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As Dr. Nancy Dickey of the American Medical Association notes, the concept of "lives not worth living" can apply even to patients who are not terminally ill. "Just chronically ill. Maybe just expensively chronically ill."
"Defective" infants and deeply depressed older people are already being euthanized in the Netherlands, and the doctors who kill them are not being punished. In Oregon, the first place in this country to legalize assisted suicide, euthanasia is not far behind. Many doctors around the nation agree that "compassionate" ending of "futile" lives by direct injection is beneficial to all concerned.
Now Princeton University has appointed its first full-time, tenured professor of bioethics: Dr. Peter Singer, the intellectual leader of the arbiters of death who now are advancing upon us. He teachesI kid you notat the Center for Human Values.
Singer, an Australian, is a former president of the International Association of Bioethics. He is also the principal founder of the animal liberation movementwhich says animals have rights that must be respected.
Singer is best known internationally, however, as a pervasively influential advocatethrough books, articles, and speechesof infanticide. He does not urge the killing of all infants, just certain disabled babies. Down's syndrome infants, for example, or human beings born with severe forms of spina bifida, an incomplete closure of the spine.
He does not dispute the right of parents to keep such defective offspring if they choose. Indeed, in Should the Baby Live? (Oxford University Press), he and his colleague, Helga Kuhse, suggest that "a period of 28 days after birth might be allowed before an infant is accepted as having the same right to live as others."
During that period, the parents or parent would have time to figure out whether it would be worth it, financially and emotionally, to keep the damaged offspring. If not, they will be permitted to have the infant killed. After all, department stores have return privileges.
Singer says that should the parents and their physicians decide this kid would have too miserable a life, there ought not be practical ethical qualms about disposing of him or her. As he has emphasized in his book Practical Ethics (Second Edition, Cambridge University Press): "Human beings are not born self-aware, or capable of grasping that they exist over time. [Newborns] are not persons."
But animals are persons. They are self-aware, and therefore, "the life of a newborn is of less value than the life of a pig, a dog, or a chimpanzee."
Professor Singer does not limit his prescription of death to imperfect infants. He is also an advocate in certain cases for killing humans at any age. If someone is so sick, so miserable, so without hope, why not permit a doctor, within certain limitations, to provide pills or other medication that will end the discussionand that person's life?
An argument against legalizing assisted suicide is the fact that many physicians do not have any expertise in the many advances in pain relief. And many doctors are unable to diagnose clinical depression, which can be treated if you know how.
But assisted suicide is especially seductive when, in this time of HMOs and other managed care, the pressure is mounting to not waste time, bed space, and money on patients who would be "better off dead."
Yet, in our present "death culture"to use a phrase of Wesley Smith, who writes with great authority and clarity on that culturethere is also a growing support for active euthanasia. That is, why not permit the doctor to not only give the death pills to a patient but also to actually be present and inject the patient directly with death?
Professor Singer sees no ethical difference between assisted suicide and having the doctor do the killing. Singer makes the point that "active euthanasia"performed by a physicianshould "be accepted as humane and proper under certain circumstances."
But that person must want to be euthanatized. Unless, Singer says, the patientlike a newbornlacks "the capacity to undertand the choice between continued existence or nonexistence."
If, for instance, you fall into what doctors call a "persistent vegetative state." The presumption is that you then do not know if you're alive or dead. You do not know anything. At that point, according to Singer, it is appropriate to kill you. Unlike an animal, you are not self-aware.
However, over the years I have interviewed doctors who, in their own experience, have known patients to have recovered from misdiagnosed "persistent vegetative states." In his book, Forced Exit: The Slippery Slope From Assisted Suicide to Legalized Murder (Times Books), Wesley Smith writes about Dr. Vincent Fortanasce, a board-certified neurologist and psychiatrist. Fortanasce tells of a 60-year-old man who "collapsed and was diagnosed as P.V.S. by his internist, who strongly urged the family to discontinue all life support, including nutrition."
Fortanasce applied the required tests and found that the patient was not P.V.S. He'd experienced a severe brain seizure, and after appropriate treatment, "a week later, the patient walked out of the hospital in full possession of his faculties."
Three of Peter Singer's grandparents died in Nazi concentration camps. Last October, he said, in a debate at Princeton: "I do not think it is always wrong to kill an innocent human being."
On October 17, 1933, The New York Times reported from Berlin that the German Ministry of Justice intended to authorize physicians "to end the suffering of incurable patients, upon request, in the interests of true humanity."
This was a prelude to the Nazi concentration camps.