A Roe vs. Wade in Geriatrics
Old folks, especially those with the usual infirmities, are high maintenance people. They have to be fed, watered and toileted--and there’s no light at the end of the tunnel as there is for a 1-year-old who requires similar care. Modern medical advances have kept the most fragile elderly alive far longer than believed possible even a decade ago. While it is true that many people are living longer, healthier lives, a considerable percentage do not age quite so benignly and will require significant bodily care.
Add to this the demographic freight train hurtling toward us in the 21st century, loaded with baby boomers whose aging, in the face of their failure to produce a replacement generation of young caretakers, promises fiscal and familial chaos, and you can see what really fuels the drive toward legalizing physician-assisted suicide. Oregon began this drive with a 1994 law, recently upheld by the Supreme Court.
Of course, there are the usual precautions under Oregon’s version of the death with dignity law; terminally ill people requesting help in their premature exits must be of sound mind and so forth. While there are no age limitations, the normal life span presupposes that most of those who voluntarily commit suicide will be elderly and will consider themselves a burden to their families, if they have families. Presumably other states, as they scrap over euthanasia, will require some semblance of safeguard for old Granny with the whopping estate.
Human nature being what it is, physician-assisted suicide under any condition is a risky solution to the combination of expensive, high-tech medicine, serious disease and a future dearth of young health workers. First of all, proper pain control is possible for almost all patients, so pain control education of medical professionals--now not standard in many medical schools--needs universal implementation.
A look at physician-assisted suicide and euthanasia in Holland, where legal sanction for these procedures has existed for two decades, may prepare us for what is to come as safeguards are stripped away in the name of relief from suffering. Two studies done in the Netherlands in 1990 and 1995, with immunity from prosecution guaranteed to participating doctors, showed that quite a few people were being terminated without their consent. The death rate from euthanasia runs about 2%, which means that one in 50 Dutch people who die will do so by the hand of other people. Half of randomly queried Dutch doctors think it’s OK to suggest euthanasia to a patient. How would you feel if your doctor told you she thought you should consider killing yourself ? In 0.7% of Dutch deaths in 1995, physicians admitted they actively caused death without the explicit consent of the decedent, and this is probably a significant underestimate, as it doesn’t address patients whose pain medication was given to end life.
One well 50-year-old Dutch woman committed suicide with the help of her psychiatrist after refusing treatment for depression associated with the death of her son, and the Dutch courts thought hers was a perfectly good reason. Depression, by the way, is a treatable illness. A physician ended the life of a breast cancer victim because “it could have taken another week before she died. I just needed this bed” that the patient was occupying.
The U.S. Supreme Court has solved a thorny fiscal problem by brushing it off onto the states through its dismissal without comment of Lee vs. Harcleroad, the Oregon case whose name recognition may some day approach that of Roe vs. Wade, as we dismiss yet another important stage of life as being just too difficult to protect.
