Tuesday, Apr. 3, 2018

Part I

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A love story that ends in suicide: New rituals around dying raise huge moral questions about the sanctity and dignity of human life

Sometimes a major milestone in morality can pass with almost no one apparently noticing, or at least few understanding what is taking place and the significance of the events. Evidently, one those moral milestones was passed on March, the 27th of this year, just a few days ago, and the events took place in a nursing home near Toronto, Canada. And as The Globe and Mail, Toronto tells us, it was the story of a couple married almost 73 years, an elderly couple who defined their life as one long love story, and a couple who intended to see that love story all the way to the end that they would plan together, which was a mutual simultaneous physician-assisted suicide.

As The Global and Mail reports, the couple known as the Brickendens, are one of the few couples in Canada yet to receive a doctor-assisted death together and they are the first, according to the paper, who spoke about it publicly. As the reporter tells us, “They wanted to explain what it meant to them to die at a time and place of their choosing, as at least 2,149 Canadians and likely hundreds more have done since assisted dying became legal in this country.” The Brickendens, according to the paper, “are at the vanguard of patients and families who are creating new rituals around dying in Canada-the kind of rituals that are only possible when death comes at a previously appointed hour. But cases like theirs,” says the paper, “also raise uncomfortable questions about whether the vague eligibility criteria in Canada’s assisted dying law are sometimes being interpreted more broadly than the government intended.”

Now, the paper goes on to say that one of the most controversial stipulations in the law is that a patient’s natural death must be, in the words of the law, “reasonably foreseeable, something,” said the paper, “that could plausibly be said of every nonagenarian. The law dictates other requirements including intolerable suffering and irreversible decline. But those concepts,” acknowledges the paper, “can be elastic, too.” The reporter for The Globe and Mail behind this story is Kelly Grant, and she writes of meeting George and Shirley just on March the 22nd. “By then,” she says, “the plans for their pre-death parties were already in full swing. Their conversations were full of gratitude, gentle teasing and gallows humor, much of it,” said the reporter, “provided by their children, Pamela, age 7I, Saxe, age 60, and Angela, age 54. The couple’s other son named Dal, age 69, was on his way to Toronto from Vancouver. Others gathering for these “pre-death parties” included grandchildren and extended family. Some coming,” we are told, “from as far away as Vietnam, Norway, Switzerland, and Scotland, all coming to bid the couple goodbye.”

The couple, by the way, George and Shirley Brickenden, defined their planned deaths as simply flying away. They’d put it this way for a long time. They told their children that they did not want to linger if their health eventually fail. “We witnessed many years ago, someone we love very much, a family member, who lived for several years and turned from being a magnificent human being into someone you couldn’t recognize, that lay in bed and made noises.” Shirley said that that was not the future, nor the death that she and George would choose for themselves.

The Canadian parliament legalized physician-assisted suicide, it’s often called there, physician-assisted death, and as a euphemism, you can understand why, that took place back in 2016. And as is almost always the case when this kind of court decision or this kind of legislation is adopted, we are told that adequate cautions and protections would be put in place. Now, according to the Canadian law, there should be no physician-assisted suicide unless the patient involved is suffering from a grievous and irremediable conditions. And furthermore, the Canadian law says that that patient must be looking at a death that is reasonably foreseeable. But when it comes to the Brickendens, and they are age 95 and 94, that wasn’t so clear. It became clear, at least in the judgment of two physicians who gave their authorization in the case of Shirley first, but George a year older, appeared to be healthier and the doctors were not adequate in agreement.

It takes to doctors to approve to move forward with a simultaneous assisted suicide. But in the words of Shirley, even as their plans appeared to be frustrated, “then miraculously he started to go downhill.” The reporter says that Shirley said that of George, laughing. Speaking of their friends, Shirley said, “Many of our friends have flown away already and the ones that are left are very precious. It’s very, very hard not to tell them, but you have to make a rule. You’re either going to tell quite a few people or you can’t tell,” now that speaking of those beyond their immediate family, their grandchildren and the relatives that they told. When the reporter asked, how does it feel to know you have only five days left on earth, Shirley said, “Well, I’m startled. How does it feel to you, darling?” She said to George. George said, “Good.” That, according to the report, provoked another burst of laughter from his children. Shirley then said, “What I’m surprised at is there’s no fear involved at all.”

