The irony! The inability to connect dots!
Oregon led the country in legally approving suicide for certain vulnerable populations–and now media and legislators are upset because pro suicide groups sell suicide kits in the state, where state law permits assisted suicide for some categories of despairing people! And yet, that fact goes completely unmentioned in the article about a terrible suicide tragedy using an Exit Bag. From the story:
The simple fact of a mail-order method of securing the means for a person to commit suicide “has a lot of visceral impact,” Gardner said. “It is so awful that somebody could make money, turning someone else’s transient despair into death. If that is happening, it’s something that needs to be changed.” Zach Klonoski, 26, the third of the five Klonoski brothers and a law student at the University of Oregon, questions whether his brother would have taken his own life had the suicide kit not been so readily available by mail order. “I will have that question in my head for the rest of my life,” he said. “We have a family friend who was severely depressed and who crashed a car into a tree at 40 mph, trying to kill himself. He survived, he got help, and he’s now married with two kids and very, very happy.”
For the same reason, Jake Klonoski wonders whether the rental or purchase of helium tanks should require two signatures instead of just one, to make helium-hood suicide more difficult. “I can’t help think that if my brother couldn’t have gotten either the kit or the helium without anyone else’s knowledge, he would still be alive,” he said. State Sen. Prozanski, who chairs the Senate Judiciary Committee, had never heard of the mail-order helium hood kit until asked by The Register-Guard for his opinion about its legality in Oregon. “We are going to move forward with legislation to prohibit this, with criminal penalties or sanctions for individuals involved in selling in the state or (from) out of state to residents in the state,” Prozanski said. “I have a bill being drafted right now. When you think about what is being marketed and to whom and in what state of mind, we need to make every possible effort to protect people’s lives.”
The family is very right to be upset that their despairing family member was facilitated in self destruction by strangers.
But this is not unconnected with legal assisted suicide in the state–even though the story is written as if these cases arise in a vacuum. Studies have shown that many terminally ill people who wanted to kill themselves, were later very happy that they didn’t. So the idea of “transient despair” should apply generally. Nor, should people whose despair is not transient be any less protected against suicide–whether sold in a kit or prescribed by doctors.
The pro suicide movement is cold and calculating, even as it hides its true core behind teary-eyed assurances of compassion. One wing pushes assisted suicide legalization for the terminally ill–as another wing facilitates suicide on demand via exit bags. (Compassion and Choices is the first wing, and Final Exit Network, the second.) I don’t understand how the reporter could write a long and detailed story and miss the obvious about suicide in Oregon. But that’s how media work these days.
So let me get to the point: How can a state–or media, since the Register Guard supports assisted suicide–say that suicide is great for one group but bad for another? At best, that is a mixed message that suffering and despairing people often cannot comprehend. And by that mixed message, the state promotes suicide as a proper way to avoid suffering generally–even if that is not the intent.
If Oregon is serious about preventing assisted suicides–it should outlaw all of them–not just some.
March 21st, 2011 | 5:41 pm
Like you said in so many words about assisted suicide Wes, two wrongs wil never make “ONE” right no matter how well “IT” might be hidden.
Peace
March 21st, 2011 | 6:47 pm
Why, Wesley, it’s obvious: The helium hood suicide is the result of an _irrational_ wish to die, while the doctor-assisted/drug overdose suicide is the result of a _rational_ wish to die. (/sarcasm) And never the twain shall meet, in the minds of those who support Oregon’s DWDA.
Once again, with feeling: The “rational wish to die” does not exist in any scientific or psychiatric literature; it was created ex nihilo from the minds and philosophical stance of the pro-suicide crowd.
HistoryWriter Reply:
March 21st, 2011 at 10:35 pm
@Kathleen Lundquist,
What you seem to be saying is that something that’s not in the scientific literature can’t exist — which seems to be placing an awful lot of trust in “soft” sciences like psychology and psychiatry. Do you believe that if enough people label a thought irrational then that’s conclusive evidence of irrationality; that rationality is something that requires a majority vote? Just asking.
