Who has the right to end a life?
March 31 will mark the second anniversary of Terri Schiavo’s death, which plunged the nation into a heated debate over who has the right to end a life. While the intensity of the debate has lessened since the days leading up to Schiavo’s death, it continues as patients, families, physicians, ethicists, legislators, judges and clergy wrestle with the difficult choices that arise when death nears.
What’s New
• On June 1, 2007, Dr. Jack Kevorkian is scheduled to be released from prison in Michigan after serving eight years of a 10- to 25-year sentence for a second-degree murder conviction for helping a man with Lou Gehrig’s disease die. Kevorkian, who has admitted participating in more than 130 suicides, will be 79 and is ill with Hepatitis C. (Michigan doesn’t release prisoners on Fridays, so he may be released on June 4 instead.)
• March 31, 2007, will mark the second anniversary of the death of Schiavo, a severely brain damaged woman who died after her water and feeding tubes were removed. The battle over her life and death engaged religious leaders, the public, Congress and the president.
• Two states are considering bills modeled after Oregon’s law. On Feb. 15, 2007, legislators introduced the California Compassionate Choices Act for consideration. The Vermont Legislature is considering a bill called Patient Choice and Control at End of Life.
• On Feb. 14, 2007, the American Academy of Hospice and Palliative Medicine issued a position statement on “Physician-Assisted Death.”
• In December 2006, the Roman Catholic Church refused to give a religious funeral to a Rome man with muscular dystrophy who had begged the Italian government to allow him to end his life legally. Piergiorgio Welby died after his doctor disconnected him from his respirator. The doctor was arrested, and the Vatican refused to give Welby a religious funeral because he had advocated euthanasia.
• In December 2006, the General Assembly of the United Nations adopted the “Convention on the Rights of Persons with Disabilities,” which prohibits nations that sign on to the convention to deny “food and fluids” to disabled people.
• On Jan. 17, 2006, the U.S. Supreme Court upheld the constitutionality of Oregon’s assisted-suicide law. Oregon remains the only state in the nation with such a law.
Why it matters
Euthanasia raises the most profound questions about who has the right to die, who has the right to help them — and who has the right to choose who lives and dies. Not a day goes by when a country, state, doctor, hospice worker, theologian, ethicist or family member doesn’t wrestle with whether to allow passive or active euthanasia and whether to challenge doctors or patients who take the law into their own hands.
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Questions for reporters
• How are religious leaders, theologians, hospital chaplains and bioethicists in your area weighing in on right-to-die issues, from passive euthanasia to active assistance in terminating life?
• What kind of end-of-life decisions are families making every day in your area, and to whom do they turn for guidance?
• What kinds of moral issues do health-care workers face when administering pain medication or withholding food or hydration from a dying patient?
• What issues do families and health-care workers face when dealing with people with dementia and Alzheimer’s?
• Should depressed people be allowed to end their lives?
• Should cost of medical treatment be a factor in deciding whether to terminate a life?
• What religious and secular groups are leading the opposition to euthanasia and physician-assisted suicide in your region?
• What groups are actively supporting legislation to allow physician-assisted suicide?
The terms are tricky to define and often used interchangeably. But it is clear that many people support physician-assisted suicide while rejecting active euthanasia.
Euthanasia – The act or practice of killing or permitting the death of hopelessly sick or injured individuals in a relatively painless way for reasons of mercy; also known as mercy killing.
Active euthanasia – The delivery of a lethal dose of medication to a terminally ill person.
Passive euthanasia – The withholding of potentially life-saving medical treatment.
Physician-assisted suicide – When a physician facilitates a patient’s death by providing the means and information to enable the patient to take his or her own life.
Euthanasia with no “free will” – When a physician decides whether or not to end the life of a person who suffers from a serious illness or medical condition.
