Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder

Rating:
Summary: Detailed examination of euthanasia and assissted suicide
Review: I am currently investigating several different ethical/public policy issues: homosexuality (i.e. advocating the behavior in schools, marriage), abortion, and euthanasia.

The author of this book is the lead lawyer of the International Task Force on Euthanasia and Assisted Suicide, an organization that opposes all forms of euthanasia and assisted suicide.

One of the changes that has made this discussion meaningful is the discussion between humane care and medical treatment. Humane care would include food, heat, washing etc; the basics, if you will. Medical treatment would be drugs, surgery and so on. In some recent US Supreme Court case, certain types of humane treatment has been reclassified as medical treatment (e.g. water and food). The significance of the change is this; patients cannot refuse humane treatment but they can refuse medical treatments, at a certain point (or have others refuse medical treatments on their behalf).

There are sections that document the development of euthanasia in the United States through court cases and attempted legislation (in the 1930's and the present).

There are sections on the Holland called, "Dutch Treat," is particularly good. Holland is the only country that where euthanasia is widely available (Holland made it totally legal on November 28, 2000). Smith shows the progression in Holland, how the guidelines are routinely violated and so on. One of the scary problems is INvoluntary euthanasia: 1,040 people (an average of 3 per day) died from involuntary euthanasia, meaning that doctors actively killed these patients without the patients' knowledge or consent.

Smith shows that the euthanasia agenda would endanger the disabled, the ill, the elderly, those with low education, minorities etc... In Holland, there is universal health care for all paid for through taxes, in the United States it is partially private and partially public.

Smith shows the two philosophies that at conflict in the current debate. The anti-euthanasia proponents hold to the equality-of-human-life ethics: "that each of us be considered of each inherent moral worth, and it makes the preservation and protection of human life society's first priority." (page xxi) This is contrasted with the quality-of-human-life ethic, which gives human beings value (protection etc...) not because they are human but only if they possess certain qualities. I think that Smith wisely chooses to examine Peter Singer as the principal philosopher of the movement; one of the interesting things was the reaction of critics to the book. In America and Britain, the book was warmly welcomed and highly praised. However, in Germany, "... Singer has... been severely criticized and demonstrated against in Germany, a country with an acute memory of the horrors can result from adopting such values as his." (page 23).

The book also exposes the myth that all persons who oppose euthanasia are religious fanatics, from atheist Nat Hentoff, "I can't base my opposition to euthanasia on religion. I am an atheist!" (page 202). Also, "As Rita Marker, director of the International Anti-Euthanasia Task Force, notes, 'Legislation that prohibits sales clerks from stealing company profits also coincides with religious beliefs, but it would be absurd with the separation of church and state.'" (page 201)

One last note, one of the main reasons that euthanasia is encouraged is that the suffering is too great etc. Smith shows that most doctors are very poorly trained in pain treatment and that hospice care is rarely promoted. Smith shows that almost all pain can be treated even advanced bone cancer etc...

The book was excellent and I appreciate the detailed examples, history and court cases that Smith writes about.

Rating:
Summary: One of the best on the subject
Review: No major change comes quickly. Little compromises are made that slowly but surely lead to a major, sometimes horrifying change. Such is the case with euthanasia.

Smith is a very readable writer and well informed on the issue. Yes there is some emotional content but that is not a bad thing. This is an emotionally charged issue. It is also a disturbing issue for many and far to many have fallen for the ready platitudes of the so called 'Death with Dignity' crowd. When the lies and sweet words are stripped from their word though a very harsh and frightening reality is left.

As one who has had to fight this beast (we lost the battle and our loved one, the war goes on) I can tell you he is spot on to the problem with this book and his other writing on the topic. He has recommendations as to the direction of the solution but the action to reach it lies with you and I.

I'm in are you?

Rating:
Summary: Exposing the culture of death
Review: This is a revision and expansion of his earlier work of 1999. In it he brings up to date recent developments in the euthanasia wars. But the same concern for where society is heading, and the same call for action is found in this volume.

Smith argues that modern medicine is undergoing a seismic shift, as is that of the surrounding culture. Whereas societies and their medical practitioners once believed that saving life and protecting life was our highest and most noble calling, they have now come to see that killing in the name of compassion is both justified and necessary.

What has brought about such a radical shift in values and priorities? Smith argues that a number of inter-related causes can be mentioned. There is the "moral Balkanization" of Western culture, with a loss in moral absolutes and religious convictions. Then there is the elevation of personal autonomy as the highest virtue.

Also there is a very sophisticated political machine pushing the euthanasia agenda. Backed with big bucks and extensive marketing research, it has become adept at selling euthanasia. With plenty of euphemisms, misinformation and scare tactics, it is managing to convince many that death is desirable, and life is not.

And then there is the bottom line of money. The huge blowout in medical costs for the elderly makes the euthanasia alternative seem very tempting indeed. It is a major savings to bump off the elderly instead of treating them.

The hazards of legalizing euthanasia are many. Suffering would increase, not decrease. For example, the funding and research on problems like AIDS could easily be cut, with the idea that it would be better for these people simply to die. Pain relief, hospice work, and palliative care would also face major cutbacks and social undermining. Why bother, after all, when a quick lethal injection would be much cheaper and easier?

Smith examines some of the recent decisions made concerning end of life care, noting a slippery slope in action. In March of 1986 an ethical advisory panel of the American Medical Association declared that food and fluids provided by feeding tubes were no longer to be considered basic humane care, but medical treatment, and could therefore be withheld. Previously hydration and nutrition, even by means of tubes, were considered to be mandatory and necessary care.

