COMMENTARY : Vote Shows That Euthanasia Debate Will Go On

Initiative 119, a proposed measure in Washington state that would have legalized physician-assisted suicide, was defeated Tuesday, but the close vote is clear evidence that the debate will go on. Sensitive issues, once concealed in hushed conversations, but now asked aloud and with immense social fallout, remain.

Proponents of permitting physicians to help terminally ill patients die will continue their campaign, and many Americans are likely to remain ambivalent about how to act or where to stand.

Some view the issues as clear-cut. Publicity surrounding “Final Exit,” Derek Humphry’s recently published suicide manual, or Dr. Jack Kevorkian’s efforts to help people die with a lethal-injection device, has focused sentiment on a key reality: Some people with terminal, debilitating illnesses prefer death to painful or even humiliating alternatives.

Confounding matters, religious consensus is crumbling. Liberal and mainline Protestant denominations appear to increasingly accept euthanasia. For example, the United Church of Christ and Unitarian Universalist Assn. have affirmed the right of terminally ill Christians to choose death over life. Also, the Pacific Northwest Conference of the United Methodist Church backed Initiative 119, although the national denomination has yet to take a stand on euthanasia.

The trend toward acceptance stands in bold relief to traditional religious prohibitions. Most churches accept the right of the terminally ill to forgo treatments that are excessively burdensome. But much religious teaching, including that of the Roman Catholic Church, regards euthanasia as a form of murder.

Meanwhile, as churches examine theological traditions and revise doctrines, many believers, caught up in a highly emotional public debate, are simply confused. The sensitivity of the issues, compounded by arguments that aiding death is prompted by compassion, has a tendency to paralyze opponents. The same is true of accusations of religious intolerance, a favorite weapon of those who favor change.

Believers should not be intimidated by such accusations, for they have an important role to play in the debate. Traditional political wisdom in America has at times accommodated groups or individuals whose religious convictions prevent their compliance with public policy. The right of conscientious objectors to avoid military service is one example.

At the same time, public institutions have at times acted in good faith to override religious convictions. For example, a Boston judge last year convicted two Christian Scientists of manslaughter after their 2-year-old son died because he was denied medical treatment on religious grounds. The judge further demanded that the parents, who were given probation, take their other children to physicians for regular medical checkups.

Here lies the rub. Most would agree that the public has an interest in supplying humane care for people who are terminally ill or have diseases that leave them with the prospect of losing mental faculties. Most states, seeking to empower patients to direct their future care, recognize living wills or health care proxies.

But in the case of euthanasia, serious doubt remains whether enough attention has been given to alternatives, such as pain management and less aggressive high-tech care. Moreover, when courts override religious conviction, as in the Boston case, they are usually convinced that morality is clearly on their side.

The public moral debate on euthanasia has yet to happen. To assume that it has occurred, or worse, to cut it short, would be a serious mistake. The burden of proof that the practice is licit rests on those who wish to change tradition.

Those persuaded on religious grounds that physician-assisted suicide is wrong can take comfort in the fact that non-religious arguments support their claims. Since the time of Hippocrates, physicians have sworn to never administer a deadly drug, an oath founded in large part on a physician’s obligation to heal and not kill. Many reasonable people worry that if aid in dying becomes legal, its use might become abuse. They also worry that terminally ill people will feel compelled to opt for such aid.

Those who object to euthanasia on religious grounds need not be intimidated by those who accuse them of intolerance. Religious people have at least as much standing in American society as any other group to demand that objectionable social practices be avoided until underlying issues are addressed and alternatives are exhausted.

Believers inclined to caution can take comfort in knowing that the weight of political tradition is on their side.