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Medical Journals & the Culture of Death Print E-mail
By Matthew Hanley   
Thursday, 16 August 2012

An acquaintance of mine is about to head off to medical school.  She is apprehensive about Obamacare – and about her loans. She is taking out a special kind of insurance in the event something happens to her over the next several years, before she can start earning back the hundreds of thousands of dollars she’ll be racking up in debt. Nonetheless, she’s eager to develop her talents and to become an instrument of healing.

She is less attuned, however, to the ideological minefield she will have to traverse, likely with little training or support, if she is to recognize the assaults on human life distorting the healing professions from within. A tour of recent issues of the leading medical journals provides a sample of what she will be up against.  The July 11 and 12 editions of the august Lancet, New England Journal of Medicine, and British Medical Journal all (not entirely by chance) published articles sympathetic to expanding the end-of-life killing license.

The Lancet study assessed trends in the practice of physician-assisted euthanasia in the Netherlands since 1990 in order to gauge the impact of its 2002 legalization.  It applauds what it deems the transparency of this transition and states that, at present, “the incidence of euthanasia and physician-assisted suicide is comparable with that in the period before the law.”  In other words:  nothing really to worry about. That was the take-home message the media compliantly touted in turn.

The data themselves point to another conclusion.  Among other troubling trends, the number of euthanasia deaths was 67 percent higher in 2010 than it was in 2005; underreporting also remains an issue, with only 77 percent of euthanasia cases properly classified.

Veteran observer Wesley Smith notes that the study’s own data reveal that physicians trigger about 14 percent of all deaths in the Netherlands today.  It climbs that high when you count the practice known as “terminal sedation,” which in substance amounts to euthanasia on the installment plan:  patients are put into a coma until death comes from starvation or dehydration – not the underlying disease or condition.

In Evangelium Vitae, John Paul II decried this very tendency “to disguise certain crimes against life…by using innocuous medical terms which distract attention from the fact that what is involved is the right to life of an actual human person.”  Those with pricked consciences about the nature of unethical end-of-life practices feel the need to resort to obfuscation. 

But once the premise becomes openly accepted – that the physician may rightly take life – disguise becomes less and less urgent, as is evident from the advent of mobile euthanasia units. There is “unmet need” for euthanasia, you see, so earlier this year the Netherlands began to equip teams to hit the road and go meet that need.  How considerate. Euthanasia prevention advocate Alex Schadenburg reports these units plan to “reach” 1,000 people per year.

Redefining Physicians’ Role in Assisted Dying” is the New England Journal of Medicine’s offering.  It is called a “perspective” piece, but that is precisely what it lacks – a humane one at any rate.  By that, I mean one roughly consistent with essentially universal codes of medical ethics (including many from non-Christian cultures) going back millennium, which do not endorse physicians taking the lives of their patients.

A number of pragmatic objections to the practice of assisted dying, the authors claim, have not come to pass. It’s therefore time to get over any unfounded, lingering qualms. They dismiss the most fundamental objection – that allowing assisted dying undermines the sanctity of life – by writing:

This is a subjective moral question, commonly framed in terms of absolute preservation of life versus respect for personal autonomy — a divide that often falls along religious lines.

It is no such thing.  Not long ago, most people would have recognized that it is objectively wrong to actively take human life just as, I suspect, most still instinctively recoil at the thought of mobile euthanasia units.

How the authors say the issue is commonly framed is also an imprecise mischaracterization. Nowadays, it often eludes those with elite schooling. It now takes a solid “old school” upbringing or a proper, well-rounded education to spot this error – reassigning matters of objective moral truth to the realm of subjective prerogative – responsible for so much of our cultural rot. 

Since there is “no clear, objective answer,” the authors maintain, all preferences should be respected.  They point, however, to a pesky obstacle to broader implementation of enlightened euthanasia policies:  most physicians are not keen on killing their patients.  Their solution? Take it out of the hands of the doctors. Establish “a central state or federal mechanism” (uh-oh!) – with appropriate safeguards, of course – whereby patients can get on with ending their lives without having to rely on doctors to lend pro-active support.

A professional ethicist, writing in the British Medical Journal, covers similar ground. He bluntly stresses that a U.K. “Sanctity of life law has gone too far”; it has infringed upon the subjective wishes of various parties and unduly cramped cost considerations. 

Aspiring doctors who suspect the journals they’ve been conditioned to regard as authoritative aren’t repositories of wisdom on such matters might ponder the relevance of these words by Hilaire Belloc:

We sit by and watch the Barbarian, we tolerate him; in the long stretches of peace we are not afraid. We are tickled by his irreverence, his comic inversion of our old certitudes and our fixed creeds refreshes us; we laugh. But as we laugh we are watched by large and awful faces from beyond: and on these faces there is no smile.

