Commentary Magazine


Suicide Made Easy

Americans have always been a handy people. If know-how were virtue, we would be a nation of saints. Unfortunately, certain old-fashioned taboos—brought to you by the people who know the difference between virtue and dexterity—have prevented Americans from gaining the ultimate know-how, the know-how to die. Until now. Riding atop the best-seller lists, outdistancing other manuals of self-help like The Seven Habits of Highly Effective People, The T-Factor Fat Gram Counter, and Wealth Without Risk, is Derek Humphry’s latest book, Final Exit,1 subtitled “The Practicalities of Self-Deliverance and Assisted Suicide for the Dying.” Know-how in spades.

What can one say about this new “book”? In one word: evil. I did not want to read it, I do not want you to read it. It should never have been written, and it does not deserve to be dignified with a review, let alone an article. Yet it stares out at us from nearly every bookstore window, beckoning us to learn how to achieve the final solution—for ourselves or for those we (allegedly) love so much that we will help them kill themselves. Says the Lord High Executioner, Derek Humphry, prophet of Hemlock: I have set before thee life and death: therefore choose death. “Courageous,” bleat the media; “Timely.” “Rational.” “Humane.” Is there no one who will call evil by its proper name?

This is not the usual and notorious evil of malicious intent or violent manner; this is humanitarian evil, evil with a smile: well-meaning, gentle, and rational, especially rational. For this reason it is both harder to recognize as evil and harder to combat. Yet, also for this reason, it deserves our most vigilant attention, for it is an exquisite model of modern rationalism gone wrong, while looking oh so right.

Duty requires a few words about the contents of the book. Following an introduction which tells us that the book is “aimed at helping the public and the health professional achieve death with dignity for those who desire to plan for it,” the (longer) first of two parts is addressed to the public and especially those interested in “exiting.” Here there are 22 chapters guiding the gentle reader ever so gently, step by step, into that gentle good night, from “The Most Difficult Decision” (a mere pages, ending with “Once these documents [Living Will and Durable Power of Attorney] are completed you are ready to tackle the other aspects of bringing your life to an end”), through (among others) “Shopping for the Right Doctor,” “Beware of the Law,” “Storing Drugs,” “Who Shall Know?,” “Insurance,” “Letters to Be Written,” and “Self-Deliverance Via the Plastic Bag,” all leading up to “The Final Act,” complete with detailed instructions for doing the deadly deed. Chapter 23 provides a check list of 16 items, after which drug-dosage tables are supplied for eighteen effective drugs. A shorter second part, addressed to doctors and nurses eager to assist, concludes with a short pharmacopoeia, rich in detail and editorial advice. A brief (and one-sidedly pro-death) bibliography, the text of the Hemlock Society’s Model Death with Dignity Act, and brief notes about the author and the Hemlock Society conclude the book, save for a copious index from Abalgin to Zyklon-B gas.

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Derek Humphry, who assisted in the suicide of his first wife (though it was a felony), and who (along with his second wife, Ann Wickett) founded the Hemlock Society in 1980, has been the country’s leading spokesman and protagonist for euthanasia in all its forms. A journalist by profession, a euthanist by conviction, a diligent student and publicist, he has researched far and wide in preparing this most handy guide. Yet it is not so much his knowledge but his character that makes him a man for modern times.