HW
Kathleen Lundquist Reply:
March 22nd, 2011 at 3:44 pm
@HistoryWriter,
In my opposition to the concept of physician-assisted suicide (as well as other forms of euthanasia), I try to create and express as many different arguments against it as I can, using whatever principles I and the other participants in the conversation have in common. In this case, being aware of those who need a consensus of scientists to validate any truth claim, I submit that in 100 years of psychiatric/psychological study and practice, no one/no school of thought has seriously proposed or defended a concept as radical as a rational suicidal wish. A suicidal wish has uniformly been categorized as irrational; all the diagnostic tools (tests, assessments) reflect this. In my view, any attempt to regard a suicidal wish as rational requires not just a change in circumstances (i.e. illness, disability), but _a change of one’s philosophical stance_ to allow a change in the _meaning_ of one’s circumstances. That’s why I say the pro-PAS crowd made it up. Though I’m not a psychiatrist or psychologist, I’ve talked to a lot of them about this issue, and I do know just enough philosophy to recognize the difference between a physical change of circumstance and a (metaphysical) change of axioms in an argument.
I have more to say to address your question directly, ’cause I think it’s an interesting one, but I haven’t time right now – I’ll come back to this thread later today if I can.
George Eighmey Reply:
March 22nd, 2011 at 4:36 pm
@Kathleen Lundquist, Dear Kathleen, Here is something for you to add to your reasoning (sarcasm)
WHAT THE EXPERTS SAY
American Medical Student Association
“Whereas there is increasing use of neutral terms like ‘physician-assisted dying,’ ‘physician-assisted death,’ or ‘physician aid in dying’ to avoid the more emotionally charged ‘physician-assisted suicide’ … therefore be it resolved that the Principles Regarding Physician-Assisted Suicide, Number 1 (pg 150) -be AMENDED to read: ‘Physician Aid in Dying.’”
The American Medical Women’s Association
“The terms ‘assisted suicide’ and/or ‘physician assisted suicide’ have been used in the past, including in an AMWA position statement, to refer to the choice of a mentally competent, terminally ill patient to self administer medication for the purpose of controlling time and manner of death, in cases where the patient finds the dying process intolerable. The term ‘suicide’ is increasingly recognized as inaccurate and inappropriate in this context and we reject that term. We adopt the less emotionally charged, value neutral and accurate terms ‘Aid in Dying’ or ‘Physician Assisted Dying.’”
Washington State Psychological Association
“WSPA recognizes that the term ‘suicide’ implies psychiatric illness or other emotional distress that impairs judgment and decision-making capacity, and thus may not be an accurate or appropriate term for a terminally ill, mentally competent individual choosing to control the time and manner of his or her death. Therefore WSPA supports value neutral terminology such as aid-in-dying, patient-directed dying, physician aid-in-dying, physician-assisted dying, or a terminally ill individual’s choice to bring about a peaceful and dignified death.”
American College of Legal Medicine
“The term ‘physician-assisted suicide’ is arguably a misnomer that unfairly colors the issue, and for some, evokes feelings of repugnance and immorality. The appropriateness of the term is doubtful in several respects….ACLM rejects the term ‘physician-assisted suicide.’”
American Public Health Association
In 2006, the APHA adopted a policy recognizing that “the term ‘suicide’ or ‘assisted suicide’ is inappropriate when discussing the choice of a mentally competent terminally ill patient to seek medications that he or she could consume to bring about a peaceful and dignified death.” The APHA policy emphasizes “the importance to public health of using accurate language.” In 2008, the APHA, the nation’s largest public health association, adopted a policy supporting aid in dying. The policy acknowledges “allowing a mentally competent, terminally ill adult to obtain a prescription for medication that the person could self-administer to control the time, place, and manner of his or her impending death, where safeguards equivalent to those in the Oregon DDA are in place.”
