On March 31, 2005, my sister, Terri SchindlerSchiavo, died from the effects of dehydration.Judge Greer ordered that my beloved sister die this unnatural and gruesome death by orderingthat her feeding tube be forcibly removed fromher without her consent. My physicallyhealthy sister lived in a neurologicallycompromised state, for reasons that arestill unknown, and my family struggled for 12years trying to protect her. We wanted nothing but permission to care for Terri for the span of hernatural life.

Terri was not hooked up to machines, not terminally

ill, and not succumbing to any killer disease. Shewas disabled. She was dependent on others. Terriwas still very much alive, a woman and a person inmy family's eyes, but most importantly, in the eyes

of God.

My family was forced to watch my sister suffer through the grisly effects of

terminal dehydration. With each passing day, Terriappeared weaker, thinner, more frightened and sovery wronged. I watched as my family beggedfor her life and as healthcare professionals turned

a blind eye to her suffering. I listened to proponentsof the so-called "right to die" coax news audiencesinto the belief that my sister was enduring a gentle,peaceful, and euphoric demise. I sat on the cornerof her bed and held her thinning hands, trying sohard to understand that what I was witnessing wasactually real. When Terri passed from this world,she took a very tangible piece of me with her.

No human being or agency should have the authorityto pronounce an innocent person, such as my sister,"unworthy of life."

By Bobby Schindler

In 1990, 26-year-old TerriSchindler Schiavo suffered braindamage when she mysteriously collapsed and stopped breathing for a period of time. Fifteen years later,on March 31, 2005, Terri died ofdehydration after 13 days withoutfood or water. Her husband, MichaelSchiavo, had obtained judicialapproval to remove her feeding tube. Woodside Hospice in PinellasPark, Florida, carried out her deathsentence.

Michael Schiavo was given the"Guardian of the Year Award" in 2005 for his successful campaign toend the life of his wife. That some inour society applaud the murder of adisabled woman is deplorable. Whatmakes Terri's case stand out is thepublic outcry in support of her rightto live. More than 100,000 peoplecontacted Florida Governor Jeb Bush,pressing him to save Terri's life.

The real heroes are Terri's parents,Bob and Mary Schindler, who wereunrelenting in their battle to save their daughter from a cruel death. The highly publicized legal tug-of-war between Michael Schiavo and the Schindlers alerted millions to thefact that our judicial system has a history of sanctioning the treatment ofdisabled human beings in ways thatwould be criminal if done to a dog.

Terri's ConditionContrary to media reports, Terri wasnot "brain dead," not terminally ill,not comatose and not on a ventilator.In 2002, Dr. William H. Hammesfahr,a neurologist, evaluated Terri. He listedamong his findings that she wasresponsive to her environment;responded to specific people best;tried to please others by doing activities for which she received verbal praise; attempted to verbalize;could swallow; and could feel pain.Numerous other physicians providedaffidavits disputing the claim thatTerri was in a persistent vegetativestate (PVS) and stating that improve-ment might occur with therapy.

Court BattlesAlmost three years after Terri's collapse, a medical malpractice juryawarded $700,000 for Terri's ongoingmedical care and $300,000 to Michaelfor loss of companionship. He hadtold the jury that he wanted to takecare of Terri for the rest of her life.Shortly thereafter, Michael deniedTerri all forms of rehabilitation andantibiotics for infections. When shedid not die from neglect, he sought tohave her feeding tube removed.Terri's parents vehemently objectedand asked to be named Terri'sguardians.

In January 2000, Judge George Greer,County Circuit Court, conducted ahearing at which Michael argued that,before her collapse, Terri had toldhim that she would not wantto be kept on life support.Why had he nevermentioned thisbefore or during themalpractice suit?Terri had left nowritten evidence ofher wishes and her parentsinsisted that shewould

never have made such a statement.Nevertheless, Greer ruled thatMichael could order all food and fluids withheld from Terri. TheSchindlers appealed.

At issue was whether Terri was in apersistent vegetative state. UnderFlorida law, only those who are PVSor terminally ill may be dehydrated todeath. The 2nd District Court ofAppeals ordered Judge Greer to holdan evidentiary hearing to determineher condition. The two physicianschosen by Michael and one appointedby the judge testified that Terri wasPVS. The two physicians chosen bythe Schindlers found that she was notPVS. Greer ruled that Terri was PVS.

On October 15, 2003, Michael hadTerri's feeding tube removed.

Six days later, theFlorida legislature

enacted "Terri'sLaw." The law

allowedGovernorBush toorderTerri's feedingtube

reinserted. Terri recovered from six-and-a-half days of dehydration whileMichael, assisted by the AmericanCivil Liberties Union, again went tocourt. On May 6, Judge W. DouglasBaird, County Circuit Court, found"Terri's Law" unconstitutional.Governor Bush filed an appeal andgot an automatic stay, but Florida'sSupreme Court upheld Baird's ruling.

The Schindlers, now desperate to saveTerri, appealed all the way to the U.S.Supreme Court, which refused to hearthe case. Time was running out.

On March 17, 2005, Terri's feedingtube was once again removed. A fewdays later, the U.S. Congress over-whelmingly approved an act that gavethe federal court in Tampa jurisdictionto review the facts of the case anddetermine whether Terri's constitu-tional rights were violated. PresidentBush quickly signed it into law, butthe court defiantly refused to reviewthe case. For Terri, this time, therewould be no stay of execution.

Anything But PeacefulIn the final 72 hours of her life,Terri’s tongue and throat were dry,cracked and raw. Her eyes werebloodshot and bleeding. In the last 26hours, she panted rapidly and couldn’tcatch her breath. Terri’s brother,Bobby, called her death “grotesque.”

Terri’s death was not only wrongbecause it was horrendously painful,but also because nutrition and hydra-tion should be considered basic care.

The soul-searching question we mustask ourselves is: Are we at peace withdehydrating disabled people to death,or does it haunt us?

Terri Schindler Schiavo: A Senseless Death

A Brother’s Grief

Lynne, Diana. Terri's Story:The Court-Ordered Death of anAmerican Woman. CumberlandHouse Publishing, 2005.

www.terrisfight.orgwww.internationaltaskforce.org

12 Human Life Alliance © 2006 � Advertising Supplement � www.humanlife.org

Information

Imposed DeathEuthanasia and Assisted Suicide

Advertising Supplement

Euthanasia literally translated from the Greekmeans "good death." Some who promote euthana-sia call it "mercy killing." Death by euthanasia isneither good nor merciful. Therefore, in this publication, the more accurate term "imposeddeath" is frequently substituted for "euthanasia"and also for "assisted suicide." (See Definitions,p.3)

You may ask, "Why should I be concerned? Whydo I need to read this publication?"

Because the entire human race has a stake in theanswer to the question, "Should imposed death bepermitted and regulated by law?" History teachesus that a society which does not respect and protectall human life will ultimately bring about its owndestruction.

Allowing the lives of certain people to be terminat-ed because they are viewed as "not worth living" or"burdensome" has profound repercussions for all ofus. Devaluing one human life devalues all humanlife. (See the true stories highlighted in our Case inPoint Features.)

This supplement examines the history of imposeddeath, the facts about it and the experiences andopinions of those most intimately affected by it.You need the unvarnished truth in order to makeinformed decisions about such vital matters.

Advocates of euthanasia and assisted suicide useterms like "choice in dying" and "self-determina-tion." They promote the social and legal acceptanceof the "right to die"—that is, the "right" for individ-uals to choose how, when, where and why to die,and to receive assistance in dying from others.Although the expression "right to die" is seductive,it is fundamentally anti-libertarian. Giving the Statethe right to authorize our "right to die" begins theprogression from voluntary imposed death to invol-untary imposed death. Who will decide for thosewho cannot make their own choices? At what pointdoes a "right" become an expectation, even a duty?

Instead of pursuing a "right to die," let us strive tocreate an environment —a culture of life— inwhich no person feels compelled to seek the "quick

fix" of death and every person's life is respected bysociety and protected by law.

ACKNOWLEDGMENTSHuman Life Alliance assembled a talented team ofwriters, researchers and experts who contributed todeveloping this supplement. We are grateful tothese men and women for their dedication to thisproject, as well as for their perseverance in defend-ing the unalienable right to life of all humanbeings, especially those who are most vulnerable,the voiceless. Foremost, we want to thank our mul-titude of friends whose faithful support enablesHuman Life Alliance to continue its life-savingeducational projects.

Imposed Death

Human Life Alliance is a non-profit,pro-life, educational organization dedicated to protecting human lifefrom fertilization until natural death.

HLA creates educational publicationson abortion, abstinence and euthanasia.

For additional copies or more information, contact:

Human Life Alliance3570 Lexington Avenue North Suite 205Saint Paul, Minnesota 55126 USAwww.humanlife.org(651) 484-1040

What’s the Big Deal?

Features4 Living Wills: Vital… or Deadly?

A Living Will may be a license to kill.

5 "Persistent Vegetative State"How reliable is a PVS diagnosis?

8 Thirsty? Too Bad.Withholding food and water is the new “mercy killing.”

11 Hospice Care: The Good, the Bad and the Uglyby Tracy Berntsen �� Tread carefully when you select a hospice.

12 Terri Schiavo: A Senseless DeathThe story of one disabled woman’s fight for life.

3 Euthanasia and Assisted Suicide: What in the World is Going On?The imposed death agenda creeps across the globe.

6 The History of Imposed Death in AmericaHow the right-to-die agenda has infiltrated America.

9 Would you never want to be hooked up to amachine?by Marlene Reid �� It might just save your life.

10 Organ Donors Wanted: Dead or Alive!by Dr. Paul A. Byrne �� Dead by whose definition?

Additional FeaturesA Time to Let GoNot Dead YetSave a LifeThanks for all the fish!Follow the MoneyOrgan Donors, NOT “Brain Dead”A Brother's Grief

humanlifealliance

President

Contributing Writer and Editor

This publication was created by Human Life Alliance © 2006 �� feedback@humanlife.org

2 Imposed Death � Human Life Alliance

Editor

"Hospice care is there to makeit possible for people who aredying to live fully until theydie."

Dame Cecily Saunders

Over 3,000 hospices operate in theUnited States, and each is a separatebusiness entity with its own uniquecharacteristics and quality of care.Many are operated by non-profitcharitable organizations, a fewremain largely voluntary, but increas-ing numbers are being operated bycorporations. You can find excellent,traditional hospice care in all threecategories.

Hospice caregivers deserve theutmost respect. We should neverunderestimate the difficulties thatpalliative caregivers endure and thededication so many demonstrate.("Palliative" describes care that comforts and relieves or moderatespain.) Unfortunately, in recent years,numerous incidents of unnecessarymorphine dosages and prematurewithdrawal of food and water frompatients have been reported by care-givers and administrators, families ofhospice patients, medical examinersand attorneys. Hospice as an industryhas become suspect.

Terminal Sedation and theWithdrawal of Food and Water"Terminal Sedation" (TS) refers tocontrolling pain by giving an opiate,primarily morphine, in sufficientquantity to induce unconsciousness.Initially used as a last resort torelieve extreme pain when a personwas dying, TS has been transformedinto a form of slow euthanasia orassisted suicide. Deep sedation com-bined with the withholding of allmedical treatment, including foodand water, is becoming routine inmany hospices and is legal in everystate. Euthanasia has moved beyondthe law, as it is difficult to tellwhether the intent is to kill thepatient or relieve his pain.

The World Health OrganizationWHO concurs with experienced palliative care doctors and nurseswho insist that pain can virtuallyalways be controlled. Even in themost difficult situations, it is possibleto have adequate pain control withoutrendering the patient comatose.1 Theoriginal and true mission of hospiceis to provide the dedication and timenecessary for real palliative care—care that allows the patient to live asfully as possible until natural death.

From Charity to Big BusinessHospice in the 1960s and 1970soperated as a charitable service rendered primarily by volunteers.

In the 1980s, Medicare and Medicaidfound it cost-effective to include hos-pice benefits. Consequently hospicebecame big business. The number offor-profit hospices and the number of Medicare recipients receiving hos-pice care more than doubled from1992-1998. The National Hospiceand Palliative Care Organizationreported 3,300 hospice programsserving 900,000 patients in 2004.2

Unfortunately, as government andinsurance (most HMOs currently pro-vide hospice benefits) dollars rolledin, both fraud and cost-containmentmeasures followed.

Infiltrated by the “Right-to-Die”MovementRecent developments confirm thesuspicion that proponents of the"right-to-die" movement find hospicethe ideal avenue to advance theirefforts to legalize assisted suicideand euthanasia.

In 2000, Choice in Dying (formerlyknown as the Euthanasia Society ofAmerica),composedof right-to-dieadvocates,becamepart of anew organ-ization,Partnershipfor Caring(PFC),founded byDr. IraByock, ahospicephysician.3

Thus, the“right-to-die” agen-da began toinfiltratethe hospiceindustry. InOctober 2002, J. DonaldSchumacher, Vice-Chair for PublicPolicy for PFC, became Presidentand CEO of the National Hospiceand Palliative Care Organization(NHPCO), the largest organization ofits kind.

In 2005 The Hospice Federation ofAmerica (HFA) published a contro-versial, eye-opening book entitledEthical Dilemmas at the End of Life.One of its authors, Thomas Attig,tries to convince readers that there is no moral culpability in assistedsuicide.4 In another chapter, RobertKastenbaum affirms the legitimacyof euthanasia when he states, "Withpersistent vegetative states, it is the

question of passive or active euthana-sia." He goes on to ask, "What aboutAlzheimer's disease?"5 Indeed, anincreasingly acceptable practice is toadmit non-terminally ill patients tohospice in order to "help" them die.

Hospice: Help for the Dying, Not Help in DyingTo be legally admitted to a licensedhospice, the patient must be sufferingfrom a terminal untreatable illnesswith a life expectancy of six monthsor less. Hospice provides palliativecare only—not cure. Hospices are notlicensed to provide care (or help indying) to non-terminally ill individualswith disabilities, brain damage,Alzheimer's disease or other forms ofdementia.

Palliative care may be provided in apatient's home, a nursing home, ahospital or a hospice facility. Manypatients prefer to be cared for in theirown homes, but sometimes this is notfeasible. It will take time and effortto choose a hospice. References from

friends,family,trustedphysicians,medicalpersonnel,or familieswho havehad recentexperiencewith thehospicebeing con-sidered,are invalu-able. Besure toread thehospice'spolicies,especiallythose con-cerning theuse of

morphine,withdrawal of nutrition and hydration,and the continuation/provision ofmedications and treatments for allconditions other than the terminal ill-ness. As documented above, there aregood reasons for suspecting hospicesthat use guidelines developed byNHPCO or who are affiliated withHFA.

Ethics CommitteesBioethics, the new philosophy ofhealth care and medical ethics, withsome notable exceptions, is based on a quality of life ethic—the beliefthat some people are better off dead.Often, the people who are least valued in bioethics are those who aremost expensive to care for. Ethicistswith a traditional sanctity of life

ethic—the belief that all human lives are valuable simply becausethey are human—are desperatelyneeded. However, ethicists and thecommittees they oversee are typicallycommitted to a school's particularphilosophy. Their ethics are usually"consensus" based—not morallybased. They frequently employ highlypaid professionals, are endorsed byHFA and are known to use the guide-lines developed by NHPCO.6

Hospice professionals (ethicists,social workers, etc.) can be veryclever about offering "false compas-sion." Key emotive language includes:unbearable or uncontrollable pain;quality of life; loss of dignity;rationing of resources and cost effec-tiveness; ethical consensus; and futilecare. The last is a term frequentlyused to justify the withdrawal of foodand water. A recent study in Oregonfound that the most common reasonspatients requested assisted suicidewere none of the above but rather"fear of future suffering," "fear of being a burden" and "losing inde-pendence."7 Hospice should help thepatient deal with his fears, not granthis wish to die—or kill him withouthis consent.

By Tracy Berntsen Human Life Alliance

1 Chevlen, Eric M. and Wesley J. Smith.Power Over Pain. International TaskForce on Euthanasia and Assisted Suicide.2002.

2 National Hospice and Palliative CareOrganization. "Facts and Figures on Hospiceand Palliative Care." Accessed 5/5/04 atwww.nhpco.org.

3 Barbero, R.N., Barbara, "HospiceLimitations." Accessed 3/6/04 atwww.caringplaceonline.com/stages/together/hospice/hospice-limitations.html.

4 Doka, Kenneth J., Jennings, Bruce and Corr,Charles A., eds. Ethical Dilemmas at the End of Life. HospiceFoundation of America. 2005.

5 Ibid. p. 313.6 Ibid. p. 209.7 Shea, M.D., John, "Palliative Care 'Killing

me Softly.'" Bioethics. Accessed July/August2004 at www.catholicinsight.com/online/bioethics/palliativecare.html.

Hospice Patients Alliancewww.hospicepatients.org

Women for Faith and Familywww.wf-f.org/02-2-terminalsedation.html

Hospice Care: The Good, the Bad and the Ugly

Information

Advertising Supplement � www.humanlife.org 11

Most people are not aware that many in the medical community areconvinced that "brain death" is nottrue death.1

Before organ transplantation becamepossible, physicians cautiously deter-mined death in order not to embalmor bury people while still alive.Today, death is often declared forreasons not related to the patient'swelfare—organ transplantation andcost containment. "Brain death" issometimes hastily declared becausethe removal of vital organs (heart,lungs, liver, kidneys, etc.) must bedone before the organs deterioratedue to cessation of blood circulation.It is the life that remains in donorsthat makes their organs useful.

