Reflections and Observations about Physician Assisted Death

by Deacon John Volk

www.deaconden.org: “The push for physician assisted death flows naturally from the secular world view. The issue is part of the same culture war that we have been engaged in for the past century… The secular world view at its core is a denial of the existence of God – the rest of secularism flows from that premise…”

Reflections and Observations about Physician Assisted Death

by Deacon John W. Volk, M.D.

Philosophical underpinnings

The push for physician assisted death flows naturally from the secular world view. The issue is part of the same culture war that we have been engaged in for the past century. The secular world view has a very different view of truth, morality, freedom and the human person than the Judeo-Christian world view. The secular world view at its core is a denial of the existence of God – the rest of secularism flows from that premise.

In the absence of God, the secular world view believes that there is no absolute truth or morality. The Christian world view says that not only do absolute truth and morality exist – but they are knowable. That leaves the secular world with a fundamental ethic of hedonism – happiness is achieved by seeking pleasure and avoiding pain. So the secular proponents of physician assisted give moral justification not by asking “is it right or wrong?” but rather, “does it help one avoid suffering?”

The secular world view also has a different idea of freedom and autonomy than the Christian world view. The secular view of freedom is freedom to do what I please – I am free to do what will enable me to seek pleasure or avoid pain. The Christian world view sees freedom as a means to an end – holiness. So the Christian is free in order to do what is right and good. This exaggerated view of autonomy is at the heart of the pro-choice movement – and physician assisted death is the logical next step in that movement. Exaggerated autonomy is one of the roots of the culture of death.

Finally the secular world view has a different idea about the human person. In the secular view the human person (and all creation for that matter) is the result of a random series of events that came about by chance. The human person is no different than the animals – only more highly evolved. Therefore, there is no moral difference between euthanizing myself or a family member and euthanizing my pet or my horse. At the deepest level, life itself, in the secular world, is a product of chance – an accident.  For the Christian, the universe is intentional – planned, designed for a purpose by a personal God. The human person is made in the image and likeness of God and has been endowed with an immortal soul that allows us to appreciate beauty, goodness and truth – very different than the animals. For the Christian, individual life at its essence is gift. My being is not random or an accident – rather I was given life by God who knew me before I was formed in my mother’s womb – from all eternity. Therefore, for the Christian, my life is not my own to do with what I please. For the Christian, suffering is not to be avoided but embraced. Christ’s passion and death has elevated human suffering to a new level. Suffering has spiritual meaning, value and power – it is redemptive.

Practical Considerations

Letters to our elected officials and legislative committee hearings do not lend themselves to prolonged discussions about culture wars and world views. When arguing against physician assisted death to a predominantly secular audience, other arguments have to be made.

All legislation that is introduced, no matter what the topic, is well intentioned. It is trying to accomplish something good for someone. In the case of physician assisted death, the intent is to allow individuals a legal means of avoiding suffering in the face of a terminal illness. On the surface, this seems like a good thing. But legislation also carries with it unintended consequences which can be harmful. This is at the core of arguments against such legislation. There are numerous unintended bad consequences of right to die legislation. I would like to reflect upon two – its effect on the poor and the vulnerable and its effect on the culture at large.

Right to die legislation threatens the poor and the vulnerable. As a physician, I have witnessed families struggle with the stress of caring for elderly, infirmed and disabled loved ones. I have watched families torn apart by infighting over even meager inheritances and estates.  With physician-prescribed suicide as an available option, do you fear the potential for subtle emotional manipulation and pressure on vulnerable elders and infirmed family members?

I have also struggled to provide medical care for patients denied benefits by an increasingly burdened and cost-conscious health care system. There is a growing strategy of identifying and managing the highest utilizers of health care dollars, particularly in the Medicaid system which funds health care for the poor. I receive regular reports from Medicaid with the names of my patients who are costing the system the most money. These patients are assigned individual case workers to help them utilize the system better and try to keep them out of the emergency room and hospital (a good thing). Physician-prescribed suicide is a very inexpensive option for a health care system under stress.  Oregon has seen the case of a woman’s insurance company denying her cancer treatment but offering to pay for assisted suicide as an alternative.  With physician-prescribed suicide as an available option, are you concerned that insurance companies or government run health programs would be tempted to deny coverage for more expensive treatments in favor of a less expensive alternative?  Would you be concerned that well meaning case workers charged to reduce health care utilization would be tempted to subtly manipulate frail and vulnerable clients into opting for physician prescribed death?

Shaping Culture

The term “culture of death” is one that we frequently use to describe our society. I like to think of a culture of death as one in which the death of a person becomes the solution to a problem. Culture is shaped by many things – discussions in coffee shops and around kitchen tables, the media, the schools – but also legislation. When a society embraces death as a solution to a problem it is shaping the culture. The effect of that embrace is to harden us and make us more calloused. If I were a legislator, I wouldn’t want to leave such a legacy to my children and grandchildren.

 

 

 

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