National sources
LAW
• Bill Colby was the attorney for the Nancy Cruzan family in the first right-to-die case heard by the U.S. Supreme Court. He is the author of Unplugged: Reclaiming Our Right to Die in America (AMACON, 2006) and Long Goodbye: The Deaths of Nancy Cruzan (Hay House, 2002). Read his commentary “Terri Schiavo’s Gift” at Living Initiatives for End-of-Life Care, The Life Project. Contact him in Kansas, 913-432-1028, bcolby25@aol.com.
• Carl H. Coleman is director of the Health Law and Policy Program at Seton Hall Law School in Newark, N.J. He has written on assisted suicide and was a member of the New York State Attorney General’s Commission on Quality of Care at the End of Life. Currently on sabbatical, he is reachable by email at colemaca@shu.edu.
• Jon B. Eisenberg is an appellate lawyer who was part of the legal team of Schiavo’s husband, Michael Schiavo. Eisenberg wrote Using Terri: The Religious Right’s Conspiracy to Take Away Our Rights (HarperSanFrancisco, 2005). He is with Eisenberg and Hancock in San Francisco. Contact 510-452-2581.
• Karen Porter is executive director of the Center for Health, Science and Public Policy at Brooklyn Law School, which trains law students in law related to health and science topics. Contact 718-780-7559, karen.porter@brooklaw.edu.
• Susan M. Wolf is a professor of law, medicine and public policy at the University of Minnesota Law School. She has written extensively on physician-assisted suicide, euthanasia and other end-of-life issues and is the author of the 2008 edition World Book Encyclopedia article on euthanasia. Contact 612-625-3406, swolf@umn.edu.
• Carl E. Schneider is Chauncey Stillman Professor for Ethics, Morality and the Practice of Law at the University of Michigan Law School. He serves on the President’s Council on Bioethics and edited Law at the End of Life: The Supreme Court and Assisted Suicide (University of Michigan Press, 2000). Contact 734-647-4170, carlschn@umich.edu.
MEDICINE
• Dr. Ira Byock is director of the palliative care program at Dartmouth-Hitchcock Medical Center in Lebanon, N.H. His books include The Four Things That Matter Most: A Book About Living (Free Press, 2004). A past president of the American Academy of Hospice and Palliative Medicine, he maintains information and resources about end-of-life care at the Web site DyingWell.org. Contact 603-650-5402, Ibyock@aol.com.
• Dr. Ezekiel J. Emanuel is chief of the department of clinical bioethics at the National Institutes of Health. An oncologist, Emanuel also has a doctorate in political philosophy from Harvard University. He has published widely on advance care directives, end-of-life care issues and euthanasia, among other policy topics. His books on medical ethics include The Ends of Human Life (Harvard University Press, 1991). Contact eemanuel@nih.gov.
• Dr. Kathleen M. Foley is a neurologist who developed the Pain and Palliative Care Service at Memorial Sloan-Kettering Cancer Center in New York, the first such center at a U.S. cancer hospital. She is the past director of the Project on Death in America of the Open Society Institute and is an internationally recognized authority on palliative care. Contact 646-888-2683.
• Dr. Joanne Lynn is a pioneer in palliative care and care of the dying, a geriatrician, a health services researcher and an ethicist. She has served as chairwoman for various efforts to improve end-of-life care, is past president of Americans for Better Care of the Dying and is the author or editor of numerous books, including Sick to Death and Not Going to Take It Anymore: Reforming Health Care for the Last Years of Life (University of California Press, 2004). She works in the Office of Clinical Standards and Quality within the federal Centers for Medicare and Medicaid Services in Baltimore; contact her through the centers’ office of external affairs in Washington, D.C., 202-690-6145.
• Dr. R. Sean Morrison is a professor of palliative care at Mount Sinai School of Medicine in New York. He co-edited a book on geriatric palliative care and is director of the National Palliative Care Research Center. Contact 212-241-1466, sean.morrison@mssm.edu.
