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By Robert K. Matsumoto
and Garret Hashimoto

Saturday, January 8, 2000

Doctor-assisted
suicide is a bad idea

IN two recent columns, contributing editor A.A. Smyser opined that Hawaii should enact legislation that would permit Physician Assisted Suicide (PAS) within Hawaii's borders. Smyser euphemistically calls it "physician-assisted death" (PAD).

It bears repeating that the U.S. Supreme Court did not hold that an individual has a "right to die" under the Constitution. Unlike abortion, the court left it to the individual states to determine whether it should be permitted and under what circumstances.

Whether called PAS or PAD, permitting physician-assisted suicide is a bad idea for a host of compelling state interests. Although not exhaustive, these are:

Bullet Preventing suicide.

Bullet Maintaining physicians' roles as their patients' healers.

Bullet Protecting vulnerable people from indifference, prejudices and psychological and financial pressure to end their lives.

Bullet Avoiding a possible slide toward euthanasia (physician actively causing death).

Balancing the conflicting interests, an objective observer must conclude that society's interest to preserve life is paramount to the individual's interest, if any, to die.

Permitting the medical profession to participate in such a practice would lead to the deterioration of quality of care.

The Institute of Medicine, an arm of the National Academy of Sciences, recently reported that medical mistakes have led to a shocking 98,000 hospitalized American patients being killed annually.

Ask whether the legalization of PAS would further add to this stunning number of deaths, voluntarily or otherwise, since the orientation of doctors would become one of terminating life rather than preserving it.

Still other troubling aspects of the deterioration of quality of care that follows from the legalization of PAS surely can be found in health maintenance organizations. The HMO's incentive to end lives if only to fatten the bottom line will often dictate care that the HMO will approve.

APART from the HMO, the bureaucracy of the State of Hawaii itself will have a very strong interest to seek PAS for its wards, many of whom are aged or disabled, since the prospect of ending the cost for long-term care is heightened in these difficult financial times.

Smyser also mentions that he was in the 11-7 majority that recommended PAS be enacted. It comes as no surprise that there was a majority favoring PAS since Governor Cayetano's so-called "Blue-Ribbon Panel on Living and Dying With Dignity," of which Smyser was a member, was stacked with a majority favoring PAS.

In contrast, the New York Task Force on Life and the Law, comprised of 24 professionals and clergy with sterling backgrounds, studied all aspects of PAS and beyond for at least five years before it came up with its monumental report.

It concluded unanimously that compelling exceptional cases did not justify changing the law governing PAS and active euthanasia even though some members felt PAS and active voluntary euthanasia, or AVE, may be morally acceptable in "exceptional cases."

The task force concluded that "abuse of the system is highly likely to follow."

Indeed, there is good reason to fear that abuse is likely to follow. The Dutch experience is a good example of the perils of allowing PAS that resulted in the proverbial "slipperly slope."

During World War II, the heroic Dutch medical profession resisted the Nazis' attempts to coerce Dutch doctors into adopting Nazi medical practice, which included AVE.

In an attempt to intimidate the Dutch medical profession, 100 Dutch doctors were shipped to concentration camps in the East, from which few returned. But the courageous Dutch doctors refused to adopt the Nazi practices, and it was the Nazis who gave up.

Yet, a generation or two later, Dutch medical practice has deteriorated to such a degree that not only has the Dutch medical profession apparently adopted PAS as a routine practice, but it also has endorsed AVE.

WHAT appears as innocent, infant steps and as compassionate and caring practices are really disguises for the ultimate in government intrusion in citizens' lives. The sad part is that there would be complicity in the medical profession in taking lives rather than in saving them if PAS is enacted.

The irony of it all is that where doctors once proudly took their Hippocratic oaths to preserve life, they now would end it with little care or compassion once PAS is enacted. If it comes to this point, God forbid, the medical profession would be in full complicity with "gods," i.e. those whose views are self-centered rather than altruistic.

Robert K. Matsumoto is state director of the American Center
for Law and Justice of Hawaii, a nonprofit public interest organization specializing
in freedom of religion and pro-life, pro-family and pro-liberty issues.
Garret Hashimoto is president of the Hawaii Christian Coalition.
Their views in this article do not necessarily represent
those of their organizations.

A.A. "Bud" Smyser's columns on physician-assisted suicide:



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