CNS STORY: Speakers at CHA workshop assess tactics of assisted suicide proponents

CHA-SUICIDE Jun-16-2010 (780 words) With photos posted April 8 and graphic posted June 16. xxxn

Speakers at CHA workshop assess tactics of assisted suicide proponents

By Catholic News Service

DENVER (CNS) -- Proponents of assisted suicide are using the U.S. church's own revised ethical directives as "propaganda to promote" their cause, a physician and Franciscan brother told a workshop at the Catholic Health Association convention June 14.

Compassion & Choices, a national organization created from the merger of the former Hemlock Society and Compassion in Dying in 2005, is telling people that the "Ethical and Religious Directives for Catholic Health Care Services" now require that "everyone will have a feeding tube rammed down their throat" at Catholic health facilities, said Franciscan Brother Daniel P. Sulmasy.

Brother Sulmasy, a medical doctor who also holds a doctorate in philosophy, is a professor of medicine and ethics at the University of Chicago. He was joined by two other speakers in a panel discussion on "Responding to the Advance of the Physician-Assisted Suicide Agenda" at the CHA convention in Denver.

"Assisted suicide is bad ethics, bad medicine and bad public policy," he told the session. "If it wasn't for that, I'd be all for it."

Reviewing the various efforts to make assisted suicide legal beyond Oregon and Washington states, Brother Sulmasy said that although most efforts have been in the courts or state legislatures, Compassion & Choices also has been conducting a public relations campaign that misrepresents the Catholic directives on withdrawal of food and water that were revised in 2009.

The revised directives state that patients with chronic conditions who are not imminently dying should receive food and water by "medically assisted" means if they cannot take them normally. But they also stipulate that "medically assisted nutrition and hydration become morally optional when they cannot reasonably be expected to prolong life or when they would be 'excessively burdensome for the patient or (would) cause significant physical discomfort.'"

Since the 1997 U.S. Supreme Court decision Vacco v. Quill, which said laws banning assisted suicide are not unconstitutional, "all of the action has been in the states," Brother Sulmasy said. Currently, 33 states have statutes explicitly banning assisted suicide and nine criminalize assisted suicide through common law. Only Oregon and Washington state permit it.

The law on assisted suicide is ambiguous in the District of Columbia and another six states, including Montana, where a court ruled in 2009 that state law protects doctors from being prosecuted for assisted suicide, but legislators are considering whether to pass a statute banning it.

Brother Sulmasy said supporters of assisted suicide also are promoting "palliative sedation for the existential suffering" of patients who say they are not in pain, but "I just wish I were dead and the anxiety that I am not dead is too much for me."

At the workshop, Mark Repenshek, health care ethicist at Columbia St. Mary's in Milwaukee, discussed the arguments used to convince the Wisconsin Medical Society to oppose a move toward assisted suicide in that state, and Father John Tuohey, director of the Providence Center for Health Care Ethics at Providence St. Vincent Medical Center in Portland, Ore., described how Catholic health facilities have been coping since assisted suicide became legal in Oregon in 1997.

Repenshek said a 10-year study of the experience in Oregon helped convince Wisconsin doctors to oppose assisted suicide there. The study showed that most physicians prescribing lethal medications had little prior relationship with the patient and the percentage of patients receiving psychiatric evaluations dropped from 33 percent in 1998 to zero in 2007, he said.

He said it is important for state medical societies to actively oppose efforts toward assisted suicide, rather than simply remaining neutral on them.

Father Tuohey said many believe that assisted suicide can be handled morally the same way abortion is -- "Catholic hospitals just don't do it" -- but the truth is "it's not quite that simple."

"Although abortion and aid in dying are equally morally prohibited, the context in which each takes place is very, very different," he said.

Father Tuohey said it is important for those in Catholic health care to understand the law in their states to properly "carve out your noninvolvement."

He said the policy at Providence St. Vincent stipulates that the hospital and its staff members "shall not be involved in aid in dying" but carrying that out in practice sometimes presents challenges. For example, the Oregon assisted suicide law requires a confirmation of the diagnosis of terminal illness, and a patient might ask for his or her medical chart to provide such a confirmation.

"If a patient asks for their chart, you have to give it to them," the priest said. But some could construe that as participation in assisted suicide, he said. "There are very difficult parameters to sort out."

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