We need them to see unsmiling faces any time they are encouraged to think that various forms of life-taking are merely the ineluctable, noble applications of medical science.
Matthew Hanley is, with Jokin de Irala, M.D., the author of Affirming Love, Avoiding AIDS: What Africa Can Teach the West, which recently won a best-book award from the Catholic Press Association. His latest report, The Catholic Church & The Global AIDS Crisis is now available from the Catholic Truth Society, publisher to the Holy See in the U.K.
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Comments (14)Add Comment
written by Michael Paterson-Seymour, August 16, 2012
The treatment of moral values as subjective goes back well over a century, when Liberal Protestants and Modernist Catholics drew a distinction between "truths of fact" (the domain of science) and "truths of value" (the domain of experience), hoping thereby to insulate the realm of religion from historical or scientific criticism. The distinction was based on a caricature of Kant's epistemology and led to a subjectivism and moral relativism that he would have utterly rejected.
written by Dennis Larkin, August 16, 2012
Belloc, as always, nails it to the barn door.
written by Jack,CT, August 16, 2012
As a nurse of almost 20 years I am so saddened by the
continued "Culture of Death" Blessed John Paul spoke of
It is worthy of our prayers, please pray for the end of
"Assisted suicide".
written by Grump, August 16, 2012
We put dogs "to sleep" out of compassion and to relieve their pain and suffering? Why not human beings? A relative of ours was in the hospital for several days in agonizing pain before finally succumbing. There was no intervention despite a DNR clause in his will. What purpose does it serve to endure extreme physical anguish when death is imminent?
written by Mark, August 16, 2012
The Hippocratic Oath was written about 400B.C. and contains this line: "I will give no deadly medicine to any one if asked, nor suggest any such counsel; and similarly I will not give a woman a pessary to cause an abortion."

Since the time that medical schools were begun, doctors have for the most part used this oath as a guide for the ethical practice of medicine. It is only relatively recently that new "Hippocratic" oaths have become fashionable that (you guessed it) leave out the above line.
written by Chris in Maryland, August 16, 2012
We need a new Cartholic Hospital watchdog, analogous to what Newman Society does for parents looking at colleges.

And Bishops with guts could help the faithful by publishing "white lists" of hospitals and colleges that actually held, rather than rejected/undermined, Catholic moral principals.

I have found that the progressive deception and evasion of accountability here works exceedingly well as a tactic, even against otherwise faithful/concerned Catholics, because so many people just naturally don't want to deal with considering the implications of the the ugly facts...and so will face them only at the moment of crisis, when they're already enrolled in college, or laying in a hospital bed, and find themselves in a very alien place.
written by Gil Bailie, August 16, 2012
This is a fine column, Matthew. Thanks for it.
written by Dave, August 16, 2012
Thank you, thank you, thank you for this article. For decades people in the mainstream have been urged to "be tolerant" only to find that once those we've been badgered to tolerate will not tolerate us once they have the upper hand. Belloc got it right -- as he so often did. Now we face the prospect of "enlightened" opinion holding the political and legal power to force us to accept or to do what is unacceptable or indecent. And we brought this upon ourselves: "for want of a nail," and when the nail went missing, we thought it was no problem or even cute the way we managed to get on. The price of freedom is eternal vigilance and attention to the little things, for the hill of beans becomes a mountain over time.
written by kristinajohannes, August 16, 2012
I'll be giving a talk in a symposium this fall on the theology of moral decision making in regards to the end of life. This will be an encore presentation but what is new since i last gave it was something called "POLST"--physician ordered life sustaining treatment. I've been given a couple of articles to read up on it and am just starting but, yikes, Satan never sleeps. It's kind of the opposite of what it sounds like.

Grump, the short answer is because we are not dogs! Sounds like your relative did not get the appropriate pain treatment. Pain meds can be given to the dying as needed to lessen or eliminate their pain even if the amounts required to do so should have the unintended effect of shortening their life . the intent in this circumstance is to eliminate pain rather than the patient.
written by J. W., August 16, 2012
Grump wrote: "We put dogs "to sleep" out of compassion and to relieve their pain and suffering? Why not human beings?"

I'm not sure you want to make a "let's treat humans like animals" argument here. We also spay and neuter dogs to control the pet population. Why not human beings?
written by Chris in Maryland, August 17, 2012
A mystery about The Body of Christ, spoken to us by the Apostle Paul: "We make up in our own sufferings what is lacking in the suffering of Christ."

God Our Father, grant us all the grace to imitate your Son.
written by Grump, August 19, 2012
@J.W. In many cases, the neutering of humans would not be a bad idea and I would be all for sparing posterity to have to suffer countless more idiots and wastrels.

As for the rest of you who argue that we are not dogs, I think the human species has no cause to boast. Mark Twain accurately observed: "If you pick up a starving dog and make him prosperous, he will not bite you. This is the principal difference between a dog and a man."
written by Mike Melendez, August 19, 2012
So, Grump, how do we keep the fight to be alpha dog out of death politics? I suggest that before we let others "sing us to our rest" that we wait for a more intelligent species to arrive on the scene. One that Mark Twain might approve of.
written by Grump, August 20, 2012
@Mike. Man was the best God could do and that wasn't good enough. However, there's plenty of time to improve on homo sapiens although the "progress" made has been disappointing so far.

Herewith my summation of the human condition: Good may triumph in the end but so far evil is way ahead.
Yours misanthropically,

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