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A Pro Life Primer on Euthanasia

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1A Pro Life Primer on Euthanasia Empty A Pro Life Primer on Euthanasia Tue Apr 14, 2009 12:31 am

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A Pro-Life Primer on Euthanasia
by Eileen Doyle, R.N.
Released October 5, 2005

Definitions and Examples

The definition of euthanasia is simple: "Easy, painless death." But the concept of euthanasia proposed by adherents of the euthanasia movement is complex and has profound consequences for all.

Because the subject involves the discipline of medicine (diagnosis, treatment, prognosis, medical ethics and so on) as well as the discipline of law, the general public will have difficulty understanding it without some knowledge of these matters.

The purpose of this study is to inform our readers clearly and coherently enough that they can make sense of the euthanasia question.

We begin with the definition of terms.

Definition of Terms

* Euthanasia: traditionally, an easy, painless death. Now used to mean "mercy killing," "assisted suicide," or "involuntary euthanasia."

* Voluntary euthanasia: death administered to one who asks for it. In practice, truly voluntary euthanasia requests may be very rare, since the patient rarely gives informed consent because the alleged consent is influenced by depression, improperly treated pain or other factors that are not controlled but could be controlled.

* Involuntary euthanasia: death administered without the recipient's consent, commonly known as "mercy killing," as in the case of children or incompetent adults.

* Active, direct or positive euthanasia: direct killing of the patient by administering lethal drugs or other direct means of ending life, or by withholding or withdrawing ordinary means of sustaining life such as food and water, protection from exposure and so on.

* Passive, indirect or negative euthanasia: ambiguous. Can be the decision by patient, parent or guardian and physician to withhold or withdraw extraordinary means of sustaining or prolonging life, such as deciding against high-risk surgery for a patient dying of cancer or kidney failure. When the intent is not to cause death but rather to reject extraordinary treatment, this results in the acceptance of death or continued life, whichever occurs, but it is not true euthanasia. The terms "passive," "indirect" or "negative euthanasia" should not be used since they play into the hands of euthanasia advocates by confusing legitimate actions with euthanasia, thereby desensitizing people to the fact that euthanasia is killing.

More importantly, passive euthanasia is sometimes defined by others as the withholding of lifesaving treatment with the intention and result of causing the patient's death. This is the equivalent to active, direct euthanasia.

* Ordinary means: food, drink, rest, medicines, treatments and operations which offer a reasonable hope of benefit for the patient and which can be obtained and used without excessive expense, pain or other inconvenience.

* Extraordinary means: those treatments, medicines and operations which are gravely burdensome to the patient, and which cannot be obtained or used without excessive expense, pain or other inconvenience or which, if used, would not offer a reasonable hope of benefit to the patient. A court recently has defined extraordinary means to include food and has ordered the removing of food from a patient for the purpose of killing the patient.



Last edited by Admin on Tue Apr 14, 2009 12:51 am; edited 1 time in total

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The Position of Medicine, Theology and Law on Euthanasia

Active, direct or positive euthanasia is forbidden by law, and by most doctors and theologians. Under the common law it is murder or manslaughter in English-speaking countries, regardless of compassionate motives or consent of the victim.

To withhold or withdraw ordinary means of sustaining life is equivalent to direct or active euthanasia. Thus this is direct killing and consequently should be forbidden by medicine, theology and law. Killing patients by withdrawing food and fluids has been advocated by some theologians, physicians and courts.

To withhold or withdraw extraordinary means of sustaining life is not forbidden as such by medicine, theology or law.

When it is necessary for the comfort of the dying patient to give drugs to alleviate pain even though they may indirectly shorten his life or deprive him of the use of reason, it is neither active euthanasia nor is it forbidden by medicine, theology or law. Proper use of painkillers can relieve pain without destroying reasoning power.

3A Pro Life Primer on Euthanasia Empty Suicide Tue Apr 14, 2009 12:37 am

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Suicide

Suicide is the act and intent of a person to cause death to himself by direct killing (such as by lethal drug) or by withholding or withdrawing ordinary means (self-starvation).

The following is based on a legal analysis of suicide by Robert M. Byrn, professor of law at Fordham University School of Law, in an article, "Compulsory Lifesaving Treatment for the Competent Adult," Fordham Law Review, Volume 44, October 1, 1975.

Suicide had at one time been a crime with a penalty of "ignominious burial" and forfeiture of property. In the U.S. this penalty was abolished so that suicide is no longer strictly speaking a crime. But that does not make it lawful "in the sense that a right has been conferred."

Professor Byrn cites a 16th-century judge's legal objections to suicide:

1. It is an unnatural violation of the rules of self-preservation, because a "right" to suicide is the "apparent contradiction in a claim of right to destroy the life from which all rights flow."

2. It is a breach of (God's) commandment, "Thou shalt not kill." In modern law, "the value of human life qua human" means that killing oneself shows disvalue for human life qua human. This constitutes aggression against life, and treats life as property rather than unalienable.

3. Suicide is "against the King," depriving him of a subject, "transformed in American law to an inherent function of government to protect human life and not allow its destruction by legally permitting self-destruction.

4. It is an "evil example" to the King's subjects. So modern government "retains the power to bar conduct which will encourage suicide as an 'evil example' to other susceptible members of society."

Attempted suicide - in some states a crime but not punished.

Aiding and abetting a suicide or a suicide attempt - in many states a crime.

Preventing another from committing suicide (or from inflicting serious harm to himself) by the use of reasonable force - legal in many states.

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Patient's Rights and Medical Care

Professor Byrn, in the previously cited article, also gave a summary of the relevant legal decisions concerning patients' rights to refuse medical care.

Legally Competent Adult Patients

Medical care per se - according to Anglo-American law every competent adult has the freedom to seek or not to seek medical care and to refuse to consent to any specific treatment proposed, under the common law right of bodily integrity and intangibility.


Lifesaving Medical Care

1. Competent adults may reject even lifesaving care under the right of bodily integrity and intangibility and also, if applicable, under the constitutional right of free exercise of religion (e.g., a Jehovah's Witness refusing a blood transfusion because it is against his religious beliefs).

2. They may not refuse lifesaving care if there is a compelling state interest in requiring treatment for the common good (e.g., immunization to prevent the spread of communicable disease).

3. A parent might be required to undergo lifesaving treatment if there is a compelling state interest in protecting the welfare of a child from being deprived of his needed caretaker.