The reporter said that after her conversation with the Brickendens, she couldn’t help feeling “slightly perplexed by their decision to die now.” Why? Because as the reporter acknowledges, both George and Shirley appeared sharp, vibrant, and even elegant. He wore a dress shirt and a tie with a sweater knotted over his shoulders like a prep-school student. “Shirley,” said the reporter, “wore a simple black turtleneck and lipstick.” The reporter also noticed that Shirley’s nails had been freshly manicured. The story turns only more dark when later we are told that two nights before their deaths, their prearranged deaths, the Brickendens went out to dinner at their favorite Toronto area restaurant known as Opus. Kelly Grant then writes, “The next night, they bid farewell to more than 20 members of their immediate family at a bon voyage dinner at their daughter, Pamela’s apartment, but the evening of their deaths was more intimate, that according to three of their children.

Grant then writes, “Present were Pamela, Saxe and Angela, their spouses, the two doctors and Andrew Asbil, the Dean of Toronto’s St. James Cathedral, who later told the reporter that he had supported the couple’s wish for their funeral to be held at the Anglican church without hesitation. We are then told that the couple dressed in caftans, drank champagne and nibbled on a last supper of hors d’oeuvres of lobster, salmon and filet. But then, shortly before 7:00, Mrs. Brickenden turned to her husband and asked, “Are you ready?” “Ready when you are,” he replied. The report then tells us they walked into their bedroom and lay down together, holding hands. The two doctors, one for each patient inserted intravenous lines into their arms. Dean Asbil, that’s the Anglican priest prayed while Mozart, Bach and Scottish folk songs wafted through the room. Their son, we are told, had assembled a playlist which was labeled “fly away music”.

Earlier in the article before the couple experience their deaths, the reporter acknowledge that there are huge moral questions to be raised here. The article cites Trudo Lemmens, a Professor of Law and Bioethics at the University of Toronto, who said that even though he doesn’t know if this is the case here, he is generally concerned about “the fragility associated with old age becoming a reason for people to legally end their lives with the help of a doctor.” In an email to the newspaper, Dr. Lemmens said, “From a societal perspective, this would be problematic, both to Supreme Court of Canada decision and the legislation treat active life ending measures by physicians as an exceptional procedure, an exception to a still existing criminal law prohibition. “We should be very careful,” he said, “not to normalize it as if it is the solution to all end of life planning, even when we may have sympathy for the idea that a couple prefers not to leave each other behind.”

But before leaving this article for an even more extended analysis in The Globe and Mail and the question of physician assisted suicide, we need to observe that what we see here is a fundamental redefinition, not only of death, but of life, and of the meaning of human life and of human autonomy. What we have here, shockingly enough, is an elderly couple, and yes, they are old, 95 and 94, and yes, they have lived long together, almost 73 years of marriage, but they are planning life on exactly their own terms as if they gave themselves the gift of life and they will rid themselves of the gift of life simultaneously.

Furthermore, you will note that they are able physically, not only to gather with parties with their friends and in anticipation of their death, they are able to go out to their favorite restaurant and without question, they appear to be in full possession of their mental faculties. As a matter of fact, if they were not regarded as being absolutely mentally competent, they would not be recognized as having the authority to demand physician-assisted suicide. This is one of the saddest stories I have seen in a very long time. I think it is no exaggeration to say that the day of their deaths, March, the 27th of 2018, does mark a very significant milestone in our morality and in the sanctity and dignity of human life. And The Globe and Mail, even though it recognizes the huge moral questions involved, does treat this story as something of a very elegant and tasteful love story. A love story that ends in what we must recognize is just another form of suicide.

Part II

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How a reordering of the theological landscape has led to a redefinition of life and death

But just a few weeks before the deaths of the Brickendens, The Globe and Mail had run a massive consideration of the development of physician-assisted suicide in Canada. The articles written by Sandra Martin, who has also written a major book on the subject, and she noted that in Canada there was what she described as a long struggle to legalize physician-assisted death, and she also points out that there were many twists and turns in the story. Every single one of them deserves our attention. Martin noted first, the so called Carter decision that was handed down by Canada Supreme Court on February the 6th of 2015. In that decision, the court found that there was a right according to the Canadian Charter of Rights, that gave citizens there, the right to demand physician-assisted suicide. But that very same decision demanded that parliament come up with legislation that would authorize how physician assisted suicide should take place. The decision called for a legislature and regulatory response.