Before 1968, a physician pronounceddeath when there was no breathing,no heartbeat and no response to stimulation. Today, a person can bejudged "brain dead" while he/she hasa beating heart, as well as normalpulse, blood pressure, color and temperature—all signs of life. Howdid this change occur?

The Journal of the American MedicalAssociation published an article entitled "A Definition of IrreversibleComa" in 1968. This article includedthe Harvard Criteria which claimedthat irreversible coma represented"brain death." The newly coined"brain death" allowed the "harvesting"of vital organs from comatosepatients on ventilators.

A ventilator moves air into and out of the lungs. It is effective only whenthe patient's respiratory and circulatorysystems are functioning. These systems working together add oxygen

to theblood,carry thebloodwith theoxygen tothe cellsof thebody, andthen take

carbon dioxide from the cells back tothe lungs to be exhaled. Respirationoccurs in all living persons, includingthose who have been declared "braindead."

By 1978, there were more than 30 different sets of criteria for determin-ing "brain death." Every set since thefirst is less strict. For instance, theHarvard Criteria required that thepatient be in a coma at least 24hours. Later sets of criteria shortenedthe time to 12 hours, then six hours.Some criteria do not even require anelectroencephalogram (EEG)—an

omission that could result in a patientwith cortical activity (memory, feel-ing, emotion, etc.) beingdeclared "dead."

Every set of criteria for"brain death" includes anapnea test. ("Apnea"means the absence ofbreathing.) This test,which has no benefit forthe comatose patient and,in fact, aggravates thepatient's condition, is donewithout the knowledge or consent of family members. The apnea test,during which the ventilator is turnedoff for up to 10 minutes, can induce"brain death" or cardiac arrest. Itssole purpose is to determine thepatient's inability to breathe on hisown in order to declare "brain death."

It is illogical to do an apnea test on a patient who has just undergonesevere head trauma. Turning off theventilator for up to 10 minutes riskskilling the comatose patient whomight otherwise survive and resumespontaneous breathing if treated longenough. Two groups of neurosur-geons (one from Germany, the otherfrom Japan) simultaneously demon-

strated that 70% of victims of severehead trauma in a deep coma NOT

SUBMITTED TO ANAPNEA TEST could berecovered to NORMALDAILY LIFE if their bod-ies were cooled down to 33degrees Celsius for 12 to24 hours ("short-term moderate hypothermia").

So, here is the transplantdilemma: Without theapnea test, the diagnosis of

"brain death" is simply not possible,and without the diagnosis of "braindeath," the transplantation of vitalorgans is not possible, or at leastmuch more difficult. Because transplant surgery is one of the mostprofitable medical activities, medicalprofessionals in the transplant system

refuse to acknowledge in public thedetrimental effects of the apnea test.They also reject obtaining writtenconsent because, if the apnea test was explained in detail, no familymember who loves the patient wouldauthorize it.

Since there is no universally acceptedstandard for determining "braindeath," a person could be declared

"brain dead" using one set of criteria,but alive using a different set. Everytransplant center agrees that death iswhatever a doctor says it is.

Ironically, a patient regarded as"dead" (for transplantation or experi-mental purposes) is sometimes treated as alive. Suction and posturaldrainage are done to prevent pneu-monia. The patient is turned to prevent bed sores. How can a deadperson (cadaver) develop pneumoniaor bed sores?

When the incision is made to removeorgans, the donor often reacts bymoving, grimacing and squirming,unless first given a paralyzing drug.Even paralyzed, his/her blood pres-sure and heart rate increase dramati-cally. The heart continues beatinguntil the transplant surgeon stops itjust beforecutting itout. As adoctor wrotein a letter tothe editor ofthe NewEnglandJournal ofMedicine,11/17/94:"The signsof life in brain dead patients…arevery real and cannot be discounted inhuman terms, even if we have doneso in public policy."

By Paul A. Byrne, MD, ClinicalProfessor of Pediatrics, MedicalUniversity of Ohio.

1 "Are Organ Transplants Ever MorallyLicit?" The Catholic World Report (CWR).3/01; "'Brain Death' Is Not Death," CWR.3/05.

ORGAN DONORS WANTED: DEAD OR ALIVE!

Organs harvested from "braindead" patients are not enough tomeet demand. One response to this "crisis" is to "redefine donoreligibility," that is, to allow organsto be taken from another categoryof patients. The most recently"defined" donors are patientstermed "hopeless" or "vegetative,"usually shortly after suffering a severe stroke or devastating trauma, but not fulfilling any set of criteria for "brain death." NancyValko, a St. Louis intensive carenurse, explains, "Because of thelegal acceptance of the so-called‘right to die,’ families or patientscan agree to have the ventilatorturned off, a ‘do not resuscitate’order written, and organs harvestedif or when the person's breathingand heartbeat stop."

To ensure healthy organs, speed isof the essence. The patient is oftentaken to the operating room andprepared for surgery before theventilator is turned off. As soon asthe heart stops beating, cardiacdeath is declared. The organretrieval team waits two to fiveminutes (sometimes less), thenorgan removal begins. The donor

may be paralyzed or given an anes-thetic before the surgeon begins tocut, just in case the team acted tooquickly.

This organ donation process hasundergone several name changes in the last few years—"non-heart-beating organ donation," "donationafter cardiac death," and mostrecently "donation from partiallybrain dead patients." In 2000, theInstitute of Medicine set criteria for "donation after cardiac death,"stating that the cessation of thepatient's heartbeat must be "irre-versible." It is impossible to determine "irreversibility" if theheart has stopped beating for fiveminutes or less. Resuscitation is apossibility even five minutes ormore after cardiac arrest.

The Denver Post, 1/19/06, report-ed, "Organ donations from partiallybrain-dead patients—a controversialsource—jumped tenfold inColorado and Wyoming last year,the group that coordinates dona-tions said."

This is major news, but unknownto most of the public.

Organ Donors, NOT “Brain Dead”

For twenty years SarahScantlin could only blink her eyesin response to questions, questionsher caregivers doubted she under-stood. At the age of 18, she washit by a drunk driver, and sufferedbrain damage so severe that doctors told her father, "Thedaughter you had is gone." InFebruary 2005, Sarah started totalk, surprising her family with aphone call to say "hello." Whenasked about 9/11, which occurredwhile she was unconscious, shesaid, "Bad, airplane, fire, building,hurt people." She'd been payingattention to the TV in her room allthose years. (CBS Transcripts,"The Early Show," 8/4/05, 8/5/05)

CaseCaseinPointinPoint

10 Imposed Death � Human Life Alliance

Euthanasia: Euthanasia means an act or omissionintended to cause death in order to eliminate suffer-ing. The act or omission is committed by someoneother than the person being euthanized, allegedly forhis/her benefit.

� Euthanasia can be an action, such as a lethalinjection, smothering or shooting.

� Euthanasia can be an omission, such as withhold-ing or withdrawing necessary and ordinary (bene-ficial, usual, and not excessively burdensome)medical care and treatment, or food and fluids.

There is no moral distinction between an act thatis intended to cause death and an omission thatcauses death. The victim is equally as dead.

� Euthanasia can be voluntary—the personrequests or gives consent to be killed.

� Euthanasia can be involuntary—the person doesnot give consent or is incapable of giving consentto be killed.

Mercy Killing: Euthanasia is sometimes calledmercy killing. "Mercy" describes the (assumed)motive. "Killing" describes the act.

Assisted Suicide: Suicide is self-murder. In assistedsuicide, the means—drugs, gun, plastic bag,

instructions for their use, counseling, etc.—are provided by someone else, but the last act is doneby the person being killed.

Physician-Assisted Suicide: Physician-AssistedSuicide means that a physician provides the meansfor a person to commit suicide.

Aid in Dying: Aid in Dying is a euphemism forassisted suicide and euthanasia.

Imposed Death: Imposed Death is an umbrellaterm which covers all acts of killing human beingseither in order to end their suffering or to relieveothers of the duty to care for them.

The Netherlands and Belgium are theonly nations in the world so far thathave legalized active euthanasia andphysician-assisted suicide (PAS).Switzerland has not legalized PAS, butliberally allows it. In the United States,although euthanasia by action is notlegal, "living will" laws and courtdecisions have ushered in euthanasiaby omission. "Right to die" activists inthe U.S. have waged battles to legalizePAS in many states, but have managedto win in only one—Oregon. In 1994,Oregon voters narrowly (51%)approved the "Death With DignityAct." They had been led to believe thatthe Act would restrict PAS to cases ofunbearable, uncontrollable pain. That'swhat they approved, but what did theyactually get?

Oregon - We'll Help You Die!Delayed by legal challenges, Oregon's"Death With Dignity Act" did notbecome operative until 1997. By theend of 2005, physicians had reported246 suicides using physician-pre-scribed drugs. These patients’ principalconcerns were "decreasing ability toparticipate in activities that made lifeenjoyable" and "loss of autonomy"—not pain.1 The Act, in fact, does notmention pain as a justification forPAS. It merely requires the diagnosisof a terminal illness that will lead todeath within six months.2

Predictions of life expectancy areunreliable. Two patients who receivedprescriptions in 2001 were still alivemore than a year later—one died in2003, the other was still alive at theend of 2003.3 Isn't it probable thatsome patients who killed themselveswould have lived longer than sixmonths? Might some physicians"help" non-terminally ill patients commit suicide?

The law requires doctors to report allprescriptions for PAS, but Oregon conducts no independent reviews toverify that doctors are complying, sothere really is no way of knowing theactual number of PAS deaths or thereasons for them.

The Hippocratic Oath states, "I willgive no deadly medicine to anyoneeven if asked," but today very few

physicians make that promise. Thisanti-Hippocratic climate disposesphysicians to do whatever the patient,physician or even the state wants.

Oregon rations health care. Its"Prioritized List of Health Services for Medicaid Patients" will not allowpayment for treatment of many typesof cancer unless the patient has at leasta five percent chance of living anotherfive years. So, a patient with cancer ofthe bowel, for example, who mightlive a few more years with treatmentto slow the cancer's progress, will notbe treated. Yet Oregon will pay forPAS as "comfort care" for Medicaidpatients.

PAS creates less concern for providingthe best medical treatment and moreconcern for cost-containment. PASdiscriminates against low-incomepatients who are old, sick, or disabledby offering them drugs to die ratherthan reasons to live. Oregon's taxpayersdid not vote to pay for killing the poor.

Understanding Gonzales v. OregonIn 2001, Attorney General JohnAshcroft issued a directive that physicians could lose their federal registration to prescribe controlledsubstances if they prescribe them forassisted suicide because it is not a"legitimate medical purpose." His successor, Alberto Gonzales, agreed.In 2004, the Ninth Circuit Courtdeclared that Ashcroft had oversteppedhis authority and the U.S. SupremeCourt agreed to hear the case ofGonzales v. Oregon.

On January 17, 2006, the SupremeCourt ruled 6-3 that the ControlledSubstances Act (CSA) does notaddress assisted suicide and thereforeAshcroft did not have the authority to prohibit doctors from prescribingfederally controlled drugs for PAS.Contrary to the spin PAS supportersput on this decision, the Court did notuphold Oregon's law nor did it endorseassisted suicide. In fact, the justices in the majority agreed that the federalgovernment possesses the power to prevent narcotics from being prescribed for PAS, for example, byamending the CSA.

The Netherlands - We EuthanizeChildren!In 2001, as a mere formality, theNetherlands legalized assisted suicideand euthanasia. Wesley Smith, anattorney and author of numerousbooks on bioethical issues, neatly sum-marizes the progression of medicalkilling in the Netherlands:

First, Dutch euthanasia advocatessaid that patient killing will be limited to the competent, terminallyill who ask for it. Then, when doctors began euthanizing patientswho clearly were not terminally ill, sweat not, they soothed: med-icalized killing will be limited tocompetent people with incurableillnesses or disabilities. Then, whendoctors began killing patients whowere depressed but not physicallyill, not to worry, they told us: onlycompetent depressed people whosedesire to commit suicide is "ration-al" will have their deaths facilitat-ed. Then, when doctors begankilling incompetent people, such asthose with Alzheimer's, it's allunder control, they crooned: non-voluntary killing will be limited topatients who would have asked forit if they were competent. And nowthey want to euthanize children.4

In 2004, Groningen UniversityHospital decided to permit its doctorsto euthanize children under the age of12 with or without the parents consent.5

By the end of 2005, the Netherlandswas setting up a commission to regulatethe practice of ending the lives of"seriously suffering" newborn babies.

Belgium - Get a Euthanasia Kit!In 2002, a new Belgian law went into effect that allows a physician toeuthanize an adult patient whorequests it because of a "hopeless"medical condition and unbearablephysical or mental pain that cannot becontrolled. With modern palliativecare, very few people should fit thatdescription. Nevertheless, the govern-ment reported that in the first yearafter the law took effect over 250Belgians were legally killed!

In 2005, pharmacies in Belgium beganselling "euthanasia kits" containing all

the necessary materials to efficientlykill a patient. A kit costs about 60euros ($77).

Switzerland - You’ll Never TakeAnother Vacation!Switzerland is becoming known for its"suicide tourism." The non-profitorganization Dignitas, headquarteredin Zurich, assists foreigners who wantto die. They fly to Zurich whereDignitas takes care of everything fromsupplying the drugs to disposing of thebody. Dignitas has recently expandedits operations by opening a branchoffice in Hanover, Germany.6

Unlike other countries, Switzerlandhas not considered assisted suicide a"medical treatment." However, that ischanging. Lausanne UniversityHospital decided to permit assistedsuicides starting January 1, 2006.Other hospitals are debating whetherto follow suit.

Does Legal Equal Ethical?Legalizing medical murder does not change a crime into a medicaltreatment; rather, it turns the law itselfinto an accessory to murder.

1 Eigth Annual Report on Oregon's Death WithDignity Act. Oregon Department of HumanServices. 3/9/06

2 Ibid.3 Stevens, Kenneth MD. "Latest assisted suicide

report should be cause for alarm," TheOregonian. 3/12/04.

4 Smith, Wesley J. "Now They Want toEuthanize Children." www.weeklystandard.com, 9/13/04

5 Hewitt, Hugh. "Death by Committee." TheWeekly Standard. 12/2/04. www.weeklystandard.com.

6 Whitlock, Craig, "Branching Out to Serve aGrowing but Dying Market." 11/1/05www.washingtonpost.com.

Definitions

Euthanasia and Assisted Suicide: What in the World is Going On?

International Task Force onEuthanasia and Assisted Suicidewww.internationaltaskforce.org

Physicians for CompassionateCare Educational Foundationwww.PCCEP.org

Information

Advertising Supplement � www.humanlife.org 3

Your life or the life of a loved onemay depend on having correct infor-mation about the ventilator, commonlycalled a "respirator."

Respiration isa bodilyfunction, nota machine'sfunction. Itcan onlyoccur whenthe body'srespiratoryand circulatorysystems areintact andfunctioning.A ventilatoris an aid tobreathing.The ventilatormachine supports the ventilation part of breath-ing—moving air into and out of thelungs. But, it does not and cannotcause the other part of breathing—respiration. Thus, the machine shouldalways be referred to by its accuratename, "ventilator."

Many people with disabilities useventilators every day of their lives to assist their breathing. For them, aventilator is a necessity of life whichallows them not only to continue living, but to breathe easier and enjoylife to its fullest. The ventilator is alsocommonly and effectively used tosave lives.

I had not given much thought to theindispensable role that a ventilatorplays in the healing process until threereal-life incidents brought the truthhome to me.

My 41-year-old nephew was sufferingfrom shocked-lung syndrome afterbeing injured in an automobile accident.This is a condition in which the elas-ticity of the lungs is greatly curtailed,causing intense pain and severe short-ness of breath. To give his body achance to heal without fighting forbreath, the doctors induced a comatosestate and put him on a ventilator. Hewas on the ventilator for more thanthree weeks. His life was hanging bya thread or, more literally, a machine.When he was finally taken off the ven-tilator, his body took over, eventuallycompleting the healing process. Todayhe is back working at his heavy-dutyconstruction job—thanks to the venti-lator and endless prayers.

In the second incident, a dear friend

sustained a head injury. Because histraumatized body started to shut downfollowing surgery to close the wound,he too was put into a medically induced

coma andhooked upto a venti-lator. Hewas in crit-ical condi-tion. Afterfive days,he wastaken offthe ventila-tor and hisnaturalbreathingfunctionstook over.This friend,who at 80doesn't

believe in retirement, is back workingfull-time, none the worse for the wear.

Imagine the outcome had he signed a Living Will that stated he wouldnever want to be put on a "respirator."If you have made a statement to thiseffect, either orally or in writing, Iadvise you to promptly and emphati-cally rescind it.

In the third incident, a friend had acardiac arrest. He was taken to thehospital by ambulance and subse-quently pronounced "brain dead." The attending physicians wanted todisconnect life support, but his wifewouldn't hear of it until all of theirchildren could get home to say theirgoodbyes. After 72 hours, the sorrowingchildren had bid their father farewell.When life support was disconnected,their father sat up in bed and startedtalking to the family! He went homeshortly thereafter and the family wasable to enjoy his company for fourmore years before he was called hometo his Maker. WHAT IF his wife had

given consent to stop life supportbefore his body's own healing powershad a chance to take their course withthe aid of the ventilator?

I am now an enthusiastic believer inthe healing benefit of the ventilator.We must all do our part to dispel themistaken assumption that use of aventilator is an extraordinary or heroicmeasure used only to temporarilyprolong life. Its role in protecting andpreserving lives must be made morewidely known. Providing accurateinformation about medical technology'sbenefits gives people the ability tomake truly informed treatment decisions.