This led to another momentous decision in 1994, when the AMA declared that foods and fluids could be withdrawn even if a patient was not terminally ill nor permanently unconscious, something that before was a requirement.

Smith points out that such steps along a slippery slope are not new, with a very similar incremental approach occurring in Germany early last century, leading to the final solution of the Nazis. A 1920 book written by two German professors, Permitting the Destruction of Life Not Worth Life became the cornerstone of Nazi practice which saw 200,000 helpless people deliberated killed by German doctors and nurses between 1939 and 1945.

The Dutch experience with euthanasia is another example of the slippery slope. First terminally ill patients were allowed to be killed. Then came the chronically ill, then the depressed, then even children. Once you accept the legalised killing of a patient is allowable, soon any and every sort of patient will become a candidate for the lethal injection. And the euthanasia virus is contagious. Belgium, a southern neighbor of Holland, also legalised euthanasia in 2002, making it the second nation in the world to do so.

The details Smith provides of the Dutch experience make for chilling reading, but they act as a sober warning to other nations. Prior to 1960 there was no push for euthanasia in Holland. But the 60s cultural revolution unleashed a host of liberalising trends, in many fields, be it sex, drugs, or the life issues.

A 1973 case saw the quasi-legalisation of euthanasia there. In 1993 guidelines were issued. But as Smith shows, these guidelines were a chimera, and euthanasia simply got out of hand. The guidelines were meant to keep euthanasia rare, only for the hard cases. But over time doctors interpreted loosely the guidelines, pushed the boundaries, and in effect ignored their intent.

Various reports have documented this slippery slope. The 1991 Remmelink Report found that nearly 9 per cent of all deaths in Holland were due to deliberate actions of doctors. And half of those were involuntary. And a 1996 study found that half of Dutch physicians took the initiative by suggesting euthanasia to their patients. Other research has found that it is usually families, not patients, who push for euthanasia. And a 1997 report found that doctors kill 8 per cent of all infants who die each year. And some 300 infants die each year because of medical neglect.

Teens suffering depression are also being bumped off. The list goes on and on. The Dutch experiment proves that once the door is opened, it does not close but simply gets pushed open even wider.

Taken as a whole, this volume makes for a worrying read. The trends in different parts of the world described here show us that we in the West have abandoned our respect for life, and have embraced the culture of death. Smith closes by noting that we have two options: we can choose the option of care and inclusion, or the option of death and exclusion. The sort of society that we become will be determined by the choices we make in this area.



Rating:
Summary: Shrill One Sided and Badly Written
Review: Wesley J. Smith has written a book about an admittedly emotional and divisive issue. The book fails because he lacks any form of objectivity, his writing lacks any sort of balance, and at times becomes so trite, reading becomes painful. "Forced Exit", fails at the very beginning when the author shares a personal experience of having lost a friend who chose to take her own life. The experience was clearly a galvanizing event for him, and it undercuts his ability to present a case that is worth reading.

I would guess that many readers who get past the first handful of pages will truly have a hard time once the author resorts to the ultimate reference, that when used infects what it touches with evil. The body of this book is 252 pages in length. When the author lists 31 pages of his book, or 12.3%, or nearly one in 8 pages under the heading of, Germany, Nazi-euthanasia practices in, the book rightfully becomes of questionable value in the least, and of near zero value in reality. If this man cannot discuss a topic that has held a prominent place in this nation's debates for the better part of 2 decades without calling on the old standby of the Nazis, his argument is exposed as the weak one that it is. Associate your argument with the Nazis and you may win some to your side, but most will run from hyperbolic comparisons, that by their use tend to trivialize who the Nazis were, and what they actually did.

Mr. Smith expresses his astonishment at the manner that traditionally held, "self evident truths", are being undermined. Perhaps Mr. Smith should read the document to which he refers. When the final draft of that famous instrument was written it contained hypocrisy that was practiced and legitimized by courts to the late 19th century. These, "wonderful", self evident truths are wonderful in theory, and are practiced when convenient, or when humanity finds a spot in government, or a seat on the highest court. Most of the signatories to the document he refers to were signed by hypocrites who advocated the most bestial of social norms, while holding the highest offices in this nation, inclusive of several presidencies.

For a moment let us imagine we are dealing with consenting adults. Society requires more standardized knowledge for the operation of an automobile, together with a license, than is required for procreation. The law allows one of the two participating people the option of terminating the results of their coupling. One person makes the decision for at least two, or if you prefer three other lives. Again, operating a car is deemed to require more contemplation.

Mr. Smith is against a person making the decision their life is one they no longer choose to live. He is against this because he sees and parades all the weaknesses of human nature. He is naïve, alarmist, in short a utopian. Humans have problems, not because they are human, but because some humans will always choose to corrupt any mechanism, any law, any opportunity for themselves at another's expense. I don't think it should be called human nature, but some subset of defective human nature. There are Doctors and there was a Dr. Mengele. Because of the latter we do not rid ourselves of the former.
Physician assisted death is not new, what it is, is not spoken of. We would have fewer doctors if it was. Patients also leave hospitals to go home to die; they do not go there empty-handed, without options.

Mr. Smith will remain agitated and lack objectivity for as long as he finds fault with the species of which he is a member. The species has flaws, but is not fundamentally and completely, flawed. I will take an imperfect system regarding euthanasia just as I accept dozens of other practices that affect my life, before I will ever agree with those like Dr. Smith who would have the 400+ members of congress tell me when I have had enough. The activities of our elected officials give me pause on far more occasions than the minority of citizens whose votes put them there.