like the energizer bunny they never quit, a state has fallen, and the most recent is Colorado this year, in terms of an election. So far right now in this country, assisted suicide is legal for people with terminal illnesses in California, Oregon, Washington, Colorado and Vermont. And then there are some who say it is legal in Montana from a court decision, but that was a very muddled decision, did not find a constitutional right to assisted suicide in the state constitution. But we can say for sure that five states in this country have legalized assisted suicide.
JOHN RUSTIN: Wesley, in these states, we are already seeing some of the scenarios come to light that patient advocates warned us about, especially as it relates to patients with acute or terminal illnesses. I’m thinking particularly of instances like the California woman who was told that her insurance would cover euthanasia but not her chemotherapy. Is this just a natural progression of a philosophy that says it is acceptable for health care providers to assist in the death of their patients?
WESLEY SMITH: Yes and it goes hand in hand with the paradigm right now with major containment of costs in healthcare. And it wasn’t just that HMO. Oregon, which has legalized assisted suicide, also has explicit healthcare rationing under its healthcare law. And in 2008, two people, Randy Stroup and Barbara Wagner, were diagnosed with a terminal illness, terminal cancer. Their oncologists prescribed for them chemotherapy, not to cure their cancer but to extend their lives, which is a normal part of cancer care. My dad, when he was dying of colon cancer, had that last shot of chemotherapy and it gave him an extra year of very good living. But in the state of Oregon, the Medicaid administrator sent them a letter specifically saying, “I’m sorry you will not live long enough for us to be willing to pay for your chemotherapy, but we will pay for your assisted suicide.” And Barbara Wagner went public and she said, “My gosh! My state is willing to pay for my death but not my life!” This becomes the neurosis that is afflicting us, when suffering has become such a fear that we’re willing to actually destroy the ethics of healthcare and medicine to make people dead rather than make sure that we care for them in a proper fashion. In California, I just wrote this article for First Things last Friday: An amazing thing has occurred where assisted suicide was legalized for the people who were competent and able to make medical decisions if they were terminally ill. The regulators took that law, which was passed by the legislature, and said that people who have been forcibly hospitalized in state institutions—meaning the very mentally ill, people with psychoses, people who may have been found not guilty of a violent crime by reason of insanity, people who’ve been found by a court beyond a reasonable doubt to be a danger to themselves or others—If they are diagnosed with a terminal illness—meaning these are people in mental institutions—if they’re diagnosed with a terminal illness they can petition the court to be released from the mental institution, not because they have been successfully cured, but for the purpose of killing themselves. Think about that! By definition these people have been forcibly hospitalized, who are receiving obviously very strong psychiatric medicines, psychotropic drugs, and yet the state wants to free them to kill themselves. And, if the court refuses to do so, let’s say, because they’re a danger to others or themselves, then the state has to facilitate the death themselves in the mental institutions. So, you’re going to have situations where people have been forcibly hospitalized because they’re so suicidal, who are going to have to be aware that perhaps the person in the next bed is receiving assisted suicide from the state. It’s just an astonishing collapse of medical ethics and an abandonment of people who really are mentally ill.
JOHN RUSTIN: Going back to something that you touched on, how big of a role does economics play in the decisions physicians, health care administrators, insurance companies and others make regarding the care of patients in states and countries that have legalized assisted suicide?
WESLEY SMITH: That’s an interesting question because it’s not something that assisted suicide advocates like to discuss very much. But, Derek Humphry, who is the original founder of the Hemlock Society—which has now renamed itself as Compassionate Choices and moved on with new management—Derek Humphry wrote a book basically calling out this cost-containment argument in The Unstated Argument for Legalizing Euthanasia, arguing that millions and millions of dollars could be saved for people who want to be treated, or people who can be cured, if we euthanize or assist the suicides of those with serious illnesses. You are going to find, I think—and we saw it already in Oregon in the Barbara Wagner and Randy Stroup case I described, and in this HMO case you mentioned—where people are going to look at the force of gravity in terms of economics and say, “Well gee, it might cost $1,000 to assist someone’s suicide, but it would cost $100,000 dollars to make sure they didn’t want assisted suicide.” The force of gravity becomes quite obvious there. It isn’t being stated overtly, but it certainly is an issue that we have to consider and think about.
JOHN RUSTIN: Wesley, what are some other negative effects of these laws that you are seeing, and what does it mean in terms of medical practice and the attitude of those in the medical field and in society at large toward the value of human life, and maybe—based on your answer to the previous question—I should say really the sanctity of human life versus the value of human life, because some would put a monetary value on it?