4. Suicide attempts which result in life-threatening injuries may require lifesaving treatment which is given without requiring the patient's consent.

5. Rejection of lifesaving medical care is not legally equivalent to suicide because in those cases decided by the court none of the patients had a specific intent to cause his own death, but simply to accept the consequences of the life-threatening illness, "to let nature take its course" rather than undergo the burden of treatment.

Legally Incompetent Patients

These are patients who lack the ability to make legal choices, so that no right to refuse consent is involved. Therefore court-ordered life-saving treatment is not a subordination of patient choice. The court will usually order lifesaving or ordinary care, but treatment that is extraordinary is not required.

5A Pro Life Primer on Euthanasia Empty Minor Children Tue Apr 14, 2009 12:41 am

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Minor Children

Prof. John A. Robertson, of the Wisconsin University Law School, wrote an article on medical care for children ("Involuntary Euthanasia of Defective Newborns - A Legal Analysis," Stanford Law Review, Vol. 27, 1975). He stated:

"Under traditional principles of criminal law the omission of ordinary care by parents, physicians and nurses creates criminal liability. The crimes committed may include murder, involuntary manslaughter, conspiracy and child abuse or neglect.

"Generally a person is criminally liable for homicide by omission if: 1) He has a legal duty to protect another; 2) with knowledge or gross negligence he fails to act; 3) and such failure proximately causes the death of the other.

"The pervasive practice of withholding ordinary medical care from defective newborns demonstrates we have embarked on a widespread program of involuntary euthanasia."

6A Pro Life Primer on Euthanasia Empty Case Studies Tue Apr 14, 2009 12:45 am

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Case Studies

Discussion of the following cases is concerned only with whether or not the decisions are legal or illegal and not with their moral implications.

Determine whether the cases involve ordinary care or extraordinary care, and whether the decisions given would be legal or illegal:

1. An infant is born with Down's syndrome, indicating probable mental retardation. He needs very low-risk surgery for an easily correctible intestinal defect. If untreated the baby will not be able to retain food and will die. The parents refuse surgery, stating that the mental retardation will mean a less than meaningful life for the baby.

Answer: This case involves ordinary care; illegal decision: Parents may not refuse ordinary care; the refusal of surgery would result in the proximate cause of death for the child they have a legal duty to protect. Courts, however, usually have ruled in favor of parents' refusal.

2. A seven-year-old girl, auto-accident victim with severe internal bleeding, needs an immediate blood transfusion to prevent death. Her parents refuse consent because blood transfusions are forbidden by their religion (Jehovah's Witnesses).

Answer: This case involves ordinary care; illegal decision: Parents may not invoke their right to free exercise of religion to refuse lifesaving care for their child, for that would be a violation of the child's unalienable right to life, which takes precedence over all other fundamental rights.

3. A baby is born with anencephaly (part or most of the brain matter absent), with a prognosis of living only a few weeks or months. A decision is made to withhold all nourishment by mouth or other means.

Answer: Ordinary care; illegal decision: Ordinary care is mandatory for all patients regardless of prognosis. However, in practice, many children like this are starved.

4. A 55-year-old man with severe circulatory problems has gangrene of the leg. Amputation is necessary to save his life. The man refuses consent.

Answer: Ordinary care - with qualifications. This is one of those difficult cases which could be classified as extraordinary care if it would involve great psychological harm to the patient to be deprived of his leg. Morally he might feel free to refuse surgery but legally it would probably be ordinary care which would be lifesaving, the usual course of treatment for gangrene and of minimal risk.

Legal decision - competent adults have the legal right to refuse treatment under the right of bodily integrity and intangibility. It would not be classified as suicide since the patient did not have the intent to cause his own death, but did not want the consequences of loss of limb resulting from surgery.

5. A 50-year-old woman is dying of cancer. She has only a few days to live. She has severe anemia due to the cancer. Even though a blood transfusion is the usual treatment for severe anemia, the decision is made not to give it.

Answer: Extraordinary care - this is an example of a treatment that is ordinary care in most instances but becomes extraordinary care due to the circumstances of the particular case. The transfusion would not be effective against the advanced cancer and would be burdensome to the patient.

Legal decision - extraordinary care is not obligatory.

6. An 87-year-old incompetent woman with congestive heart and kidney failure has primary cancer of the intestine. Surgery is the usual treatment for such cancer but the family and doctor decide against it.

Answer: Extraordinary care - because of the advanced age and serious medical condition of the patient the surgery that might be considered ordinary care becomes extraordinary care because of its high risk under these circumstances.

Legal decision - extraordinary care is not obligatory.

7. A 45-year-old man has a bleeding ulcer for which he needs a blood transfusion. He refuses treatment because of religious beliefs which forbid transfusions of blood.

Answer: Ordinary care; legal decision - competent adults have the right to refuse even lifesaving treatment involving ordinary care under the right of bodily integrity and intangibility. In addition, this patient also had the right to refuse under the free exercise of religious right.

8. A baby is born with spina bifida (open spine with spinal cord exposed) and hydrocephalus (excessive fluid surrounding the brain). Immediate surgery is necessary to close the exposed spinal cord to prevent dangerous infection that could cause death, and to install a shunt to drain the excess fluid in the brain to prevent brain damage. The parents refuse consent because the child may be physically handicapped, involving hardship for the child and parents.

Answer: Ordinary care - because of the recent advances in spina bifida surgery and medical care, what had been high-risk surgery at one time is no longer so risky.

The Spina Bifida Association of America filed an amicus curiae brief to the New York State Court of Appeals Oct. 28, 1983, in the Infant Jane Doe case. The brief states, "Nearly all patients who receive prompt and proper treatment now survive . . . have normal lifespans. . . . Left untreated, many die or live with greatly impaired futures, facing physical disabilities far more severe than they would have experienced with proper treatment and mental disabilities [which] proper treatment would have spared them altogether."

Illegal decision - because the surgery involves ordinary care.

9. A baby is born with the same condition as above, spina bifida, but in addition the baby has no kidneys, a rare and fatal condition for which there is no treatment. No surgery was done for the spina bifida.

Answer: Extraordinary care - ordinary care (surgery for spina bifida) becomes extraordinary care because the fatal kidney condition makes surgery useless. The baby will die regardless of treatment.

Legal decision - useless treatment not required.

10. 5-year-old man stabs himself in the chest in a suicide attempt. Emergency chest surgery is needed to save his life. The man refuses consent.