By Marlene Reid, PresidentEmeritus, Human Life Alliance

For some people in government andhealth care, limitingmedical care andending the lives ofcertain patientsmakes economicsense. One expertput it bluntly, "A

quick death is acheap death."

"Futile care" used to mean that the patient would not benefit from treatment—a medical judgment. In recentyears, the term has been redefined to mean that thepatient's life is deemed not worth the investment of life-sustaining treatment—a value judgment. "Futile care theory" is used to rationalize withholding treatment,and even food and fluids, regardless of the patient'sor family's wishes. Implicit in this new ethic is the profoundly unjust notion that some people have a duty to die.

Wesley J. Smith, in his book Forced Exit, suggeststhat money is "the most influential and dangerous force driving the euthanasia juggernaut." In fact, the push for Living Wills as cost-saving devices was the precursor to hospital "futile care" policies. The two work hand in hand. When a patient does not "choose" to forgo treatment, a "futile care"policy allows the hospital ethics committee tomake that "choice" for him/her.

In 1977, Robert Derzon, head of Health Care Financingfor the Department of Health, Education and Welfare,pointed out that the "cost-savings from a nationwide pushtoward 'Living Wills' is likely to be enormous." In 1987,Dr. Otis Bowen, Secretary of Health and Human Services(HHS), echoed Derzon in testimony before the SenateFinance Committee. In due course, the Patient Self-Determination Act became law, requiring facilities and

programs that receive Medicare and Medicaid funds to

give every adult patient the "opportunity" to sign aLiving Will. In 2005, HHS Secretary Mike Leavitt,speaking to hospital administrators, stated that encouragingnew Medicare participants to write Living Wills "wouldnot just save families anguish but would likely save thesystem a remarkable amount of money…"

Likewise, cost containment is the chief incentive for the"futile care" movement sweeping through our health caresystem. High-sounding motives such as "doing what isbest for patients" and "saving families anguish" are simply camouflage.

One way to spot potential problems is to review a hospital'sor nursing home's policy on the withdrawal or withholding

of tube-feeding. The provision of food andwater for a patient who is not otherwise

dying is basic, ordinary care.Unfortunately, this ethical

norm is fast becoming theexception while imposeddeath by dehydration isbecoming commonplace.

4

There may come a time when it ismedically indicated and morally permissible to forgo a specific treat-ment or other medical intervention.

Insistence against the patient's wishesthat every means available be used topostpone death is contrary to law, andwould be senseless and inhumane.There is no moral or ethical require-ment to provide or obtain treatmentthat is ineffective. Those treatmentsthat are extremely burdensome, overlyzealous, or otherwise extraordinaryare optional. However, people whowant treatment should not be deniedit.

We must be careful that what wejudge to be a "burden" is NOT the

patient's life, andthat the particular

treatment is truly a burden to thepatient - not to the family, insurancecompany, hospital or state.

If a time comes when it is impossibleto heal or cure, we do not deliberatelyhasten the death of a person. Wechange our roles. We become CAREgivers, doing what we can to meet the physical, emotional, social andspiritual needs of the person who issick or dying.

A balanced view accepts the moralityof refusing unduly burdensome orineffective treatment while rejectingimposed death. There is a world ofdifference between "allow her to die"and "kill her off."

Living Wills: Vital... or Deadly?

A Time to Let Go

Imposed Death � Human Life Alliance

*To obtain a PMDD packet specific to your state, contact:International Task Force onEuthanasia and Assisted Suicide,P.O. Box 760, Steubenville, OH43952; 800-958-5678.

Advance Directives: Who NeedsThem? (6 pages), 2004,International Task Force onEuthanasia and Assisted Suicide,800-958-9678.

Life, Life Support and Death:Principles, Guidelines, Policiesand Procedures for MakingDecisions to Protect andPreserve Life. 2nd Ed. 2005,American Life League, 540-659-4171.

Advance directives for health careare legal documents by which indi-viduals express their wishes in casethey are ever unable to make healthcare decisions for themselves. Thereare two types: the Living Will andthe Durable Power of Attorney for Health Care (DPAHC). Someadvance directives are a combinationof the two.

The laws governing Living Will and DPAHC documents permit thewithholding or withdrawal of ordi-nary treatment and care, includingfood and fluids, even when theomission will be the direct cause ofdeath. Thus, these documents canbe used to license euthanasia. Thewrong kind of advance directive inthe wrong hands can be a deadlycombination.

Federal regulations require everyhealth facility and program thatreceives Medicare and Medicaidfunds to inform patients aboutadvance directives. Many hospitalsand nursing homes give patients aLiving Will or DPAHC to sign atthe time of admission, a time whenmost people are under stress anddistracted by other paperwork and questions. This is not an idealcircumstance for considering a legal document with life and deathconsequences. It is wise to arrivewith your own carefully prepareddirective in hand.

When considering an advancedirective, you will need to under-stand the significant differencesbetween the two types.

A Living Will is downright danger-ous. It gives an attending physician

—very likely a stranger—the powerto make life and death decisions foryou. A doctor may do a poor job ofdeciphering your wishes, particular-ly if he/she does not share yourmoral values. Furthermore, realend-of-life decisions often involvecomplicated medical and ethicalquestions that can't be answered ina Living Will.

Keeping an open mind to the futureis essential. It is impossible to giveor withhold consent to treatmentbased on guesswork about a futureillness or injury, and withoutknowledge of potential future treatment options. Nevertheless, thedirections you give in a LivingWill, by law, must be followed.Therefore, you may tie the hands ofa physician whose skills couldrestore you to health or save yourlife. The directions in a Living Willare either so vague as to be uselessor so specific as to be hazardous.

A Durable Power of Attorney forHealth Care document is a betteroption. In a DPAHC you specificallyname a trusted family member orfriend ("agent") to make decisionsfor you if you are unable—eithertemporarily or permanently—to doso for yourself. Your "agent" willendeavor to make decisions inaccord with your personal valuesand wishes. Your "agent" will basemedical decisions on knowledge ofyour actual condition and treatmentoptions, not guesswork.

It is important to discuss your wisheswith your "agent" on a continuingbasis. Preferences tend to changeover time. Particularly as healthdeclines, patients often accept

medical interventions they previ-ously thought they would neverwant. Many people are not comfort-able talking about aging, illness,injury and death. However, as difficult as it may be to discussthese issues ahead of time, during amedical crisis it may be even moredifficult or even impossible.

As with any legal document, thewording of a DPAHC is criticallyimportant. Also, it must complywith the laws in your state. That iswhy Human Life Alliance recom-mends the Protective MedicalDecisions Document (PMDD)* formulated by the InternationalTask Force on Euthanasia andAssisted Suicide. The PMDD givesyour "agent" the authority to act onyour behalf and take legal action, ifnecessary, to insure that your rightsare protected. The PMDD clearlystates that your "agent" does nothave the authority to approve thedirect and intentional ending ofyour life. This limitation not onlyprotects you, but it also protectsyour "agent" from being subjectedto pressure to authorize suchactions.

A Durable Power of Attorney forHealth Care is absolutely essen-tial for anyone who is 18 years orolder. To be certain that a personyou trust will be making medicaldecisions for you if you becomeincapacitated by an injury or illness,you must have specifically namedthat person in a legal document.

Filling out a PMDD takes only afew minutes - a few minutes thatmay mean the difference betweenlife and death.

Information

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MMOONNEEYYMMOONNEEYY

Are You Sure You’d Never Want to be "Hooked Up to a Machine?"

Advertising Supplement � www.humanlife.org 9

Widespread legal and medicalendorsement of death by dehydrationand starvation has led to confusion.Is it right or wrong to withdraw foodand water from seriously ill, mentallyimpaired or persistently non-respon-sive (so-called "vegetative") patients?

It is important to distinguish betweenappropriate medical decisions anddiscriminatory decisions based onvalue judgments:

�When a person's body is shuttingdown during the natural dyingprocess, or when a person is unableto receive food and fluids withoutharm, it is medically appropriate tostop providing food and water. Inthese cases, patients die naturallyfrom their disease or injury.

�When a person is not dying (or notdying quickly enough), food andfluids— whether provided bymouth or tube—are withdrawnbecause the person is viewed ashaving an unacceptably low "quali-ty of life" and/or as imposing bur-dens on others. Some people areeven described as "vegetables" or "vegetative"—dehumanizing terms.These judgments on the value ofindividual human lives are used tojustify deliberately killing them bydehydration and starvation.

Consider the cases of two elderlywomen. In 1984, 92-year-old MaryHier had lived in a state hospital for over fifty years. Demented, buthappy, she thought she was theQueen of England. Mary was not ter-minally ill, but had needed a feedingtube for many years. When her gastrostomy (stomach) tube became dislodged, a court denied permissionto replace it, declaring that it wouldbe "a major medical procedure" with"relatively high risk" due to her

age. Just as Mary's case was beingreported, the same newspaper carriedanother story about a 94-year-oldwoman who was doing well after"minor surgery to correct a nutritionalproblem." The surgery, performedunder local anesthesia on an outpatientbasis, was the insertion of a gastros-tomy tube. The woman was RoseKennedy, matriarch of a rich andpolitically powerful family. MaryHier's life would have been prema-turely ended without last minuteintervention by a physician and anattorney who exposed the inequity.Her tube was replaced. Both womenlived for a number of years longer.

In too many instances, whetherinserting a feeding tube is considereda "major" or "minor" medical proce-dure depends upon whether the personis viewed by others as expendable orvaluable, burdensome or beloved.

Advocates of euthanasia assert thatproviding food and water to patientsis medical treatment that may bewithheld or withdrawn. On the contrary, food and water are basichuman needs and therefore basichuman rights.

Feeding tubes are used for variousreasons. Tube-feeding is often simpler,less costly and safer than spoon-feed-ing a patient who is a slow eater orchokes on food. It may be necessaryfor comfort, to ensure adequate nutri-tion and hydration or to sustain lifewhen a person is unable to swallow.The nourishment provided through a tube is real food and water, not"artificial nutrition and hydration."

Yes, feeding tubes are artificial. Soare electricity, running water, air-con-ditioning, cars and telephones. Asdemonstrated in the wake of

Hurricane Katrina, people die with-out these "artificial life supports."Should we therefore take away alllife-sustaining technologies so thatpeople who would die without themcan die naturally?

When a mother is unable to breast-feed, she bottle-feeds her baby.Technically this way of feeding ababy is "artificial life support." If amother refuses to bottle-feed andinstead says, "Let nature take itscourse," no one would consider herhelpless child's death to be natural.Likewise, to refuse to tube-feed ahelpless, otherwise non-dying patientresults in a very cruel and unnaturaldeath.

Dr. William Burke, a St. Louis neurologist, describes what happens topatients as they die from dehydration:

They will go into seizures. Theirskin cracks, their tongue cracks,their lips crack. They may havenosebleeds because of the dryingout of the mucus membranes, andheaving and vomiting might ensuebecause of the drying out of thestomach lining. They feel thepangs of hunger and thirst.Imagine going one day without aglass of water! Death by dehydra-tion takes 10 to 14 days. It is anextremely agonizing death.1

Food and fluids do not become"treatment" simply because they aretaken by tube any more than peni-cillin and Pepto-Bismol become"food" when taken by mouth. Thosewho claim otherwise do so toadvance their own agenda. In 1984,at a World Federation of Right to DieSocieties conference, bioethicist Dr.Helga Kuhse explained the strategyof euthanasia advocates:

If we can get people to accept theremoval of all treatment and care,especially the removal of foodand fluids, they will see what apainful way this is to die, andthen, in the patient's best interest,they will accept the lethal injec-tion.

Death by dehydration and starvationis inhumane. Nonetheless, in everystate it is now legal to impose deathon non-dying patients by taking awaytheir food and water. These laws areunjust and discriminatory. Theyimply that some people are "betteroff dead" and society is better offwithout them. They open the door tomedical murder by lethal injection.

"Always to care, never to kill," hasbeen the constant motto of honorablemedical professionals. No law canmake killing patients, regardless oftheir perceived "quality of life," medically or morally right.

1 Smith, Wesley J. "Dehydration Nation," The

Human Life Review. Fall 2003, Vol. XXIX,

No. 4, pp. 69-79.

Thirsty? Too Bad.

In March 2005, people from all over the countrymade their way to Florida to pray for Terri Schiavooutside the hospice where she was being dehydratedto death. (See p.12) The media were mostlyunsympathetic to these last friends of Terriand their expression of outrage that acourt had seen her disability as reason toimpose a death sentence. John Zarella,covering the case for CNN, describedtheir concern as "religious zealotry"and intimated that they were "extremists" akin tocriminals who murder abortion doctors.

Incredibly, on the same program, Zarella por-trayed hundreds of people working to save twodozen dolphins as heroes. He reported, "The

volunteers are in the pool 24/7 holding theanimals and keeping their blowholes

out of the water so they canbreathe. A veterinarianinjects the dolphins withvitamin E to help withmuscle cramping. Thesemammals are unable toeat on their own. Kate

Banick uses a feeding tubeto get them the nutrition they

need." Not a word about zealotry orextremism.

It is a tragic irony that, in pre-World War IIGermany (1933), strong animal protection laws were passed. Fifteen years later, the

Nuremberg Tribunal declared the Nazieuthanasia program a "crime against

humanity." U.S. Brigadier GeneralTaylor, chief counsel, concluded, "Ifthe principles announced in this lawhad been followed for human beingsas well, this indictment would neverhave been filed. It is perhaps thedeepest shame of the defendants that it

probably never occurred to them thathuman beings should be treated with at

least equal humanity."

Who will sit in judgment on the United States?

Thanks for all the fish!

Ted Stith, Sr., an up-stateNew York farmer and auctioneerwho suffered a stroke while onvacation in Florida, died February1st in a Florida Hospice on hiseighth day without food or water.His son had agreed to removal ofthe feeding tube. However, therewas no evidence that he wantedfood and water withheld.According to a good friend whohad flown to his bedside, Mr. Stithhad indicated that he wanted tolive, was improving, and hadasked for water. (North County

Gazette, 2/1/06)

CaseCaseinPointinPoint

8 Imposed Death � Human Life Alliance

The dehumanizing label "persistentvegetative state" (PVS) was crafted in1972 just as the euthanasia movementbegan to build up steam. It becamemore familiar in the 1980s as neurolo-gists began to use it to justify with-drawing food and water from other-wise non-dying brain-injuredpatients.

Many peoplehave blindfaith in med-ical labeling.Most probablythink that PVSis a simplediagnosis.However,experts dis-agree aboutwhat it is andmethods for diagnostic testing are disputed. In the InternationalClassification of Diseases, PVS isgrouped with "Symptoms, Signs andIll-Defined Conditions."

A "vegetative state" is not a coma.According to the 1994 Multi-SocietyTask Force (MSTF) on the medicalaspects of PVS, a person in a coma isneither awake nor aware; a person in avegetative state is awake but notaware. The MSTF defined "persistentvegetative state" as a vegetative statethat lasts more than one month.1 PVScan last for many years; however, thelonger a person is in PVS the less likelyit is that they will have a significantrecovery.

The person in PVS has sleep-wakecycles, eye movement, and normalrespiratory, circulatory and digestivefunctions. Some have random move-ment, some do not; some can swallow,others cannot. Some have been physi-cally injured; others suffer from strokeor dementia. In some cases the brainitself appears to change, in others itappears unchanged.

In simple terms, the diagnosis of PVSis based on a lack of evidence ofawareness of self or environment.However, it is not that simple.

Some patients who are diagnosed inPVS do exhibit evidence of awareness,but the diagnostician misses (or dismisses) the evidence. They may bemute and immobile ("locked-in"), butmentally alert and able to communicateby blinking or through aids such ascomputers—if someone gives themthe opportunity. Others retain somemeasure of awareness even thoughthey do not exhibit any evidence of it.Patients who have recovered fromsuch a state can recall things that weresaid or done to them while no oneknew they were aware.

How reliable, then, is the diagnosis ofPVS?

�In 2002, a study of mistaken diagno-sis of PVS revealed a 15% error rate.2

�Data gathered by the MSTF on agroup of 434 adult patients who

were in PVS asa result of trau-matic injuryshowed thatthree monthsafter injury,33% of thepatients had regainedconsciousness;by six months,46% had; and at12 months, 52%had.3

�Out of 40patients diag-nosed as being

in PVS, 17 (43%) were later foundto be alert, aware, and often able toexpress a simple wish. The author,London neurologist Dr. KeithAndrews, said, "It is disturbing tothink that some patients who wereaware had for several years been

treated as being vegetative."4

Studies show that PVS patients feelpain. A University of Michigan neurol-ogist, in one of the most completestudies, concluded that, when food and fluids are withdrawn (to imposedeath), the patient should be sedated.5

Some objections to imposed death forpatients in PVS have rested on thehope that they might recover. Let'sface it: many people with disabilitieswill not recover—but killing them isnot a cure!

It is now common for persistentlyunresponsive or minimally responsivepatients—who are not dispatched bydehydration in a hospital or hospice—to end up warehoused in nursinghomes, deprived of rehabilitation andother beneficial medical treatment.The unconscious world is far morecomplex than most of us can imagine.Patients with severe brain damagemay still enjoy touch, taste, smell and sound; they may also feel loneliness,fear, despair and pain.

A patient's inability to satisfy our

longing for response does not justify abandonment or imposed death.

1 Mappes, Thomas A. "Persistent VegetativeState, Prospective Thinking and AdvanceDirectives," Kennedy Institute of EthicsJournal. 2003: Vol. 13. No. 2: 119-139.

