The Briefing 08-11-15

Part I

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Rapid rise of euthanasia in Belgium, Switzerland exposes dangerous idolatry of full autonomy

Euthanasia is back in the headlines again, this time in a headline story in the Wall Street Journal yesterday. The article is by Shirley Wang and it has to do with two nations in particular, Belgium and the Netherlands. And specifically, it focuses upon one region of Belgium that is the Flemish region, the Dutch speaking population of Belgium in which there has been a remarkable rise and assisted suicide and euthanasia deaths just in the last recorded year. As a matter of fact, the article says,

“In Flanders—the Dutch-speaking, northern part of Belgium—euthanasia increased to 4.6% of a sample of 3,751 deaths in the first half of 2013, up from 1.9% of a similar sample during the first half of 2007”

According to the news article, this is a big increase in the use of and demand for euthanasia and assisted suicide. But we also need to note our vocabulary very carefully here. In the case of both the Netherlands and Belgium we really are talking about euthanasia. One of the things that becomes evident in terms of many contemporary debates over the question of assisted suicide and euthanasia is that many people think they are one and the same thing they come to the same and of course which is the voluntary insistent determination upon death, but they get there by different means.

In the United States we have several states that allow for so-called assisted suicide or physician-assisted suicide. In the United States where only a minority of states allow for physician-assisted suicide, the physician must prescribe the terminal medication that will bring about death, but cannot administer it directly, the patient must do that. Meanwhile, when you cross the Atlantic and go to several European nations, Switzerland, the Netherlands and Belgium in particular, medical personnel can actually administer and do administer the lethal dose of medication. The point to be made here and historical observation now clearly points this out is that physician-assisted suicide eventually leads to physician administered euthanasia. Furthermore, so-called passive euthanasia, that means the withdrawal of medical treatment hydration or food often then leads to active euthanasia and even more chillingly what is called voluntary euthanasia in which the patient requests or demands euthanasia leads to involuntary euthanasia and that raises a host of issues that are actually reflected in the medical study published at the Journal of the American Medical Association internal medicine upon which the Wall Street Journal article was based.

One of the physicians cited in the Wall Street Journal article actually makes this point, that is Dr. Kenneth Chambaere identified as professor and postdoctoral fellow at the End-of-Life Care Research Group, which is a collaboration between the Vrije Universiteit Brussel and Ghent University, he said,

“It’s like a rolling ball that goes on and on. People recognize this more and more as a valid option of last resort.”

That’s how the culture of death moves forward, and that is how euthanasia gains momentum. It is exactly as this doctor in Belgium said it’s like a rolling ball that just keeps rolling and rolling. And as the ball has been rolling onward in terms of euthanasia the article in the Wall Street Journal makes very clear that one of the issues that is now concerning even some people in Belgium in particular. Some medical authorities is, and I quote,

“The cases in both countries [that’s Belgium and the Netherlands] in which the right to die was granted because of a psychological condition rather than an incurable physical illness.”

The Journal then states the obvious and I quote,

“Requests based on psychiatric conditions are often difficult for a physician because it might be harder to assess if a request is voluntary and well-considered, if the suffering of the patient is without prospect of improvement and if there are no more reasonable alternatives for the patient—three of the criteria in the Dutch law.”

Just to state the matter clearly, the ball rolling on and on in this case means that assisted suicide, the original argument was that assisted suicide was made necessary by intractable and incurable untreatable physical suffering. But now as this article and the underlying study makes very clear, it is now being extended in terms of ever greater numbers to those whose condition is actually psychological or psychiatric. An American doctor cited in the Wall Street Journal article, Barron Lerner, a bioethicist and professor of medicine at New York University’s Langone Medical Center said,

“The question for me would be, to what degree do people who are approving this very dutifully try to exhaust all other options?”

Then these chilling words,

“One hopes that these cases are viewed as last resort.”

What does it mean to say, one hopes? We’re talking here about human life. The Wall Street Journal article is basically for doctor assisted suicide and euthanasia. That’s made very clear with the way the article continues, but it’s interesting that when the article comes to a conclusion, Dr. Chambaere turns up again and the article says,

“Despite the increase” –

That is in the number of patients who been euthanized for psychiatric and psychological conditions,

“Despite the increase, there isn’t any indication that there is overuse of euthanasia in Belgium.”

Again, that’s cited by Dr. Chambaere. Well, let’s just ask the obvious question – what would be the indication that there might be an overuse of euthanasia in Belgium? What would that look like? Even Dr. Chambaere said,

“It’s of course very important to keep monitoring it and see how it evolves in the future.”