Answer: Ordinary care; illegal decision - even though he is a competent adult, surgery to treat his injuries may be done without his consent because they were incurred as a result of a suicide attempt.

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The Euthanasia Movement and Its Goals The Position of the Euthanasia Movement

The Euthanasia Society of America was formed in 1938 with the aim of proposing legislation to allow active voluntary euthanasia. Three past presidents and one treasurer also favored involuntary, active euthanasia, according to Yale Kamisar in Euthanasia and the Right to Death.

In 1967 the society's name was changed to the Euthanasia Educational Council and it officially supported voluntary, passive euthanasia. Many of its members, however, were in favor of active euthanasia.

Dr. Joseph Fletcher, on the advisory council of the Euthanasia Educational Council, advocated in the Atlantic Monthly (April 1968) that a parent has the right to choose active, involuntary euthanasia for his child who has Down's syndrome.

The Euthanasia Educational Council held a series of conferences since 1968 with publications of the proceedings showing advocacy for not only active, voluntary euthanasia but also for active, involuntary euthanasia if society were ready to accept it.

In Attitudes Toward Euthanasia, a publication of the Third Euthanasia Conference (1970), Dr. Marvin Kohl, Ph.D., said, "In some situations, especially in certain cases of euthanasia, morality demands the killing of the innocent" (p. 6).

And Dr. Joseph Fletcher remarked that he welcomed the fact that Judge Russell Frankel of the N.Y. Federal District Court and others had adopted this statement for public use, "We should make a study of whether suicide and other laws can be modified to enable victims of terminal illnesses to avoid the unwelcome prolongation of life with assistance and without penalty" (p. 11).

The Rev. M. McKinney, former president of the Euthanasia Educational Council, spoke in 1971 at the Fourth Euthanasia Conference, and his remarks were published in Dilemmas of Euthanasia: "When the society began its work some 30 or 40 years ago, the primary thrust was . . . to try to get laws passed allowing voluntary euthanasia . . . our board came to the conclusion that it was a mistake to try to push for legislation and that the educational task before us was enormous" (page 31).

At that same conference a doctor thought it wrong to keep alive a grossly retarded child because it would harm parents and family. Commenting on the idea of euthanasia for children, Dr. Joseph Fletcher stated, "In terms of educational strategy . . . we use tactics of emotional gradation. If . . . in old age it is less tragic than in youth, we begin with that . . . Then we can begin to apply them to more difficult ages emotionally."

On the same point Dr. Ruth Russell thought euthanasia for children ought to be legalized.

In 1978 the Euthanasia Educational Council's newsletter, Euthanasia News (Winter 1978), quoted the current views of Dr. Fletcher, president emeritus of the Euthanasia Society of America, renamed the Society for the Right to Die. He admitted that the need for euthanasia because of unbearable pain was now invalid because of modern analgesia, but the new emphasis was respect for the dignity of patients and concern for their loss of personal qualities even if they had no pain. He favored a change in the law to allow active euthanasia.

In his book, Humanhood: Essays in Biomedical Ethics (Prometheus Books, 1979), Dr. Fletcher advocated "a new ethical concept centered on the quality of life to replace the old ethics based on the sanctity of life." He asserted that in some cases active euthanasia is a "moral obligation."

In November 1978 the Euthanasia Educational Council, formerly part of the Euthanasia Society to America, changed its name to Concern for Dying. But the goals had not changed!

The executive director, Mrs. A.J. Rock Levinson, stated in a letter that "our people believe rational suicide to be acceptable but that to foist our ideas too strongly and too soon on a society not yet ready to consider them, we will damage, if not destroy our effectiveness" (Euthanasia News, March 1978).

8A Pro Life Primer on Euthanasia Empty Strategy Tue Apr 14, 2009 12:48 am

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Strategy

Since the euthanasia movement's goal is to legalize active, voluntary and, in some cases, involuntary euthanasia, what has to be legalized is what cannot be legalized! That is, we cannot legalize the killing of people who are innocent of unjust aggression against other's lives.

Under our system of law, which must abide by the Constitution, laws permitting the killing of innocent citizens would be clear violations of the Fifth and Fourteenth Amendments of the Constitution and therefore invalid. This point is crucial! It demonstrates that the only way euthanasia could be legalized is by a court decision, not by a statute.

Even more important, killing the innocent, regardless of motive, is a violation of our most cherished principles as a people, embodied in the concept of unalienable rights - to life, liberty and the pursuit of happiness.

This sanctity-of-life ethic, as it is called, while rapidly eroding among elites in the academic, medical and legal spheres, is still held in high esteem by millions of ordinary American citizens who would be outraged to find it swept away and replaced by a new, "enlightened" quality-of-life ethic, conceived and orchestrated by those same elites.

Euthanasia advocates are well aware of these formidable obstacles, so they must devise a strategy which will overcome them. By analyzing their tactics and programs, a definite strategy becomes clear:

1. They are asserting that there is a constitutional right to die and have geared their educational programs to the general public, professional groups in medicine, theology, nursing and law to persuade people to accept this concept.

2. They propose to redefine legal personhood and replace the sanctity-of-life ethic with the quality-of-life ethic.

3. They discuss "hard cases" and blur the crucial distinction between cases involving ordinary care (legally mandatory) and extraordinary care (not legally required). Recall that the definition of active, direct or positive euthanasia includes the withholding or withdrawal of ordinary care!

9A Pro Life Primer on Euthanasia Empty Analysis of the Strategic Concepts Tue Apr 14, 2009 12:50 am

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Analysis of the Strategic Concepts

We will examine first the idea of a constitutional right to die, and all that that implies, and then we will turn to consideration of redefining legal personhood, coupled with the establishment of the quality-of-life ethic.

The constitutional right to die: In order to legalize euthanasia, a way must be found to circumvent the Fifth and Fourteenth Amendments to the Constitution, which protect the lives of innocent persons, since society is not about to repeal those amendments.

So euthanasia proponents propose a new, additional unalienable right - a "right to die." This way people can choose to forfeit their right to life in favor of their right to die.

This right, they say, could find precedent in the constitutionally protected right of privacy granted by the Supreme Court abortion decisions of 1973 (Roe v. Wade, 410 U.S. 113, and Doe v. Bolton, 410 U.S. 179). The Court could simply extend that right to include decisions about dying.