2 Ibid.3 Ibid.4 British Medical Journal. 7/6/965 Detroit Free Press. 6/26/90

“Persistent Vegetative State”

Arthur Wold, 30, had beenlabeled "severely mentally retard-ed" from age four. Unable to con-trol his body, he could make onlyrandom gestures and say isolatedwords. But, in 1991, at a shelteredworkshop, a counselor offered hima computer keyboard. He typed,"My name is Art." No one eversuspected he could read. Whenasked if he preferred to be calledArthur or Art, he spelled, "I don'tcare, just don't call me stupid."(Parade Magazine, 9/20/92)

CaseCaseinPointinPoint

On February 2, 2006,Not Dead Yet, the national

disability rights group, called foran investigation into the shoddymedicine that led to a court order toremove life-support from 11-year-oldHaleigh Poutre just days after heradmission to Massachusetts' BaystateMedical Center. Allegedly beaten byher adoptive mother and stepfather,Haleigh suffered a severe braininjury and was hospitalized inSeptember 2005. Four months afterbeing declared "virtually brain dead"and in an "irreversible coma" shewas responsive, interactive andbreathing on her own. In lateJanuary, she was moved to a rehabil-itation center for children. If thecourt order had not been appealed,Haleigh would now be dead.

According to Not Dead Yet, investi-gations are imperative into:

�How doctors at Baystate Medicalcould be so wrong in their hastydiagnosis that Haleigh had "nochance of recovering cognitive orsensate functioning" and that she"cannot hear, feel or respond."They presented their diagnosis asmedical fact, whereas any prognosisfollowing a brain injury must beprovisional. These doctors mustanswer to charges of incompetenceand negligence. Do they haveexpertise regarding brain injuries?

Furthermore, have they with-drawn life-support in similar

circumstances in the past?�How the medical tests run after

Poutre's biological mother sawsigns of responsiveness could be sowrong. Accepting the test results asincontestable, doctors again toldthe Department of Social Servicesthat there was "not a chance" ofrecovery. A few days later, Poutrebecame responsive. These tests areobviously fatally flawed.

�How Baystate Medical could support the incorrect diagnosis justeight days after Poutre's admission.In January, Dr. Douglas Katz, medical director of the traumaticbrain injury program at BraintreeRehabilitation Hospital, stated, "Iwouldn't give up before a year."(The Boston Globe, 1/27/06) Is giving up after eight days standardoperating procedure at Baystate?Have this hospital and othersallowed children with brain injuriesto die under such rushed circum-stances?

�Whether this rush to withdraw lifesupport from brain injured patientsis accepted medical practice inMassachusetts. Baystate doctorsclaimed their recommendationswere in line with established medical ethics. Perhaps we needsome new ethics.

�How the Juvenile Court, and theSupreme Judicial Court ofMassachusetts, could naivelyaccept medical testimony regarding

life and death withoutadditional investigation. Peoplewith disabilities have a lot ofexperience with medical hubrisregarding the quality of our lives,and know firsthand how mistakenand prejudicial doctors can be. The courts must stop their slavishdeference to "established medicalopinion," which is continuallychanging.

�How the courts understand the concept of "dignity." On October 5,barely three weeks after HaleighPoutre's admission, a juvenile courtjudge ruled that her "dignity andquality of life would be mostrespected by withdrawing both theventilator and the feeding tube."Now that Poutre is responsive, doesshe have her dignity back? Or isshe still at risk of being viewed asliving an undignified life?

Not Dead Yet leads the disabilitycommunity's opposition to legalizedassisted suicide, euthanasia andother forms of medical killings.

Not Dead Yet

Not Dead Yet 7521 Madison Street Forest Park, IL 60130 Contact: Stephen Drake708-209-1500 www.notdeadyet.org

Advertising Supplement � www.humanlife.org 5

Information

advance directive (LW or DurablePower of Attorney for Health Care)law.

1996�After Jack Kevorkian assists the

suicides of two women with non-terminal disabilities and isacquitted, disability activists formNOT DEAD YET. NDY makesnews by picketing Kevorkian'shome and conducting a sit-in at theDenver HS office. Disability rightsgroups' energetic opposition toassisted suicide becomes a "thorn in the side" of assisted suicide advocates.

�Barbara Coombs Lee replaces Meroat the helm of CID. She helpeddraft, promote, and defend theOregon PAS law (DWD Act).Under her, CID becomes a well-funded national organization.

1997�President Clinton signs the

"Assisted Suicide FundingRestriction Act" prohibiting federalfunds from paying for or promotingassisted suicide.

�The U.S. SupremeCourt unanimously upholdsthe right of states to prohibit PAS.This decision overturns the 9thCircuit Court of Appeals ruling thatWA State's law prohibiting assistedsuicide is unconstitutional and the2nd Circuit Court ruling that NYhas no rational interest in preventingassisted suicide for the terminallyill. CID had initiated these chal-lenges of laws forbidding PAS.

�A court clears the way for theOregon DWD Act to go into effect;physicians may now write prescrip-tions for suicide. Oregonians votedown a bill to repeal the law.

1998�Michigan voters crush a PAS meas-

ure 71%-29%. In ensuing years, the"right to die" movement meets withfailure after failure in state afterstate and numerous states strengthenexisting laws forbidding PAS.

1999�After assisting the deaths of at least

130 people, Kevorkian is convictedon one count of second-degree murder. He had videotaped himselfinjecting lethal drugs into ThomasYouk, a man with Lou Gehrig's disease. CBS "60 Minutes" airedthe video in 1998. It was used asevidence against Kevorkian. He isserving 10-25 years in prison.

2000� 62-year-old Choicein Dying lays the ground-work for Partnership for

Caring (PFC), votes to dissolveitself, and transfers its programs andstaff to PFC.

�In Jan., a FL judge rules that TerriSchiavo’s husband Michael canorder the removal of her feedingtube. Terri is brain-damaged, notterminally ill. Her parents fightdesperately for her life.

2001�In Nov., U.S. Attorney General

John Ashcroft announces that theControlledSubstances Act(CSA) pro-hibits the useof federallycontrolleddrugs forassisted suicidein Oregonbecause it is not a legitimate medical purpose.

2002�Oregon and assisted suicide

supporters challenge Ashcroft. U.S.District Judge Robert E. Jones rulesin favor of OR Justice Departmentattorneys appeal to the 9th U.S. Circuit Court of Appeals.

2003�The Hemlock Society changes its

name to End-of-Life Choices.�In a dramatic turn of events, on

10/21, the FL legislature enacts"Terri's law," permitting Gov. Jeb Bush to order Terri Schiavo's feedingtube reinserted after six days withoutfood or water. (See p.12)

�In Dec., Partnership for Caring(ESA descendant) and Robert WoodJohnson Foundation's Last Acts program merge to form Last ActsPartnership.

2004�On 3/20, Pope John Paul II defini-

tively declares that providingpatients in "vegetative" states withtube-administered food and fluids is "morallyobligatory,"and that nojudgmenton theirquality oflife couldjustify"euthanasia by omission." JPII alsostates, "A man, even if seriously illor disabled in the exercise of hishighest functions, is and always willbe a man, and he will never becomea 'vegetable' or an 'animal.'"

�On 5/6, a judge declares "Terri'sLaw" unconstitutional. Gov. Bush

appeals and receives a stay whilethe ruling is reviewed.

�On 5/26, the 9th Circuit Court rules2-1 that the U.S. Attorney Generalcannot penalize Oregon physicianswho assist suicides by prescribingcontrolled substances (narcotics).

�In Nov., CID (headquartered inPortland, OR) and End-of-LifeChoices (Denver, CO) merge tobecome Compassion & Choices,hoping to be a more powerful entityto lobby states to enact PAS laws(in other words, trying to jump-starta movement that's been stalled since1994).

�Last Acts Partnership ceases opera-tions after 66 years of working tochange the mindset of this nation.(Note: The current president andCEO of the National Hospice andPalliative Care Organization,Donald Schumacher, was vice chair of the board of directors ofPartnership for Caring and itsDirector of National Policy.Hospice has been infiltrated by the euthanasia/assisted suicidemovement.)

2005�On 3/31, Terri Schiavo dies of

dehydration after all efforts by her parents, numerous physicians,disability rights groups, pro-lifeorganizations, concerned citizens,the Legislature and Governor ofFlorida, the U.S. President andCongress fail to halt Judge

George W. Greer's unjust and cruelorder that Terri be denied all foodand water until dead.

�A PAS bill, the deceptively named"California Compassionate Choices Act," is introduced in theCA legislature. Support is lacking in both the Assembly and theSenate, so the bill's authors turn itinto a 2-year bill, meaning it maybe voted on in 2006. Facing defeat,Californians for CompassionateChoices blame media for using the"negative" term "assisted suicide" todescribe their bill, and urge themedia to use "more neutral" termssuch as "death with dignity," "rightto die" and "end of life choices."

2006�On 1/17, in Gonzales v. Oregon, the

U.S. Supreme Court rules 6-3 thatthe CSA does not prohibit the use offederally controlled substances forPAS. However, contrary to somemedia reports, the Court does notendorse assisted suicide. (See p.3)

1967�ESA launches a massive educational

campaign, establishing theEuthanasia Education Council(EEC) and introducing the LivingWill (LW) as a tool to promote discussion of euthanasia.

1973�The first state LW-type legislation

fails in Florida thanks to strongopposition fromadvocates for retardedchildren and theFL CatholicConference.Rep. Walter S.Sackett, MD,introduced thebill as a cost-saving measure thatwould save billions of dollars "ifthe state's mongoloids were permit-ted to succumb to pneumonia."

1975�ESA becomes the Society for the

Right to Die (SRD), expunging"euthanasia" (a reminder of theNazi killing program) from itsname.

1976�SRD's first success: the California

"Natural Death Act," a LW law,passes.

�Basing its decision on the "right toprivacy," a NJ court permits a ven-tilator to be removed from 21-year-old Karen Ann Quinlan, diagnosedto be in a persistent vegetative state(PVS). She unexpectedly lives fornine more years, requiring onlyordinary care, including tube feeding.

1980�British journalist, Derek Humphry,

immigrates to the U.S. He and hissecond wife, Ann Wickett, start theHemlockSociety (HS) inCA. (In 1975,Humphry hadhelped his firstwife kill herselfand later wroteJean's Way, abook recountingher "suicide.")Hemlock's purpose: to promote death-on-demand without any restrictions.

�"Dear Abby" promotes the LivingWill in her advice column and iscredited by SRD for an avalancheof requests for the document.

1984�22 states and the District of

Columbia have adopted LW laws.

1986�At a conference

titled "A NewEthic for the NewMedicine," the American MedicalAssociation's Council on Ethicaland Judicial Affairs issues this poli-cy: "Even if death is not imminent,but a patient's coma is beyonddoubt irreversible, ...it is not uneth-ical to discontinue all means oflife-prolonging medical treatment(including) medication and artifi-cially or technologically suppliedrespiration, nutrition and hydration.

�HS forms Americans AgainstHuman Suffering (AAHS) to seeklegalization of "physician-aid-in-dying" (medical homicide).

1987�32-year-old Nancy Ellen Jobes dies

from dehydration at her parents'request. Even though two neurolo-gists agreed that she was aware,responsive and purposeful, the NJSupreme Court upheld lower courtdecisions that family members mayrefuse medical care without clearevidence of a patient's wishes. SRD

participated in this and all early"right to die" court cases.

�In his book Setting Limits, DanielCallahan, director of the HastingsCenter (a bioethical think tank),proposes rationing medical treat-ment after a certain (unspecified)age. This is consistent with previousstatements, such as, "Given theincreasingly large pool of super-annuated, chronically ill, physicallymarginalized elderly, [denial offood and water] could well becomethe non-treatment of choice..."

1988�AAHS fails to gather enough

signatures to place its "physician-aid-in-dying" initiative on the CAballot. Humphry calls the effort "avaluable dress rehearsal."

�The American Association ofRetired Persons (AARP) is congratulated by HS of IL for publishing an article promotingHemlock, SRD, and Concern forDying.

1989�HS moves its headquarters to

Oregon, planning to eventuallyplace a "physician-assisted suicide"(PAS) initiative on the OR ballot.

�Medical journals increasingly givefavorable treatment to assisted suicide and euthanasia, setting thestage for physicians' acceptance ofmedically imposed death.

1990�In Michigan, unemployed patholo-

gist Jack Kevorkian hooks JanetAdkins to his "self-execution

machine." His first known victim,Adkins, was a 54-year-old Oregonwoman in an early stage ofAlzheimer's disease. Criminalcharges against Kevorkian aredropped, but a judge orders himnot to use the machine again.Thumbing his nose at the legal system, he goes on a killing spree.

�The U.S. Supreme Court, in its firsttermination of food and fluids case,Cruzan v. Missouri Department of Health, upholds Missouri'srequirement that there be "clear and convincing evidence" of anincompetent patient's wishes.Nevertheless, 33-year-old NancyCruzan is starved and dehydratedto death after a lower court finds new evidence—an allegedconversation she had 12 years prior—"clear and convincing."

�The "Patient Self-DeterminationAct" (federal law forcing healthcare facilities and programs to promote Living Wills) is enacted.

1991�D. Humphry's Final Exit (how to

commit suicide manual) hits NYTimes best seller list. This bookhas been found next to the bodiesof suicide victims.

�Washington voters reject the"Death With Dignity" (DWD)—assisted suicide— initiative placedon the ballot by the WA StateChapter of HS, led by Ralph Mero,a Unitarian minister.

�Choice in Dying forms by re-merg-ing SRD and Concern for Dying(which split from SRD in 1979). Itpromotes "end-of-life choices"through education and distributionof LW documents.

1992�Americans for Death with Dignity

(formerly AAHS) tries again inCA, collecting enough signaturesto put a PAS initiative on the ballot. Voters reject it.

1993�Compassion in Dying (CID), an HS

spin-off, is founded in WA State tocounsel the terminally ill and helpthem "with personal assistance, ifnecessary, to intentionally hastendeath." Ralph Mero is CID's firstexecutive director and president.

1994�The Oregon DWD Act is narrowly

approved by voters. Legal challenges ensue, blocking thisPAS measure from taking effect.

�Every state now has some type of

Save a Life!Become a patient advocate to safe-guard the welfare of a patient in thehospital or health care system.Patient advocates may accompany a medically vulnerable person todoctor appointments or stay withthe person when hospitalized.Particularly in need of advocatesare people whose lives are devaluedin our society—those who are men-tally or physically disabled, chroni-cally ill, elderly, incurable, or poor.

Many hospitals are short-staffed.This often results in overuse oftranquilizers or physical restraintsfor patients who are restless ordemanding, feeding tubes forpatients who can swallow but are inneed of assistance with meals, andcall bells ignored when help isurgently needed. The advocate cansoothe the restless patient, preventhim from pulling out tubes orfalling out of bed, assist with meals,offer drinks of water, go for help inan emergency, etc.

Some hospital personnel perceivecertain patients as being of "lowvalue" and therefore give them lesscare because they think they wouldbe "better off dead." The advocate'spresence will encourage hospitalstaff to be more attentive to thepatient's needs.

The most important role the patientadvocate can play is to be a visibleally for the patient—a sign to theworld that this patient is valued andshould be treated with care.

Organizations

ESA: Euthanasia Society ofAmerica. Later names were SRD:Society for the Right to Die; ChoiceIn Dying; PFC: Partnership ForCaring; Last Acts Partnership.EEC: Euthanasia Education Council(arm of ESA). Later names wereConcern for Dying; Choice InDying.AAHS: Americans Against HumanSuffering. Later named Americansfor Death with Dignity.CID: Compassion In DyingFederation. Now called Compassion& Choices.HS: Hemlock Society. Later namedEnd-of-Life Choices. Now calledCompassion & Choices (after unitingwith CID).

Abbreviated Terms

LW: Living WillPVS: Persistent Vegetative StatePAS: Physician-Assisted SuicideDWD: Death with DignityCSA: Controlled Substances Act

Wolfensberger, Wolf. A Guidelineon Protecting the Health and Livesof Patients in Hospitals, Especiallyif the Patient is a Member of aSocietally Devalued Class. 2nd Ed.2005. To order, contact: SyracuseUniversity Training Institute, 800South Wilbur Avenue, Suite 3B1,Syracuse, New York 13204.

The History of Imposed Death in America

LifeTree, Inc., a pro-life organiza-tion, has a detailed timeline atwww.lifetree.org/timeline.html.

Smith, Wesley J. Forced Exit: TheSlippery Slope from Assisted Suicideto Legalized Murder. SpencePublishing, 2003.

In 1938, the EuthanasiaSociety of America (ESA) wasfounded in New York. In 1939,ESA proposed legislation for"voluntary" euthanasia.According to attorney CharlesNixdorff, Treasurer, "the societyhoped eventually to legalize theputting to death of non-volunteersbeyond the help of medical science." ESA's president, Dr.Foster Kennedy, a neurologist,speaking before the Society ofMedical Jurisprudence at theAcademy of Medicine, urgedlegalizing euthanasia "primarilyin cases of born defectives whoare doomed to remain defective."These statements reveal the ultimate goal of the "right to die"movement: the legalization of the"right to kill" persons who aredeemed "defective" with or with-out their consent.

After numerous unsuccessfulattempts to legalize euthanasia,ESA leaders realized that theymust first change the mindset ofthe nation.

— Edmund Burke

Salvatore Crisafulli, anItalian, was considered by doctorsto be in a "deep coma" and "nearlydead" after being injured in a 2003road accident. He began to showsigns of alertness in July 2005.About three months later, he saidhis first word, "Mamma."Crisafulli was quoted as saying,"The doctors said that I wasn'tconscious, but I understood every-thing and I cried in desperation."