But as it turned out, and Sandra Martin makes this clear too, the actual regulations, very province by province as medical practice is delegated to the provinces for a good deal of regulatory authority. Parliament basically went on and authorized the overarching legislation and in doing so, they again promised that they were adopting all kinds of precautions and stipulations that would limit access to physician-assisted suicide only to those who were defined as having a terminal disease or being in interminable suffering, and again, whose death was reasonably foreseeable. But this very article by Sandra Martin points out that those who’ve been pushing the limits on physician-assisted death, had been doing so by using even such techniques as actuarial tables in order to say that that foreseeable future, in terms of their death, could well be five to six years out. Then quite shortly after that, it could be 10 years out.

And even as Martin points out that there were some physicians ready to support and to provide physician- assisted suicide, she also points to the fact that the great obstacle in many ways was and is the medical profession. “Doctors,” she writes, “are trained to save lives, not too them.” And furthermore, one of the documentations made in the article is that those physicians who were trained in the specific sub-specialization of palliative care are not those, who in the main, have taken up the task of physician-assisted suicide. Rather, other doctors who clearly are driven by a moral interest more than a medical specialization have given themselves to this practice more than others. Sandra Martin writes, “An idea that was once impossible to imagine is becoming normalized, and estimated 2,500 people in Canada have died with medical assistants in the past three years.

Martin then writes, “There is no turning back. We are a country that recognizes that medical assistance in death is a human right.” That’s an astounding statement. First of all, there’s no turning back, and secondly, that Canada has become a society that recognizes the equivalent of a constitutional right to physician assisted suicide. Martin says that this became a debatable issue in Canada in the 1990s. “Back then,” she said, “Canadians heard a lot about the sanctity of life. Like so many lofty ideals,” she wrote, “the concept that life is precious, was tossed around in a legal, medical, and ethical discussion, but many people were not clear what it meant.” Here, we should simply note that if people do not know what the sanctity of human life means, there’s full evidence here that what they will do is undermine, subvert, and attempt to destroy that sanctity.

Martin points to the Canadian Charter of Rights and Freedoms, which she says was in its infancy in the 1990s. She also points out that no other jurisdiction in the world had yet implemented a legal and regulatory context for physician-assisted suicide. Interestingly, The Globe and Mail tells us that the kind of physician actively and rather eagerly involved in physician-assisted suicide is represented by someone like Dr. Ellen Wiebe, identified as a clinical professor in family medicine at the University of British Columbia. She also, according to the paper, is a specialist for more than 40 years in women’s health, providing antenatal care, contraception, and medical abortions.

Now, here we should simply note the fact that when you begin to undermine the sanctity of human life and redefine humanity, you have to do so, most importantly at the margins of life, the huge ethical issues where life and death meet. And you also have to do so at the beginning and the end of life, where the greatest vulnerabilities amongst human beings are found. So we really shouldn’t be surprised by this Globe and Mail story telling us that a doctor who has given herself to abortion is now giving herself to physician-assisted suicide. It’s all of a piece. It’s a story with a beginning and an end and all kinds of moral confusion in the middle.

Sandra Martins’ article in The Globe and Mail is massive, it’s important. Every word of it’s important. But from a Christian worldview perspective, one of the most important issues we can realize is that this moral milestone with this couple who arranged their own premeditated physician-assisted suicide, this moral milestone took place just a relatively few miles across America’s northern border in Canada. We also must observe once again that Canada is following a trajectory culturally and morally, also expanded to the reality of worldview that is more in sync with Europe than with the United States. But that does not mean that the United States is far behind. We are perhaps just one major court decision from a similar kind of action in the United States. And we have also been subverting here, the sanctity of human life in virtually every way imaginable.

In her article, Sandra Martin acknowledges rather fully, the fact that there is a huge need for increased regulation in Canada because physicians and others had been pushing the limits that were supposedly set in place in order to protect persons over against the reality of too easy access to physician-assisted suicide. But here we simply must have observed that the culture of death resists every single boundary. It will find a way around every single regulation. When you redefine medicine, redefine humanity, and redefine life and death, you’re going to find a way to redefine every word of every regulation, law and court decision. You might say that as we think of the differences and distinctions in worldviews, it comes down now to whether or not you see the story of George and Shirley Brickenden as a beautiful love story lived out to their own chosen beautiful end, or if it is instead the victory of the culture of death over the sanctity of human life. And of course, what’s lurking in the background here is that there could not be such a redefinition of life or of death without a fundamental re-shifting and reordering of the theological landscape.

The bottom line is that physician-assisted suicide as part of the culture of death, goes hand in hand with secularism. Secularism sacraments are abortion and physician assisted suicide. That doesn’t mean that secularism is less religious. It’s very religious. But what it does mean is that secularism is very deadly.