In the publication of the Fourth Euthanasia Conference, Dilemmas of Euthanasia, Prof. Cyril Means acknowledged the legal problems posed by euthanasia and proposed a method of winning through the court for someone "who is conscious but suffering from an incurable malady" under the Eighth Amendment, which forbids the state to impose cruel and unusual punishment.

Therefore the state could not forbid a patient to take "measures to alleviate his suffering even by shortening or terminating his own life." If the patient is unconscious, a guardian or committee could be appointed on his behalf.

In response to comments that there should be a test case in the Supreme Court and the idea that the right to die entailed a "claim on other people to help us die," Professor Means, as a law professor, gave his opinion that "we have a system of constitutional adjudication whereby people can assert rights as against the state or as against their professional aides like doctors and others. Consequently, if one makes a claim of such a constitutional right and gets it before a court and the court says, 'you have got it,' you can have it without legislation. In every other country . . . you would have to get through legislation" (p. 36).

Persuading much of society to accept the idea of a right to die has been relatively easy, especially with all the help of the media publicizing the phrase "right to die."

Propaganda began in the late 1960s and early 1970s at euthanasia conferences and in the media and with the introduction of right- to-die or living-will legislation in state legislatures. By 1978 the Euthanasia Society had changed its name to the Society for the Right to Die, announcing plans to get right-to-die legislation passed in as many states as possible and, by 1981, reporting success in 11 states. The Society for the Right to Die again changed its name to Choice in Dying, its current name in 1992.

Right-to-die or living-will legislation: This merits further discussion, since these bills are being promoted vigorously in many state legislatures as part of the euthanasia strategy.

The short-term purpose, seemingly innocuous, is to have states legalize living-will documents. These documents were conceived by the Euthanasia Society in 1967. In them the person states, "If there is no reasonable expectation of my recovery from extreme mental or physical disability, I direct that I be allowed to die and not be kept alive by medications, artificial means or heroic measures."

10A Pro Life Primer on Euthanasia Empty Analysis of the Strategic Concepts Tue Apr 14, 2009 12:53 am

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Objections to right-to-die or living-will legislation:

1. Legally, patients already have the right, under the common law right of bodily integrity and intangibility, to refuse extraordinary care, which is at issue in this type of legislation.

2. Physicians may feel constrained by the legal limitations of these documents and discontinue treatment too soon. Inevitably, some patients will die who might have recovered.

3. If living wills are legalized, then physicians of patients who have not signed them might assume that patients want maximum treatment and refuse to discontinue inappropriate treatment, thereby causing excessive hardship and expense for patient and family.

4. Living-will documents are signed before, often long before, the circumstances of a particular illness occur. Therefore it is doubtful that they fulfill the legal requirements of informed consent as stated in the federal guidelines, which require that "a patient must be given . . . a detailed explanation of the procedures, benefits and alternative procedures connected with his treatment . . ."

The patient may not sign a consent document waiving his legal rights or releasing an institution or agent from liability for negligence (R. Hummel, Hospital Progress, June 1976, p. 55).

5. The terminology is so broad and, in some cases, so vague it becomes medically and legally ambiguous. It is virtually impossible to write a bill comprehensive enough to cover the special circumstances of each patient's medical condition, which would be essential for the practice of good medicine and good law.

6. Some groups such as the elderly, the immature or the indigent might be unduly pressured, because they do not want to be a "burden," to cut down on the increasingly higher medical costs for treatment.

7. The terminology in some of the bills is so ambiguous it could be construed to allow withholding ordinary care. For example, "artificial means" might be interpreted to exclude the use of tube feedings for patients unable to take food by mouth, thus denying a patient all nourishment.

All of the living-will type of legislation is geared to blur the distinction between ordinary and extraordinary care.

The long-term purpose of right-to-die or living-will legislation is the great propaganda value in conditioning people, state by state, to accept that they have a "right to die."

However, the goals of active voluntary and involuntary euthanasia cannot be achieved by such legislation since direct killing or the withholding of ordinary care are not permitted and any attempt to pass such laws would quickly bring a challenge in the courts, which is where the euthanasia advocates plan and hope to win all their goals.

It would be the Supreme Court which would ultimately have to decide: Do we or do we not have a constitutional right to die? The implications are awesome and will be dealt with subsequently in our study of the question. Fortunately, in Cruzan v. Harmon, 110 S. Ct. 2841 (1990), the U.S. Supreme Court decided that the U.S. Constitution does not include a "right to die."

Redefine "legal person" and replace the sanctity-of-life ethic with the quality-of-life ethic: Under the Constitution, all innocent persons are guaranteed the protection of their lives. The dictionary defines "person" as "a human being" and defines a human being as "a person." The U.S. Constitution gives rights not to human beings, but rather to persons. Title I U.S. Code Section 1 defines "person" to include individuals. The 1947-1948 U.S. Congress first enacted the definition of "person" without making it clear that every human being or individual is a person. After a few months' exposure to publicity from the Nazi War Crimes trials Congress realized that the method the Nazis used to justify the holocaust was to define Jews and other unwanted humans as non-persons. Defining them as non-persons took away all their rights and protections. The same Congress that had passed Title I U.S. Code Section 1 a few months before then changed Title I U.S. Code Section 1 to make certain that every human being had to be defined as a person by defining every individual to be a person. Euthanasia adherents propose that we redefine "person" to exclude some classes of human beings; that human beings must pass certain tests before being declared persons who have unalienable rights.

Daniel Callahan (not in favor of euthanasia) in Abortion: Law, Choice and Morality defines "person" as "one who is capable of rationality, interaction with others, affectivity and culture making."

Joseph Fletcher, a leading euthanasia advocate, gave his version of "person" in Attitudes Toward Euthanasia: "Something that has to be answered in terms of cerebration, memory, sense of futurity, some evident clinical capacity for interpersonal relationships, will or purpose; lovingness . . . a minimum I.Q.; utilitarian questions about social productivity and its potential . . ."

The argument goes that those human beings who fail to qualify as persons under this new definition can then be legally denied unalienable rights, so to kill them would then not be a violation of law.

This is precisely what the Supreme Court abortion decisions of 1973 ruled concerning all human beings before birth, declaring they were not persons because they were not "capable of meaningful life" and were "not persons in the whole sense." Thus they were deprived of their unalienable right to life and it became legal to kill them.

