Targeting People With Mental Illness and Dementia for Euthanasia
A few years ago, a Dutch doctor attended her elderly Alzheimer’s disease patient at a nursing home. The doctor’s purpose wasn’t to examine the patient or prescribe new medicines. Rather, she was there to kill.
While competent, the patient asked to be euthanized when incapacitated, but she also instructed that she be allowed to say when.
But before she did that, the doctor and her family decided that her time had come. The doctor drugged the woman’s coffee and, once she was asleep, began the lethal injection procedure. But the patient awakened unexpectedly and fought against being killed. Rather than stopping, the doctor instructed the family to hold the struggling woman down while she completed the homicide.
This would seem to be a clear-cut case of murder. But a judge recently exonerated and praised the doctor for acting in the “best interests” of the patient by merely executing the woman’s previously stated wishes.
The only unusual aspect of the “Case of the Struggling Alzheimer’s Patient” was the struggle. Even when incompetent and unable to make their own decisions, the law of Netherlands and Belgium allows dementia patients to be killed by doctors.
Such procedures are not rare. According to government statistics, in 2017, Dutch psychiatrists and doctors euthanized 83 patients. Sometimes these legal homicides are accompanied by organ harvesting after death. One case — reported in an international transplant medical journal — without criticism — or even a moment’s reflection about the moral questions raised by such an act — reported approvingly that the lungs of the deceased patient were well accepted by their recipients.
There are many verified cases of the non-physically ill being assisted to kill themselves — including an elderly woman who wanted to die because she had lost her looks.
Canada, which recently legalized lethal injection euthanasia for those whose deaths are “reasonably foreseeable,” now is debating expanding the right to be killed to those whose lives are not in danger. Prime Minister Justin Trudeau is on record as favoring liberalization and has stated his government will not appeal a recent court ruling declaring the foreseeable death limitation to be unconstitutionally restrictive and discriminatory.
How far is the expansion likely to go? Many Canadian euthanasia advocates are pushing for revisions that would allow people with dementia to be killed by doctors in the same manner as now allowed in the Netherlands and Belgium.
And here’s some breaking news: the Alzheimer Society of Canada — which is supposed to advocate for the welfare of such patients — has officially endorsed allowing euthanasia even if the incompetent patient is not suffering — even if he or she expresses no desire to die.
Meanwhile, there has already been at least one Canadian apparently euthanized even though his death was not foreseeable. The man’s family even begged doctors to spare his life, but to no avail.
What about the U.S.?
Would we ever follow such a course? As of now, the nine states and the District of Columbia that have legalized assisted suicide access to patients who are terminally ill. But that’s more a political expediency than a principled limitation. Indeed, restricting assisted suicide to the dying is philosophically unsustainable.
Think about it. If the point of allowing suicide by doctor is to eliminate suffering — and if eliminating suffering can include eliminating the sufferer — how can facilitated death be forbidden to patients, such as those with dementia, who may suffer far more extremely and for a much longer time than the already dying? It makes no sense.
That point is increasingly being made in the media and professional journals. For example, an article just published in the American Journal of Bioethics argues that since “the suffering associated with mental illness can be as severe, intractable, and prolonged as the suffering due to physical illness,” as a matter of “parity,” in “severe” cases, “PAD” (physician-assisted death) should be made available to mentally ill patients with “decisional capacity” — even when they have “a relatively long expected natural lifespan.”
The authors, University of Utah psychiatry professor Brent M. Kious and noted assisted suicide advocate and bioethicist Margaret (Peggy) Battin, go so far as to suggest that “psychiatrists and other mental health professionals” could one day become “gatekeepers for PAD” once “a metric for suffering in both mental and physical illness” is established.
Ponder this for a moment.
Instead of being duty-bound to save the lives of patients, mental health professionals would become approvers for and facilitators of destruction. That should be unthinkable.
Alas, the first small legal steps toward permitting the demented to access death by doctor have already been taken.
After California legalized assisted suicide for the terminally ill, the Department of State Hospitals promulgated a regulation requiring that patients who have been involuntarily committed be provided access to assisted suicide despite mental illness. By definition such people are not legally competent, or else why would they be involuntary hospitalized?
Nevada just enacted a law that allows dementia patients to instruct caregivers to withhold “food and water” once they reach incapacity toward the end that they starve to death.
Please note that this first-of-a-kind law isn’t about refusing a feeding tube or preventing force-feeding. Rather, the law (SB 121) permits patients to be refused “food and water” — even if they willingly eat, perhaps even if they ask caregivers for sustenance. That’s homicide by neglect.
Don’t take my word for it. The influential bioethicist Thaddeus Mason Pope wrote about the law: "Even after we stop offering food and fluids, other problems may arise. Once the patient reaches late-stage dementia, she is unable to knowingly and voluntarily make decisions with capacity. But the answer remains uncertain in the United States".
In other words, Pope believes that a court could one day rule that an advanced dementia patient isn’t “competent” to want to eat.
Of course, the point of such advocacy isn’t really starvation but convincing people to allow intentional overdosing of these vulnerable patients by doctors.
After all, if we are going to end their lives, the reasoning goes, we should at least do it humanely.
If we accept the propriety of intentionally ending dementia patients’ lives, that argument certainly has emotional appeal.
Accelerating advocacy for legalizing euthanasia is pushing us toward making a stark choice.
We can decide that this is an acceptable response to human suffering, unleashing gravitational forces of logic that will lead inexorably (over time) to a broader killing license, including of the killing of dementia patients as advocated by Kious and Battin.
https://spectator.org/targeting-people-with-mental-illness-and-dementia-for-euthanasia/
Discuss.