Then these words,

“It’s a possibility that it could become too frequent.”

Well, just to ask the obvious question – if you accept the worldview that we are autonomous creatures and self-determination means that every single one of us has the right to say when our life will end and under what conditions, how by their definition and how according to their worldview could euthanasia ever become too frequent? How in the world can they say even now and I quote again from the article,

“There isn’t any indication that there is over use of euthanasia in Belgium.”

There you see the equivocations and the very dangerous logic of the culture of death and in particular of the movement for physician-assisted suicide and euthanasia. A movement we should note that seems to be gaining traction in terms of popular support and political activity in the United States.

Meanwhile, on Sunday, USA Today moved a story by Helena Bachmann in which she writes about her defense of Switzerland’s right to die law. In this case she’s writing about a case that had been reported recently in the media in which Gill Pharaoh, a 75-year-old British nurse had demanded assisted suicide in Switzerland on July 21. As she says,

“In Pharaoh’s case, the news reports said she had no terminal illness and wished to die merely because she was afraid of aging.”

Then Bachmann writes,

“I don’t personally know people who chose to end their lives the same way as Pharaoh did — by ingesting a lethal dose of barbiturates in a Swiss “suicide clinic.” And, not having walked in her shoes, I can’t weigh in on whether such a radical act is cowardice or courage. But, having written a number of articles about Switzerland’s uniquely liberal “right to die” law and followed the public debate on this subject, I do know that when it comes to assisted suicide, there isn’t a “right” or “wrong” answer.”

Well, let me just take the worldview significance of that particular sentence. If there is no right or wrong answer then everything is left an absolute fluidity, which is exactly what is reflected in the logic of that Wall Street Journal article and the internal medicine study behind it. Bachmann openly acknowledges as she is defending Switzerland’s right to death law that Switzerland has become a tourist destination with suicide tourism becoming an increasingly large business. According to this USA Today article about a third of the 1400 people who experienced assisted suicide or euthanasia in Switzerland every year are foreigners who go to Switzerland just for that purpose. Bachmann then writes this sentence,

“Clearly, this is not the kind of tourism boom that authorities want to promote, but the attempts to regulate the right-to-die industry, and especially to limit the influx of patients coming from abroad, have failed.”

Now keep that sentence in mind when you remember she’s defending the Swiss law, even as she acknowledges that attempts to limit it to restricted or to reform it in terms of the political sphere have absolutely failed. Her last paragraph from a worldview perspective is particularly interesting, she says,

“When I analyze this particular topic from a purely human, rather than a journalistic, point of view, all kinds of contradictory feelings emerge. Taking one’s own life is such a drastic and irrevocable step that a part of me cringes at the mere thought of it.”

She then writes this,

“But on the other hand, if we are indeed masters of our destinies, then the manner in which we choose to die should be a personal decision.”

That’s the key issue. That is the fundamental issue. The definition of the human being as “indeed masters of our destinies.” Well that’s exactly what gets us not only on the road toward assisted suicide and euthanasia, but on the road to any number of other horrors as well. The moment we define ourselves as fully autonomous creatures who have supposedly the right to control our own destinies right down to the timing and the conditions of our death, then we had clearly bought into what Scripture is unhesitant to call a form of unquestionable idolatry. We are idolizing personal autonomy and we’re making the idolatrous claim that we are the masters of our own destiny. To put the matter simply, Scripture does not define us in anything like those terms, instead it defines us as a creature made as an act of love by a divine and sovereign creator who has a purpose for our lives and as Scripture says, is the author of our beginning and of our end in terms of our earthly lives. Keep in mind by the way that the USA Today article, began by citing the case of Gill Pharaoh that 75-year-old British nurse who demanded the right to assisted suicide and then fulfilled that wish in terms of one of these suicide tourism clinics in Switzerland, simply because she did not want to grow any older and face the challenges of old age. There’s a parable of exactly what this worldview represents.

Meanwhile in recent weeks, The Economist of London has run a major cover story in that magazine explaining why the magazine supports calls for euthanasia and also indicating that virtually worldwide there is increased support for both assisted suicide and euthanasia. According to the magazine, a study that was commissioned by The Economist of people in 15 countries indicated that in all of the country cited with the exceptions of Russia and Poland solid majority supported a right to assisted suicide or euthanasia for as is defined here, “Terminally ill adults.”