(Reuters, 10/5/05)

CaseCaseinPointinPoint

Information

Information

6 Imposed Death � Human Life Alliance Advertising Supplement � www.humanlife.org 7

advance directive (LW or DurablePower of Attorney for Health Care)law.

1996�After Jack Kevorkian assists the

suicides of two women with non-terminal disabilities and isacquitted, disability activists formNOT DEAD YET. NDY makesnews by picketing Kevorkian'shome and conducting a sit-in at theDenver HS office. Disability rightsgroups' energetic opposition toassisted suicide becomes a "thorn in the side" of assisted suicide advocates.

�Barbara Coombs Lee replaces Meroat the helm of CID. She helpeddraft, promote, and defend theOregon PAS law (DWD Act).Under her, CID becomes a well-funded national organization.

1997�President Clinton signs the

"Assisted Suicide FundingRestriction Act" prohibiting federalfunds from paying for or promotingassisted suicide.

�The U.S. SupremeCourt unanimously upholdsthe right of states to prohibit PAS.This decision overturns the 9thCircuit Court of Appeals ruling thatWA State's law prohibiting assistedsuicide is unconstitutional and the2nd Circuit Court ruling that NYhas no rational interest in preventingassisted suicide for the terminallyill. CID had initiated these chal-lenges of laws forbidding PAS.

�A court clears the way for theOregon DWD Act to go into effect;physicians may now write prescrip-tions for suicide. Oregonians votedown a bill to repeal the law.

1998�Michigan voters crush a PAS meas-

ure 71%-29%. In ensuing years, the"right to die" movement meets withfailure after failure in state afterstate and numerous states strengthenexisting laws forbidding PAS.

1999�After assisting the deaths of at least

130 people, Kevorkian is convictedon one count of second-degree murder. He had videotaped himselfinjecting lethal drugs into ThomasYouk, a man with Lou Gehrig's disease. CBS "60 Minutes" airedthe video in 1998. It was used asevidence against Kevorkian. He isserving 10-25 years in prison.

2000� 62-year-old Choicein Dying lays the ground-work for Partnership for

Caring (PFC), votes to dissolveitself, and transfers its programs andstaff to PFC.

�In Jan., a FL judge rules that TerriSchiavo’s husband Michael canorder the removal of her feedingtube. Terri is brain-damaged, notterminally ill. Her parents fightdesperately for her life.

2001�In Nov., U.S. Attorney General

John Ashcroft announces that theControlledSubstances Act(CSA) pro-hibits the useof federallycontrolleddrugs forassisted suicidein Oregonbecause it is not a legitimate medical purpose.

2002�Oregon and assisted suicide

supporters challenge Ashcroft. U.S.District Judge Robert E. Jones rulesin favor of OR Justice Departmentattorneys appeal to the 9th U.S. Circuit Court of Appeals.

2003�The Hemlock Society changes its

name to End-of-Life Choices.�In a dramatic turn of events, on

10/21, the FL legislature enacts"Terri's law," permitting Gov. Jeb Bush to order Terri Schiavo's feedingtube reinserted after six days withoutfood or water. (See p.12)

�In Dec., Partnership for Caring(ESA descendant) and Robert WoodJohnson Foundation's Last Acts program merge to form Last ActsPartnership.

2004�On 3/20, Pope John Paul II defini-

tively declares that providingpatients in "vegetative" states withtube-administered food and fluids is "morallyobligatory,"and that nojudgmenton theirquality oflife couldjustify"euthanasia by omission." JPII alsostates, "A man, even if seriously illor disabled in the exercise of hishighest functions, is and always willbe a man, and he will never becomea 'vegetable' or an 'animal.'"

�On 5/6, a judge declares "Terri'sLaw" unconstitutional. Gov. Bush

appeals and receives a stay whilethe ruling is reviewed.

�On 5/26, the 9th Circuit Court rules2-1 that the U.S. Attorney Generalcannot penalize Oregon physicianswho assist suicides by prescribingcontrolled substances (narcotics).

�In Nov., CID (headquartered inPortland, OR) and End-of-LifeChoices (Denver, CO) merge tobecome Compassion & Choices,hoping to be a more powerful entityto lobby states to enact PAS laws(in other words, trying to jump-starta movement that's been stalled since1994).

�Last Acts Partnership ceases opera-tions after 66 years of working tochange the mindset of this nation.(Note: The current president andCEO of the National Hospice andPalliative Care Organization,Donald Schumacher, was vice chair of the board of directors ofPartnership for Caring and itsDirector of National Policy.Hospice has been infiltrated by the euthanasia/assisted suicidemovement.)

2005�On 3/31, Terri Schiavo dies of

dehydration after all efforts by her parents, numerous physicians,disability rights groups, pro-lifeorganizations, concerned citizens,the Legislature and Governor ofFlorida, the U.S. President andCongress fail to halt Judge

George W. Greer's unjust and cruelorder that Terri be denied all foodand water until dead.

�A PAS bill, the deceptively named"California Compassionate Choices Act," is introduced in theCA legislature. Support is lacking in both the Assembly and theSenate, so the bill's authors turn itinto a 2-year bill, meaning it maybe voted on in 2006. Facing defeat,Californians for CompassionateChoices blame media for using the"negative" term "assisted suicide" todescribe their bill, and urge themedia to use "more neutral" termssuch as "death with dignity," "rightto die" and "end of life choices."

2006�On 1/17, in Gonzales v. Oregon, the

U.S. Supreme Court rules 6-3 thatthe CSA does not prohibit the use offederally controlled substances forPAS. However, contrary to somemedia reports, the Court does notendorse assisted suicide. (See p.3)

1967�ESA launches a massive educational

campaign, establishing theEuthanasia Education Council(EEC) and introducing the LivingWill (LW) as a tool to promote discussion of euthanasia.

1973�The first state LW-type legislation

fails in Florida thanks to strongopposition fromadvocates for retardedchildren and theFL CatholicConference.Rep. Walter S.Sackett, MD,introduced thebill as a cost-saving measure thatwould save billions of dollars "ifthe state's mongoloids were permit-ted to succumb to pneumonia."

1975�ESA becomes the Society for the

Right to Die (SRD), expunging"euthanasia" (a reminder of theNazi killing program) from itsname.

1976�SRD's first success: the California

"Natural Death Act," a LW law,passes.

�Basing its decision on the "right toprivacy," a NJ court permits a ven-tilator to be removed from 21-year-old Karen Ann Quinlan, diagnosedto be in a persistent vegetative state(PVS). She unexpectedly lives fornine more years, requiring onlyordinary care, including tube feeding.

1980�British journalist, Derek Humphry,

immigrates to the U.S. He and hissecond wife, Ann Wickett, start theHemlockSociety (HS) inCA. (In 1975,Humphry hadhelped his firstwife kill herselfand later wroteJean's Way, abook recountingher "suicide.")Hemlock's purpose: to promote death-on-demand without any restrictions.

�"Dear Abby" promotes the LivingWill in her advice column and iscredited by SRD for an avalancheof requests for the document.

1984�22 states and the District of

Columbia have adopted LW laws.

1986�At a conference

titled "A NewEthic for the NewMedicine," the American MedicalAssociation's Council on Ethicaland Judicial Affairs issues this poli-cy: "Even if death is not imminent,but a patient's coma is beyonddoubt irreversible, ...it is not uneth-ical to discontinue all means oflife-prolonging medical treatment(including) medication and artifi-cially or technologically suppliedrespiration, nutrition and hydration.

�HS forms Americans AgainstHuman Suffering (AAHS) to seeklegalization of "physician-aid-in-dying" (medical homicide).

1987�32-year-old Nancy Ellen Jobes dies

from dehydration at her parents'request. Even though two neurolo-gists agreed that she was aware,responsive and purposeful, the NJSupreme Court upheld lower courtdecisions that family members mayrefuse medical care without clearevidence of a patient's wishes. SRD

participated in this and all early"right to die" court cases.

�In his book Setting Limits, DanielCallahan, director of the HastingsCenter (a bioethical think tank),proposes rationing medical treat-ment after a certain (unspecified)age. This is consistent with previousstatements, such as, "Given theincreasingly large pool of super-annuated, chronically ill, physicallymarginalized elderly, [denial offood and water] could well becomethe non-treatment of choice..."

1988�AAHS fails to gather enough

signatures to place its "physician-aid-in-dying" initiative on the CAballot. Humphry calls the effort "avaluable dress rehearsal."

�The American Association ofRetired Persons (AARP) is congratulated by HS of IL for publishing an article promotingHemlock, SRD, and Concern forDying.

1989�HS moves its headquarters to

Oregon, planning to eventuallyplace a "physician-assisted suicide"(PAS) initiative on the OR ballot.

�Medical journals increasingly givefavorable treatment to assisted suicide and euthanasia, setting thestage for physicians' acceptance ofmedically imposed death.

1990�In Michigan, unemployed patholo-

gist Jack Kevorkian hooks JanetAdkins to his "self-execution

machine." His first known victim,Adkins, was a 54-year-old Oregonwoman in an early stage ofAlzheimer's disease. Criminalcharges against Kevorkian aredropped, but a judge orders himnot to use the machine again.Thumbing his nose at the legal system, he goes on a killing spree.

�The U.S. Supreme Court, in its firsttermination of food and fluids case,Cruzan v. Missouri Department of Health, upholds Missouri'srequirement that there be "clear and convincing evidence" of anincompetent patient's wishes.Nevertheless, 33-year-old NancyCruzan is starved and dehydratedto death after a lower court finds new evidence—an allegedconversation she had 12 years prior—"clear and convincing."

�The "Patient Self-DeterminationAct" (federal law forcing healthcare facilities and programs to promote Living Wills) is enacted.

1991�D. Humphry's Final Exit (how to

commit suicide manual) hits NYTimes best seller list. This bookhas been found next to the bodiesof suicide victims.

�Washington voters reject the"Death With Dignity" (DWD)—assisted suicide— initiative placedon the ballot by the WA StateChapter of HS, led by Ralph Mero,a Unitarian minister.

�Choice in Dying forms by re-merg-ing SRD and Concern for Dying(which split from SRD in 1979). Itpromotes "end-of-life choices"through education and distributionof LW documents.

1992�Americans for Death with Dignity

(formerly AAHS) tries again inCA, collecting enough signaturesto put a PAS initiative on the ballot. Voters reject it.

1993�Compassion in Dying (CID), an HS

spin-off, is founded in WA State tocounsel the terminally ill and helpthem "with personal assistance, ifnecessary, to intentionally hastendeath." Ralph Mero is CID's firstexecutive director and president.

1994�The Oregon DWD Act is narrowly

approved by voters. Legal challenges ensue, blocking thisPAS measure from taking effect.

�Every state now has some type of

Save a Life!Become a patient advocate to safe-guard the welfare of a patient in thehospital or health care system.Patient advocates may accompany a medically vulnerable person todoctor appointments or stay withthe person when hospitalized.Particularly in need of advocatesare people whose lives are devaluedin our society—those who are men-tally or physically disabled, chroni-cally ill, elderly, incurable, or poor.

Many hospitals are short-staffed.This often results in overuse oftranquilizers or physical restraintsfor patients who are restless ordemanding, feeding tubes forpatients who can swallow but are inneed of assistance with meals, andcall bells ignored when help isurgently needed. The advocate cansoothe the restless patient, preventhim from pulling out tubes orfalling out of bed, assist with meals,offer drinks of water, go for help inan emergency, etc.

Some hospital personnel perceivecertain patients as being of "lowvalue" and therefore give them lesscare because they think they wouldbe "better off dead." The advocate'spresence will encourage hospitalstaff to be more attentive to thepatient's needs.

The most important role the patientadvocate can play is to be a visibleally for the patient—a sign to theworld that this patient is valued andshould be treated with care.

Organizations

ESA: Euthanasia Society ofAmerica. Later names were SRD:Society for the Right to Die; ChoiceIn Dying; PFC: Partnership ForCaring; Last Acts Partnership.EEC: Euthanasia Education Council(arm of ESA). Later names wereConcern for Dying; Choice InDying.AAHS: Americans Against HumanSuffering. Later named Americansfor Death with Dignity.CID: Compassion In DyingFederation. Now called Compassion& Choices.HS: Hemlock Society. Later namedEnd-of-Life Choices. Now calledCompassion & Choices (after unitingwith CID).

Abbreviated Terms

LW: Living WillPVS: Persistent Vegetative StatePAS: Physician-Assisted SuicideDWD: Death with DignityCSA: Controlled Substances Act

Wolfensberger, Wolf. A Guidelineon Protecting the Health and Livesof Patients in Hospitals, Especiallyif the Patient is a Member of aSocietally Devalued Class. 2nd Ed.2005. To order, contact: SyracuseUniversity Training Institute, 800South Wilbur Avenue, Suite 3B1,Syracuse, New York 13204.

The History of Imposed Death in America

LifeTree, Inc., a pro-life organiza-tion, has a detailed timeline atwww.lifetree.org/timeline.html.

Smith, Wesley J. Forced Exit: TheSlippery Slope from Assisted Suicideto Legalized Murder. SpencePublishing, 2003.

In 1938, the EuthanasiaSociety of America (ESA) wasfounded in New York. In 1939,ESA proposed legislation for"voluntary" euthanasia.According to attorney CharlesNixdorff, Treasurer, "the societyhoped eventually to legalize theputting to death of non-volunteersbeyond the help of medical science." ESA's president, Dr.Foster Kennedy, a neurologist,speaking before the Society ofMedical Jurisprudence at theAcademy of Medicine, urgedlegalizing euthanasia "primarilyin cases of born defectives whoare doomed to remain defective."These statements reveal the ultimate goal of the "right to die"movement: the legalization of the"right to kill" persons who aredeemed "defective" with or with-out their consent.

After numerous unsuccessfulattempts to legalize euthanasia,ESA leaders realized that theymust first change the mindset ofthe nation.

— Edmund Burke

Salvatore Crisafulli, anItalian, was considered by doctorsto be in a "deep coma" and "nearlydead" after being injured in a 2003road accident. He began to showsigns of alertness in July 2005.About three months later, he saidhis first word, "Mamma."Crisafulli was quoted as saying,"The doctors said that I wasn'tconscious, but I understood every-thing and I cried in desperation."

(Reuters, 10/5/05)

CaseCaseinPointinPoint

Information

Information

6 Imposed Death � Human Life Alliance Advertising Supplement � www.humanlife.org 7

Widespread legal and medicalendorsement of death by dehydrationand starvation has led to confusion.Is it right or wrong to withdraw foodand water from seriously ill, mentallyimpaired or persistently non-respon-sive (so-called "vegetative") patients?

It is important to distinguish betweenappropriate medical decisions anddiscriminatory decisions based onvalue judgments:

�When a person's body is shuttingdown during the natural dyingprocess, or when a person is unableto receive food and fluids withoutharm, it is medically appropriate tostop providing food and water. Inthese cases, patients die naturallyfrom their disease or injury.

�When a person is not dying (or notdying quickly enough), food andfluids— whether provided bymouth or tube—are withdrawnbecause the person is viewed ashaving an unacceptably low "quali-ty of life" and/or as imposing bur-dens on others. Some people areeven described as "vegetables" or "vegetative"—dehumanizing terms.These judgments on the value ofindividual human lives are used tojustify deliberately killing them bydehydration and starvation.

Consider the cases of two elderlywomen. In 1984, 92-year-old MaryHier had lived in a state hospital for over fifty years. Demented, buthappy, she thought she was theQueen of England. Mary was not ter-minally ill, but had needed a feedingtube for many years. When her gastrostomy (stomach) tube became dislodged, a court denied permissionto replace it, declaring that it wouldbe "a major medical procedure" with"relatively high risk" due to her

age. Just as Mary's case was beingreported, the same newspaper carriedanother story about a 94-year-oldwoman who was doing well after"minor surgery to correct a nutritionalproblem." The surgery, performedunder local anesthesia on an outpatientbasis, was the insertion of a gastros-tomy tube. The woman was RoseKennedy, matriarch of a rich andpolitically powerful family. MaryHier's life would have been prema-turely ended without last minuteintervention by a physician and anattorney who exposed the inequity.Her tube was replaced. Both womenlived for a number of years longer.

In too many instances, whetherinserting a feeding tube is considereda "major" or "minor" medical proce-dure depends upon whether the personis viewed by others as expendable orvaluable, burdensome or beloved.

Advocates of euthanasia assert thatproviding food and water to patientsis medical treatment that may bewithheld or withdrawn. On the contrary, food and water are basichuman needs and therefore basichuman rights.

Feeding tubes are used for variousreasons. Tube-feeding is often simpler,less costly and safer than spoon-feed-ing a patient who is a slow eater orchokes on food. It may be necessaryfor comfort, to ensure adequate nutri-tion and hydration or to sustain lifewhen a person is unable to swallow.The nourishment provided through a tube is real food and water, not"artificial nutrition and hydration."

Yes, feeding tubes are artificial. Soare electricity, running water, air-con-ditioning, cars and telephones. Asdemonstrated in the wake of

Hurricane Katrina, people die with-out these "artificial life supports."Should we therefore take away alllife-sustaining technologies so thatpeople who would die without themcan die naturally?

When a mother is unable to breast-feed, she bottle-feeds her baby.Technically this way of feeding ababy is "artificial life support." If amother refuses to bottle-feed andinstead says, "Let nature take itscourse," no one would consider herhelpless child's death to be natural.Likewise, to refuse to tube-feed ahelpless, otherwise non-dying patientresults in a very cruel and unnaturaldeath.

