The Ethical Culture Society of Essex County

Social Action Committee Urges Freedom for the Dying

by Win Thies

Our Social Action Committee in its March 17 (2002) meeting launched a three-part campaign to put the Society on record as supporting physician aid-in-dying (PAD). First, it enacted a resolution to be presented from the Committee to the membership at our May 19 Annual Meeting endorsing decriminalizing PAD “with reasonable protections against abuse.” PAD allows a physician at the repeated request of a patient who is within six months of expected death or in intractable suffering and who has full decision-making capacity to write a prescription for a lethal dose of drugs which the patient later may or may not decide to self-administer in order to hasten dying. PAD in New Jersey is now a crime of the second degree, subjecting an offending doctor to up to 10 years in jail and as much as a $100,000 fine. In America PAD is only lawful in Oregon, under its four-year-old Death With Dignity Act. The resolution also calls upon the AEU to reconfirm its resolution of some ten years ago in support of PAD.

Second, the Committee voted to sponsor a public discussion meeting on “Toward Common Ground on End of Life Issues.” The meeting has been set for 12:45 p.m. on Sunday, May 5, immediately after a short Social Action Committee meeting at our Meetinghouse. It will be facilitated by Committee member Win Thies and will follow the format used by him at his interactive Platform of the same title at the Ethical Culture Society of Queens on Feb. 24.

Such meeting will also serve more fully to meet the spirit of our By-Law provision on adopting resolutions on public issues. Art. IX, Sec. 2(d) requires considered deliberation and discussion prior to adoption of any resolution. To the extent that is reasonably fully accomplished at the April 28 discussion meeting, it will go far to shortening the May 19 Annual Meeting. The By-Laws also only permit a resolution on a public issue if it is an outgrowth of the “core beliefs” of the Ethical Culture Society. These are set down as belief in the intrinsic worth of each individual and in respect for the dignity and welfare of all people. Also, that it is essential to “develop the highest values in human relationships”.

Third, the Committee voted to nominate Dr. Jack Kervorkian for the Elliott-Black Award to be presented at the AEU Assembly in 2003. Today Dr. Kervorkian sits in solitary confinement in a Michigan jail cell    [Note: this essay is out of date: as of June 2007 Dr. Kervorkian was released and placed on parole, according to Wikepedia and other sources]   facing as much as 23 further years of imprisonment for his having euthanized the suffering, ALS-afflicted Thomas Youk at Mr. Youk’s repeated and insistent request. The disabled Mr. Youk was unable to effect his own death. Some characterize Dr. Kervorkian as the loose cannon of the Right to Die Movement, while others think him a prisoner of conscience jailed for a compassionate act. Plainly, the Committee is of the second view. Dr. Kervorkian’s actions in respect to Mr. Youk go beyond PAD and would not be legal under a new law solely decriminalizing PAD. The full text of the resolution adopted by the Committee reads:

 

 

Whereas the Social Action Committee of the Ethical Culture Society of Essex County has heretofore adopted a resolution in favor of physician aid-in-dying, Now then, said Committee commends to the Society the adoption at the nearing Annual Meeting of a resolution in favor of physician aid-in-dying in the following form:

Be it resolved that the Ethical Culture Society of Essex County hereby supports the decriminalization of the furnishing of a prescription for a lethal dose of drugs by a physician to an adult patient with full decision-making capacity, at such patient’s insistent and repeated request, where such patient is not treatably depressed and either terminally ill (within six months of expected death) or in intractable suffering, with reasonable protections against abuse. Such protections may well be modeled on those of the Oregon Death With Dignity Act and thus include the requirement of a second physician opinion, full disclosure of alternatives, waiting periods, full recording of all interactions with patient in medical records and report of the furnishing of such prescription to responsible authorities.

The Society further commends that the American Ethical Union take like action in support of physician aid-in-dying.

 

 

 

 

The Core Beliefs of Ethical Culture Call for Physician Aid-in-Dying

By Winthrop Drake Thies, LL.M., member, Social Action Committee

(The following does not necessarily reflect the views of the Social Action Committee.)

 

Our Society’s By-Laws in Art. IX, Sec. 2(a) discuss our “core values” by stating: “We derive our commitment to social action from our belief in the intrinsic worth of all people, from our commitment to the dignity and welfare of all people, and from our desire to develop the highest values in human relationships…” Each of those three elements of our “core values”, we submit, calls for support of physician aid-in-dying (PAD).

PAD is the furnishing of a prescription for a lethal dose of drugs to a terminally ill or intractably suffering person of full decision-making capacity at such person’s repeated request, which such person may later choose to self-administer to hasten dying.

