Thread by me.
There is an interesting discussion underway in the thread from a previous post between two valued SHS commenters, as to whether the Dutch infanticide that has flowed illegally, but generally undisturbed. from the country’s euthanasia permissiveness, can be fairly compared to the infanticide of disabled infants during the medical Holocaust in Germany during World War II. One commenter said, appropriately, that we should be very careful before drawing such analogies. The other, who is reading Robert Jay Lifton’s magnificently researched The Nazi Doctors, sees striking similarities and is disturbed.
I think both are right. There are some similarities between what is happening in the Netherlands now, and what happened in Germany then. But there are also pronounced differences. In fact, I spent quite a bit of time on this subject in both Forced Exit and Culture of Death.
First, let’s start with the significant differences:
But these real and substantial differences should not make us sanguine. I strongly recommend all who are interested in this topic read The Nazi Doctors by Lifton and Death and Deliverance by Burleigh, the two best books on this topic. If you do, you will see that:
And then there is this: The history of the first baby killed in the medical Holocaust, is eerily similar to what happens in the Netherlands–and what bioethicists like Peter Singer advocate. From my book Culture of Death:
The first known German government-approved infanticide, the killing of Baby Knauer, occurred in early 1939. The baby was blind and had a leg and an arm missing. Baby Knauer’s father was distraught at having a disabled child. So, he wrote to Chancellor Hitler requesting permission to have the infant “put to sleep.” Hitler had been receiving many such requests from German parents of disabled babies over several years and had been waiting for just the right opportunity to launch his euthanasia plans. The Knauer case seemed the perfect test case. He sent one of his personal physicians, Karl Rudolph Brandt, to investigate. Brandt’s instructions were to verify the facts, and if the child was disabled as described in the father’s letter, he was to assure the infant’s doctors that they could kill the child without legal consequence. With the Fuhrer’s assurance, Baby Knauer’s doctors willingly murdered their patient at the request of his father. Brandt witnessed the baby’s killing and reported back to Hitler who was pleased all went as planned. Based on this case of requested infanticide, Hitler signed the order permitting doctors to kill disabled infants.[i]
[i] Lifton, Nazi Doctors, Supra., p. 51.
So, while the Nazi analogy should be used with great restraint, and differences should be noted, the charge that Dutch infanticide has certain very disturbing similarities cannot be rejected out of hand. Indeed, in the concept of the life deemed so compromised that it justifies killing, we see disturbing echoes from history that should give us all great pause.
Two threads by me.
There's an all-party panel of Quebec politicians travelling across that province to gather public opinion on the legalization of euthanasia and assisted suicide. The hearings are aptly titled "Dying with Dignity," but since the right-to-kill crowd long ago co-opted that phrase to mean the individual right to choose the time and means of one's own death, there's little doubt which side of life the hearings will be biased toward.
After just one day of testimony, the press gave front-page coverage to the story of Laurent Rouleau. He was wheelchair bound and had lived for 15 years with multiple sclerosis. One day last June, he took out a hunting rifle and ended his life. It's a shocking story, made even more emotional as his wife told the committee that her husband "had to find a way to die before he was a complete prisoner of his body."
Such stories touch our hearts, but they also tend to push us into the erroneous belief that if we could be in complete control until the end, death would come in a sweet, neat package.
But tucked into the back pages of the papers is another story of a 48-year-old Ontario minister whose medical treatment -- or lack of it -- has been at the centre of controversy. In April, he suffered a heart attack that left him deprived of oxygen and brain damaged. Despite visible signs of progress, the hospital made the decision to withdraw nutrition from him in June. The family appealed the decision and the nutrition was returned to him.
But a capacity and consent board refused to acknowledge a family member as his substitute decision maker (SDM) and instead appointed a family friend. However, the board made the appointment contingent on his agreement that the nutrition tubes be removed. That is, 'you can be his SDM as long as you make the decisions we want.'