Consider his virtues. Up to date: “Aren’t these archaic laws [against assisting suicide] ready to be changed to situations befitting modern understanding and morality?” Progressive: “Now is the time to go one step further. Final Exit . . . is a book for the 1990′s. As a society we have moved on.” Clean and collegial: “This method [shooting] is not favored by the euthanasia movement because it is messy (who cleans up?) and it has to be a lonely act, the opposite of the right-to-die credo, which aims to share the dying experience.” High-minded: “A method for which I have respect is freezing to death on a mountain. It takes a certain sort of person to wish to die this way: determined, having knowledge of the mountains, and an enduring courage to carry it off.” Thorough: “Make two copies of this [suicide] note because the police or coroner, if they become involved, will take the top copy and your survivors or attorney will need a copy also.” Considerate: “Self-destruction by hanging is almost always an act of protest, a desire to shock and hurt someone. . . . Even if it is left to a policeman or paramedic to cut the corpse down, I still think this is an unacceptably selfish way to die.” Orderly: “If you are now comfortable with the decision to die . . . you should review the following list.” (The check list of 16 items follows, concluding with the injunction, “Leave nothing to chance.”) Respectful of competence: “Unless you are an ingenious and accomplished engineer, electricity is definitely not advised for self-deliverance.” Gracious: “If you are unfortunately obliged to end your life in a hospital or motel, it is gracious to leave a note apologizing for the shock and inconvenience to the staff. I have also heard of an individual leaving a generous tip to a motel staff.” Cheerful: “Remember, life is well worth living to its fullest extent”—a homily that wanders illogically into a paragraph about how to achieve long-term storage of your lethal drugs. Folksy: “[A television program] featured a member who kept her ‘insurance’ in a hat box in her closet. That is as good a place as any.” Open-minded: “Should you use a clear plastic bag or an opaque one? That’s a matter of taste. Loving the world as I do, I’ll opt for a clear one if I have to.” Helpful to the handicapped: “As many of the readers of this book will be people with poor sight, it has been set in large type (14-point Dutch Roman type) to assist them.” Resourceful: “[I]t is always worth an inspection of your medicine cabinet for any barbiturates left over from previous illnesses suffered by you or your family.” Balanced: “While the Nazi motives were barbarous, ruthless, and unforgivable, the actual deaths [with cyanic acid gas] were swift, though this is small consolation to the families of the killed.” Meticulous: “Make sure you have absolute privacy for up to eight hours. A Friday or Saturday night is usually the quietest time; there are generally no business transactions until Monday.” Technically precise: “To compensate for this possible shortfall in toxicity, add one extra capsule or tablet to every ten of the recommended lethal dose.” Tolerant: “If you consider God the master of your fate, then read no further. Seek the best pain management available and arrange hospice care”; or, “Pious persons may believe in medical miracles and that is their right.” Forth-comingly frank: “If I ever need to end my own life because of terminal suffering, whether I employed the most potent drugs or the less so, I would still use the plastic bag technique. If you are repulsed by the addition of the plastic bag, then you must accept a 10-percent chance that by some quirk you will wake up, and will have to try again. With the bag, it is 100-percent certain.” Non-directive: “I am extremely careful not to offer an opinion, but let myself merely be a sounding board, a sympathetic ear”; but also Authoritative: “It is imperative that your loved ones know what you are contemplating.” Financially shrewd: “My advice is that if you are considering self-deliverance from a terminal illness, look at the dates of your [insurance] policies. If they are more than two years old, your family is safe.” Morally superior: “A nurse who wishes to participate in the euthanasia process should become well versed in the ethics and law of euthanasia particularly as applied in the applicable county, state, professional organization and institution. [But] to know the rules does not necessarily require obedience if there is an overriding moral imperative” (emphasis added); or, “Never join in the slightest attempt to persuade a dying person to end life. . . . Many laws are specific about the criminality of ‘counseling and procuring’ a suicide. In any event, it is ethically a wrong thing to do” (emphasis added. Question: why is it considered an act of the greatest love and friendship to assist in doing what it is immoral to counsel? Why, if “self-deliverance” is really “in my best interests,” should not my true friends be praised for helping me to see it?)

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Above all, the author is calm, cool, and collected, and marvelously matter-of-fact. His confident voice of experience guides us through every step of the process, allaying anxieties, dispelling doubts, showing us exactly how-to-do-it. Adopting a tone and manner midway between the Frugal Gourmet and Mister Rogers, Humphry has written a book that reads like “A Salt-Free Guide to Longer Life” or “How to Conquer Fear in Twenty-two Easy Lessons.” The reader, blinded by blandness, nearly loses sight of the big picture: this self-appointed messiah is indiscriminately and shamelessly teaching suicide (and worse) to countless strangers.

Humphry sanctimoniously insists that his book is not intended for everyone.2 He intends, he avers, to be helpful only to those who are (or will be) terminally ill and who wish a quiet release from pain, suffering, or indignity. He even publishes a “Euthanizer-General’s Warning”—but buries it in the footnotes to the drug-dosage table on the last page of Part 1, after all the lethal instructions have been given—telling us that “this information is meant for consideration only for a mature adult who is dying and wishes to know about self-deliverance.” His concern for the others is touching, if brief:

Advice:

If you are considering taking your life because you are unhappy, cannot cope, or are confused please do not read this table but contact a Crisis Intervention Center or Suicide Prevention Center. (Look in the telephone book. It may be under “Hotlines.”) An unfinished life is a terrible thing to waste. [Emphasis added.]