Intrinsic Worth

This concept was proposed by Dr Felix Adler at the birth of the Ethical Culture Movement. Indeed, the Movement was the response to Adler’s exposition of this concept. Adler largely owes this idea to Immanuel Kant. It claims that each person must be treated as an end in his- or herself and never as a means. Those who would deny to the dying person the right to control the time and manner of his or her own dying variously invoke the duties which such person assertedly owes to God and/or the community. This, it can be argued, violates the intrinsic worth of the individual: it treats such individual as a means to serve God and/or the community. A variant on the prior claim is that by hastening dying the dying person wrongfully deprives the community of the opportunity to show loving care to the dying person. Again, this argument in effect holds the suffering dying person hostage (a means) so that the living may perfect their souls. And at the practical level the claim of duties owed by the dying to God and/or the community is misplaced: the dying no longer have much if any capacity to serve anyone: they are dying!

Dignity and Welfare

How a person defines his or her own dignity and welfare is an intensely personal matter. Are we going to reimpose a “Doctor knows best”-type approach in which third parties decide what is “in the best interests” of the dying person? One assumes that with the Karen Ann Quinlan case and the cases following it we rejected all that in favor of respect for the autonomy of the individual. That is, the individual alone defines what decisions respect his or her dignity and support his or her “best interests” (welfare). In any event, needless suffering—which even with the highest art of the pain-control physician is too often the lot of the dying—is contrary to the welfare of the dying. To end otherwise intractable suffering through a slightly hastened dying thus benefits such persons.

Enhancing the Highest Values in Human Relationships

Two organized groups who minister to the dying seeking PAD are Compassion in Dying and the Caring Friends program of the Hemlock Foundation. “Compassion” and “caring” say a lot about what these groups exemplify. They give moral and spiritual support to the dying and technical information on how to achieve a “good death”: one that is quick, sure and gentle. They promise never to abandon those they serve, but to be with them unto the very end—if that is what the dying person wants. Timothy Quill, M.D., the noted Rochester physician-author, has written about this, too, and has analogized the role of the caring physician with a dying person to that of the midwife with a newborn. The physician ideally lovingly “midwifes” the dying person from this world of suffering. (And believers hold, into the better world to be.) Dying is a part of life: that final chapter in the book of life. Compassion, love and caring shown to the dying mark PAD as profoundly “pro-life” in the fullest sense of that term. “There is a time to be born and a time to die.” Not desperately holding on to the dying, prolonging their suffering, but having the unselfish and courageous love to let go—this is of the essence of true love.

As we minister to the dying through PAD, we enhance the highest values in human relationships: compassion, caring and love. The “Slippery Slope”? Many attracted to PAD are concerned that it will be bring on an unacceptable level of abuse: that many persons who really do not want PAD or, indeed, lack decision-making capacity, will covertly be forced into seeming PAD. The settled response in ethical discourse to this type of argument is the maxim “Abusus non tollit usum”: “The abuse of a thing does not bar its proper use.” We do not outlaw matches—that can burn down buildings. And while some 40,000 Americans die yearly in car accidents we do not outlaw cars. Rather, we regulate their use, with licensing, car inspections, rules of the road, etc.

Again, the actual experience in Oregon, the one state with legalized PAD, does not support these “Chicken Little” prophecies. In the four full years that the Oregon Death with Dignity Act has been in operation only 91 persons have chosen to avail themselves of the benefits of the Act by taking lethal prescriptions. All have had health insurance. Most were suffering from cancer. Some 80% had previously tried hospice but found it inadequate. Those availing themselves of the Act constitute less than 1/10th of 1% of the dead in Oregon over such period. Anecdotal reports tell of families and friends gathered around the dying as lethal doses were consumed, in a loving, supportive and even celebratory environment.

Like Oregon, we have the capacity to set up reasonable protections against abuse and to police the actual functioning under any PAD law. It may be rejoined that PAD is thus a small problem not worthy of our concern. But such an attitude contradicts our belief in the worth of each individual. Such belief calls on us to support even one suffering person. And if the problem is in a sense small (compared with AIDS, world hunger, nuclear proliferation, etc.) it is (unlike such global problems) one easily solved: by enacting appropriate legislation freeing the dying and their physicians from governmental intermeddling into this most personal, private and (to many) religious decision of one’s life: how and when to die.

Conclusion

The “slippery slope” argument having been revealed as misplaced, PAD thus is fully called for in adherence to our Ethical core beliefs: in supporting the inherent worth of each individual, in supporting his or her dignity and welfare, and in enhancing the highest values in human relationships.

 

 

 

Chapter II of the Japanese Constitution: Renunciation of War Article 9.