• Dr. Richard Payne is professor of medicine and divinity and director of the Duke Institute on Care at the End of Life at Duke University, established in 2000 to improve end-of-life care and facilitate “dying well.” Contact 919-660-3553, rpayne@div.duke.edu.
• Dr. Daniel Sulmasy is a professor of medicine and director of the Bioethics Institute of the New York Medical College in Valhalla, N.Y. Sulmasy is a Franciscan friar and a physician. He also holds a doctorate in philosophy and has expertise in end-of-life decision-making. His writings include “Are Feeding Tubes Morally Obligatory?” in the January 2006 St. Anthony Messenger, examining Catholic teachings about extraordinary medical treatments. Contact 914-594-4060, daniel_sulmasy@nymc.edu.
THEOLOGY
• Lucy Bregman, a professor of religion at Temple University in Philadelphia, has written extensively on death and dying. Contact 215-204-1746, bregman@temple.edu.
• The Rev. John J. Paris is a Jesuit priest who teaches in the theology department of Boston College. He has been a consultant to the President’s Commission for the Study of Ethics in Medicine and the United States Senate Committee on Aging and presented to Gregorian University in Rome on Catholic approaches to end-of-life care. Contact 617-552-8434, John.Paris@bc.edu.
• Kenneth L. Vaux is a professor of theological ethics at Garrett Evangelical Theological Seminary of Northwestern University in Evanston, Ill. He has written about theology and medicine and is the co-author of Dying Well (Abingdon Press, 1996). Contact 847-866-3887, Ken-Vaux@garrett.edu.
ORGANIZATIONS
• J. Donald Schumacher is president and CEO of the National Hospice and Palliative Care Organization in Alexandria, Va., a membership organization for hospices and palliative care groups. Contact 703-837-3136, dschumacher@nhpco.org.
• The International Association for Hospice and Palliative Care in Houston maintains a searchable directory of organizations that concern themselves with hospice and palliative care. Programs can be searched by state. Contact 936-321-9846.
• Dr. J. Cameron Muir is president of the American Academy of Hospice and Palliative Medicine, which issued a position statement on Feb. 14, 2007, on “physician-assisted death.” Contact 847-375-4712, cmuir@capitalhospice.org.
• The American Medical Association has issued a statement against physician-assisted suicide.
• The Death with Dignity National Center supports Oregon’s physician-assisted suicide legislation.
• The National Right-to-Life Committee opposes euthanasia and physician-assisted suicide.
• The World Federation of Right to Die Societies links 38 right-to-die organizations in 23 countries and provides information on the latest developments on the issue.
SUPPORTERS OF PHYSICIAN-ASSISTED SUICIDE AND/OR EUTHANASIA
• Timothy Quill, professor of medicine, psychiatry and the humanities at the University of Rochester School of Medicine, was the lead physician plaintiff in the 1977 New York state legal case challenging the prohibition of physician-assisted suicide. He is co-editor of Physician-Assisted Dying: The Case for Palliative Care and Patient Choice (Johns Hopkins University Press, 2004) and author of A Midwife Through the Dying Process: Stories of Healing and Hard Choices at the End of Life (Johns Hopkins University Press, 2001). Contact 585-273-1154 (prefers not to be contacted by email).
• Barbara Coombs Lee is chief petitioner of Oregon’s Death with Dignity Act. She is the president of Compassion & Choices, formed when the Compassion in Dying Federation, based in Portland, merged with End-of-Life Choices, formerly known as the Hemlock Society. Contact through Claire Simons, media relations: 800-247-7421, Csimons@compassionandchoices.org.
• Dr. Robert Brody is a professor of medicine at the University of California at San Francisco and chief of the Pain Consultation Clinic at San Francisco General Hospital. A former hospice director, he is a Compassion & Choices board member. Contact 415-206-8267, robert.brody@ucsf.edu.
• Peter Singer, Princeton University bioethics professor, caused an outcry when he advocated euthanasia for those born with severe mental disabilities. Contact 609-258-2202.