Euthanasia advocates argue that other classes of human beings could be declared non-persons, without unalienable rights, in order for them to be killed legally. The abortion decisions could be used as precedent.

In The Right to Die with Dignity, publication of the First Euthanasia Conference (1968), Dr. Henry Pitney Van Dusen said the term "life" meant "the total personal being - body, mind and spirit."

Florence Clothier argued for "death of the body for those whose central nervous system and mind are already dead . . . these once men and women."

Chaplain Robert Reeves argued that when illness caused someone to lose his freedom, integrity and dignity, then his personhood was gone and we should find a way to give him "an honorable exit from life."

In Dilemmas of Euthanasia (publication of the Fourth Euthanasia Conference), Prof. Cyril Means, euthanasia movement leader (also pro-abortion leader in the Supreme Court abortion cases), said, "What is sacred and what the law seeks to protect is not human life itself, but the human person."

Dr. Joseph Fletcher argued that a new ethical concept based on the quality of life must replace the old ethics based on the sanctity of life, in Humanhood: Essays in Biomedical Ethics (Prometheus Books, 1979).

Definition-of-death bills: These pieces of legislation define death as a "total cessation of all brain function" and are supported by euthanasia advocates as part of their strategy of redefining personhood.

William J. Curran, J.D., refers to "brain death - a form of irreversible coma, which is a quality-of-life standard" (New England Journal of Medicine, February 2, 1984, p. 298).

Willard Gaylin wrote in Harper's Magazine in September, 1974: "The problem [of euthanasia] is well on its way to being resolved by what must have seemed a relatively simple and ingenious method. As it turned out, the difficult issues of euthanasia could be evaded by redefining death."

Arguments against definition-of-death bills: Paul A. Byrne, M.D., and Paul M. Quay, S.J., Ph.D., presented many arguments against brain-related criteria for death, including the following: "Cessation of total brain function, whether irreversible or not, is not necessarily linked to destruction of the brain or to the death of the person" (JAMA, 242: 1985-1990, 1979; and Understanding Brain Death, Nebraska Coalition for Life Educational Trust Fund).

Irreversible cessation of breathing was, at one time, a sign of death but when it was discovered that non-functioning of the respiratory organs did not always mean the destruction of the organs, it led to the use of mechanical ventilators or respirators to take over the lost function. This saved many lives.

So, too, with heart functioning; when it was found that cessation of heartbeat did not mean the destruction of the heart, mechanical means of resuscitation of heart functioning were contrived.

Drs. Byrne and Quay cited the work of P. Safer ("On Evolution of Brain Resuscitation," Critical Care Medicine, 1978, pp. 199-202) on successful brain resuscitation in cases where both brain-related criteria and the older, generally accepted criteria would have declared that death had occurred.

The authors spoke of the "recoveries of all those who have shown for many hours, or even days, no discernible brain function as a result of various depressant poisons or of hypothermia."

They later stated that "almost all sets of criteria depend for their reliability on the absence of drugs (and a number of other medical conditions) that can mimic death by suspending brain activity for lengthy periods."

Yet several of the greatest experts in this field (who themselves accept the notion of "brain death") state that it is often impossible to find out whether such drugs or other conditions are present or absent.

They further state that there are more than 30 different sets of medical criteria to determine irreversible cessation of brain function, and that "one out of every 12 patients declared dead by the various criteria strongly urged upon state legislatures and courts, still shows non-random function of the cortex of the brain, the part where sensation, feeling and consciousness seem to reside."

Dr. Byrne, Father Quay and attorney Peter Salsich have, in an in-depth article in the Gonzaga Law Review, presented reasoning as to why it is necessary to pass a statute worded as follows: "No one shall be declared dead unless the respiratory and circulatory systems and the entire brain have been destroyed. Such destruction shall be determined in accord with universally accepted medical standards." The Gonzaga Law Review article is "Brain Death - the Patient, the Physician, and Society" (18: 3, 1982/83, pp. 429-516). A reprint is available from American Life League.

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Arguments Against Euthanasia

Some Arguments Against Voluntary Active Euthanasia

Germain Grisez and Joseph M. Boyle, Jr., authors of Life and Death with Liberty and Justice (University of Notre Dame Press, 1979, pp. 149-170), offered the following objections to legalizing voluntary active euthanasia:

1. Patients will have to be told the full extent of the pain, suffering and hopelessness of their medical condition all at once rather than in gradual, tolerable stages, in order to safeguard the legal requirements of informed consent needed for truly voluntary euthanasia.

2. Patients not wanting euthanasia would inevitably hear about their dreadful prognosis from other patients with similar medical conditions, relatives and so on, and have to bear the burden of such unwanted information.

3. It will cause conflict for people who are morally opposed to euthanasia but who might be tempted to accept it anyway to avoid the burden of suffering. This will add a second burden of feeling guilty for having violated their consciences.

4. Patients may be tempted to choose euthanasia from altruistic motives, even though morally or otherwise opposed, so as not to be a "burden" or from a feeling of guilt for using scarce medical and economic resources.

5. No matter what the safeguards, patients not wanting euthanasia may become anxious that they will be included as victims.

Very sick or debilitated people in hospitals or nursing homes are often confused, anxious and not too reasonable. Emotional regression is common. Just knowing that people around them are being killed could arouse in them tremendous apprehension that all the reassurance in the world will not ease.

6. The family or loved ones of a patient choosing euthanasia may find it morally repugnant (as with suicide) and suffer much more grief than if it were a natural death.

Most of the objections concern the harmful effects of legalizing euthanasia on those who are opposed to euthanasia. Grisez and Boyle argued, "From the point of view of sound jurisprudence, the self-interest of the opponents of euthanasia can no more be excluded from consideration than the self-interest of its proponents." They stated that legalizing voluntary euthanasia would serve no public interest but only the personal, private interest of those demanding legalization.

The authors believe that the most decisive argument against legalization is the one based on the "jurisprudential principles of justice and liberty." The argument is as follows:

7. "If voluntary active euthanasia is legalized without regulation, those who do not wish to be killed are likely to become its unwilling victims; this would deny them the protection they presently enjoy of the law of homicide. And since the denial is to serve a private interest, it will be an injustice.

"If voluntary active euthanasia is legalized with close regulation, which will involve the government in killing, those who abhor such killing will be involved against their wishes, at least to the extent that the government and institutions will be utilized for this purpose.