Part III

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Abuse of junk science leads California judge to order cancer warnings on coffee: What this reveals about Americans’ chemophobia

Meanwhile, back in the United States, we’re reminded from a court case in California of just how large a role the courts are taking in our society and have done so, especially since the 1940s, and accelerating through the last several decades. The headline from the Washington Post is this, “California ordered to add cancer warning to coffee”. “But the science,” says the Washington Post, “does it hold up?” Well, whether or not the science holds up and it doesn’t make very clear in this article, the fundamental reality is that cups of coffee sold in local coffee shops, there in the state of California, are going to have to carry from now on, a cancer warning, this according to a judge’s ruling in the vicinity of Los Angeles County.

The judge there ruled last week that coffee, roasted coffee, includes a chemical called acrylamide, which when fed to mice and other rodents at levels between 1000 and 10,000 times those experienced by human beings, can often lead to cancer. Well, you might think, if there’s any risk of cancer, perhaps consumers should be told in advance by means of a warning so that consumers can make an informed choice. But as the news articles and others make very clear, as scientists are speaking into this issue, the problem is that acrylamide is found in virtually all cooked foods to one degree or another, especially those that are fried, or toasted, or roasted as in the case of coffee beans.

And even as there is the warning now on a cup of coffee in California, or soon to arrive by court order, the reality is that there is no indication that drinking coffee is going to lead to cancer. Some doctors even say that drinking coffee is basically more helpful than unhelpful. But that doesn’t matter because a judge in Los Angeles County has ruled that because of a 1980s law adopted by the General Assembly in California, it has to be applied in this case so that regardless of how small the risk, if there is acrylamide, there must be a warning on coffee cups.

The Wall Street Journal responded to this with an editorial entitled “Attack of the Killer Cappuccino”. And of course, the editors are making fun of this judge’s decision, but they’re pointing to something more serious, which is the fact that junk science is being used and applied. It’s being abused and distorted in such a way that before long, everything is going to have to have multiple warnings because in one way or another, everything can injure us. An interesting statement in the Washington Post was made by Michelle Francl, a chemist at Bryn Mawr College in Pennsylvania. She pointed out that human beings in general, but Americans specifically, tend to have a certain chromophobia, a certain fear of chemicals. She says that Americans likely would fear to ingest the liquid known as oxidane, which would sound ominous even though it’s just another name for water. The Journal’s editorial also makes clear that this is something of a financial shakedown operation. There are lawyers involved who make their business and have built a legal empire on bringing charges against one manufacturer, the next, in this case, the coffee makers of California, and that goes right down to local coffee shops, claiming that they have endangered Californians with their carcinogeneric products.

Part IV

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Stephen Reinhardt, the liberal lion of California, dies at 87, but there are many cubs following close behind

But finally, considering the outsize role currently paid by judges and particularly federal judges, we note the obituaries that appeared in both the New York Times and the Washington Post for Stephen Reinhart. He was a member of the 9th U.S. Circuit Court of Appeals, one of the most famously liberal jurists in American history. He was the very last judge, the very last federal judge appointed to the bench, by President Jimmy Carter. He was aged 87, still a participating member of the 9th Circuit when he died of a heart attack when he was on a routine visit to his dermatologist. Interestingly, recognizing his importance, both the Washington Post and The New York Times used the exact same expression. The Washington Post editorial headline was this, “Stephen Reinhart, liberal lion of federal judiciary in California dies at age 87.” The New York Times Obituary, “Stephen Reinhart, liberal lion of the federal court dies at age 87.” Both of these influential newspapers referred to judge Reinhart as a liberal lion.

Now, one of the questions you need to ask is whether or not, the same newspapers will recognize a similarly distinguished jurist as a conservative lion. But liberal lion seems to work, and that is because the elites in this country have looked to judges, to federal judges specifically, and to the most liberal of the federal appeals courts, that’s the 9th Circuit in California, as driving engines of social change. Judge Reinhart, during his career had struck down laws against same-sex marriage, he had struck down laws against partial birth abortion, and he had even struck down the pledge of allegiance because of the words under God, which he said, violated the establishment clause of the first amendment. He was one of the most reversed judges by the United States Supreme Court. He seemed to wear that as a badge of pride and he handed down liberal decision after liberal decision. Speaking of the Supreme Court, he said, “They can’t catch them all.” Even conservative colleagues said that he was respectful and kind, but the reality is that he points to how the courts have become driving engines of moral change, even of moral revolution in this country. The liberal lion of California is dead, but there are many cubs following close behind.