One thing is very clear from the ongoing debate about physician-assisted suicide — the advocates for death are never satisfied and will never give up. The advocates who are pushing for doctor-aided death try to convince people that they're only interested in helping relieve suffering of people who are close to death with an incurable terminal illness. The reality is that they want to legalize and normalize not just assisted suicide but also euthanasia — a polite name for murder by doctor. Under the guise of "compassion", they are actually pushing a cruel agenda that stigmatizes and dehumanizes persons with disabilities and that will harm vulnerable people and their families
This can be seen by the latest initiative from End of Life Choices New York, the leading advocate for legalizing assisted suicide in our state. They have published a document they call the "Advance Directive for Receiving Oral Food And Fluids in Dementia". The primary stated reason for this document is to enable patients to require their legal representatives and health practitioners to "stop efforts to provide assisted oral feeding because of an advanced dementia."n
Let's be clear about this. The document is designed to facilitate and normalize killing patients who do not have a terminal condition, but who are experiencing cognitive decline. It is intended to legally require family members, doctors and other caregivers to obey the directive. The inevitable result—and the explicit intention—is the deliberate killing of patients by dehydration and starvation
This can be seen by looking at the way the advanced directive works. It is supposed to take effect only if a patient is "in an advanced stage of Alzheimer's or other incurable, advanced dementing disease" and they are unable to make health care decisions or feed themselves. This is a dangerous definition. While the directive provides a reference to a recognized test for an Alzheimer's diagnosis, there is no definition for the term "other incurable, advanced dementing disease". So who will decide that? What criteria will they use? Will there be any review by another physician? The risk of abuse is massive
These triggering conditions contain other dangerous elements. The phrase "unable to make informed decisions" is also used without any further specificity as to what standard will be used or who will make that determination. Again, the lack of clarity opens up a real possibility of abuse, for example collusion between self-interested family members and a doctor who is sympathetic to euthanasia or assisted suicide
Once the directive takes effect, it gets even worse. It offers the patient two alternatives concerning feeding and hydration. Option A is the most radical, and calls for the withholding of all medication and all food and water under all conditions. Even if the patient is clearly willing to accept food and water by hand, this directive would require caregivers to refuse them and then watch their loved one die of dehydration. It's mandatory murder by neglect
Option B also calls for the withholding of all medications and assisted food and water. But it also permits feeding by hand only if the patient meets some very ambiguous and subjective standards, like if she "appear[s] receptive and cooperate in eating and drinking by showing signs of enjoyment or positive anticipation". It requires denial of all food and water "when I no longer seem to enjoy or appear willing to eat or drink", or "once I no longer willingly open my mouth or I appear indifferent to being fed", and adds that "I do not wish to be coerced, cajoled or in any way forced to eat or drink."n
There is no indication who is making these assessments, what standard is to be used, whether there is any review or accountability, and whether there is any opportunity for a patient to change their mind. The use of such vague standards (e.g., "showing signs of enjoyment", "appear indifferent to being fed", "cajoled", etc.) leaves the fate of patients at the whim of some unknown person, who will interpret ambiguous signals from the patient and decide whether they will live or die. The vulnerability to abuse is obvious and severe
Remember, this directive is not dealing with medical treatments for any kind of disease or disorder—it involves food and water, which are basic human needs. Nor is it limited to simple medical interventions like the insertion of a feeding tube. It would require family members and health professionals to stand idly by while an otherwise healthy patient, who is perfectly capable of eating and drinking with assistance, dies from dehydration and starvation
One of the critical moments in the history of euthanasia advocacy came in 1920, with the publication in Germany of the book Permitting the Destruction of Life Not Worthy of Life. That book, written by a leading lawyer and an influential doctor, rejected the inherent and equal dignity of human life for those with disabilities, and coined the infamous phrase "lives unworthy of living". The authors said, "It can in no way be doubted that there are living human beings whose death would be a deliverance both for themselves and society, and especially for the state, which would be liberated from a burden that fulfills absolutely no purpose"
This is what we are coming to, where people with dementia are deemed to be "lives unworthy of living" and who will be killed by their relatives and doctors. It is cruel and barbarous. We must resist this with all our might.