Whom are we kidding? Every since Socrates’ attack on writing, everyone knows that one cannot control who reads what is written or what is done with it. Only a fool could believe—and only a knave would pretend—that Humphry’s instructions will be heeded only by the desperately dying or that his belated, brief, and saccharine advice to the depressed will lead them to re-embrace their precious unfinished lives.

The Centers for Disease Control have just reported that one in twelve American high-school students (grades 9-12)—or nearly 276,000 teenagers—tried to commit suicide in 1990, and more than one in four seriously contemplated it. Of those attempting, one in four—2 percent of the entire population—sustained serious injuries. (The rate of “successful” suicide attempts is roughly eleven deaths per 100,000 students, or 365 teenage suicides per year.) Thanks to Derek Humphry’s book, our youth need no longer fail. Though the drugs he recommends require a doctor’s prescription, they are, in fact, ubiquitous and easily available, as he surely knows (“Inspect your medicine cabinet for any barbiturates left over . . .”). And thanks to his instructions about sleeping pills, alcohol, and the proper way to use plastic bags, successful “self-deliverance” is available to anyone who can read—or who has a “loving friend” who can read. Even if only one teenager is now helped to suicide, Derek Humphry will have a lot to answer for.

Humphry has no intention of aiding poisoners, any more than he wishes to improve the suicide rate of the young. But he is, here too, equally naive, reprehensibly so. He is not so innocent as to be unaware of the danger, and in one (but only one) brief sentence—buried in the chapter on secrecy, “A Private Affair?”—makes a dashing display of his eagerness to prevent foul play: “I do not propose to name the drugs which are hard to trace because that information could possibly aid people with evil intent toward the lives of others.” But such people need not have evil intent; they could be merely compassionate toward senile Aunt Agatha—or just tired of visiting her or of paying the medical and nursing bills. Anyone with homicidal intent has been taught more lethal pharmacology than he ever needs to know—and also how to avoid detection. Just two pages before this pious refusal to help the wicked, Humphry has counseled the aiders-in-dying to refuse permission for autopsy, in order that death might pass as from “natural causes.”

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Even ignoring the intenders-of-evil, the teenagers, and the others whom Humphry excludes from his audience because they are “emotional,” not “rational,” it is perfectly clear that his intended readership is in fact much broader than the now or soon-to-be terminally ill. In a chapter on “The Dilemma of Quadriplegics,” he embraces the principle of self-determination, terminal disease or not: “I respect the right of that small number of quadriplegics who want—either now or in the future—to have self-deliverance without being preached to and patronized by those on the religious Right.” Not just terminal cancer but any sort of illness can qualify: “Nobody wants to die, yet life with an incurable or degenerative illness can be unacceptable for some people. Therefore, death is the preferred alternative” (emphasis added).

The elderly or the infirm or the demented or the blind—and, presumably, also the lonely or the humbled or the unwanted—are also on Humphry’s compassionate and philanthropic mind: “I am not for one moment advocating that elderly people, or patients with degenerative diseases, should take their lives. It is too personal a decision” (emphasis added). Advocacy no, able assistance yes. On the very same page, Humphry coins a new term to cover those who, alas, have no fatal disease to carry them off—“what I call ‘terminal old age’ ”—a euphemism that can now justify death for the not-dying.

Nor is Humphry shy about facilitating euthanasia for people with Alzheimer’s disease: “There is a trend in the euthanasia movement to legislate only for physician aid-in-dying for the terminal patient who is rational. . . . But I believe that to duck responsibility for the incompetent patient is a serious gap in our humanitarian cause.” Today the rational and terminal, tomorrow the blind and the lame, the deaf and the dumb: let there be nothing but compassion (and “aid-in-dying”) for those who choose death—and even for those poor “incompetents” whose debility or loss of dignity convinces us that they would choose death had they only mind enough to do so. Thus does the right to choose one’s own death become quickly mixed up with the right to “choose” someone else’s.

