Treatment Concerns - Definitions / Living Wills / Palliative Care / Terminal or Excessive Sedation / Organ Donation / DCD or NHBD / Hospice / POLST / DNR

How the Culture of Death Was Brought to American Medicine

You may be dismayed that the United States Supreme Court refused in March 2005 to take the case of Terri Schiavo and wonder how this came to be.  As with the abortion movement, this right-to-die movement is based on a false philosophy of choice and is riddled with misinformation and confusion. 

LifeTree (www.lifetree.org/timeline.html) has researched the campaign which has been actively changing America’s view on hastening death in order to  inflict euthanasia on our land.  

The Supreme Court’s decision in March did not just happen. Much money and time paved the way. This campaign has spent hundreds of millions of dollars to change a society’s morality and public policies.  It involves several non-profits, think tanks, and university chairs.  It continues to reach young doctors, lawyers, nurses, as well as legislators and the general public. 

Mainstreaming the idea of hastening death by withdrawal of food and water is just one success of this end-of-life program.  

This research is in the form of a timeline at: http://www.lifetree.org/timeline.html.  The chronology, long as it is, is still only an overview (about 27 printed pages) which explores the many links to primary sources which have been gathered into this unique work.
   
A brief overview of this chronology follows: 

In retrospect, 1997 was a pivotal year.

The Supreme Court vote to let the Florida court ruling stand in the Schiavo case can be linked to another Supreme Court action in 1997.    Although at the time pro-lifers claimed victory, the Supreme Court’s decision in Vacco v Quill gave a major impetus to the right-to-die movement. 

 The Court held that states could make their own laws relating to the legality of physician assisted suicide.  More importantly, their reasoning relied on a distinction between physician assisted suicide (lethal overdose or injection) and withdrawing life sustaining treatment.   

Hindsight is sometimes 20-20, but earlier that same year, in an attempt to ensure that the federal budget would not subsidize physician assisted suicide in Oregon or elsewhere, Congress passed almost unanimously a bill to deny such funds.   BUT, in that bill were exceptions which impliedly approved (1) the withholding or withdrawing of life sustaining treatment and (2) the treatment of pain even if it hastens death as long as death was not intended.  

These 1997 events solidified the emergence of two distinct wings within the right-to-die movement – one was a more militant wing with Western origins including the Hemlock Society, Oregon Right to Die, Death With Dignity and Compassion in Dying (which promoted physician assisted suicide) and the other was a more nuanced wing whose periodic name changes have included Euthanasia Society of America, Choice in Dying, Partnership for Caring and Last Acts Partnership (which promoted (1) and (2) above).  

The more subtle wing seized upon a distinction between “active” and “passive”, and has been able to build its argument based on a misleading division between physician assisted suicide and the exceptions based on withdrawing treatment (including artificial nutrition and hydration) and pain treatment/palliative care.  

Since 1997, the distinction has played out without controversy in proposed state and federal legislation.  (See, for example, the NC bill to ban assisted suicide in 2003-04 (S145) and the Federal Pain Relief Promotion Act of 1999).   Several state statutes banning assisted suicide also protect within their exceptions activity advocated by this wing of the right-to-die movement.

The legacy of foundation money described in this chronology is that they have had great success in changing society to accept right-to-die ideas and policies.   Have you noticed that everyone in this more subtle right-to-die wing seems to be working from the same set of talking points today?   

·        Everyone should have a living will or advance directive to protect him from unnecessary medical treatment at the end of life.

·        Withholding/withdrawing food and water is a natural – and even pleasant—way to die, and is a perfectly ethical means of controlling the time of death.

·        The principle of double effect can be used even to justify terminal sedation.

[www.lifetree.org; N. Valko R.N., 21Feb05]