No news on why such a board is allowed to make these kind of demands a condition of being appointed as a SDM. But the tubes were removed and the minister died this week.
If the pressure from the board was strong enough to remove life support from a patient -- against the family's wishes -- in an age when euthanasia is illegal, it's frightening to think how strong that pressure would be if euthanasia was a legal option. It can easily be argued that the above are extreme examples -- because they are. The problem is, extreme cases become the basis of bad laws.
So the Quebec panel would do well to dispense with hearing the individual cases that evoke an emotional response and focus on the facts that relate to euthanasia. Thanks to a laissez-faire commitment to life in the Netherlands over the past 30 years, we have plenty of them.
While individual stories emphasize that we have the right to self-determination and the state has an obligation to respect my right to autonomy, a 1999 article in the Journal of Medical Ethics reported that almost 20 per cent of all euthanasia deaths in the Netherlands occurred without the patient's explicit request. So much for autonomy and choice.
While individual stories emphasize that uncontrollable pain is a main reason for legalizing euthanasia, this journal reported that pain is rarely the cause for the request. Instead it is a vague fear of a loss of dignity.
Individual stories will also emphasize that this is "my body" and this decision only affects me. But it becomes a public act when killing is legislated and when it involves the assistance of another. It would diminish the measure of trust that is required for any healthy physician/ patient relationship and that would impact all of us.
Stories emphasize individuals whose choices will not impact society, but the facts from the Netherlands show that, once started, a culture of death can't be controlled. The Netherlands started with euthanasia for competent adults who were terminally ill. Just two decades later, the law covers depressed adults (with no physical illness), incompetent adults whom others believe probably want to die and disabled babies. Those over 16 can obtain euthanasia without parental consent and the latest move is to grant a final exit to those over 70 who simply want to end their lives. In short, there's plenty to think about the next time the news promotes an emotional story about suicide.
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Quebec's public hearings into assisted suicide continued in Montreal Wednesday, with an appearance by the president of the Right to Die With Dignity Association, among others.
Hélène Bolduc told the all-party panel of MNAs leading the hearing that the debate is being sidetracked by calls for better palliative care, more hospital beds and better pain management.
Bolduc said she's surprised by the opposition to euthanasia from doctors working in palliative care.
"We seem like radicals now," Bolduc said of her association, which has 310 members. "I am not a radical."
Bolduc said she finds it hard to be on the opposite side of the debate from palliative care doctors given that those are the professionals currently caring for her terminally ill sister.
"I don't want to be against palliative care," Bolduc said. "But I have to say: there is a limit.
"It's not because I don't believe in this type of care, but palliative care shouldn't be practised with dogged determination."
She likened the palliative care community to the church, with doctors acting as "apostles of redemption."
Bolduc said she's seen palliative care units in which health professionals try to delay an individual's death as long as possible for the sake of the family, who want to see the patient resigned and serene. But they're not serene, Bolduc said; they're simply drugged to ease the pain.
The association wants individuals to have the right to decide when to die, and Bolduc said she hopes Quebec will at the very least stop prosecuting doctors who assist in a terminally ill person's death.
The commission also heard from Sara Raphals, 89, a retired school teacher and cancer survivor.
Raphals told the panel that there is little dignity in the way the elderly are treated and that suicide should be a basic human right.
"I know many people [in institutions] who are absolutely miserable," Raphals said.
"For the few of my peers who are still left, the first greeting is, 'I hope I go to sleep tonight and don't wake up in the morning'."
Raphals said she hoped Quebec will consider legalizing assisted-suicide, but she doesn't believe someone other than the ailing individual should dictate the terms of that person's death.
The public hearing, dubbed Dying With Dignity, will visit 11 communities across the province this fall to hear what individuals and groups think about assisted suicide.
A friend of mine was born in Holland. nazi protocols established during the Holocaust permeated the region and remained after the war was over. Hitler is winning there at the moment.