"Since the government's involvement will be required only as a means to the promotion of a private interest, this state action will unjustly infringe the liberty of all who do not consent to mercy killing as a good to whose promotion state action might legitimately be directed.

"A solution involving a compromise between legalization of voluntary active euthanasia without regulation of the practice and legalization with close regulation, which will involve the government in mercy killing, would mean some degree of lessened protection together with some degree of government involvement, a situation which will result in injustice partly due to the reduced protection of the lives of those who do not wish to be killed and partly due to the unwilling involvement of those who do not wish to kill.

"Since the stated conditions are all the possible conditions under which voluntary active euthanasia could be legalized, legalization is impossible without injustice.

"Therefore, the legalization of voluntary active euthanasia must be excluded" (p. 153).

On these points, the authors further argued that "The public has a liberty to stand aloof from the killing of human beings. This consideration, together with the already well-argued point that even voluntary euthanasia cannot be legalized without undue danger or extensive public involvement, poses a very serious dilemma for proponents of legalization. . . . Nor will it do to say that the liberty of those who abhor mercy killing to stand aloof would only be slightly infringed by governmental involvement in this practice. Reading a few Bible verses each day in the public schools is only a little establishment of religion. But that little is too much for those who take conscientious objection to it" (pp. 169, 170).

8. The psychological burden of having to make such a decision rests on an already overburdened patient. Most of us find making major decisions very difficult. We are often filled with conflict, ambivalence and anxiety and would be over the enormous consequences of that choice.

If we were asked to choose regarding euthanasia, which conflicts with our instinct for self-preservation, the pain of having to choose could put an unbearable pressure on most people.

If we choose death, there is no undoing the choice and no way of knowing from experiences of others who have made that choice if it is a good one or a bad one, because those who have made it are no longer alive to advise us.

It is also relatively rare to find a patient with a fixed and enduring wish to die. What we claim we would do while in good health and under no threat is not an indicator at all.

Avery Weisman, M.D., of the department of psychiatry at Harvard Medical School, brought up this point in his book On Dying and Denying: "When healthy people are asked what they would do should they be found to have an incurable illness, many promptly declare they would commit suicide. Actually, evidence indicates suicide is rather infrequent among cancer patients. . . .

"The intention to take one's own life rather than submit to fatal illness is rarely implemented. . . . The option to destroy oneself is not an expression of freedom, but one of despair . . ." (pp. 25-38).

Elisabeth Kubler Ross, M.D., who has done extensive studies involving dying patients, stated in Attitudes Towards Euthanasia (publication of the Third Euthanasia Conference), "Our interviews have shown that all patients have kept a door open to continued existence and not one of them has at all times maintained that there is no wish to live at all."

9. Euthanasia portends harmful effects on good medical care. Alfred Jatetzki, M.D., associate professor of surgery at Columbia-Presbyterian Medical School, stated in Dilemmas of Euthanasia (publication of the Fourth Euthanasia Conference), that it was hard to be certain a patient was really dying in many cases.

He cautioned that many doctors have had patients whom they thought hopeless recover, and stated, "As the medical sciences progress, it becomes more and more of a problem . . .

"If we ... are thinking of ten patients who were put through a great ordeal and only one or two or three benefit from it, then this becomes a major moral issue. . . . The doctors cannot help but be influenced by maybe even those two or three . . ."

Lawrence V. Foye, M.D., in his statement before the Senate Special Committee on Aging, August 7, 1972 (as reported in the AARP News Bulletin, September 1972), expressed a similar concern:

"If a physician withholds maximum efforts from patients he considers hopelessly ill, he will unavoidably withhold maximum effort from the occasional patient who could have been saved." He reasoned that the only way to be sure a case is hopeless is to try all available therapies and find them of no avail.

Jonathan H. Pincus, M.D., associate professor of neurology at Yale University School of Medicine, declared in a New York Times letter on January 24, 1973, "Many patients who could have been allowed to die are alive and doing well because of some new advance in therapeutics which occurred during the course of their illness . . . when a doctor is considering possible therapeutic courses of action for his patient, homicide would not be among them!"

Another of his concerns was that fewer health care resources would be allocated to those considered "better off dead."

A Dr. Lebensohn spoke at the Third Euthanasia Conference, according to Attitudes Towards Euthanasia: "His [the physician's] mere presence in the room is a symbol of hope. . . . If he is associated in the mind of the patient or of the public with being also the terminator of life . . . there is going to be a great conflict, fear and distrust, similar to that which occurred in the time of Rome, where the poisoners were very prevalent."

10. There are the subtle but nonetheless powerful pressures exerted by those who are involved in the care of the hopelessly ill. If the patient decides to hang on to life rather than choose to be put to death, hard-pressed medical personnel and economically and emotionally exhausted families may become less tolerant of these "better-off-dead" patients.

Their feelings could be expressed in countless unspoken and even spoken ways, exerting pressure on the patient to choose death against his own real wishes or making him feel unloved and unwanted while he remains alive.

Perhaps those few who would truly choose euthanasia if it were legal might find a meaning in their suffering, knowing that a liberty for themselves is a liberty worth rejecting if it would cause great harm to many others.

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Arguments Against Non-Voluntary Active Euthanasia

Grisez and Boyle in Life and Death with Liberty and Justice moved the debate to non-voluntary active euthanasia. The basis of their argument against it is, as with voluntary euthanasia, that to legalize it would be a violation of the jurisprudential principles of justice and liberty.

The authors reasoned that even though euthanasia advocates attempt to show that Anglo-American legal conceptions of justice have religious roots, this point is irrelevant, since "they are an essential part of the consensus upon which the legitimacy of American government rests" (p. 217).

Further, the authors pointed out "that no advocate of euthanasia has challenged the requirement of equal protection of the laws. . . . The manner in which they argue for their proposals shows they are seeking to meet the requirement of equal protection of the laws with respect to the law of homicide" (p. 217).

Instead of denying equal protection, euthanasia advocates have three ways of arguing against applying the principle:

1. They assert that killing some human beings is a benefit to the ones killed rather than a harm, since their quality of life is so poor: life is no longer a good to be protected by the law.

2. They believe that even though some human beings may belong to the human species, they don't merit equal protection because they should not be legally classified as persons.

3. They argue that there is a compelling state interest sufficient to deny equal protection of the law to a certain class of people: those who are permanently dependent, institutionalized, not able to contribute to society and being cared for by public funds.

