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have a letter, and my guess is that you have one like it. Mine is
from a middle-aged woman who brings me news of her father, an old
friend retired in Arizona who slipped out of sight a few years ago.
His daughter writes now to inform me of her own daughter's college
plans and of her father's inability to help. "I never anticipated
that dad would be in a nursing home, a virtual infant and not even
know who I was much less [his granddaughter]. Alzheimer's Disease
has to be one of the most horrible diseases there is today. I pray
every day that he will die. And that is something that I have told
very few people. My family is suffering terribly from what is happening
with dad every day."
That doesn't sound quite right, does it — to pray that someone
living should die? But though the sentiment is furtive, it has to
be the wholesome sentiment of those who care deeply and experience
intimately the plight of loved ones whose survival is only a technical
biological finding. In rhetoric, the denial of the opposite (a litotes)
is the gentler way of saying it, as in, "I am hardly praying
that Ronald Reagan should live another eight years . . ." Directly
said, that would translate into: I hope he will cease to suffer,
and cause others to suffer.
Now that is not quite the question posed by the Oregon imbroglio.
There you had a plebiscite pass, called an assisted-suicide law.
It is very specific legislation. It authorizes a physician to prescribe
a terminal medicine (morphine, the layman assumes) to a patient
in pain who in the judgment of that physician and one more doctor,
will not live another six months, and, being mentally competent,
communicates to his doctor the desire to expedite death. An interesting
nod to tradition: The physician may prescribe the death potion,
but not administer it.
In the four years since the plebiscite was activated, 70 residents
of Oregon have taken advantage of its provisions. Now John Ashcroft,
as Attorney General, comes on the scene with an injunction forbidding
the practice. More exactly, he advises doctors in Oregon that in
prescribing the fatal substances, they are deploying something that
is regulated under federal law. And federal law views such substances
as designed as therapeutic, not mortal provender. The Attorney General
threatened to withdraw the license to prescribe drugs from any doctor
who used his authority to prescribe them intending that they be
used to facilitate assisted suicide.
Oregon's own attorney general howled, his position being that which
laws govern the administration of medicine in the state of Oregon
are the business of the people of the state of Oregon. Enter, on
Thursday, a federal judge in the District Court who stayed the order
of the Attorney General of the United States. The order gives the
higher court a November 20 deadline if it elects to overrule and
reimpose the federal ban. Judge Robert Jones said that pending a
broader judicial hearing, "there is no showing that the U.S.
would be irreparably impaired by a temporary stay of the attorney
general's action." That has to mean that if the 71st petitioner
for the terminal prescription of morphine is given it, and dies
before November 20, the Ashcroft cause is not irreparably damaged;
though to be sure, the patient will be dead.
Now as with the fight over the marijuana laws in California, there
is in Oregon a constitutional contention: Who should decide such
matters? Washington or Salem? But again, as with the marijuana laws,
there is a third presence, which asserts, or tries to do so, a transcendent
point. In California, it was: Nobody should go to jail for smoking
pot. In Oregon it is: Nobody should intervene between a patient
and his doctor. "Helping nature take its course is not criminal
and it should be outside governmental regulation," writes Jerome
Groopman, professor of medicine at Harvard.
Now the Oregon imbroglio, constitutional and ethical, is a distance
removed from the plight of my friend in Arizona who is dying, but
not fast enough to appease undeniable demands of mercy. That is
the major ethical question to be faced in a world whose scientists
struggle so successfully to prolong life, and whose moralists are
retrograde in formulating correlative codes that confront the raw
message of the time: In 1960, the percentage of those in America
alive at 75 or over was 3.1. In the year 2000, the percentage is
6. That is, in general, wonderful news for a great many people.
But for a few, it is bad news. And these present us with the problem.
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