One cannot exaggerate the importance of this difficulty, for it is buried by sloppy reasoning and by the (yes) emotional appeal of the insistence on choice. If suicide (and its assistance) is to be justified by a right to choose the time and manner of one’s death, if the right of life, liberty, and the pursuit of happiness or the so-called right of privacy encompasses also a “right to die,” then (as Humphry argues) the whole matter is “too personal” and subjective; and the case for suicide need not rest on any objective or demonstrable criteria—such as certifiable terminal illness or truly intractable pain. For who is to say what makes life “unbearable,” or death “electable,” for another person? The autonomy argument kicks out all criteria for evaluating the choice, save that it be uncoerced.

Of course no one, not even Humphry, wants to leave it at that. Instead, reasons are given to justify choosing death: too much pain, loss of dignity, lack of self-command, poor quality of life. These are supposed to add up to a plausible verdict: life is no longer worth living. Such “useless” or “degrading” or “dehumanized” lives now plead for active, “merciful” termination—choice or no choice.

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The line between voluntary and non-voluntary (or involuntary) euthanasia cannot hold in practice, not least because it cannot be sustained in theory. Once suicide and assisting suicide are okay, for reasons of “mercy,” then delivering the dehumanized is okay, whether chosen or not. Humphry and his crowd are well aware of the slippery slope. Yet pretending to want only a partial slide, they have both embraced the principle and started us on a decline that will take us all the way—to eliminating everyone deemed unfit.

This is already happening in Holland, as we are now beginning to discover. Humphry, like many other enthusiastic euthanists, touts the Dutch experience of physician-assisted suicide and treats it as a model, presenting a disingenuously rosy picture of the practice.3 But the newly emerging truth should help restore sanity. In a recent book, Regulating Death,4 Carlos S. Gomez reports that the practice in fact ignores virtually all the self-imposed guidelines and standards imposed by the Netherlands Medical Society: physicians sometimes do not seek a second opinion before administering death; they do not report the deed or even note it on the death certificate; where they do report euthanasia, no one investigates the facts; where someone does investigate, the physician controls all the evidence; and—quite clearly—they euthanize some patients who have not requested death. The practice is utterly unregulated—no big surprise to anyone who has given the matter any forethought.

Even more alarming is the newly released report of the government’s Committee to Investigate the Practice of Euthanasia in Holland.5 The report contains the most extensive and most reliable information to date on euthanasia in the Netherlands. Its reassuring conclusions are, to say the least, at great variance with the wealth of disturbing data it provides. Here are just a few of the findings: 25,300 cases of euthanasia (active and passive) occur in the Netherlands every year, 19.4 percent of all deaths in the country. These include 1,000 cases of direct active involuntary euthanasia. In addition, there are 8,100 cases in which morphine was overdosed with the intention to terminate life, 61 percent of the time without the patient’s knowledge or consent. And there are another 8,750 cases in which life-preserving treatment was stopped or withheld without consent of the patient and with the intention to shorten life. “Low quality of life,” “no prospect of improvement,” and “the family could not take it anymore” were among the most frequently cited reasons to terminate patients’ lives without their consent. In 45 percent of cases in which the lives of hospital patients were actively terminated without their consent, this was done without the knowledge of the families. Are you duly reassured? Hail to the Dutch, says Uncle Derek.

Hail also Dr. Jack Kevorkian, inventor of the suicide machine and self-appointed father of “obitiatry,” the doctoring of death. Humphry gives him ten pages, the longest chapter in the book, and praises him for “notable public service by forcing the medical profession to rethink its attitude on euthanasia.” Having been present at Dr. Kevorkian’s civil trial—I was a witness for the state on matters of medical ethics—and having read his testimony, watched his demeanor in court, read letters in which he promised to “help” a woman who later was found to be suffering merely from treatable migraine, and, above all, having seen the self-serving and manipulative videotape he made of his only conversation with the unfortunate Janet Adkins the day before he helped her to “self-deliver,” I feel the deepest shame for my profession that he should be counted a member.

But what does Humphry know or care about medical ethics or the meaning of permission to kill for the doctor-patient relationship? He celebrates the new age in which “physicians are now more likely to be seen as ‘friendly body technicians.’ ” Though he acknowledges the right of individual physicians to abstain for personal reasons from assistance-in-suicide, he has absolutely no idea of a professional ethic as such, or of why, for several thousand years, doctors have vowed neither to give nor suggest a deadly drug, not even if asked for it.6

True enough, many physicians fall far short of the professional ideal; many lack empathy or rely too heavily on technology. But will it really restore the ethical dimension constitutive of the profession if we permit doctors to become technical dispensers of death? What will happen to the doctor’s unswerving allegiance to the patient’s best interests once he is entitled to start thinking that death by injection is a possible “treatment option”? Drunk on what passes for compassionate caring, Humphry does not truly care.