WESLEY SMITH: Also, some are saying that human lives don’t have equal value: it depends on the quality of the life. So, let’s say I’m suicidal because I did a lousy interview on this program. Some people would say, “Oh, no no! We’re going to give you suicide prevention.” But then I say, “I have cancer.” “Oh well never mind, here are your pills.” What are you saying to the person with cancer? You’re saying that their life does have less value; you’re confirming their worst fears. And your listeners may be thinking, “Well, here in North Carolina, we’re pretty safe from assisted suicide,” and you may be for now but I want you to consider that with five states having now legalized assisted suicide, your listeners might face what I call “social martyrdom” and here’s what I’m talking about. Let’s say sister Sue calls you and says “You know Grandma has cancer; she’s expected to live five to six months, and she’s decided she’s dying next Tuesday. She wants you to fly out to California and be with her when she takes the pills.” What do you do? If you say, “Yes, okay, I’ll be there,” you’re confirming grandma’s worst fears, that she doesn’t have dignity, that she will be allowed to die in agony, that she is less worthy of being loved because she’s in a period of decline and demise, that the cost of caring for her both emotional and financial just is too great a burden on the family. But if you say, “No,” then your sister Sue might say, “How day you say no! How dare you judge Grandma! How dare you impose your religious beliefs on Grandma! Who are you to abandon Grandma like that! We’re pushing you out of the family! We never want to see you again! Don’t even bother coming for Thanksgiving dinner!” I call that “social martyrdom.” So people, even in places where assisted suicide might not be legalized, could face that conundrum of either validating somebody’s suicide and becoming complicit in it—and in my view morally accountable for it even more than the person who wants to commit suicide whose undergoing severe distress or they wouldn’t want to commit suicide. It’s the people around those people and how they react to that desire that really, in my view, counts. Here in California, we actually have now had stories in the media celebrating suicide parties, where there was a woman, for example, who in Southern California, who has Lou Gehrig’s disease, held a big going away party and people came and they laughed and hugged and had a good time and then she killed herself. What kind of a society are we when we’re normalizing that kind of a situation? This woman was given validation for killing herself with a party, rather than, “No, I’m not going to come to your party, but here’s what I can do: I will never abandon you; I will always love you; we will make sure you are not by yourself, we will make sure that you’re cared for properly.” It is an insidious change of culture.
JOHN RUSTIN: This conversation about legalized suicide and euthanasia is also a matter of public policy with enormous implications for our culture. What are the implications of legalizing assisted suicide from a policy and societal standpoint? In other words, why should it matter to our society as a whole if a terminally ill patient or an elderly individual wants to choose the time and manner of their own death?
WESLEY SMITH: Because you’re basically creating a two-tiered system of a society, where some lives are worth protecting, even from suicide, and some aren’t. And, there’s no reason, by the way, to think that it will be limited to the terminally ill. Why should it be? The ideological premise underlying assisted suicide and euthanasia is this: that killing is an acceptable answer to human suffering. Or, that eliminating the sufferer is a proper response to human suffering. So, why in the world would you limit it to the terminally ill? There are a lot of people who experience far more suffering and for a far longer period of time than the dying: people with disabilities, for example; people with mental illnesses. And if you take a look at societies in which euthanasia and assisted suicide have been widely accepted by the society, which has not yet happened in the United States, and I’m hoping that shows like this will keep that from happening, but if it ever becomes widely accepted and adopted, it very quickly moves away from the terminally ill to people with much more suffering or longer-term suffering. Mental illness, for example. Mentally ill people—not people who are mentally ill with cancer—but people with mental illness are now euthanized as a treatment for their mental illnesses, killed by psychiatrists in the Netherlands and in Belgium. So, what happens when you accept killing as an acceptable answer to human suffering? Your whole brain-set, your mind-set, your value system, your ethics, turns on its head, and that which was once deemed a terrible tragedy, the joint death of elderly people, is celebrated now as death with dignity. It is really a remarkable collapse of everything that is good and decent in healthcare.
JOHN RUSTIN: Unfortunately, Wesley, our time has flown by. It’s been a great discussion. Before we go, I do want to give you an opportunity to let our listeners know where they can go to get more information about your books, about your other resources, and about the Discovery Institute.
WESLEY SMITH: My books are all available either in bookstores or they’re available by special order. Amazon.com certainly has them. The Discovery Institute is www.discovery.org and the Center on Human Exceptionalism can be found there.
JOHN RUSTIN: And with that, Wesley Smith, I want to thank you so much for being with us again on Family Policy Matters and for your incredibly important work defending human life and the dignity and value of every human being. We’re so grateful for all that you do and appreciate your taking the time to be with us on Family Policy Matters.
WESLEY SMITH: Thanks for having me, I appreciate it.
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