American Academy of Hospice and Palliative Medicine
“The term PAD (Physician Assisted Death) is utilized in this document with the belief that it captures the essence of the process in a more accurately descriptive fashion than the more emotionally charged designation Physician-Assisted Suicide.”
LANGUAGE MATTERS
As society considers important social questions, language is important. Words matter. Reporters and editors often use the term ‘assisted suicide’ to describe a terminally ill patient’s choice to shorten a dying process that the patient finds unbearable. But this is the terminology of zealous opponents of this choice. Why would journalists adopt the language preferred by those opposed to this option?
Language evolves. In the same way that people with disabilities were once referred to as “crippled” or “handicapped,” and people with developmental disabilities were referred to as “retarded,” the words we use and the philosophies behind them change over time.
Medical, health policy and mental health professionals recognize that the terms “suicide” and “assisted suicide” are inaccurate, biased and pejorative in this context. Increasingly, mainstream medical, mental health and health policy organizations have adopted the term “aid in dying” to refer to this choice.
SUICIDE: INACCURATE AND BIASED
Oregon, Washington and Montana are currently the states that have legalized a mentally competent, terminally ill patient’s choice to ingest medications to bring about a peaceful death. The Oregon and Washington laws clearly state: “Actions taken in accordance with (the Death with Dignity Act) shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law.”
A Washington State Judge refused to allow the biased term “assisted suicide” on Washington State’s Death with Dignity ballot measure, finding the term “suicide” is “loaded” and adding, “it’s important that that term not be used.”
The Oregon Department of Human Services (DHS) adopted value-neutral language for describing practice under Oregon’s Death with Dignity Act (DWDA). DHS will now use the functional term “persons who use the ODWDA” on its Web site and in all future reports. The language replaces the term “physician-assisted suicide” used in past DHS reporting.
The term ‘assisted suicide’ is inaccurate and misleading with respect to the DWDA [Death with Dignity Act]. These patients and the typical suicide are opposites.” – E. James Lieberman, M.D./Psychiatric News, Aug. 4, 2006
PATIENTS AND FAMILIES ARE HURT
Those facing a terminal illness do not want to die but—by definition—are dying. They are facing an imminent death and want the option to avoid unbearable suffering. Terminally ill patients who legally access the Death with Dignity Act find the word “suicide” offensive and inaccurate. Many have publicly expressed that the term is hurtful and derogatory to them and their loved ones.
Jack Newbold, a retired sea captain from Astoria, Oregon, told a news conference he resented media reports that he is about to “kill” himself. “I’m not committing suicide, and I don’t want to die. I was upset by media reports that I intend to ‘kill’ myself. I’m not killing myself; bone cancer is taking care of that. I may take the option of shortening the agony of my final hours.”
Charlene Andrews, patient-plaintiff in Gonzales v. Oregon, addressed the National Press Club and attended oral arguments at the US Supreme Court. She pleaded with the media saying, “Please do not call it suicide; that is an insult to my fight against cancer. With cancer we know when there are no treatment options.”
Louise Schaefer, in an article published in the Lincoln/Sacramento Bee, proclaimed “All I am asking for is to have some choice over how I die. Portraying me as suicidal is disrespectful and hurtful to me and my loved ones. It adds insult to injury by dismissing all that I have already endured; the failed attempts for a cure, the progressive decline of my physical state and the anguish which has involved exhaustive reflection and contemplation leading me to this very personal and intimate decision about my own life and how I would like it to end.”
Morgan Reply:
March 22nd, 2011 at 10:40 pm
@George Eighmey, This redefinition of terms sounds chillingly like something out of Orwell’s 1984. The fact that the medical community has consented to stop using the term ‘suicide’ doesn’t change what’s actually taking place in these cases. ‘Dying’ is what happens naturally. When someone chooses to end their own life, we call that ‘suicide,’ and no amount of redefining terms is going to change what it actually is. The fact that the word ‘suicide’ was used initially reveals what’s really happening. Enough time has passed to allow those who favor Physician Assisted Suicide to make their language more palatable–which is a very creepy reality in my book.