• Mayer Morganroth is attorney for Jack Kevorkian, the physician who is serving a 10- to 25-year sentence for aiding in the death of a man suffering from end-stage Lou Gehrig’s disease. Contact 248-355-3084, mmorganroth@morganrothlaw.com.
• Margaret Pabst Battin is a University of Utah philosophy professor and a leading figure in the public debate on end-of-life issues. She has written extensively on religious and ethical concerns in physician-assisted suicide and euthanasia and has researched active euthanasia and assisted suicide in the Netherlands. Her books include Ending Life: Ethics and the Way We Die (Oxford, expected March 2005) and The Least Worst Death: Essays on Bioethics on the End of Life (Oxford, 1994). Contact 801-581-6608, battin@utah.edu.
• Dr. Timothy Quill is director of the Center for Ethics, Humanities and Palliative Care at the University of Rochester Medical Center. He has written and spoken frequently about physician-assisted suicide. Contact 585-273-1154.
OPPONENTS OF PHYSICIAN-ASSISTED SUICIDE AND/OR EUTHANASIA
• Wesley J. Smith, San Francisco-based attorney, columnist and anti-euthanasia activist, believes the Dutch have lost their moral compass. He is the author of Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder (Times Books/Random House, 1997). Contact 510-886-8609, wjs@wesleyjsmith.com.
• Diane Coleman, an attorney, is the founder of Not Dead Yet, a Forest Park, Ill.-based organization of people with disabilities who actively oppose euthanasia and physician-assisted suicide. Contact 708-209-1500, ndycoleman@aol.com.
• F. Michael Gloth, associate professor of medicine at Johns Hopkins University School of Medicine in Baltimore, believes that calling an act physician-assisted suicide “makes it no less suicide and no less murder.” Gloth has written extensively about pain management in the elderly. Contact 410-526-1490, mgloth@adelphia.net.
• Richard Doerflinger, deputy director of the Secretariat for Pro-Life Activities of the United States Conference of Catholic Bishops, is a bioethicist who writes frequently on euthanasia. Contact 202-541-3070, rdoerflinger@usccb.org (prefers calls).
• Daniel Callahan is a bioethicist at The Hastings Center, a leading figure in the public debate over euthanasia and the author of The Troubled Dream of Life: In Search of a Peaceful Death (Simon & Schuster, 1993). He opposes physician-assisted suicide and has written that, “the application of mercy killing has no logical boundaries.” Contact 845-424-4040 ext. 222, callahand@thehastingscenter.org.
• Rabbi David Novak, University of Toronto Jewish studies professor, believes that euthanasia and physician-assisted suicide are contrary to the teachings of Jews and Christians. Contact by email only, david.novak@utoronto.ca.
• Read Oregon’s “Death with Dignity” law and see a page from the Oregon Depart of Human Services that links to reports on physician-assisted suicide.
• Read a transcript of “The Right to Assisted Suicide?: Oregon Goes to the Supreme Court,” a Sept. 29, 2005, discussion co-sponsored by the Pew Forum that featured M. Edward Whelan of the Ethics and Public Policy Center and Robert Raben of The Raben Group.
• Read a backgrounder on the case issued in September 2005 by the Pew Forum on Religion and Public Life.
• Read a transcript of “Right to Die? Legal, Ethical and Public Policy Implications,” a May 2005 public discussion sponsored by the Pew Forum that featured Daniel W. Brock of Harvard Medical School, R. Alta Charo of the University of Wisconsin Law School, Robert P. George of Princeton University and Carlos Gómez of Capital Hospice.
• Euthanasia.com has a state-by-state breakdown of assisted-suicide laws.
• California: On Feb. 15, 2007, legislators introduced the California Compassionate Choices Act for consideration.
• Vermont: The Vermont Legislature is considering a bill called Patient Choice and Control at End of Life.