Two further passages show his colors. In the first, Humphry helpfully drafts a model suicide note, to be written and signed as “your last letter.” Here are the last letter’s last words:

If I am discovered before I have stopped breathing, I forbid anyone, including doctors or paramedics, to attempt to revive me. If I am revived, I shall sue anyone who aided in this. [Emphasis added.]

Compassionate words, intended to soften the blow when one finds one’s loved one a suicide?

In the second vignette, concerning physician-and-nurse-assisted suicide, Humphry insists that the entire medical team must be informed about time and manner of the planned death. Why? Because “while everything must be done to reduce the stress on the medical team, a degree of emotional involvement in the dying of the patient is eminently worthwhile to preserve an appreciation of the inherent sanctity of life” (emphasis added). What kind of man would use “the inherent sanctity of life,” no less, as a club to browbeat possibly reluctant nurses or doctors into participating in plans to kill?

No discussion of this book, especially in this magazine, could be complete without commenting on Humphry’s respect for the fine work of his German counterparts, expressed at length in the chapter, “The Cyanide Enigma.” After a (single) paragraph condemning the Nazi atrocities (but appreciating the swiftness of death by their Zyklon-B), Humphry rehabilitates the German euthanasia of the present day:

In the 1980′s, the situation with regard to the suffering of terminally ill people was as tragic in Germany as elsewhere. Regardless of the terrible connotation given to the word “euthanasia” (which means help with a good death) by the Nazi atrocities, some people felt that compassionate action to help the dying was needed. In 1980, a pro-euthanasia society was formed, Deutsche Gesellschaft Für Humanes Sterben (German Society for Humane Dying), by a small group of brave people under the leadership of Hans Henning Atrott.

Unlike other countries, DGHS found it did not need to campaign for a change in the law on assisted suicide. There was no legal prohibition on helping another to die in justified circumstances so long as the request for help was clear and convincing.

The favorite method of DGHS is cyanide; Humphry, though he professes skepticism about peaceful death with cyanide, describes the German technique in minute detail, dosages included. He then goes on to praise “the simple cleverness of the DGHS method,” which obviates the need for Zyklon-B gas by having the gas’s active ingredient produced in the stomach following ingestion of potassium cyanide in water. Is not German science splendid? Does the high priest of euthanasia think that we have forgotten how to shudder?

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Let me not be misunderstood. Dying in our technological age, even in humanitarian institutions, often comes attended by horrors unknown to our ancestors, often as an unintentional consequence of medical success in the battle against death. Medicine or no medicine, mortality remains our lot. Yet our secular and utopian culture does not prepare us well to face this truth and its consequences. Both painful personal experience and serious study for over two decades have taught me to appreciate deeply the anguish and fear of patients and families in the myriad matters surrounding decay and death; I know and feel the horror of the way many of us now end our lives. There are many, many circumstances—too numerous, too particular, too nuanced to lay out in advance—that call for the cessation of medical intervention, even if death comes as a result. There is rarely a good reason for withholding proper doses of pain medication, even if providing effective analgesia runs an increased risk of earlier death. And there is much more that we can do—most of it a matter of human relations, not of technological devices—to support the morale and dignity of people faced with incurable or fatal illness.7 But to cross the line and accept active euthanasia, mercy killing, “aid-in-dying,” death from doctor’s healing hand, “dignified autoeuthanasia,” and “self-deliverance”—that way lies madness.

At the very least, we must now open our eyes to the situation before us. We must not allow ourselves to be gulled by euphemisms and by falsely calming images like “final exit.” We must not accept Humphry’s shallow notion that “dignity” can be delivered by a hypodermic needle filled with lethal medicine. We must not forget the cost-containers and the eugenicists who stand ready in the wings to exploit the “choice” for death, to make sure that the burdensome and incurable take advantage of the deadly option.8 And, above all, we must not fall for the calm and matter-of-fact talk of “rational suicide.”