Wesley J. Smith Reply:
March 22nd, 2011 at 10:43 pm
Morgan: Bingo.
Kathleen Lundquist Reply:
March 23rd, 2011 at 1:47 am
@George Eighmey,
Though I’m not the blog host here, I’d like to say, I for one welcome your comments. Yours has been a prominent voice in the debate here in Oregon over assisted suicide (sorry!) since Oregon’s DWDA (Death With Dignity Act) first became law in the ‘90s. I don’t know whether you’ll stick around this thread to see my response below, but I’ll do my best to keep it on point and short as possible.
First, re: the quotes from various health organizations regarding the terms ‘suicide’ and ‘assisted suicide’, I see how these organizations have changed their terminology to accommodate the Oregon law. (I see also that most respected of national health organizations, the American Medical Association, is conspicuously absent from your list.) I also observe that not one offered a psychological or philosophical rationale for the change. The closest they come is the statement by the Washington State Psychological Association: “WSPA recognizes that the term ‘suicide’ implies psychiatric illness or other emotional distress that impairs judgment and decision-making capacity, and thus may not be an accurate or appropriate term for a terminally ill, mentally competent individual choosing to control the time and manner of his or her death.” But this is not an argument; it is a simple statement that “a terminally ill, mentally competent individual choosing to control… his or her death” is not suicide. The rest of the quotes also simply state a conclusion: We shouldn’t use the word ‘suicide’ because it frightens people.
I agree that people have a visceral reaction to the word ‘suicide’. I submit that this is because the word describes a course of action undertaken by a person with the goal of causing their own death, whatever the reason or circumstances may be; the action of overdosing on drugs is exactly the same, whether the person is suffering from ALS or clinical depression. This is the word, in English, describing such a course of action, and psychiatric and psychological theory to date overwhelmingly support the fact that a healthy human consciousness rebels against this. I’m not in a position to keep Compassion & Choices, the WSPA, Oregon’s DHHS (Department of Health and Human Services), and all the other organizations you listed from using whatever terminology you all like; it doesn’t change the fact that the action it describes is the same, whether it’s performed by a terminally ill, chronically ill, or mentally ill person.
As an example, consider this: I have a family member who is severely, chronically mentally ill. Every day, his caregivers and my family and I take pains to talk with him and communicate our love for him and our desire for his wellbeing, even in the midst of his struggle with debilitating hallucinations and delusions. Say he goes in for his routine yearly physical, and that pain he was having in his back turns out to be Stage III cancer of the kidney. And then on a subsequent day he says, “I don’t want to live anymore”. Would you call that a rational wish to die, or an irrational wish to die? How could you possibly tell the difference with his past psychiatric history? Or, does the fact that he now has a cancer diagnosis “change everything” regarding his mental health care? (I invite interested readers to Google the name “Michael Freeland” for more on this sort of situation.)
You note that the DWDA states: “Actions taken in accordance with (the Death with Dignity Act) shall not, for any purpose, constitute suicide, assisted suicide, mercy killing or homicide, under the law.” Again, no reason is given, either by you or in the Act itself, why this should be the case. I submit that the real reason the law contains this sentence is simple: The group that met in 1993 and crafted the language of the Act (including Cheryl K. Smith, Eli Stutsman, Dr. Peter Goodwin, and Barbara Coombs Lee among others) simply wrote it that way, creating ex nihilo a new category of type of death in Oregon. For which the DHHS was simply to make a new file folder. With, literally, no questions asked.