Now what The Economist really demonstrates in this very cover story is that it is by no means where it is legalized eventually limited merely to terminally ill adults. That is what is demonstrated now very clearly in Switzerland and in Belgium and in the Netherlands as well. The article goes to Switzerland again citing the case,

“In 2008 Dan James, a 23-year-old who had become almost totally paralysed in a rugby accident a year earlier, died in Dignitas; his parents said he had come to regard his body as a prison and was “not prepared to live what he felt was a second-class existence”. They accompanied him to Switzerland and were investigated on their return to England for assisting a suicide, though it was eventually decided that prosecution would not be in the public interest.”

That’s becoming increasingly the pattern in the United Kingdom. In terms of just how fast the logic of death moves forward.The Economist article includes this,

“The Netherlands and Belgium allow doctor-assisted dying in many more circumstances than Oregon—and permit doctors to administer the lethal dose intravenously, rather than requiring patients to take it themselves, usually in liquid form, as in both Oregon and Switzerland. In the Netherlands, it is available for people experiencing “unbearable suffering with no prospect of improvement”, and for terminally ill children over the age of 12, with parental consent.”

Just consider those words. But the article continues,

“Around 3% of Dutch deaths each year are doctor-assisted, the world’s highest rate. But it is Belgium that has stretched eligibility furthest. Last year it scrapped all minimum age limits, though children can only be granted assisted dying if they are close to death and in great pain.”

Well there you see how the logic moves forward. Once again, from assisted suicide to euthanasia from passive euthanasia to active euthanasia from voluntary euthanasia to involuntary euthanasia. At this point voluntary euthanasia is how all of these experiences are defined, but when you look at the policies currently in place and the fact that in Switzerland you have families bringing people to these assisted suicide clinics, you have to wonder just how voluntary this really is. You also have to wonder how in short order, medical and financial pressure is going to be brought upon persons so that they no longer just have what is claimed to be a right to die, but furthermore a duty to die to get out of the way and stop taking up a bed and stop using up so many precious medical resources. You can see how that is already shaping up before us.

In its editorial on the issue, The Economist gets right to the worldview significance saying that liberty and autonomy are sources of human dignity. Now what we see here is that human dignity is no longer grounded as the biblical worldview grounds it. In an understanding of the respect for every single human life because it is a divine gift without regard to the individual’s condition, or furthermore age, closing the article in a very chilling way, The Economist gets right to the worldview significance of what we’re talking about when the editors write,

“The criterion for assisting dying should be a patient’s assessment of his suffering, not the nature of his illness. Some activists for the rights of the disabled regard the idea that death could be better than a chronic condition as tantamount to declaring disabled people to be of lesser worth.”

They then respond in this way,

“We regard it as an expression of their autonomy.”

There you see the absolute idolatry of autonomy above everything else, including the inherent dignity of every single human life, including the life of those who are defined here as being disabled.

Finally on this issue in terms of the slippery slope – it demands our attention in this length of discussion as is reflected in the fact that I was waiting for the letters to the editor in The Economist after that cover story. I’ll mention just one – it was written by pediatricians at the Eastbourne and Great Ormond Street Hospital in London and they were writing about euthanasia for children. They write,

“We are not saying children should be given this right automatically, but we are well aware of the maturity and insight that such children may have, regardless of their chronological age. We think that maturity, rather than some arbitrarily determined age cut off, ought to determine access to assisted dying or euthanasia if they are lawful in a jurisdiction. Safeguards to prevent coercion or exploitation would be required.”

Well, what in the world with those safeguards be? Supposedly to avoid coercion or exploitation. Once you’ve decided on the culture of death, the question is not whether or not you can come up with safeguards; you’ve taken the only safeguard away that preserves the dignity and sanctity of human life. I’m haunted by those words of Dr. Chambaere quoted in the Wall Street Journal article I cite them again,

“It’s like a rolling ball that goes on and on.”

Part II

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Beginning of life treated as negotiable by ethicist criticizing pro-life politicians

Next, on a related front in the sanctity of human life, Forbes magazine released an article yesterday by Arthur Caplan, who is head of medical ethics at New York University’s Langone Medical Center. It’s entitled,

“Marco Rubio And The GOP’s Dangerous Misconception On When Life Begins.”

