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Jewish World Review Jan. 2, 2001 / 7 Teves, 5761

Nat Hentoff

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Expanding the culture of death -- THE NETHERLANDS has become the first nation since Hitler's Germany to legalize euthanasia -- the direct killing of patients by physicians. There are restrictions. There must be voluntary consent to be euthanized; the patient must be suffering irremediable and unbearable pain; and a second physician's opinion must be obtained.

But these restrictions already existed during the years in which euthanasia was quasi-legal in the Netherlands. That is, patients were put to death by doctors who were very rarely even prosecuted, let alone convicted. During that time, official figures revealed that many patients were euthanized without their consent. Their compassionate doctors felt those lives were of such low quality that they were not worth being continued.

In his prison cell in Michigan, Dr. Jack Kevorkian, serving a 10-to-25 year sentence for sending yet another patient into eternity, is greatly encouraged by the decision of the Netherlands' parliament. He predicts that similar laws will be adopted here in the next three to five years.

Although measures legalizing assisted suicide have failed to pass in Maine and Massachusetts, Oregon has already legalized the right of physicians to provide the means of death to those who wish to commit suicide -- although doctors are not allowed to be present at the actual departure.

Meanwhile, California's legislature will soon consider an assisted-suicide law, and Alaska's Supreme Court is addressing the issue. Moreover, referendums for "death with dignity" laws are likely to take place in other states. In recent years, national polls have indicated that 60 percent to 70 percent of Americans believe that people suffering in pain should be able to terminate their lives, with the help of a doctor if that is necessary.

In Maine, assisted suicide was defeated by a close 51.3 percent to 48.7 percent vote.

In Toronto's Globe and Mail, Ian Hunter, a law professor at the University of Western Ontario, quotes Ohio oncologist Eric Chevlen about the "informed consent" that the Netherlands and the state of Oregon require before euthanasia or assisted suicide are administered.

Informed consent is a sham, says Dr. Chevlen, "behind which doctors may hide the awful fact that it is really they who make the life-and-death decisions for their patients. Legalized euthanasia is not freedom to choose; it is not even freedom to die. It is freedom to be killed."

Dr. Kathleen Foley of the Memorial Sloan-Kettering Cancer Center in New York City is an expert on pain relief, and has been emphasizing that many doctors are not aware of the advances in relieving pain when they are confronted by acutely suffering patients.

She also points out that, with the increasing emphasis by HMOs on controlling the cost of patient care, "my worry is that it's going to be cheaper to kill people than to care for them when they're dying." Palliative care can make terminal illness much more humane, but is it "cost-effective" enough?

To my surprise and great disappointment, the California Nurses Association, which has been battling on patients' behalf against HMOs now says -- according to professor Ian Hunter -- that it favors physician-assisted suicide because "long-term patient care is simply too costly."

Not all of Dr. Kevorkian's patients were terminally ill, and not all of the people euthanized in the Netherlands in recent years have been terminally ill or in intractable pain. Some have been severely depressed.

During the Nazi occupation of the Netherlands, that country's physicians rebelled against the culture of death by refusing to cooperate with the killing of patients.

But now, their changed attitude reminds me of an Oct. 17, 1933, New York Times report from Berlin that the German Ministry of Justice intended to authorize physicians "to end the suffering of incurable patients, upon request, in the interests of true humanity."

Before the gas chambers, before the Holocaust, German doctors euthanized not only the "incurable" but also mentally defective patients on the principle that some lives are unworthy of living ("lebensunvertes Leben"). Later, the Nazis called those unfit to live "useless eaters."

In "Culture of Death," a book by Wesley Smith that was published this month, the author, who has done vast research on assisted suicide and euthanasia, describes how many of us have gotten to the point of believing that some lives are not worth living. "We ignore," he says, "the lessons of the Netherlands at our own peril."

At last, have we learned nothing from the Holocaust?

JWR contributor Nat Hentoff is a First Amendment authority and author of numerous books. Send your comments to him by clicking here.


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