Dr. William Burke, a St. Louis neurologist, describes what happens topatients as they die from dehydration:

They will go into seizures. Theirskin cracks, their tongue cracks,their lips crack. They may havenosebleeds because of the dryingout of the mucus membranes, andheaving and vomiting might ensuebecause of the drying out of thestomach lining. They feel thepangs of hunger and thirst.Imagine going one day without aglass of water! Death by dehydra-tion takes 10 to 14 days. It is anextremely agonizing death.1

Food and fluids do not become"treatment" simply because they aretaken by tube any more than peni-cillin and Pepto-Bismol become"food" when taken by mouth. Thosewho claim otherwise do so toadvance their own agenda. In 1984,at a World Federation of Right to DieSocieties conference, bioethicist Dr.Helga Kuhse explained the strategyof euthanasia advocates:

If we can get people to accept theremoval of all treatment and care,especially the removal of foodand fluids, they will see what apainful way this is to die, andthen, in the patient's best interest,they will accept the lethal injec-tion.

Death by dehydration and starvationis inhumane. Nonetheless, in everystate it is now legal to impose deathon non-dying patients by taking awaytheir food and water. These laws areunjust and discriminatory. Theyimply that some people are "betteroff dead" and society is better offwithout them. They open the door tomedical murder by lethal injection.

"Always to care, never to kill," hasbeen the constant motto of honorablemedical professionals. No law canmake killing patients, regardless oftheir perceived "quality of life," medically or morally right.

1 Smith, Wesley J. "Dehydration Nation," The

Human Life Review. Fall 2003, Vol. XXIX,

No. 4, pp. 69-79.

Thirsty? Too Bad.

In March 2005, people from all over the countrymade their way to Florida to pray for Terri Schiavooutside the hospice where she was being dehydratedto death. (See p.12) The media were mostlyunsympathetic to these last friends of Terriand their expression of outrage that acourt had seen her disability as reason toimpose a death sentence. John Zarella,covering the case for CNN, describedtheir concern as "religious zealotry"and intimated that they were "extremists" akin tocriminals who murder abortion doctors.

Incredibly, on the same program, Zarella por-trayed hundreds of people working to save twodozen dolphins as heroes. He reported, "The

volunteers are in the pool 24/7 holding theanimals and keeping their blowholes

out of the water so they canbreathe. A veterinarianinjects the dolphins withvitamin E to help withmuscle cramping. Thesemammals are unable toeat on their own. Kate

Banick uses a feeding tubeto get them the nutrition they

need." Not a word about zealotry orextremism.

It is a tragic irony that, in pre-World War IIGermany (1933), strong animal protection laws were passed. Fifteen years later, the

Nuremberg Tribunal declared the Nazieuthanasia program a "crime against

humanity." U.S. Brigadier GeneralTaylor, chief counsel, concluded, "Ifthe principles announced in this lawhad been followed for human beingsas well, this indictment would neverhave been filed. It is perhaps thedeepest shame of the defendants that it

probably never occurred to them thathuman beings should be treated with at

least equal humanity."

Who will sit in judgment on the United States?

Thanks for all the fish!

Ted Stith, Sr., an up-stateNew York farmer and auctioneerwho suffered a stroke while onvacation in Florida, died February1st in a Florida Hospice on hiseighth day without food or water.His son had agreed to removal ofthe feeding tube. However, therewas no evidence that he wantedfood and water withheld.According to a good friend whohad flown to his bedside, Mr. Stithhad indicated that he wanted tolive, was improving, and hadasked for water. (North County

Gazette, 2/1/06)

CaseCaseinPointinPoint

8 Imposed Death � Human Life Alliance

The dehumanizing label "persistentvegetative state" (PVS) was crafted in1972 just as the euthanasia movementbegan to build up steam. It becamemore familiar in the 1980s as neurolo-gists began to use it to justify with-drawing food and water from other-wise non-dying brain-injuredpatients.

Many peoplehave blindfaith in med-ical labeling.Most probablythink that PVSis a simplediagnosis.However,experts dis-agree aboutwhat it is andmethods for diagnostic testing are disputed. In the InternationalClassification of Diseases, PVS isgrouped with "Symptoms, Signs andIll-Defined Conditions."

A "vegetative state" is not a coma.According to the 1994 Multi-SocietyTask Force (MSTF) on the medicalaspects of PVS, a person in a coma isneither awake nor aware; a person in avegetative state is awake but notaware. The MSTF defined "persistentvegetative state" as a vegetative statethat lasts more than one month.1 PVScan last for many years; however, thelonger a person is in PVS the less likelyit is that they will have a significantrecovery.

The person in PVS has sleep-wakecycles, eye movement, and normalrespiratory, circulatory and digestivefunctions. Some have random move-ment, some do not; some can swallow,others cannot. Some have been physi-cally injured; others suffer from strokeor dementia. In some cases the brainitself appears to change, in others itappears unchanged.

In simple terms, the diagnosis of PVSis based on a lack of evidence ofawareness of self or environment.However, it is not that simple.

Some patients who are diagnosed inPVS do exhibit evidence of awareness,but the diagnostician misses (or dismisses) the evidence. They may bemute and immobile ("locked-in"), butmentally alert and able to communicateby blinking or through aids such ascomputers—if someone gives themthe opportunity. Others retain somemeasure of awareness even thoughthey do not exhibit any evidence of it.Patients who have recovered fromsuch a state can recall things that weresaid or done to them while no oneknew they were aware.

How reliable, then, is the diagnosis ofPVS?

�In 2002, a study of mistaken diagno-sis of PVS revealed a 15% error rate.2

�Data gathered by the MSTF on agroup of 434 adult patients who

were in PVS asa result of trau-matic injuryshowed thatthree monthsafter injury,33% of thepatients had regainedconsciousness;by six months,46% had; and at12 months, 52%had.3

�Out of 40patients diag-nosed as being

in PVS, 17 (43%) were later foundto be alert, aware, and often able toexpress a simple wish. The author,London neurologist Dr. KeithAndrews, said, "It is disturbing tothink that some patients who wereaware had for several years been

treated as being vegetative."4

Studies show that PVS patients feelpain. A University of Michigan neurol-ogist, in one of the most completestudies, concluded that, when food and fluids are withdrawn (to imposedeath), the patient should be sedated.5

Some objections to imposed death forpatients in PVS have rested on thehope that they might recover. Let'sface it: many people with disabilitieswill not recover—but killing them isnot a cure!

It is now common for persistentlyunresponsive or minimally responsivepatients—who are not dispatched bydehydration in a hospital or hospice—to end up warehoused in nursinghomes, deprived of rehabilitation andother beneficial medical treatment.The unconscious world is far morecomplex than most of us can imagine.Patients with severe brain damagemay still enjoy touch, taste, smell and sound; they may also feel loneliness,fear, despair and pain.

A patient's inability to satisfy our

longing for response does not justify abandonment or imposed death.

1 Mappes, Thomas A. "Persistent VegetativeState, Prospective Thinking and AdvanceDirectives," Kennedy Institute of EthicsJournal. 2003: Vol. 13. No. 2: 119-139.

2 Ibid.3 Ibid.4 British Medical Journal. 7/6/965 Detroit Free Press. 6/26/90

“Persistent Vegetative State”

Arthur Wold, 30, had beenlabeled "severely mentally retard-ed" from age four. Unable to con-trol his body, he could make onlyrandom gestures and say isolatedwords. But, in 1991, at a shelteredworkshop, a counselor offered hima computer keyboard. He typed,"My name is Art." No one eversuspected he could read. Whenasked if he preferred to be calledArthur or Art, he spelled, "I don'tcare, just don't call me stupid."(Parade Magazine, 9/20/92)

CaseCaseinPointinPoint

On February 2, 2006,Not Dead Yet, the national

disability rights group, called foran investigation into the shoddymedicine that led to a court order toremove life-support from 11-year-oldHaleigh Poutre just days after heradmission to Massachusetts' BaystateMedical Center. Allegedly beaten byher adoptive mother and stepfather,Haleigh suffered a severe braininjury and was hospitalized inSeptember 2005. Four months afterbeing declared "virtually brain dead"and in an "irreversible coma" shewas responsive, interactive andbreathing on her own. In lateJanuary, she was moved to a rehabil-itation center for children. If thecourt order had not been appealed,Haleigh would now be dead.

According to Not Dead Yet, investi-gations are imperative into:

�How doctors at Baystate Medicalcould be so wrong in their hastydiagnosis that Haleigh had "nochance of recovering cognitive orsensate functioning" and that she"cannot hear, feel or respond."They presented their diagnosis asmedical fact, whereas any prognosisfollowing a brain injury must beprovisional. These doctors mustanswer to charges of incompetenceand negligence. Do they haveexpertise regarding brain injuries?

Furthermore, have they with-drawn life-support in similar

circumstances in the past?�How the medical tests run after

Poutre's biological mother sawsigns of responsiveness could be sowrong. Accepting the test results asincontestable, doctors again toldthe Department of Social Servicesthat there was "not a chance" ofrecovery. A few days later, Poutrebecame responsive. These tests areobviously fatally flawed.

�How Baystate Medical could support the incorrect diagnosis justeight days after Poutre's admission.In January, Dr. Douglas Katz, medical director of the traumaticbrain injury program at BraintreeRehabilitation Hospital, stated, "Iwouldn't give up before a year."(The Boston Globe, 1/27/06) Is giving up after eight days standardoperating procedure at Baystate?Have this hospital and othersallowed children with brain injuriesto die under such rushed circum-stances?

�Whether this rush to withdraw lifesupport from brain injured patientsis accepted medical practice inMassachusetts. Baystate doctorsclaimed their recommendationswere in line with established medical ethics. Perhaps we needsome new ethics.

�How the Juvenile Court, and theSupreme Judicial Court ofMassachusetts, could naivelyaccept medical testimony regarding

life and death withoutadditional investigation. Peoplewith disabilities have a lot ofexperience with medical hubrisregarding the quality of our lives,and know firsthand how mistakenand prejudicial doctors can be. The courts must stop their slavishdeference to "established medicalopinion," which is continuallychanging.

�How the courts understand the concept of "dignity." On October 5,barely three weeks after HaleighPoutre's admission, a juvenile courtjudge ruled that her "dignity andquality of life would be mostrespected by withdrawing both theventilator and the feeding tube."Now that Poutre is responsive, doesshe have her dignity back? Or isshe still at risk of being viewed asliving an undignified life?

Not Dead Yet leads the disabilitycommunity's opposition to legalizedassisted suicide, euthanasia andother forms of medical killings.

Not Dead Yet

Not Dead Yet 7521 Madison Street Forest Park, IL 60130 Contact: Stephen Drake708-209-1500 www.notdeadyet.org

Advertising Supplement � www.humanlife.org 5

Information

Your life or the life of a loved onemay depend on having correct infor-mation about the ventilator, commonlycalled a "respirator."

Respiration isa bodilyfunction, nota machine'sfunction. Itcan onlyoccur whenthe body'srespiratoryand circulatorysystems areintact andfunctioning.A ventilatoris an aid tobreathing.The ventilatormachine supports the ventilation part of breath-ing—moving air into and out of thelungs. But, it does not and cannotcause the other part of breathing—respiration. Thus, the machine shouldalways be referred to by its accuratename, "ventilator."

Many people with disabilities useventilators every day of their lives to assist their breathing. For them, aventilator is a necessity of life whichallows them not only to continue living, but to breathe easier and enjoylife to its fullest. The ventilator is alsocommonly and effectively used tosave lives.

I had not given much thought to theindispensable role that a ventilatorplays in the healing process until threereal-life incidents brought the truthhome to me.

My 41-year-old nephew was sufferingfrom shocked-lung syndrome afterbeing injured in an automobile accident.This is a condition in which the elas-ticity of the lungs is greatly curtailed,causing intense pain and severe short-ness of breath. To give his body achance to heal without fighting forbreath, the doctors induced a comatosestate and put him on a ventilator. Hewas on the ventilator for more thanthree weeks. His life was hanging bya thread or, more literally, a machine.When he was finally taken off the ven-tilator, his body took over, eventuallycompleting the healing process. Todayhe is back working at his heavy-dutyconstruction job—thanks to the venti-lator and endless prayers.

In the second incident, a dear friend

sustained a head injury. Because histraumatized body started to shut downfollowing surgery to close the wound,he too was put into a medically induced

coma andhooked upto a venti-lator. Hewas in crit-ical condi-tion. Afterfive days,he wastaken offthe ventila-tor and hisnaturalbreathingfunctionstook over.This friend,who at 80doesn't

believe in retirement, is back workingfull-time, none the worse for the wear.

Imagine the outcome had he signed a Living Will that stated he wouldnever want to be put on a "respirator."If you have made a statement to thiseffect, either orally or in writing, Iadvise you to promptly and emphati-cally rescind it.

In the third incident, a friend had acardiac arrest. He was taken to thehospital by ambulance and subse-quently pronounced "brain dead." The attending physicians wanted todisconnect life support, but his wifewouldn't hear of it until all of theirchildren could get home to say theirgoodbyes. After 72 hours, the sorrowingchildren had bid their father farewell.When life support was disconnected,their father sat up in bed and startedtalking to the family! He went homeshortly thereafter and the family wasable to enjoy his company for fourmore years before he was called hometo his Maker. WHAT IF his wife had

given consent to stop life supportbefore his body's own healing powershad a chance to take their course withthe aid of the ventilator?

I am now an enthusiastic believer inthe healing benefit of the ventilator.We must all do our part to dispel themistaken assumption that use of aventilator is an extraordinary or heroicmeasure used only to temporarilyprolong life. Its role in protecting andpreserving lives must be made morewidely known. Providing accurateinformation about medical technology'sbenefits gives people the ability tomake truly informed treatment decisions.

By Marlene Reid, PresidentEmeritus, Human Life Alliance

For some people in government andhealth care, limitingmedical care andending the lives ofcertain patientsmakes economicsense. One expertput it bluntly, "A

quick death is acheap death."

"Futile care" used to mean that the patient would not benefit from treatment—a medical judgment. In recentyears, the term has been redefined to mean that thepatient's life is deemed not worth the investment of life-sustaining treatment—a value judgment. "Futile care theory" is used to rationalize withholding treatment,and even food and fluids, regardless of the patient'sor family's wishes. Implicit in this new ethic is the profoundly unjust notion that some people have a duty to die.

Wesley J. Smith, in his book Forced Exit, suggeststhat money is "the most influential and dangerous force driving the euthanasia juggernaut." In fact, the push for Living Wills as cost-saving devices was the precursor to hospital "futile care" policies. The two work hand in hand. When a patient does not "choose" to forgo treatment, a "futile care"policy allows the hospital ethics committee tomake that "choice" for him/her.

In 1977, Robert Derzon, head of Health Care Financingfor the Department of Health, Education and Welfare,pointed out that the "cost-savings from a nationwide pushtoward 'Living Wills' is likely to be enormous." In 1987,Dr. Otis Bowen, Secretary of Health and Human Services(HHS), echoed Derzon in testimony before the SenateFinance Committee. In due course, the Patient Self-Determination Act became law, requiring facilities and

programs that receive Medicare and Medicaid funds to

give every adult patient the "opportunity" to sign aLiving Will. In 2005, HHS Secretary Mike Leavitt,speaking to hospital administrators, stated that encouragingnew Medicare participants to write Living Wills "wouldnot just save families anguish but would likely save thesystem a remarkable amount of money…"

Likewise, cost containment is the chief incentive for the"futile care" movement sweeping through our health caresystem. High-sounding motives such as "doing what isbest for patients" and "saving families anguish" are simply camouflage.

One way to spot potential problems is to review a hospital'sor nursing home's policy on the withdrawal or withholding

of tube-feeding. The provision of food andwater for a patient who is not otherwise

dying is basic, ordinary care.Unfortunately, this ethical

norm is fast becoming theexception while imposeddeath by dehydration isbecoming commonplace.

4

There may come a time when it ismedically indicated and morally permissible to forgo a specific treat-ment or other medical intervention.

Insistence against the patient's wishesthat every means available be used topostpone death is contrary to law, andwould be senseless and inhumane.There is no moral or ethical require-ment to provide or obtain treatmentthat is ineffective. Those treatmentsthat are extremely burdensome, overlyzealous, or otherwise extraordinaryare optional. However, people whowant treatment should not be deniedit.

We must be careful that what wejudge to be a "burden" is NOT the

patient's life, andthat the particular

treatment is truly a burden to thepatient - not to the family, insurancecompany, hospital or state.

If a time comes when it is impossibleto heal or cure, we do not deliberatelyhasten the death of a person. Wechange our roles. We become CAREgivers, doing what we can to meet the physical, emotional, social andspiritual needs of the person who issick or dying.

A balanced view accepts the moralityof refusing unduly burdensome orineffective treatment while rejectingimposed death. There is a world ofdifference between "allow her to die"and "kill her off."

Living Wills: Vital... or Deadly?

A Time to Let Go

Imposed Death � Human Life Alliance

*To obtain a PMDD packet specific to your state, contact:International Task Force onEuthanasia and Assisted Suicide,P.O. Box 760, Steubenville, OH43952; 800-958-5678.

Advance Directives: Who NeedsThem? (6 pages), 2004,International Task Force onEuthanasia and Assisted Suicide,800-958-9678.

Life, Life Support and Death:Principles, Guidelines, Policiesand Procedures for MakingDecisions to Protect andPreserve Life. 2nd Ed. 2005,American Life League, 540-659-4171.

Advance directives for health careare legal documents by which indi-viduals express their wishes in casethey are ever unable to make healthcare decisions for themselves. Thereare two types: the Living Will andthe Durable Power of Attorney for Health Care (DPAHC). Someadvance directives are a combinationof the two.