Arthur Caplan is a very well-known bioethicist writing from a secular viewpoint. He’s very influential and this article really demands our attention. He’s responding to a statement that had been made by Florida Senator Marco Rubio, when he was involved in a rather heated exchange with Chris Cuomo of CNN. I won’t go into the details of that exchange that should be embarrassing for CNN, but I will go directly to Caplan’s article. He writes the question,

“Does human life begin at conception? For Marco Rubio and some other politicians now running for the presidential nomination in the GOP herd, the answer is yes. There is no doubt in their mind about when life begins.”

Caplan then describes this view that he rejects as “conceptionalism.” That is the belief that human life begins when an egg is fertilized and embryo begins to be formed. Caplan then goes on to describe all the policy implications that would be true if indeed human life began there at conception defined as the fertilization of the egg. He raises a host of issues including infertility treatment with in vitro fertilization, embryonic stem cell research, emergency contraception and to that those of us who hold to the position he rejects would simply say that’s absolutely right, defined in these terms, that is, if the intention is to cause or to allow the destruction of a human embryo. It gets really important when Caplan writes,

“So is Rubio right? Does science show that life begins at conception? Science supports no such view.”

He then writes,

“Is conception when a sperm reaches an egg, when it penetrates the shell of an egg, when genetic recombination begins, when a new genome is formed, or, when a functioning new genome is formed? Science is not a guide in this conceptual thicket so much as it is a stark reminder that nature rarely has clean boundaries.”

Let me just get to the bottom line here, here you have one of most influential bioethicists in America, writing at Forbes.com, who acknowledges that if indeed human life does begin at conception defined as the fertilization of an egg, he will lead to an absolute moral revolution in the understanding that the current medical community has about the dignity and sanctity of life, that is what so many of us are contending for but it’s what worries Arthur Caplan and so many like him. He actually accuses most doctors of wanting to stay out of the ideological fray. He also interestingly cites the US National Academy of Sciences that stated in 1981 that the existence of human life at conception is a question to which science can provide no answer. He says, then that far too many medical doctors and scientists have been mum because they’re afraid to bring up anything that could bring about criticism. Caplan argues that the beginning of human life cannot be at conception defined in this way it has to be at some point later.

Further in the article he writes,

“Not only is it unlikely that a life begins at conception.”

Indicating that he is not so sure that it doesn’t, even though he argues earlier that it does. He concludes his article writing,

“Conception is the start of something, but it is the start of the possible rather than the actual. Presidential candidates can propose drawing lines wherever they want. But, they cannot and ought not be permitted to invoke science on their behalf when the science does not support what they say.”

Well, just a couple of very quick points – first of all, when he argues that conception is the start of something potential rather than actual we simply have to respond with the base fact that the fertilized egg and the developing embryo is indeed a something not just a something possible and it’s not by accident that the Christian worldview says that when God says let there be life, there is not just potential life, but actual life, even if there’s a miscarriage even if that actual life does not make it to survive outside the womb. It still is a person, according to the biblical worldview. The other thing to note, finally, is that Arthur Caplan says he’s certain, absolutely certain that life doesn’t begin at conception and even as he acknowledges that no less than the National Academy of Sciences said that science can’t say when human life begins. He’s quite ready to say that those who believe in what he calls conceptionalism are wrong and that science supports him.

The most important thing, however, to note about this article is that Arthur Caplan never tells us when he believes that human life begins. That’s the ultimate failure of his argument and the ultimate failure of his worldview that means that when human life begins and thus when human personhood must be respected is entirely fluid and negotiable. That is exactly the worldview that threatens human life at its very beginning. As the previous discussion points out, it also threatens human life at the end, and the thing we need always to keep in mind is that it threatens human life at every point between the beginning and the end.

That takes us right back to that statement in the Wall Street Journal article from Dr. Chambaere “the ball keeps rolling on and on” and so is the great worldview collision between the biblical Christian worldview that grounds the dignity of every single human life at every point of development under every condition in the fact that every single human life is a divine creation and that every single human being is made in God’s image and the worldview that is now accelerating and undergirding the culture of death, both in terms of the beginning of life and the end-of-life, a worldview that says that human beings are simply the accidental byproducts of evolution and that human life is whatever we will define it to be, it begins whenever we will debate and then decide it begins, it will continue whenever we decide to allow to continue it under the circumstances that we think are permissible and that nothing can stand in the way of our personal autonomy and our self-determination. That is the great clash of worldviews we see before us. It is helpful and illuminating for us to understand that these two worldviews stark as they are in opposition are actually consistent with their underlying foundational principles. If we do not have an adequate response to the argument that human beings are simply autonomous accidents, then to quote Dr. Chambaere “the ball will just keep rolling on and on and on.”