When Roe v. Wade was decided in 1973, we were caught off guard. We had to build a pro-life infrastructure almost from scratch to provide alternatives for women with crisis pregnancies. We now find ourselves at a similar point with euthanasia. We know that stealth euthanasia is here, that it is essentially legally protected already, and its prevalence is going to explode. We need to warn and educate the public. We also must identify and network with pro-life healthcare providers who are striving to provide ethical end of life care within a healthcare system that is becoming increasingly comfortable with prematurely ending the lives of certain patients. We urgently need to build the pro-life infrastructure that is still missing, but which is essential to providing concrete alternatives to stealth euthanasia.
Taking Stock
As we swiftly move toward the close of 2013, with the full implementation of the Affordable Care Act (ACA) on the immediate horizon, it is prudent to take stock of where the pro-life movement stands.
Despite measures in the ACA which will undeniably increase the overall rates of abortion (with estimates that new abortion coverage under the ACA will result in taxpayers subsidizing up to 111,500 abortions each year
{1}, the culture at large is becoming more pro-life. Abortion clinics are closing at record rates and health care providers have no interest in entering the abortion field. Gallup polls in 2012[2] revealed that Americans now self identify as pro-life at record rates. The pro-abortion movement is horrified to see the graying of its own movement as America's youth reject the pro-abortion agenda and swell the ranks of the pro-life movement. On the issue of abortion, there is great reason for hope. Anyone attending the March for Life each year in Washington, DC witnesses this heartening change.
Looking at the opposite end of the life spectrum, there is cause for grave concern.
In the USA, approximately 2.5 million people die annually from all causes. Approximately 1.7 million patients receive hospice care annually (with more than 200,000 discharged alive from hospice care each year). With each passing year, a higher percentage of total yearly mortality occurs within the context of hospice and palliative care.
The roots of hospice care are thoroughly Christian, based on the corporal and spiritual works of mercy and dating back a thousand years to the times of the Crusaders in the Holy Land. In the 20th century, hospice care was a continuation of the work of Irish and French nuns dedicated to the care of the sick and dying, and furthered by Mother Teresa of Calcutta's global efforts. Modern hospice care, with its interdisciplinary approach and modern methods of alleviating physical, emotional and spiritual suffering, was the brainchild of Dame Cecily Saunders, an Evangelical Christian who came to her faith in a study group founded by C.S. Lewis at Oxford University. When hospice care is provided by professionals who still strive to uphold these Godly roots, it can be an awesome resource for the patient and loved ones, with nothing to fear.
Unfortunately, the overall picture today does not reflect the roots of hospice philosophy. Of the 1.5 million who die annually under hospice care, a growing number are dying premature deaths due to "stealth euthanasia," primarily via over-medication, terminal sedation and withdrawal of hydration and nutrition. Furthermore, hospice Medicare fraud is soaring. Most of the large corporate hospice providers have been accused of millions, and in some cases billions, of dollars in insurance fraud, often certifying patients for hospice care who were not actually dying, while profit-driven negligence in patient care has hastened the deaths of many.
Because death records never list over-medication, terminal sedation, deliberate dehydration or neglect as the immediate cause of death, it is very difficult to obtain concrete data regarding the number of those dying in such circumstances. However, having spoken with pro-life leaders in the end of life care field, I think it is safe to say that the numbers are not small and that they are increasing rapidly. A very conservative estimate would be that about one out of five patients under the care of the hospice and palliative care industry are caused to die premature deaths at present. That is 300,000 deaths by stealth euthanasia yearly. Many in the hospice and palliative care field are trying to make terminal sedation the standard of care. Those who are terminally sedated cannot take food and water, and the end of life care industry rarely provides assisted nutrition and hydration. As terminal sedation becomes more prevalent, the number of those dying by euthanasia will increase steadily.
ObamaCare Rationing
Unfortunately, health care rationing is going to contribute to the increasing number of premature deaths in healthcare settings. The Independent Payment Advisory Board (IPAB), the "death panel" being instituted under the ACA that Sarah Palin warned us about, will be tasked with rationing health care spending and making life and death decisions for enrollees. During the 2008 Presidential campaign, Obama telegraphed where health care rationing is heading when he said that the elderly needed to be encouraged to forgo expensive care in the last years of their lives, choosing instead palliative or hospice care. When directly questioned about refusing an elderly women needed surgery, he responded, "Maybe this isn't going to help. Maybe you're better off not having the surgery, but taking the painkiller."
Those whose surgical procedures or expensive medical plans of care are deemed by the IPAB to be "futile" will be sent home or to the nursing home, hospice or palliative care unit to "take the painkiller."
Stealth euthanasia will become the norm. Most laws that directly prohibit physician assisted suicide also protect physicians whose use of opioids, sedatives and antipsychotics for pain management or alleviation of agitation might also hasten death. Thus stealth euthanasia, under cover of law, is little different than the outright legalization of abortion through nine months of pregnancy that was the result of Roe v. Wade.
The pro-life movement is at a crossroads. As the total number of surgical abortions has dropped to approximately 1.1 million per year, the number of stealth euthanasia cases has rapidly increased. As the total percentage of those who die in the USA within the context of hospice and palliative care climbs and the cultural acceptance and general practice of stealth euthanasia increases, we could see deaths by euthanasia surpass deaths by abortion within a generation.
It is indeed urgent that we build the pro-life infrastructure necessary to provide ethical alternatives to euthanasia.
About the author: Brian J. Kopp, DPM, is a podiatrist in private practice in Johnstown, PA. He has written articles on a range of subjects, primarily the culture of life, medicine, and ethics, that have been published in the L'Osservatore Romano (English Edition), New Oxford Review, The Wanderer National Catholic Weekly, LifeSiteNews.com, World Net Daily, and Podiatry Today magazine. Dr. Kopp is assisting Catholic Hospice of Pittsburgh to expand their pro-life hospice care services and will serve as Faith Community Liaison for Catholic Hospice of Greensburg. Dr. Kopp recently became a member of the PHA.
[1] "Affordable Care Act Could Fund Over 100,000 Abortions," Christine Rousselle,
Townhall.com, 9/26/2013
[2] "'Pro-Choice' Americans at Record-Low 41%," Lydia Saad,
Gallup.com, 5/23/2012