Aspiring sincerely to an international peace based on justice and order, the Japanese people forever renounce war as a sovereign right of the nation and the threat or use of focrce as means of settling international disputes. In order to accomplish the aim of the preceeding paragraph, land, sea, and ai forces, as well as other war potential, will never be maintained. The right of belligerency of the state will not be recognized.

 

 

 

Letter and Proposed Resolution for Towns of South Orange and Maplewood, published in The News Record of Maplewood and South Orange, July, 2003

Dear Editor,
      The Social Action Committee of the Ethical Culture Society of Essex County has unanimously adopted the following resolution, which it respectfully asks the governing bodies of Maplewood and South Orange to adopt. The resolution deplores the inroads made into our centuries-old, Constitutionally protected civil rights by the so-called U.S.A. Patriot Act. We believe it would be tragic if, in our efforts to protect ourselves from terrorism, we only succeeded in degrading the very rights that our nation boasts of supporting.
                                                                 Sincerely,
                                                                 Meredith Sue Willis
                                                                 Chair Social Action Committee
                                                                 Ethical Culture Society of Essex County



A PROPOSED RESOLUTION CONCERNING CIVIL LIBERTIES

(Sent to the Township Committee of Maplewood and the Board of Trustees of the Township of South Orange Village)

The Governing Body of this town is concerned by the erosion and violation of the rights and liberties of citizens and legal non-citizen residents, rights guaranteed by the Bill of Rights and other amendments to the Constitution of the United States of America, and by the Constitution of the State of New Jersey. This Governing Body notes with growing concern that such erosion and violation is taking place under certain provisions of the U.S.A. Patriot Act, the Homeland Security Act and other actions of the Federal Government of recent years and through certain administrative actions of the U.S. Department of Justice– in particular, the detention of persons without the bringing of legal charges; denial of detained persons' right to counsel; expansion of authority to conduct unregulated electronic surveillance of lawful activities; limiting access to public documents; expanded information gathering about persons without any demonstrated evidence of criminal behavior and without court order; the threat of secret military tribunals; the unregulated ethnic profiling of individuals; and the threatening public statements by the U.S. Attorney General regarding legal public opposition to these policies.

This Governing Body now therefore resolves that: 1. Officials are hereby urged, to the extent legally permissible, not to cooperate or participate in actions which appear to violate constitutionally-guaranteed civil liberties. 2. These concerns shall be communicated to state and federal representatives who shall be urged to work toward repeal of the unconstitutional provisions of the U.S.A. Patriot Act and the Homeland Security Act.

 

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A Letter from Patricia Fressola Idrobo

My Washington trip [to protest the war in Iraq] went very well. No one knew quite what to expect and we were pleasantly surprised to see so many people there. It was very energizing to be among so many people. The New York Times reported "thousands" of demonstrators, saying the turnout was disappointing. I'm not sure where they got that info. but I can assure you no one was disappointed. Then three days later the New York Times made a correction, saying that police estimated 100,000 and organizers estimated 200,000.

There were people of all ages, a lot of college students, all races and nationalities. I spent a lot of time just reading everyone's signs. I am very sensitive about the impact of signs. I don't like signs that divide people into "us" versus "them," or are personal attacks on a politician (as opposed to their policies). To me that is not very peaceful and also doesn't advance the cause. My favorites were, "Peace is patriotic," "Globalize this: (peace sign)", "Our country should never start a war," "War is not the answer," "Peaceful thinking is the answer," and "An eye for an eye leaves us all blind."

There were over two hours of speeches, including some famous speakers such as Jesse Jackson, Ramsey Clark, and Susan Sarandon. I liked Jesse Jackson's speech and tone. Again, for the same reasons as for signs, I don't like speeches that are personal attacks and create a wide gap between groups with opposing views. Jesse Jackson basically said that we are a great nation and our actions should not be based on political or economic expediency, but on what is right. He said we will lose our moral authority if we attack Iraq. He said Saddam Hussein should be held accountable for his actions. But, he said, that is a good argument for a World Court, not an attack on Baghdad.

Actually I liked his speech so much I looked for a transcript on the internet and found it, but it apparently [the transcript] was his printed version and it seemed to me that he left out a lot of it as he spoke. I'd like to compare it to the audio, which I think is on WBAI's http://www.democracynow.org The parts he left out were the very political parts about Bush's policies.

Then we walked to the White House. It was like a parade, some people had drums and music, some sang or chanted, and there were some, well, colorful groups. My group actually had to leave early (4:00 PM) because we had to meet the bus back at a certain time. I'm glad I went and I hope we have some effect on the direction our country is taking.

                                                            Bye, Tricia

Patricia Idrobo is a former member and friend of our Society.