• Euthanasia.com, an anti-euthanasia site, contains numerous articles on topics such as physician-assisted suicide in Oregon, euthanasia in the Netherlands and statements by religious groups and medical organizations.
• Willamette University’s College of Law in Salem, Ore., offers a Web site that breaks down physician-assisted suicide legislation and medical and international developments from 1997 to 2006.
Background
• Read a March 7, 2007, Associated Press article that says 46 people used Oregon’s Death with Dignity law to end their lives in 2006, up eight from 2006. The story is posted by the International Herald Tribune.
• Read a Jan. 12, 2007, article on Vermont television news station WCAX’s Web site previewing the state’s legislative session, including debate on a right-to-die bill.
• Read a Jan. 2, 2007, article on the Baptist Press Web site on the American Public Health Association joining Oregon’s Department of Human Services in no longer using the term “physician-assisted suicide.”
• Read a Dec. 26, 2006, article on the Web site LifeSite about the United Nations’ Convention on the Rights of Persons with Disabilities.
• Read a Dec. 22, 2006, New York Times article on an Italian man’s fight to end his life. The article appears on the San Francisco Chronicle’s Web site.
• Read a Nov. 6, 2006, article on the American Medical Association’s news Web site on how Oregon’s Department of Human Services will no longer use the term “physician-assisted suicide.”
• Read a March 31, 2006, article in The Washington Times on the one-year anniversary of Schiavo’s death.
• Read a Jan. 18, 2006, Time magazine article on how the Supreme Court’s decision upholding the Oregon suicide law does not end the national debate.
• Read a Jan. 17, 2006, Fox News story about the Supreme Court upholding Oregon’s assisted-suicide law.
• To find out how religious groups weigh in, read a 2000 essay, “Euthanasia and Religion” by Courtney Campbell, Oregon State University philosophy professor. Campbell says there continue to be five basic denominational positions in regard to physician-assisted suicide and euthanasia:
| • Physician-assisted suicide is immoral and should be illegal (Roman Catholics, Southern Baptists, Latter-day Saints).
• Physician-assisted suicide is immoral, but its legality is not a “religious” issue per se (most mainstream Protestants, Conservative and Orthodox Judaism, Islam.) • No denominational position has been formulated on physician-assisted suicide because it is a political/medical issue (many Protestant groups). • Physician-assisted suicide is moral in limited circumstances as a matter of respecting individual choice (United Church of Christ, Reformed Judaism). • Physician-assisted suicide is moral in limited circumstances and it is a religious responsibility to advocate for passage of laws securing this right (Unitarian Universalist). |
• Euthanasia.com posts and links to position papers by numerous religious groups, from the Salvation Army to the Sikhs.
• AboutBuddhism.com describes the Buddhist perspective on euthanasia.
• See opinion polls on end-of-life issues and on Schiavo from PollingReport.com.
• The Pew Forum on Religion & Public Life posted research related to the first anniversary of Schiavo’s death.
• Read the summary of a poll released Jan. 5, 2006, by the Pew Research Center for the People and the Press. It found that 46 percent of Americans support the right to assisted suicide, while 45 percent oppose the practice.
Regional sources
• Arthur Dyck, Harvard University professor of population ethics, argues against assisted suicide. Contact 617-495-5742 (does not use email).
• Lisa Sowle Cahill, Boston College theology professor, has written about Catholic and Protestant perspectives on euthanasia. Contact 617-552-3890, Lisa.Cahill@bc.edu.
• George Annas, Boston University professor of health law, bioethics and human rights, is an expert on euthanasia and court decisions. Contact 617-638-4626, annasgj@bu.edu.
• Arthur Caplan, University of Pennsylvania bioethics professor, has written about finding common ground in the assisted-suicide debate, the definition of death and the ethics of withdrawing treatment from babies and adults. Contact 215-898-7136, caplan@mail.med.upenn.edu.