You say that people with terminal illness who wish to end their lives are offended and harmed by the use of the word ‘suicide’. For every person you mention who takes offense at the word ‘suicide’, we could find a matching opposite story of someone harmed by the prevalence of compassionate-sounding euphemisms for suicide – including that of Robert Salamanca (whose story is chronicled in an earlier post on this blog), and those of Ric Burger and other members of the disability-rights organization Not Dead Yet, who because of their chronic disabilities constantly hear society’s megaphone shouting “Better dead than disabled” at them. What about their feelings? When voluntary euthanasia becomes socially acceptable as you and others desire, what will their quality of life be like? Should we not care, because of the right-to-die movement’s central dogma: My Choices Must Rule The Earth, Yet Must Simultaneously Not Matter To You?
Yes, please, let’s talk about dogma – both religious and non-religious, about philosophy, worldview, the assumptions and axioms at the basis of our thinking and get underneath the euphemism and boilerplate. As Flannery O’Connor said, “Dogma is an instrument for penetrating reality.” This is where the conflict really exists: at the level of our bedrock beliefs about the nature of Man (if there is one), the nature of God (if there is one), and what constitutes the meaning of our common human experience of existence. John Donne said, “No man is an island…” In the final analysis, do you think he was wrong?
Kathleen Lundquist Reply:
March 23rd, 2011 at 4:31 pm
@HistoryWriter,
To clarify: I don’t regard psychiatric/psychological theory as supremely authoritative in all situations; I’m not a psychologist or Jung devotee or anything like that. My familiarity with the field and its guiding principles comes from working for psychiatrists as a medical transcriptionist for over a decade as well as having a family member who consumes mental health services. As I mentioned before, I’m just trying to find and express logical arguments against PAS that might carry weight with some readers, and since most folks agree that any wish to die has at least some psychological component, I’m trying to cite facts that are relevant to the discussion – and at least let people know that, contra Mr. Eighmey, there’s no consensus in psychiatry that PAS is now a neutral or acceptable act.
Here’s a G.K. Chesterton quote that perfectly illustrates my point of view on rationality; it’s long, so I’ll edit it as best as I can:
Every one who has had the misfortune to talk with people in the heart or on the edge of mental disorder, knows that their most sinister quality is a horrible clarity of detail; a connecting of one thing with another in a map more elaborate than a maze. If you argue with a madman, it is extremely probable that you will get the worst of it; for in many ways his mind moves all the quicker for not being delayed by the things that go with good judgment. He is not hampered by a sense of humour or by charity, or by the dumb certainties of experience. He is the more logical for losing certain sane affections. Indeed, the common phrase for insanity is in this respect a misleading one. The madman is not the man who has lost his reason. The madman is the man who has lost everything _except_ his reason.
The madman’s explanation of a thing is always complete, and often in a purely rational sense satisfactory. Or, to speak more strictly, the insane explanation, if not conclusive, is at least unanswerable… If a man says (for instance) that men have a conspiracy against him, you cannot dispute it except by saying that all the men deny that they are conspirators; which is exactly what conspirators would do. His explanation covers the facts as much as yours…
Nevertheless he is wrong. But if we attempt to trace his error in exact terms, we shall not find it quite so easy as we had supposed. Perhaps the nearest we can get to expressing it is to say this: that his mind moves in a perfect but narrow circle. A small circle is quite as infinite as a large circle; but, though it is quite as infinite, it is not so large. In the same way the insane explanation is quite as complete as the sane one, but it is not so large. A bullet is quite as round as the world, but it is not the world. There is such a thing as a narrow universality… The lunatic’s theory explains a large number of things, but it does not explain them in a large way. [from Chesterton’s Orthodoxy]
I make a distinction between the concepts of “rationality” and “healthy, integrated human consciousness”. Rationality (i.e. facility with logic) is a _component_ of a healthy mind; some are born adept at it, most others can be taught basic reasoning skills. But it’s not everything; a person can be impeccably logical and quite insane. To put GKC’s point another way, the madman isn’t the one who’s lost his reason; the madman is the one who has lost his perspective, i.e. his ability to perceive and process information that threatens to reconfigure his tightly closed mental circle.
