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It is death by philosophy, it is murder by decree, and the curiously named "freedom to die" becomes a freedom only to die. Wesley Smith reports on the case of Andrea Clark, down in Texas¯where a state "futile-care law" has allowed the bioethics committee at St. Luke’s, an Episcopalian hospital in Houston, to reject a patient’s desire for treatment.

As Smith puts it, "The idea behind futile-care theory goes something like this: In order to honor personal autonomy, if a patient refuses life-sustaining treatment, that wish is sacrosanct. But if a patient signed an advance medical directive instructing care to continue¯indeed, even if the patient can communicate that he or she wants life-sustaining treatment¯it can be withheld anyway if the doctors and/or the ethics committee believes that the quality of the patient’s life renders it not worth living."

In other words, you’re free to choose, as long as your choice is for death.

Andrea Clark’s family faced a problem when they were delivered a notice that the patient must be removed from the hospital within ten days. The local hospitals have joined, Smith reports, in a "Houston City-Wide Guidelines on Medical Futility," and will not contradict each other’s futility decrees.

But in response to the embarassment generated by the rapid response of the pro-life world, St. Luke’s has offered to pay the $14,000 or more it will cost to move Andrea Clark to a hospital in Illinois that contacted the woman’s family and offered to take her. Clark’s sister reports that the hospital gave them one day to decide¯declaring that it would pay only half the cost if the family took a second day, and nothing if the family took more time.

The conservative pro-lifers moved this story, through the network and quick responses put in place by the death of Terri Schiavo. But the appeal for Andrea Clark originally appeared on a left-wing website , Democratic Underground , where the response was strong and heartfelt.

For years, many activists against euthanasia and physician-assisted suicide¯Wesley Smith among them¯pitched their appeal primarily to the Left. Smith was a Naderite, co-authoring books with Ralph Nader, and he, like many others, originally thought of the fight in leftist terms: the struggle of citizens against large-corporation hospitals, insurance companies, and HMOs. But they got very little traction on the Left, and gradually found themselves preaching to the pro-life community on the Right.

That the pro-life political connection isn’t necessary seems to be proved by the reaction to Andrea Clark’s story on Democratic Underground . But maybe that’s too strong a conclusion. Abortion has so badly skewed American politics, it’s hard to see what natural groups would be formed. Still, it does suggest there is a constituency for Democrats who could successfully buck their party on the life issues.

In addition to which :

Nobody questions the stature of Richard Pipes as an expert on the history of Russia. But Daniel Mahoney, who has written influentially on the thought of Alexander Solzhenitsyn, explains why Pipes neglects the ideological factor in the dreadful history of the “evil empire.” This is among the many lively arguments engaged in the May issue of First Things . Isn’t it time for you to subscribe to First Things ?

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