The laws governing Living Will and DPAHC documents permit thewithholding or withdrawal of ordi-nary treatment and care, includingfood and fluids, even when theomission will be the direct cause ofdeath. Thus, these documents canbe used to license euthanasia. Thewrong kind of advance directive inthe wrong hands can be a deadlycombination.

Federal regulations require everyhealth facility and program thatreceives Medicare and Medicaidfunds to inform patients aboutadvance directives. Many hospitalsand nursing homes give patients aLiving Will or DPAHC to sign atthe time of admission, a time whenmost people are under stress anddistracted by other paperwork and questions. This is not an idealcircumstance for considering a legal document with life and deathconsequences. It is wise to arrivewith your own carefully prepareddirective in hand.

When considering an advancedirective, you will need to under-stand the significant differencesbetween the two types.

A Living Will is downright danger-ous. It gives an attending physician

—very likely a stranger—the powerto make life and death decisions foryou. A doctor may do a poor job ofdeciphering your wishes, particular-ly if he/she does not share yourmoral values. Furthermore, realend-of-life decisions often involvecomplicated medical and ethicalquestions that can't be answered ina Living Will.

Keeping an open mind to the futureis essential. It is impossible to giveor withhold consent to treatmentbased on guesswork about a futureillness or injury, and withoutknowledge of potential future treatment options. Nevertheless, thedirections you give in a LivingWill, by law, must be followed.Therefore, you may tie the hands ofa physician whose skills couldrestore you to health or save yourlife. The directions in a Living Willare either so vague as to be uselessor so specific as to be hazardous.

A Durable Power of Attorney forHealth Care document is a betteroption. In a DPAHC you specificallyname a trusted family member orfriend ("agent") to make decisionsfor you if you are unable—eithertemporarily or permanently—to doso for yourself. Your "agent" willendeavor to make decisions inaccord with your personal valuesand wishes. Your "agent" will basemedical decisions on knowledge ofyour actual condition and treatmentoptions, not guesswork.

It is important to discuss your wisheswith your "agent" on a continuingbasis. Preferences tend to changeover time. Particularly as healthdeclines, patients often accept

medical interventions they previ-ously thought they would neverwant. Many people are not comfort-able talking about aging, illness,injury and death. However, as difficult as it may be to discussthese issues ahead of time, during amedical crisis it may be even moredifficult or even impossible.

As with any legal document, thewording of a DPAHC is criticallyimportant. Also, it must complywith the laws in your state. That iswhy Human Life Alliance recom-mends the Protective MedicalDecisions Document (PMDD)* formulated by the InternationalTask Force on Euthanasia andAssisted Suicide. The PMDD givesyour "agent" the authority to act onyour behalf and take legal action, ifnecessary, to insure that your rightsare protected. The PMDD clearlystates that your "agent" does nothave the authority to approve thedirect and intentional ending ofyour life. This limitation not onlyprotects you, but it also protectsyour "agent" from being subjectedto pressure to authorize suchactions.

A Durable Power of Attorney forHealth Care is absolutely essen-tial for anyone who is 18 years orolder. To be certain that a personyou trust will be making medicaldecisions for you if you becomeincapacitated by an injury or illness,you must have specifically namedthat person in a legal document.

Filling out a PMDD takes only afew minutes - a few minutes thatmay mean the difference betweenlife and death.

Information

FFOOLLLLOOWW FFOOLLLLOOWW

TTHHEE TTHHEE

MMOONNEEYYMMOONNEEYY

Are You Sure You’d Never Want to be "Hooked Up to a Machine?"

Advertising Supplement � www.humanlife.org 9

Most people are not aware that many in the medical community areconvinced that "brain death" is nottrue death.1

Before organ transplantation becamepossible, physicians cautiously deter-mined death in order not to embalmor bury people while still alive.Today, death is often declared forreasons not related to the patient'swelfare—organ transplantation andcost containment. "Brain death" issometimes hastily declared becausethe removal of vital organs (heart,lungs, liver, kidneys, etc.) must bedone before the organs deterioratedue to cessation of blood circulation.It is the life that remains in donorsthat makes their organs useful.

Before 1968, a physician pronounceddeath when there was no breathing,no heartbeat and no response to stimulation. Today, a person can bejudged "brain dead" while he/she hasa beating heart, as well as normalpulse, blood pressure, color and temperature—all signs of life. Howdid this change occur?

The Journal of the American MedicalAssociation published an article entitled "A Definition of IrreversibleComa" in 1968. This article includedthe Harvard Criteria which claimedthat irreversible coma represented"brain death." The newly coined"brain death" allowed the "harvesting"of vital organs from comatosepatients on ventilators.

A ventilator moves air into and out of the lungs. It is effective only whenthe patient's respiratory and circulatorysystems are functioning. These systems working together add oxygen

to theblood,carry thebloodwith theoxygen tothe cellsof thebody, andthen take

carbon dioxide from the cells back tothe lungs to be exhaled. Respirationoccurs in all living persons, includingthose who have been declared "braindead."

By 1978, there were more than 30 different sets of criteria for determin-ing "brain death." Every set since thefirst is less strict. For instance, theHarvard Criteria required that thepatient be in a coma at least 24hours. Later sets of criteria shortenedthe time to 12 hours, then six hours.Some criteria do not even require anelectroencephalogram (EEG)—an

omission that could result in a patientwith cortical activity (memory, feel-ing, emotion, etc.) beingdeclared "dead."

Every set of criteria for"brain death" includes anapnea test. ("Apnea"means the absence ofbreathing.) This test,which has no benefit forthe comatose patient and,in fact, aggravates thepatient's condition, is donewithout the knowledge or consent of family members. The apnea test,during which the ventilator is turnedoff for up to 10 minutes, can induce"brain death" or cardiac arrest. Itssole purpose is to determine thepatient's inability to breathe on hisown in order to declare "brain death."

It is illogical to do an apnea test on a patient who has just undergonesevere head trauma. Turning off theventilator for up to 10 minutes riskskilling the comatose patient whomight otherwise survive and resumespontaneous breathing if treated longenough. Two groups of neurosur-geons (one from Germany, the otherfrom Japan) simultaneously demon-

strated that 70% of victims of severehead trauma in a deep coma NOT

SUBMITTED TO ANAPNEA TEST could berecovered to NORMALDAILY LIFE if their bod-ies were cooled down to 33degrees Celsius for 12 to24 hours ("short-term moderate hypothermia").

So, here is the transplantdilemma: Without theapnea test, the diagnosis of

"brain death" is simply not possible,and without the diagnosis of "braindeath," the transplantation of vitalorgans is not possible, or at leastmuch more difficult. Because transplant surgery is one of the mostprofitable medical activities, medicalprofessionals in the transplant system

refuse to acknowledge in public thedetrimental effects of the apnea test.They also reject obtaining writtenconsent because, if the apnea test was explained in detail, no familymember who loves the patient wouldauthorize it.

Since there is no universally acceptedstandard for determining "braindeath," a person could be declared

"brain dead" using one set of criteria,but alive using a different set. Everytransplant center agrees that death iswhatever a doctor says it is.

Ironically, a patient regarded as"dead" (for transplantation or experi-mental purposes) is sometimes treated as alive. Suction and posturaldrainage are done to prevent pneu-monia. The patient is turned to prevent bed sores. How can a deadperson (cadaver) develop pneumoniaor bed sores?

When the incision is made to removeorgans, the donor often reacts bymoving, grimacing and squirming,unless first given a paralyzing drug.Even paralyzed, his/her blood pres-sure and heart rate increase dramati-cally. The heart continues beatinguntil the transplant surgeon stops itjust beforecutting itout. As adoctor wrotein a letter tothe editor ofthe NewEnglandJournal ofMedicine,11/17/94:"The signsof life in brain dead patients…arevery real and cannot be discounted inhuman terms, even if we have doneso in public policy."

By Paul A. Byrne, MD, ClinicalProfessor of Pediatrics, MedicalUniversity of Ohio.

1 "Are Organ Transplants Ever MorallyLicit?" The Catholic World Report (CWR).3/01; "'Brain Death' Is Not Death," CWR.3/05.

ORGAN DONORS WANTED: DEAD OR ALIVE!

Organs harvested from "braindead" patients are not enough tomeet demand. One response to this "crisis" is to "redefine donoreligibility," that is, to allow organsto be taken from another categoryof patients. The most recently"defined" donors are patientstermed "hopeless" or "vegetative,"usually shortly after suffering a severe stroke or devastating trauma, but not fulfilling any set of criteria for "brain death." NancyValko, a St. Louis intensive carenurse, explains, "Because of thelegal acceptance of the so-called‘right to die,’ families or patientscan agree to have the ventilatorturned off, a ‘do not resuscitate’order written, and organs harvestedif or when the person's breathingand heartbeat stop."

To ensure healthy organs, speed isof the essence. The patient is oftentaken to the operating room andprepared for surgery before theventilator is turned off. As soon asthe heart stops beating, cardiacdeath is declared. The organretrieval team waits two to fiveminutes (sometimes less), thenorgan removal begins. The donor

may be paralyzed or given an anes-thetic before the surgeon begins tocut, just in case the team acted tooquickly.

This organ donation process hasundergone several name changes in the last few years—"non-heart-beating organ donation," "donationafter cardiac death," and mostrecently "donation from partiallybrain dead patients." In 2000, theInstitute of Medicine set criteria for "donation after cardiac death,"stating that the cessation of thepatient's heartbeat must be "irre-versible." It is impossible to determine "irreversibility" if theheart has stopped beating for fiveminutes or less. Resuscitation is apossibility even five minutes ormore after cardiac arrest.

The Denver Post, 1/19/06, report-ed, "Organ donations from partiallybrain-dead patients—a controversialsource—jumped tenfold inColorado and Wyoming last year,the group that coordinates dona-tions said."

This is major news, but unknownto most of the public.

Organ Donors, NOT “Brain Dead”

For twenty years SarahScantlin could only blink her eyesin response to questions, questionsher caregivers doubted she under-stood. At the age of 18, she washit by a drunk driver, and sufferedbrain damage so severe that doctors told her father, "Thedaughter you had is gone." InFebruary 2005, Sarah started totalk, surprising her family with aphone call to say "hello." Whenasked about 9/11, which occurredwhile she was unconscious, shesaid, "Bad, airplane, fire, building,hurt people." She'd been payingattention to the TV in her room allthose years. (CBS Transcripts,"The Early Show," 8/4/05, 8/5/05)

CaseCaseinPointinPoint

10 Imposed Death � Human Life Alliance

Euthanasia: Euthanasia means an act or omissionintended to cause death in order to eliminate suffer-ing. The act or omission is committed by someoneother than the person being euthanized, allegedly forhis/her benefit.

� Euthanasia can be an action, such as a lethalinjection, smothering or shooting.

� Euthanasia can be an omission, such as withhold-ing or withdrawing necessary and ordinary (bene-ficial, usual, and not excessively burdensome)medical care and treatment, or food and fluids.

There is no moral distinction between an act thatis intended to cause death and an omission thatcauses death. The victim is equally as dead.

� Euthanasia can be voluntary—the personrequests or gives consent to be killed.

� Euthanasia can be involuntary—the person doesnot give consent or is incapable of giving consentto be killed.

Mercy Killing: Euthanasia is sometimes calledmercy killing. "Mercy" describes the (assumed)motive. "Killing" describes the act.

Assisted Suicide: Suicide is self-murder. In assistedsuicide, the means—drugs, gun, plastic bag,

instructions for their use, counseling, etc.—are provided by someone else, but the last act is doneby the person being killed.

Physician-Assisted Suicide: Physician-AssistedSuicide means that a physician provides the meansfor a person to commit suicide.

Aid in Dying: Aid in Dying is a euphemism forassisted suicide and euthanasia.

Imposed Death: Imposed Death is an umbrellaterm which covers all acts of killing human beingseither in order to end their suffering or to relieveothers of the duty to care for them.

The Netherlands and Belgium are theonly nations in the world so far thathave legalized active euthanasia andphysician-assisted suicide (PAS).Switzerland has not legalized PAS, butliberally allows it. In the United States,although euthanasia by action is notlegal, "living will" laws and courtdecisions have ushered in euthanasiaby omission. "Right to die" activists inthe U.S. have waged battles to legalizePAS in many states, but have managedto win in only one—Oregon. In 1994,Oregon voters narrowly (51%)approved the "Death With DignityAct." They had been led to believe thatthe Act would restrict PAS to cases ofunbearable, uncontrollable pain. That'swhat they approved, but what did theyactually get?

Oregon - We'll Help You Die!Delayed by legal challenges, Oregon's"Death With Dignity Act" did notbecome operative until 1997. By theend of 2005, physicians had reported246 suicides using physician-pre-scribed drugs. These patients’ principalconcerns were "decreasing ability toparticipate in activities that made lifeenjoyable" and "loss of autonomy"—not pain.1 The Act, in fact, does notmention pain as a justification forPAS. It merely requires the diagnosisof a terminal illness that will lead todeath within six months.2

Predictions of life expectancy areunreliable. Two patients who receivedprescriptions in 2001 were still alivemore than a year later—one died in2003, the other was still alive at theend of 2003.3 Isn't it probable thatsome patients who killed themselveswould have lived longer than sixmonths? Might some physicians"help" non-terminally ill patients commit suicide?

The law requires doctors to report allprescriptions for PAS, but Oregon conducts no independent reviews toverify that doctors are complying, sothere really is no way of knowing theactual number of PAS deaths or thereasons for them.

The Hippocratic Oath states, "I willgive no deadly medicine to anyoneeven if asked," but today very few

physicians make that promise. Thisanti-Hippocratic climate disposesphysicians to do whatever the patient,physician or even the state wants.

Oregon rations health care. Its"Prioritized List of Health Services for Medicaid Patients" will not allowpayment for treatment of many typesof cancer unless the patient has at leasta five percent chance of living anotherfive years. So, a patient with cancer ofthe bowel, for example, who mightlive a few more years with treatmentto slow the cancer's progress, will notbe treated. Yet Oregon will pay forPAS as "comfort care" for Medicaidpatients.

PAS creates less concern for providingthe best medical treatment and moreconcern for cost-containment. PASdiscriminates against low-incomepatients who are old, sick, or disabledby offering them drugs to die ratherthan reasons to live. Oregon's taxpayersdid not vote to pay for killing the poor.

Understanding Gonzales v. OregonIn 2001, Attorney General JohnAshcroft issued a directive that physicians could lose their federal registration to prescribe controlledsubstances if they prescribe them forassisted suicide because it is not a"legitimate medical purpose." His successor, Alberto Gonzales, agreed.In 2004, the Ninth Circuit Courtdeclared that Ashcroft had oversteppedhis authority and the U.S. SupremeCourt agreed to hear the case ofGonzales v. Oregon.

On January 17, 2006, the SupremeCourt ruled 6-3 that the ControlledSubstances Act (CSA) does notaddress assisted suicide and thereforeAshcroft did not have the authority to prohibit doctors from prescribingfederally controlled drugs for PAS.Contrary to the spin PAS supportersput on this decision, the Court did notuphold Oregon's law nor did it endorseassisted suicide. In fact, the justices in the majority agreed that the federalgovernment possesses the power to prevent narcotics from being prescribed for PAS, for example, byamending the CSA.

The Netherlands - We EuthanizeChildren!In 2001, as a mere formality, theNetherlands legalized assisted suicideand euthanasia. Wesley Smith, anattorney and author of numerousbooks on bioethical issues, neatly sum-marizes the progression of medicalkilling in the Netherlands:

First, Dutch euthanasia advocatessaid that patient killing will be limited to the competent, terminallyill who ask for it. Then, when doctors began euthanizing patientswho clearly were not terminally ill, sweat not, they soothed: med-icalized killing will be limited tocompetent people with incurableillnesses or disabilities. Then, whendoctors began killing patients whowere depressed but not physicallyill, not to worry, they told us: onlycompetent depressed people whosedesire to commit suicide is "ration-al" will have their deaths facilitat-ed. Then, when doctors begankilling incompetent people, such asthose with Alzheimer's, it's allunder control, they crooned: non-voluntary killing will be limited topatients who would have asked forit if they were competent. And nowthey want to euthanize children.4

In 2004, Groningen UniversityHospital decided to permit its doctorsto euthanize children under the age of12 with or without the parents consent.5

By the end of 2005, the Netherlandswas setting up a commission to regulatethe practice of ending the lives of"seriously suffering" newborn babies.

Belgium - Get a Euthanasia Kit!In 2002, a new Belgian law went into effect that allows a physician toeuthanize an adult patient whorequests it because of a "hopeless"medical condition and unbearablephysical or mental pain that cannot becontrolled. With modern palliativecare, very few people should fit thatdescription. Nevertheless, the govern-ment reported that in the first yearafter the law took effect over 250Belgians were legally killed!

In 2005, pharmacies in Belgium beganselling "euthanasia kits" containing all

the necessary materials to efficientlykill a patient. A kit costs about 60euros ($77).

Switzerland - You’ll Never TakeAnother Vacation!Switzerland is becoming known for its"suicide tourism." The non-profitorganization Dignitas, headquarteredin Zurich, assists foreigners who wantto die. They fly to Zurich whereDignitas takes care of everything fromsupplying the drugs to disposing of thebody. Dignitas has recently expandedits operations by opening a branchoffice in Hanover, Germany.6

Unlike other countries, Switzerlandhas not considered assisted suicide a"medical treatment." However, that ischanging. Lausanne UniversityHospital decided to permit assistedsuicides starting January 1, 2006.Other hospitals are debating whetherto follow suit.

Does Legal Equal Ethical?Legalizing medical murder does not change a crime into a medicaltreatment; rather, it turns the law itselfinto an accessory to murder.

