Politics & Policy

Compassionate or Callous?

Assisted suicide undermines our essential humanity.

Compassion, literally defined, means, “to suffer with another.” That is why I have always found the monopolization of that word by proponents of euthanasia and assisted suicide so discordant. Euthanasia isn’t about suffering with anybody. It’s about using someone’s suffering–and the pity it evokes–as a justification to kill.

The Netherlands has allowed euthanasia for more than 30 years, supposedly under strict guidelines to protect the vulnerable from abuse. But the list of those “eligible” has steadily lengthened, to the point that it now includes depressed people without organic illnesses. And now, the Dutch government has opened the legal door to killing patients with Alzheimer’s disease. In doing so, the nation sent a powerful message to Alzheimer’s patients and their families: The lives of those with this dreaded disease are so burdensome and undignified that they are not worth maintaining or protecting.

Contrast this with the message Nancy Reagan and her family sent the world by lovingly caring for Ronald Reagan in his declining years. This is what true compassion looks like. Through their unwavering devotion–giving wholeheartedly to Reagan even when he had little to give back in return, and taking some of his suffering on their own shoulders for ten difficult years–the Reagan family provided a vivid demonstration of the power of unconditional love. Nothing that has been done to recognize the late president–the naming of an airport after him, the public outpouring of respect during the week of mourning, the burying of political hatchets–could have honored Ronald Reagan the man, husband, and father more appropriately.

Ronald Reagan understood clearly how crucial it is to value all people equally, regardless of their capacities or state of health. Writing in Human Life Review in 1983, in words that are especially poignant considering what befell him ten years later, he warned:

Regrettably, we live at a time when some persons do not value all human life. They want to pick and choose which individuals have value. Some have said that only those individuals with “consciousness of self” are human beings.

This dehumanization offended Reagan to his core. He warned that the philosophy established at the Founding of the United States that all are created equal, possessing an inalienable right to life, is subverted when some of us are seen as disposable. And he recognized that sanctioning their killing–even in a desire to alleviate suffering–undermines our essential humanity.

Of course, some would say that the reverse is true, that a life with Alzheimer’s isn’t really living. Better to put people out of their misery than allow them to die slowly, while losing their identities. Such an end is seen as especially burdensome for those who have lived robust lives of independence, intellectual rigor, achievement, and accomplishment–people who would be humiliated to see themselves having to depend so totally on others for their care.

But the life Reagan led in his declining years demonstrates how wrongheaded such views are. True, Reagan was no longer able to occupy the public stage. True, he was very ill. True, this caused him and his family tremendous anguish. But it is untrue that falling prey to catastrophic illness meant that he possessed less human dignity and moral worth than he did when telling Mikhail Gorbachev to “tear down this wall.” Indeed, what we have learned in the last week about Reagan’s gentle life in his final, private years demonstrates that there can be profound meaning even in the most difficult and trying circumstances.

Betsy Streisand’s “Memories of a Friend in the Park,” a first-person observation piece published in the June 21, 2004 U.S. News and World Report, was especially touching in this regard. Streisand recounts how, as Reagan’s Alzheimer’s forced him out of the public limelight in the late 1990s, he frequented a park in Beverly Hills. Reagan, accompanied by his nurse, liked to sit on a park bench and watch children at play. She recalled:

Reagan didn’t speak much to adults. It was our children he was interested in. Time and again these sticky little specimens encrusted with juice and sand would come up next to him as they made their way to the bags of snacks on the bench. And he would beckon them closer…And although he gradually stopped speaking to us–and our children–we never stopped speaking to him or having the kids play close by where he could watch.

As Reagan’s cognitive and verbal abilities collapsed, his human desire to love and be loved remained undiminished. Reagan’s son Michael spoke emotionally to this when he described his dad’s joy at hugging and being hugged. “As the years went by and he could no longer recognize me,” Michael said in a tribute to his father, “I began a process of hugging him whenever I would see him.” Most poignantly, the son recalled once forgetting to hug his father goodbye. As he was about to get into his car, Michael’s wife told him to turn around. There in the doorway was Ronald Reagan, arms outstretched, waiting for his hug. Tears in his eyes, Michael rushed back to his father and the two embraced.

Even at the very end, love triumphed over disease. Reagan loved his Nancy deeply and intensely, and as he was breathing his last breaths, somehow, some way, he dug deep within himself and found some final reserve of devotion. He opened his eyes, recognized her, and giving her one final look, he died. Nancy Reagan and the family called his final great communication a “wonderful gift.”

Now juxtapose this story of anguish–as well as love, grace, and devotion–with euthanasia in the Netherlands, which will now be applied to patients with Alzheimer’s. The best view of it is found in a book by a nursing-home doctor named Bert Keizer. In >Dancing with Mr. D. Keizer describes several euthanasia cases in which he provided lethal injections. In every case, he depicts the lives of frail and dying people under his care as pointless, useless, ugly, grotesque. Those with whom he interacts all seem to share these views, including his colleagues, family members of patients, and the patients themselves–allowing Keizer to kill patients without bad conscience.

One man he describes probably has lung cancer but the diagnosis is never certain. When a colleague asks, “Why rush?” while pointing out that the man isn’t suffering terribly, Keizer snaps, “Is it for us to answer this question? All I know is that he wants to die more or less upright and that he doesn’t want to crawl to his grave the way a dog crawls howling to the side walk after he’s been hit by a car.”

Keizer either doesn’t know or doesn’t care that with proper medical treatment, people with lung cancer don’t have to die in unmitigated agony. The next day, he lethally injects the patient, telling his colleagues as he walks to the man’s room, “If anyone so much as whispers cortisone [a palliative agent] or ‘uncertain diagnosis,’ I’ll hit him.”

Another patient Keizer kills is disabled by Parkinson’s disease. The patient requests euthanasia, but before the act can be carried out, he hesitates after receiving a letter from his religious brother who warns that God is against suicide. This upsets Keizer, who writes: “I don’t know what to do with such a wavering death wish. It’s getting on my nerves. Does he want to die or doesn’t he? I do hope we won’t have to go over the whole business again, right from the very start.”

Keizer decides to push the process along. He asks the nursing-home chaplain to assure the man that his euthanasia will not upset God. The man reconsiders and again decides he wants to die. Keizer is quick with the lethal injection, happy the man has “good veins.” The patient expires before his uncertainty can disturb his doctor’s mood again.

Where is the compassion in this? Caring, unlike killing, can be costly in time, money, and emotional anguish. But, as the near universal outpouring of admiration for Nancy Reagan as caregiver demonstrates, it also ennobles and liberates. Indeed, as Ronald Reagan wrote long before he knew the words would apply so personally:

My Administration is dedicated to the preservation of America as a free land, and there is no cause more important for preserving that freedom than affirming the transcendent right to life of all human beings, the right without which no other rights have any meaning.

Wesley J. Smith is a senior fellow at the Discovery Institute, an attorney for the International Task Force on Euthanasia and Assisted Suicide, and a special consultant to the Center for Bioethics and Culture.


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