SAN FRANCISCO – Calling proposed California physician-assisted suicide legislation “strongly and implicitly anti-Catholic” and accusing its advocates of “trying to bend the Catholic Church’s moral teaching to the will of the culture of death agenda,” an international expert on bioethics urged listeners at a May 7 lecture to do everything in their power to help defeat the controversial bill.
Titled the California Compassionate Choices Act, Assembly Bill 374 would allow physicians to prescribe a lethal dose of medication to people diagnosed with a terminal illness, given less than six months to live and declared mentally competent.
Wesley J. Smith, keynote speaker at the annual public policy breakfast sponsored by the San Francisco Archdiocese’s Office of Public Policy and Social Concerns and held at St. Mary’s Cathedral, said the measure seeks to establish “ending life as an appropriate way to relieve suffering.”
Once that premise has been established, he said, it becomes logical to extend what would be seen “as a legitimate medical treatment” to the chronically ill, the terminally ill at any stage, individuals in intractable pain and even those who are depressed.
“How can you not go there?” he asked. “How can you say yes to a person with terminal cancer and no to a quadriplegic” who wishes to end his or her life?
“Premises lead to places,” said Mr. Smith, a consultant to both the Center for Bioethics and Culture and the International Task Force on Euthanasia and Assisted Suicide.
While news reports often say the language of A.B. 374 mirrors Oregon’s physician-assisted suicide law, Mr. Smith said the California bill would prohibit care centers, hospice facilities and other in-patient residences from barring medical personnel from providing physician-assisted suicide.
While a conscience clause does exist for general, acute-care hospitals allowing them to bar doctors from prescribing life-ending medications, smaller facilities are exempt, said Mr. Smith who is an attorney as well as senior fellow at the Discovery Institute, a Seattle-based think tank.
The situation could force Catholic nursing homes to either allow physician-assisted suicide or close, Mr. Smith said. “It would be a huge dilemma – choose between no care or unwillingly becoming part of snuffing out human life.”
The author of 11 books including “Culture of Death: The Assault on Medical Ethics in America,” Mr. Smith went into detail on developments in the Netherlands where legal and medical protocols now allow doctors to kill people without their permission. “It is called termination without consent,” he said, “and between 800 and 1,000 are killed every year.”
He also said 8 percent of the babies who die annually in the Netherlands are euthanized because of physical or mental disabilities.
Key to reaching this point, he said, is coming to believe “that those babies are not really human” and substituting a “quality of life” ethic for acceptance “of the intrinsic value of human life.”
Mr. Smith advised his audience to pay attention to “the money imperative” in the debate surrounding A.B. 374.
He said it costs “about $100 in medication and maybe another $500 to $1,000” for a medical consultation to arrange for assisted suicide, while it takes perhaps “$100,000 or more” to care for a terminally ill person in the last stages of life.
Health care organizations such as HMOs, he charged, cannot help but view physician-assisted suicide as “cost containment.”
The inclination to eliminate the costly care of terminally ill or other so-called “less valuable” people could be made more acute as universal health plans come into play and “there is a rationing of health care services.”
Likewise, he argued, as a culture becomes more accustomed to assisted suicide as a medical treatment, people whose illness has forced them to turn over decision-making to others may fall victim to “substitute consent” physician-assisted suicide in which a family member or legal guardian authorizes the death.
Assisted suicide strategists see the Oregon law as “a beachhead,” Smith said, claiming they use “gooey words” to indicate the Oregon situation is “proof that the slippery slope” fears are unfounded.
However, he argued, Oregon statistics are suspect in that they rely on self-reporting physicians and that the state has no funds or mechanism for “independent oversight.”
During a question-answer period, Mr. Smith emphasized his view of A.B. 374 as “total abandonment” of an individual at a critical time. “The law would not even require that the doctor be present (at the time of death). He just prescribes the medications and the person is left to go crawl into a corner and die like a dog.”