There might be said to be concentric circles of rationality, wider and wider webs of theory and belief systems that explain more and more of the humanly perceptible phenomena in our universe (including experiences that seem to go beyond the five senses). In the types of discussions we have here at ShS, I do my best to locate common assumptions or axioms from whatever circle I can find, and construct a logical edifice from there. After all, you have to be convinced on the basis of your own principles, not mine. :)
A more detailed response can be found on my own blog, http://kathleenlundquist.blogspot.com/2011/03/on-reasonability-of-faith.html Feel free also to peruse an essay I published on Catholic Exchange several years ago: http://catholicexchange.com/2008/06/03/112743/ Thanks for the interesting question.
March 21st, 2011 | 8:46 pm
[...] First Things (blog) [...]
March 22nd, 2011 | 2:48 pm
It breaks my heart to see some politician aout the government interfering in some one’s personal business.
I have always felt suicide takes more guts than I’ve got but I keep thinking about it. Maybe I should get my ‘death kit’ on order before its legal to contemplate suicide.
March 23rd, 2011 | 12:32 pm
@ Al,
I had often wondered how people could ever commit suicide, then my own life went on a rollercoaster ride with huge ups and downs. I was never tempted to commit suicide, but I did get my answer: all of my problems would go away. Never mind what life will bring me, all that matters are the problems I’m having now. There are a few reasons why I have never been tempted to follow through on this realization. First, I have always looked (and still do look) at suicide as being one of the great acts of cowardice. It is the ultimate running away from my problems. Second, not only would I be running, but I would be putting those problems on others and compounding their own. What of my wife, my family, my friends? The simple fact is that it’s not my personal business because it has a direct affect on absolutely everyone around me. I cannot tell you how angry I get when I think of my friends who committed suicide, for tearing themselves from me and their loved ones. They, of course, are no longer around to see the great harm that they caused to others because of their actions, sometimes even resulting in the suicide of another who was close to them. Third, in some ways my life just keeps getting harder and harder, but the beauty of life is always there. There is so much good and I thank God for my being around for it. The only thing a “death kit” says is “We don’t care about you,” and that simply is not true.
March 24th, 2011 | 3:31 am
Wesley: Are you prepared to fight to outlaw the right to refuse respirators and feeding tubes?
That would be the consistent thing to do here.
Wesley J. Smith Reply:
March 24th, 2011 at 9:47 am
HMC: No, it isn’t. That isn’t killing. That is allowing nature to take its course. See Vacco v. Quill, US Supreme Court 1997- 9-0.
HCM Reply:
March 24th, 2011 at 3:17 pm
@Wesley J. Smith,
Wesley: Would you also grant that right to a 20-year-old quadraplegic on a respirator?
Wesley J. Smith Reply:
March 24th, 2011 at 3:35 pm
Yes.
HCM Reply:
March 24th, 2011 at 4:03 pm
@Wesley J. Smith,
But Wesley, wouldn’t refusing the respirator in that case be suicide? Such an individual would be starved of air until death.
Wesley J. Smith Reply:
March 24th, 2011 at 4:56 pm
No. It is letting take its course. If the death comes, it is due to the condition. And sometimes people don’t die, as in Karen Ann Quinlin. Read my book Forced Exit. It will answer your questions.
March 25th, 2011 | 12:29 am
But Wesley, why would such an individual ask for the respirator to be removed unless they wanted to die?
Wesley J. Smith Reply:
March 25th, 2011 at 9:22 am
Probably wouldn’t, although they just might want to see if they could live without it too.
HCM Reply:
March 25th, 2011 at 9:14 pm
@Wesley J. Smith,
Wesley: So, would you still support their right if they couldn’t live without a respirator, and were informed that removing it would lead to their death, would you still support their right to make that choice?
March 25th, 2011 | 7:11 am
Once you let go of integrity and allow cherry-picking, there’s never an end.
Every question there is becomes open to exceptions, and more exceptions – and the idea of having laws and rules applied equally becomes replaced with a reality where the important people get to decide when and whether exceptions are warranted – or even just what the rules should be, in the first place.
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