• James Hoefler, Dickinson College political science professor, has written about terminal dehydration as an alternative to physician-assisted suicide and moral decisions about tube feeding for severely demented patients at the end of life. He hosts a web site on the topic. Contact 717-245-1311, hoefler@dickinson.edu.
• Sylvia Law, professor at New York University School of Law, distinguishes between euthanasia and assisted dying, which she supports. Contact 212-998-6265, sylvia.law@nyu.edu.
• Tom Beauchamp, Georgetown University professor of philosophy, edited Ethical Issues in Death and Dying (Prentice Hall, 1996). Contact 202-687-6726, beauchat@georgetown.edu.
• Rita Simon, an American University professor of justice, law and society, co-authored Euthanasia and the Right to Die: A Comparative View (Rowman & Littlefield, 1999). Contact 202-885-2965, rsimon@american.edu.
• Jonathan Moreno, University of Virginia biomedical ethics professor, has written about the controversy surrounding physician-assisted suicide and euthanasia. Contact 434-924-8274, jdm8n@virginia.edu.
• Dixon Sutherland, Stetson University professor of religion and ethics, has written about the search for a legal and ethical basis for physician-assisted suicide. Contact 386-822-8931, dsutherl@stetson.edu.
• John Hardwig, University of Tennessee philosophy professor, is the author of Is There a Duty to Die? & Other Essays in Medical Ethics (Routledge, 2000) Contact 865-974-3255, jhardwig@utk.edu.
• Stella Capek, Hendrix College sociology professor, has studied the right-to-die movement in the United States. Contact 501-450-1308, capek@hendrix.edu.
• Kathryn Rettig, professor of family social science at the University of Minnesota, has looked at the values underlying end-of-life decisions. Contact 612-625-7745, krettig@umn.edu.
• Cathleen Kaveny, University of Notre Dame law and theology professor, has focused on vulnerable populations in her writing about assisted suicide. Contact 574-631-7844, M.Cathleen.Kaveny.1@nd.edu.
• Gerald McKenny, University of Notre Dame professor of Christian ethics, has written about a Protestant perspective on physician-assisted suicide. Contact 574-631-4520, Gerald.P.McKenny.4@nd.edu.
• The Rev. John Kavanaugh, St. Louis University philosophy professor, has looked at human identity and “the ethics of killing.” Contact 314-977-3159, kavanasj@slu.edu.
• Donald Messer, professor emeritus of practical theology, Iliff School of Theology, has focused on helping Christians debate assisted suicide. Contact 303-770-5809, dmesser@iliff.edu.
• Daniel McGee, a retired Baylor University ethics professor, has written about a “Believers’ Church” perspective on euthanasia and physician-assisted suicide. Contact 254-710-6316, Daniel_Mcgee@baylor.edu.
• Courtney Campbell, Oregon State University philosophy professor, has focused on the Latter-day Saints and medical ethics, as well as hospice and assisted suicide. Contact 541-737-6196, ccampbell@oregonstate.edu.
• Darien Fenn, professor in the psychiatry department at Oregon Health Sciences University, has studied the attitude of Oregon psychologists toward physician-assisted suicide and the Oregon Death with Dignity Act. Contact 503-685-9357, fennd@pipeline.com.
• Linda Ganzini, professor of psychiatry and medicine at Oregon Health Sciences University, surveyed 2,500 Oregon physicians and 500 hospice workers about patients’ experience of assisted suicide. Contact by email only, Ganzini@ohsu.edu.
• Joel Zimbelman, a California State University, Chico, religious studies professor, has written on legal decisions and public opinion informing the debate over the removal of life-sustaining treatment, assisted suicide and euthanasia. Contact 530-898-4741, jzimbelman@csuchico.edu.
• Rabbi Elliot Dorff, University of Judaism bioethics professor, has focused on the Jewish perspective on assisted death. He is the author of Matters of Life and Death: A Jewish Approach to Modern Medical Ethics (Jewish Publication Society, 1998). Contact 310-440-1255, edorff@uj.edu.
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