1 Eigth Annual Report on Oregon's Death WithDignity Act. Oregon Department of HumanServices. 3/9/06

2 Ibid.3 Stevens, Kenneth MD. "Latest assisted suicide

report should be cause for alarm," TheOregonian. 3/12/04.

4 Smith, Wesley J. "Now They Want toEuthanize Children." www.weeklystandard.com, 9/13/04

5 Hewitt, Hugh. "Death by Committee." TheWeekly Standard. 12/2/04. www.weeklystandard.com.

6 Whitlock, Craig, "Branching Out to Serve aGrowing but Dying Market." 11/1/05www.washingtonpost.com.

Definitions

Euthanasia and Assisted Suicide: What in the World is Going On?

International Task Force onEuthanasia and Assisted Suicidewww.internationaltaskforce.org

Physicians for CompassionateCare Educational Foundationwww.PCCEP.org

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Euthanasia literally translated from the Greekmeans "good death." Some who promote euthana-sia call it "mercy killing." Death by euthanasia isneither good nor merciful. Therefore, in this publication, the more accurate term "imposeddeath" is frequently substituted for "euthanasia"and also for "assisted suicide." (See Definitions,p.3)

You may ask, "Why should I be concerned? Whydo I need to read this publication?"

Because the entire human race has a stake in theanswer to the question, "Should imposed death bepermitted and regulated by law?" History teachesus that a society which does not respect and protectall human life will ultimately bring about its owndestruction.

Allowing the lives of certain people to be terminat-ed because they are viewed as "not worth living" or"burdensome" has profound repercussions for all ofus. Devaluing one human life devalues all humanlife. (See the true stories highlighted in our Case inPoint Features.)

This supplement examines the history of imposeddeath, the facts about it and the experiences andopinions of those most intimately affected by it.You need the unvarnished truth in order to makeinformed decisions about such vital matters.

Advocates of euthanasia and assisted suicide useterms like "choice in dying" and "self-determina-tion." They promote the social and legal acceptanceof the "right to die"—that is, the "right" for individ-uals to choose how, when, where and why to die,and to receive assistance in dying from others.Although the expression "right to die" is seductive,it is fundamentally anti-libertarian. Giving the Statethe right to authorize our "right to die" begins theprogression from voluntary imposed death to invol-untary imposed death. Who will decide for thosewho cannot make their own choices? At what pointdoes a "right" become an expectation, even a duty?

Instead of pursuing a "right to die," let us strive tocreate an environment —a culture of life— inwhich no person feels compelled to seek the "quick

fix" of death and every person's life is respected bysociety and protected by law.

ACKNOWLEDGMENTSHuman Life Alliance assembled a talented team ofwriters, researchers and experts who contributed todeveloping this supplement. We are grateful tothese men and women for their dedication to thisproject, as well as for their perseverance in defend-ing the unalienable right to life of all humanbeings, especially those who are most vulnerable,the voiceless. Foremost, we want to thank our mul-titude of friends whose faithful support enablesHuman Life Alliance to continue its life-savingeducational projects.

Imposed Death

Human Life Alliance is a non-profit,pro-life, educational organization dedicated to protecting human lifefrom fertilization until natural death.

HLA creates educational publicationson abortion, abstinence and euthanasia.

For additional copies or more information, contact:

Human Life Alliance3570 Lexington Avenue North Suite 205Saint Paul, Minnesota 55126 USAwww.humanlife.org(651) 484-1040

What’s the Big Deal?

Features4 Living Wills: Vital… or Deadly?

A Living Will may be a license to kill.

5 "Persistent Vegetative State"How reliable is a PVS diagnosis?

8 Thirsty? Too Bad.Withholding food and water is the new “mercy killing.”

11 Hospice Care: The Good, the Bad and the Uglyby Tracy Berntsen �� Tread carefully when you select a hospice.

12 Terri Schiavo: A Senseless DeathThe story of one disabled woman’s fight for life.

3 Euthanasia and Assisted Suicide: What in the World is Going On?The imposed death agenda creeps across the globe.

6 The History of Imposed Death in AmericaHow the right-to-die agenda has infiltrated America.

9 Would you never want to be hooked up to amachine?by Marlene Reid �� It might just save your life.

10 Organ Donors Wanted: Dead or Alive!by Dr. Paul A. Byrne �� Dead by whose definition?

Additional FeaturesA Time to Let GoNot Dead YetSave a LifeThanks for all the fish!Follow the MoneyOrgan Donors, NOT “Brain Dead”A Brother's Grief

humanlifealliance

President

Contributing Writer and Editor

This publication was created by Human Life Alliance © 2006 �� feedback@humanlife.org

2 Imposed Death � Human Life Alliance

Editor

"Hospice care is there to makeit possible for people who aredying to live fully until theydie."

Dame Cecily Saunders

Over 3,000 hospices operate in theUnited States, and each is a separatebusiness entity with its own uniquecharacteristics and quality of care.Many are operated by non-profitcharitable organizations, a fewremain largely voluntary, but increas-ing numbers are being operated bycorporations. You can find excellent,traditional hospice care in all threecategories.

Hospice caregivers deserve theutmost respect. We should neverunderestimate the difficulties thatpalliative caregivers endure and thededication so many demonstrate.("Palliative" describes care that comforts and relieves or moderatespain.) Unfortunately, in recent years,numerous incidents of unnecessarymorphine dosages and prematurewithdrawal of food and water frompatients have been reported by care-givers and administrators, families ofhospice patients, medical examinersand attorneys. Hospice as an industryhas become suspect.

Terminal Sedation and theWithdrawal of Food and Water"Terminal Sedation" (TS) refers tocontrolling pain by giving an opiate,primarily morphine, in sufficientquantity to induce unconsciousness.Initially used as a last resort torelieve extreme pain when a personwas dying, TS has been transformedinto a form of slow euthanasia orassisted suicide. Deep sedation com-bined with the withholding of allmedical treatment, including foodand water, is becoming routine inmany hospices and is legal in everystate. Euthanasia has moved beyondthe law, as it is difficult to tellwhether the intent is to kill thepatient or relieve his pain.

The World Health OrganizationWHO concurs with experienced palliative care doctors and nurseswho insist that pain can virtuallyalways be controlled. Even in themost difficult situations, it is possibleto have adequate pain control withoutrendering the patient comatose.1 Theoriginal and true mission of hospiceis to provide the dedication and timenecessary for real palliative care—care that allows the patient to live asfully as possible until natural death.

From Charity to Big BusinessHospice in the 1960s and 1970soperated as a charitable service rendered primarily by volunteers.

In the 1980s, Medicare and Medicaidfound it cost-effective to include hos-pice benefits. Consequently hospicebecame big business. The number offor-profit hospices and the number of Medicare recipients receiving hos-pice care more than doubled from1992-1998. The National Hospiceand Palliative Care Organizationreported 3,300 hospice programsserving 900,000 patients in 2004.2

Unfortunately, as government andinsurance (most HMOs currently pro-vide hospice benefits) dollars rolledin, both fraud and cost-containmentmeasures followed.

Infiltrated by the “Right-to-Die”MovementRecent developments confirm thesuspicion that proponents of the"right-to-die" movement find hospicethe ideal avenue to advance theirefforts to legalize assisted suicideand euthanasia.

In 2000, Choice in Dying (formerlyknown as the Euthanasia Society ofAmerica),composedof right-to-dieadvocates,becamepart of anew organ-ization,Partnershipfor Caring(PFC),founded byDr. IraByock, ahospicephysician.3

Thus, the“right-to-die” agen-da began toinfiltratethe hospiceindustry. InOctober 2002, J. DonaldSchumacher, Vice-Chair for PublicPolicy for PFC, became Presidentand CEO of the National Hospiceand Palliative Care Organization(NHPCO), the largest organization ofits kind.

In 2005 The Hospice Federation ofAmerica (HFA) published a contro-versial, eye-opening book entitledEthical Dilemmas at the End of Life.One of its authors, Thomas Attig,tries to convince readers that there is no moral culpability in assistedsuicide.4 In another chapter, RobertKastenbaum affirms the legitimacyof euthanasia when he states, "Withpersistent vegetative states, it is the

question of passive or active euthana-sia." He goes on to ask, "What aboutAlzheimer's disease?"5 Indeed, anincreasingly acceptable practice is toadmit non-terminally ill patients tohospice in order to "help" them die.

Hospice: Help for the Dying, Not Help in DyingTo be legally admitted to a licensedhospice, the patient must be sufferingfrom a terminal untreatable illnesswith a life expectancy of six monthsor less. Hospice provides palliativecare only—not cure. Hospices are notlicensed to provide care (or help indying) to non-terminally ill individualswith disabilities, brain damage,Alzheimer's disease or other forms ofdementia.

Palliative care may be provided in apatient's home, a nursing home, ahospital or a hospice facility. Manypatients prefer to be cared for in theirown homes, but sometimes this is notfeasible. It will take time and effortto choose a hospice. References from

friends,family,trustedphysicians,medicalpersonnel,or familieswho havehad recentexperiencewith thehospicebeing con-sidered,are invalu-able. Besure toread thehospice'spolicies,especiallythose con-cerning theuse of

morphine,withdrawal of nutrition and hydration,and the continuation/provision ofmedications and treatments for allconditions other than the terminal ill-ness. As documented above, there aregood reasons for suspecting hospicesthat use guidelines developed byNHPCO or who are affiliated withHFA.

Ethics CommitteesBioethics, the new philosophy ofhealth care and medical ethics, withsome notable exceptions, is based on a quality of life ethic—the beliefthat some people are better off dead.Often, the people who are least valued in bioethics are those who aremost expensive to care for. Ethicistswith a traditional sanctity of life

ethic—the belief that all human lives are valuable simply becausethey are human—are desperatelyneeded. However, ethicists and thecommittees they oversee are typicallycommitted to a school's particularphilosophy. Their ethics are usually"consensus" based—not morallybased. They frequently employ highlypaid professionals, are endorsed byHFA and are known to use the guide-lines developed by NHPCO.6

Hospice professionals (ethicists,social workers, etc.) can be veryclever about offering "false compas-sion." Key emotive language includes:unbearable or uncontrollable pain;quality of life; loss of dignity;rationing of resources and cost effec-tiveness; ethical consensus; and futilecare. The last is a term frequentlyused to justify the withdrawal of foodand water. A recent study in Oregonfound that the most common reasonspatients requested assisted suicidewere none of the above but rather"fear of future suffering," "fear of being a burden" and "losing inde-pendence."7 Hospice should help thepatient deal with his fears, not granthis wish to die—or kill him withouthis consent.

By Tracy Berntsen Human Life Alliance

1 Chevlen, Eric M. and Wesley J. Smith.Power Over Pain. International TaskForce on Euthanasia and Assisted Suicide.2002.

2 National Hospice and Palliative CareOrganization. "Facts and Figures on Hospiceand Palliative Care." Accessed 5/5/04 atwww.nhpco.org.

3 Barbero, R.N., Barbara, "HospiceLimitations." Accessed 3/6/04 atwww.caringplaceonline.com/stages/together/hospice/hospice-limitations.html.

4 Doka, Kenneth J., Jennings, Bruce and Corr,Charles A., eds. Ethical Dilemmas at the End of Life. HospiceFoundation of America. 2005.

5 Ibid. p. 313.6 Ibid. p. 209.7 Shea, M.D., John, "Palliative Care 'Killing

me Softly.'" Bioethics. Accessed July/August2004 at www.catholicinsight.com/online/bioethics/palliativecare.html.

Hospice Patients Alliancewww.hospicepatients.org

Women for Faith and Familywww.wf-f.org/02-2-terminalsedation.html

Hospice Care: The Good, the Bad and the Ugly

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On March 31, 2005, my sister, Terri SchindlerSchiavo, died from the effects of dehydration.Judge Greer ordered that my beloved sister die this unnatural and gruesome death by orderingthat her feeding tube be forcibly removed fromher without her consent. My physicallyhealthy sister lived in a neurologicallycompromised state, for reasons that arestill unknown, and my family struggled for 12years trying to protect her. We wanted nothing but permission to care for Terri for the span of hernatural life.

Terri was not hooked up to machines, not terminally

ill, and not succumbing to any killer disease. Shewas disabled. She was dependent on others. Terriwas still very much alive, a woman and a person inmy family's eyes, but most importantly, in the eyes

of God.

My family was forced to watch my sister suffer through the grisly effects of

terminal dehydration. With each passing day, Terriappeared weaker, thinner, more frightened and sovery wronged. I watched as my family beggedfor her life and as healthcare professionals turned

a blind eye to her suffering. I listened to proponentsof the so-called "right to die" coax news audiencesinto the belief that my sister was enduring a gentle,peaceful, and euphoric demise. I sat on the cornerof her bed and held her thinning hands, trying sohard to understand that what I was witnessing wasactually real. When Terri passed from this world,she took a very tangible piece of me with her.

No human being or agency should have the authorityto pronounce an innocent person, such as my sister,"unworthy of life."

By Bobby Schindler

In 1990, 26-year-old TerriSchindler Schiavo suffered braindamage when she mysteriously collapsed and stopped breathing for a period of time. Fifteen years later,on March 31, 2005, Terri died ofdehydration after 13 days withoutfood or water. Her husband, MichaelSchiavo, had obtained judicialapproval to remove her feeding tube. Woodside Hospice in PinellasPark, Florida, carried out her deathsentence.

Michael Schiavo was given the"Guardian of the Year Award" in 2005 for his successful campaign toend the life of his wife. That some inour society applaud the murder of adisabled woman is deplorable. Whatmakes Terri's case stand out is thepublic outcry in support of her rightto live. More than 100,000 peoplecontacted Florida Governor Jeb Bush,pressing him to save Terri's life.

The real heroes are Terri's parents,Bob and Mary Schindler, who wereunrelenting in their battle to save their daughter from a cruel death. The highly publicized legal tug-of-war between Michael Schiavo and the Schindlers alerted millions to thefact that our judicial system has a history of sanctioning the treatment ofdisabled human beings in ways thatwould be criminal if done to a dog.

Terri's ConditionContrary to media reports, Terri wasnot "brain dead," not terminally ill,not comatose and not on a ventilator.In 2002, Dr. William H. Hammesfahr,a neurologist, evaluated Terri. He listedamong his findings that she wasresponsive to her environment;responded to specific people best;tried to please others by doing activities for which she received verbal praise; attempted to verbalize;could swallow; and could feel pain.Numerous other physicians providedaffidavits disputing the claim thatTerri was in a persistent vegetativestate (PVS) and stating that improve-ment might occur with therapy.

Court BattlesAlmost three years after Terri's collapse, a medical malpractice juryawarded $700,000 for Terri's ongoingmedical care and $300,000 to Michaelfor loss of companionship. He hadtold the jury that he wanted to takecare of Terri for the rest of her life.Shortly thereafter, Michael deniedTerri all forms of rehabilitation andantibiotics for infections. When shedid not die from neglect, he sought tohave her feeding tube removed.Terri's parents vehemently objectedand asked to be named Terri'sguardians.

In January 2000, Judge George Greer,County Circuit Court, conducted ahearing at which Michael argued that,before her collapse, Terri had toldhim that she would not wantto be kept on life support.Why had he nevermentioned thisbefore or during themalpractice suit?Terri had left nowritten evidence ofher wishes and her parentsinsisted that shewould

never have made such a statement.Nevertheless, Greer ruled thatMichael could order all food and fluids withheld from Terri. TheSchindlers appealed.

At issue was whether Terri was in apersistent vegetative state. UnderFlorida law, only those who are PVSor terminally ill may be dehydrated todeath. The 2nd District Court ofAppeals ordered Judge Greer to holdan evidentiary hearing to determineher condition. The two physicianschosen by Michael and one appointedby the judge testified that Terri wasPVS. The two physicians chosen bythe Schindlers found that she was notPVS. Greer ruled that Terri was PVS.

On October 15, 2003, Michael hadTerri's feeding tube removed.

Six days later, theFlorida legislature

enacted "Terri'sLaw." The law

allowedGovernorBush toorderTerri's feedingtube

reinserted. Terri recovered from six-and-a-half days of dehydration whileMichael, assisted by the AmericanCivil Liberties Union, again went tocourt. On May 6, Judge W. DouglasBaird, County Circuit Court, found"Terri's Law" unconstitutional.Governor Bush filed an appeal andgot an automatic stay, but Florida'sSupreme Court upheld Baird's ruling.

The Schindlers, now desperate to saveTerri, appealed all the way to the U.S.Supreme Court, which refused to hearthe case. Time was running out.

On March 17, 2005, Terri's feedingtube was once again removed. A fewdays later, the U.S. Congress over-whelmingly approved an act that gavethe federal court in Tampa jurisdictionto review the facts of the case anddetermine whether Terri's constitu-tional rights were violated. PresidentBush quickly signed it into law, butthe court defiantly refused to reviewthe case. For Terri, this time, therewould be no stay of execution.

Anything But PeacefulIn the final 72 hours of her life,Terri’s tongue and throat were dry,cracked and raw. Her eyes werebloodshot and bleeding. In the last 26hours, she panted rapidly and couldn’tcatch her breath. Terri’s brother,Bobby, called her death “grotesque.”

Terri’s death was not only wrongbecause it was horrendously painful,but also because nutrition and hydra-tion should be considered basic care.

The soul-searching question we mustask ourselves is: Are we at peace withdehydrating disabled people to death,or does it haunt us?

Terri Schindler Schiavo: A Senseless Death

A Brother’s Grief

Lynne, Diana. Terri's Story:The Court-Ordered Death of anAmerican Woman. CumberlandHouse Publishing, 2005.

www.terrisfight.orgwww.internationaltaskforce.org

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