The compelling state interest they see there rests on the high public expense of the care of these people, which they say is sufficient to override the right of these unfortunates not to be killed.

They further claim that the state interest overrides the "liberty [of other citizens] to stand aloof" from killing.

Therefore, this class of dependent people should be killed to ease the economic burden and, it is further asserted, it would be less unjust to kill them than to let them die of neglect, as we do now.

(Richard Trubo gave examples of some institutions for the retarded spending less for food on each patient a day than a pet owner spends on his cat.)

Grisez and Boyle made the following points to refute this argument:

Killing these patients is not a necessity (that is, not the only way) to solve the problem of great economic costs. There are certainly alternatives short of the drastic one of killing the patients!

Even if the state ceased to pay for their care (a step certainly not advocated by any means), it would be no more unjust than killing them and would at least leave open the possibility that other private interests would provide the care.

Killing them would offer no hope at all. At the very least, the state, in refraining from killing them, is not violating its duty to provide equal protection of the law of homicide and has protected other citizens' liberty to remain aloof from killing.

The authors maintained, "Money is only a means, not a substantial public purpose in itself. The preamble to the Constitution of the U.S. mentions justice and liberty, public tranquility and the common defense, civil unity and the general welfare.

"It does not mention saving money . . . [Therefore] budgetary considerations as such never offer a compelling reason to override the liberty of citizens."

Euthanasia advocates claim that these dependent people make no contribution to society in return for the economic costs of their care. Grisez and Boyle questioned why the contribution is considered only in economic terms, rather than non-economic ones:

"The non-economic contribution of the helpless to society can be much more significant if it not merely generates psychological satisfactions but provides an occasion for exercising moral qualities of compassion and fairness."

They contended that the economic and the non-economic view each represent a particular worldview and asked, "Why should it be fair to impose one of these worldviews rather than the other upon helpless individuals? Equal protection of the law of homicide ought not to be modified to leave some class of individuals unprotected on the ground that on one or another worldview - perhaps even a widely held set of ideals and interests - such individuals contribute nothing" (pp. 228, 229).

If net burden to society is the criterion, the authors pointed out that "The wealthy consume tremendous amounts of scarce resources" and questioned whether they contribute sufficiently "to approximate the costs they impose on society."

Is a handicapped child or a millionaire a greater burden? The answer is purely subjective, depending on personal values or worldview. The rich and the powerful, of course, are in little danger of losing their right to equal protection.

It might also be argued there are numerous other classes of dependent citizens receiving enormous amounts of public funds: prisoners, those in drug or alcoholic abuse programs, people on Medicaid, Medicare and Social Security, welfare recipients, farmers receiving subsidies.

The list could go on and on. It is surely unfair discrimination to single out one group as candidates for killing because of a compelling state interest in saving funds.

13A Pro Life Primer on Euthanasia Empty It Used to Be Killing Tue Apr 14, 2009 1:00 am

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It Used to Be Killing

Changes in dictionary definitions reflect changed perceptions on the part of the dictionary makers as to how the public uses the word in question. Check the definitions for "euthanasia" below and ask yourself, "Have we really forgotten that euthanasia is killing?"

From a pre-1950 dictionary: "Mode or act of inducing death painlessly or as a relief from pain."

From Webster's Third International Unabridged Dictionary (1968): "1. An easy death or means of inducing one. 2. The act or practice of painlessly putting to death persons suffering from incurable conditions or diseases."

From Taber's Cyclopedic Medical Dictionary (1981): "1. Dying easily, quietly and painlessly. 2. The act of willfully ending life in individuals with an incurable disease." (References provided by Mrs. Mary Stone, Allentown, PA.)

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Should Voluntary Euthanasia Be Legalized?: Second Thoughts

The propaganda onslaught for legalizing voluntary euthanasia has been "sweet talking" the nation into believing that this is a beneficial private choice imposing no burdens or harm to others so why should those who wish it for themselves be denied the legal right to have it?

On the contrary, we argue that the legalization of voluntary euthanasia would impose enormous harmful consequences on the lives of many, including the person requesting it!

15A Pro Life Primer on Euthanasia Empty Harm to the Patient Requesting Euthanasia Tue Apr 14, 2009 1:02 am

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Harm to the Patient Requesting Euthanasia

1. It would rarely be a truly free choice. It would be very difficult to obtain valid informed consent. It is rare to find a patient with a fixed, rational, enduring wish to die. Fear of pain, rejection, loneliness and lowered self-esteem because of dependency are all variables that can influence the patient's wishes. As these needs are met the desire for death recedes.

If a patient is depressed or in pain, informed consent is not possible and the physician may not be able to assess depression in a patient he does not know well.

The result could be that a goodly number of patients would be killed who didn't really want it. Uncontrolled depression and pain are thought to be the two most frequent reasons why patients seek euthanasia. Both can be controlled so that the reason for seeking euthanasia vanishes.

2. Diagnoses and prognoses are not always accurate. Errors would lead to unnecessary deaths for some patients.

16A Pro Life Primer on Euthanasia Empty Harm to Others Tue Apr 14, 2009 1:03 am

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Harm to Others

1. There would be subtle pressure on other patients to request death to ease the burden on family and overworked doctors and nurses. There would be financial pressures, especially for the elderly, incurably ill or disabled. This might be in conflict with the patient's moral code and real desire to live, and could cause enormous suffering for the patient already burdened by his illness. If such a patient actually did sign for euthanasia it would be a totally invalid consent.

For patients morally opposed to euthanasia who courageously accept their difficult end, the temptation to take the easy way out of suffering could cause great conflict, weakening their resolve to do the right thing. With little support from society, this could impose an additional burden on their already overburdened lives.

Care and advances in treatment may deteriorate for those so-called "better off dead" patients who refuse the option to die.

2. Some families of patients choosing euthanasia will be morally opposed and angry at the patient for causing conflict. Or the family may feel they let the patient down in not meeting his needs for care and, just as in cases of suicide, feel guilt and anger directed against the patient. Death under such circumstances would hardly be the peaceful one promised by the death-with- dignity crowd.

3. Giving doctors the legal power to kill their patients gives them power that no human being should have. Killing an innocent human being, for whatever reason, can have terrible moral consequences for the killer. It is unfair to demand that the healer become the killer on request! And nurses are inevitably involved as parties to the killing. To be obligated to work in a profession contaminated by killing turns the hospital into a schizoid world of curing some and killing others.

There could be a loss of trust in their doctors by patients fearful of the healer/killer role. (In Holland elderly people are often afraid to go into the hospital, where doctors might kill them!)

Physicians and nurses might be required to participate in what is to them morally and ethically wrong.

17A Pro Life Primer on Euthanasia Empty Harm to Society Tue Apr 14, 2009 1:05 am

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Harm to Society

1. Voluntary euthanasia would soon lead to non-voluntary euthanasia. If legalized, voluntary euthanasia statutes would eventually be brought before the Supreme Court. The Court would have to decide that these laws are either a violation of the unalienable right to life or that there is an unalienable right to die. If it decides the former, then euthanasia could not be legalized, but if it decides the latter, then all people would have to be allowed the same constitutional right to die. Then guardians could demand this right for children and incompetent persons. State-appointed guardians could exercise the right for the mentally ill or mentally retarded who have no next of kin. Thus we have non-voluntary euthanasia. It would also extend to those who are not terminally ill, since the law may not discriminate but must be granted to all as a constitutional right. This would extend the killing on a massive scale, and would be very tempting as a solution to skyrocketing medical costs of federal and state budgets! But think of the moral cost of all this killing to our American society!

2. Granting a constitutional right to die as a fundamental right would so undermine the fundamental constitutional right to life that it would be virtually cancelled out as a guaranteed right. This would put the protection of all citizens' lives on very shaky legal ground. (Fortunately, in Cruzan v. Harmon, in 1990, the U.S. Supreme Court found that there is no right to die in the U.S. Constitution. The U.S. Supreme Court also found in Cruzan v. Harmon that a patient's medical care can be cut off pursuant to state law if the patient has previously expressed a wish that medical care be cut off under the existing circumstances, even if cutting off medical care would cause the death of the patient.)

3. Granting a private right serving no public interest and indeed causing so much harm to others and society would involve the government in sanctioning killing merely to serve the private interests of the few at the expense of the many whose liberty and life would be put at risk. Those who request that euthanasia be legalized may come to realize that it would be unfair to impose such harm on others merely to "benefit" the few.

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Consequences of the Euthanasia Movement's Goals

If the strategy of the euthanasia movement to legalize voluntary and non-voluntary euthanasia should be successful in securing a "constitutional right to die" or a "redefinition of personhood," what are the probable long-term consequences for American society?

Consequences of a Constitutional Right to Die

The Supreme Court abortion decisions granted women the right to abortion as a fundamental constitutional right under a "right to privacy." Such a right is disputed by many constitutional law scholars, but as long as the decision is not reversed it is operative and serves as a precedent.

A number of state court decisions have used this same right to privacy as a precedent to declare the right to die, or the refusal of medical care, to be a fundamental right under the right to privacy.

In a 1973 Pennsylvania case, a patient in a state mental institution refused surgery for cancer. The state court ruled in her favor: ". . . The right to privacy includes the right to die which the state should not interfere with . . ."

In reviewing the case, Prof. Robert Byrn questioned the "court's resort to the right of privacy" rather than the "traditional right of bodily self-determination which includes the right to refuse life-saving treatment in a non-emergency" (Byrn, Robert M., Fordham Law Review, October 1975.)

The New Jersey Supreme Court, in its Karen Quinlan decision, declared that the constitutional right to privacy "is broad enough to encompass a patient's decision to decline medical treatment under certain circumstances in much the same way as it is broad enough to encompass a woman's decision to terminate pregnancy. . . ."

The court cited as precedent the abortion decision of Roe v. Wade (Matter of Quinlan, 355, A2d at p. 663).

A Massachusetts state court in the Saikewicz case recognized that there was a constitutional right of privacy involved in decisions about medical care and that the non-competent patient had the same rights as the competent patient. The court allowed a mental patient's guardian to refuse chemotherapy for leukemia on his behalf (Superintendent of Belchertown State School v. Saikewicz, 370 NE2d 417).

A New York State Appellate Court, in a case involving a Brother Fox who was on a respirator and in a coma, ruled that this non- competent patient had a right to refuse treatment (the respirator). The ruling was based on the "constitutional right of privacy" cited by the Supreme Court abortion decisions and that non-competent patients have the same constitutional right of privacy as competent patients (Matter of Eichner v. Dillon, March 27, 1980).

Fundamental U.S. Constitutional Rights

U.S. Constitutional rights can be fundamental or non-fundamental. Fundamental rights cannot be restricted unless there is a compelling state interest. The U.S. Supreme Court will strictly scrutinize any restriction of a fundamental U.S. constitutional right. If a future U.S. Supreme Court holds that the right to die is a fundamental right, every state will have unrestricted euthanasia on demand, in spite of contrary state laws, in the same way every state had unrestricted abortion on demand after Roe v. Wade.

19A Pro Life Primer on Euthanasia Empty The Next Step / And Then, Death on Demand Tue Apr 14, 2009 1:09 am

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The Next Step

If an assisted-suicide initiative such as those in Washington in 1991 or California in 1992 or a similar law passes, euthanasia will be the law. Even if such a law does not pass, euthanasia advocates may use the courts to establish euthanasia by a scenario such as the following:

A case (probably initiated by euthanasia advocates) will be brought involving a terminally ill competent patient dying a slow, painful death without the aid of a respirator or other extraordinary medical care.

The patient will demand the right to exercise his alleged constitutional right to die, a right he cannot exercise because he lacks the means. A physician will offer to supply the means - a painless poison.

Having bestowed a right to die as a fundamental right, will the court now be able to deny this patient the means necessary to exercise that right?

A leading euthanasia advocate, law professor Cyril Means, spoke of a Supreme Court abortion case heard prior to Roe v. Wade in which an attorney argued that the woman had a right over her own body. Justice Blackmun countered that if this were accepted then the Court might also be compelled to hold unconstitutional all laws against suicide (Dilemmas of Euthanasia, a publication of the Euthanasia Council, December 4, 1971).

Grisez and Boyle, arguing as opponents of euthanasia in Life and Death with Liberty and Justice, nonetheless saw the logic in the argument that if the court is going to allow a consitutional right to die then there would be entitlement to means and "obviously active euthanasia must be permitted."

And Then, Death on Demand

If the right to die should come to encompass the right of the terminally ill to be killed on request, how does the court then argue against the right to die being exercised by those patients who may not be dying but who find their illness too great a burden?

Would it not be unfair discrimination and denial of

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