Calmness and coolness are, by themselves, no proof of rationality. Neither is deliberate planning, or the stockpiling of “magic pills.” All human conduct is motivated—by desire or fear or some other appetite or emotion; thought alone moves nothing. However much Humphry talks of rationality—“It was not done out of cowardice or escapism but from long-held rational beliefs”; “Very, very few physicians will prescribe a lethal dose for a fit person. The stigma of being associated with a possible emotional suicide (as distinct from a rational suicide) is too risky”; etc.—the truth is that passions, sentiments, desires drive our every action. In the case of those explicitly addressed by this book, the dominant motives—the true movers of the soul—will be fear, resignation, and despair, or, in other words, the desire to escape. It is surely not pure reason that finds life unbearable.

Let’s get serious about “rationality” and reason. Do we know what we are talking about when we claim that someone can rationally choose non-being or nothingness? How can poor reason even contemplate nothingness, much less accurately calculate its merits as compared with continued existence? What we have in so-called rational suicide is a mere rationality of means, rationality of technique, but utter non-rationality regarding the end and its putative goodness. An act of “rational suicide” may be psychologically understandable and (even, in some cases) morally pardonable, but it is utterly unreasonable.

Humphry and others contend that it is religious dogma alone, not human reason, which regards suicide as unethical. But this is patent nonsense. Immanuel Kant, whose claim to rationality is second to none, regarded the will to suicide as inherently self-contradictory, and thus, precisely, irrational:

It seems absurd that a man can injure himself (volenti non fit injuria [Injury cannot happen to one who is willing]). The Stoic therefore considered it a prerogative of his personality as a wise man to walk out of this life with an undisturbed mind whenever he liked (as out of a smoke-filled room), not because he was afflicted by actual or anticipated ills, but simply because he could make use of nothing more in this life. And yet this very courage, this strength of mind—of not fearing death and of knowing of something which man can prize more highly than his life—ought to have been an ever so much greater motive for him not to destroy himself, a being having such authoritative superiority over the strongest sensible incentives; consequently, it ought to have been a motive for him not to deprive himself of life.

Man cannot deprive himself of his person-hood so long as one speaks of duties, thus so long as he lives. That man ought to have the authorization to withdraw himself from all obligation, i.e., to be free to act as if no authorization at all were required for this withdrawal, involves a contradiction. To destroy the subject of morality in his own person is tantamount to obliterating from the world, as far as he can, the very existence of morality itself; but morality is, nevertheless, an end in itself. Accordingly, to dispose of oneself as a mere means to some end of one’s own liking is to degrade the humanity in one’s person (homo noumenon), which, after all, was entrusted to man (homo phaenomenon) to preserve.

So-called “rational suicide” is finally a sophism. Those who preach it and abet it are teachers of evil.

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Modern rationalism, whose leading branch is modern natural science and whose purest fruit is medical technology, has certainly made human life less poor, brutish, and short. Yet because, being morally neutral, it knows only the means, never the end, it has left us lost at sea without a compass. Worst of all, blinded by pride in our technique, we do not even suspect that we are lost, that we have become, as Churchill put it, “the sport and presently the victim of tides and currents, whirlpools and tornadoes amid which [we are] far more helpless than [we have] been for a long time.” We do not yet understand that the project for the mastery of nature and the conquest of death leads only to dehumanization; that any attempt to gain the tree of life by means of the tree of knowledge leads inevitably also to the hemlock; and that the utter rationalization of life under the banner of the will tragically produces a world in which we all get to become senile and in which our loved ones get to do us in.

The taboos against homicide, suicide, and euthanasia—like those against incest, adultery, and fornication, central insights of the receding wisdom from a more sensible age—are today weak and increasingly defenseless against the rising tide of gentle dehumanization. Yet they are all that stands between us and the flood. Everyone who cares truly for human dignity and decency—that is, everyone who would be truly rational—must now come to their defense, before it is too late.


Footnotes

1 The Hemlock Society, 192 pp., $16.95.

2 Just after I wrote this sentence, in an eerie coincidence, a telephone call informed me of the suicide of Derek Humphry's (divorced) second wife, an act which he apparently deplored. In a display of despicable shamelessness, Humphry took out a quarter-page ad in the New York Times (October 14, 1991) distancing himself and the Hemlock Society from such “irrational suicides.” He neglected to mention his earlier penchant for distance: two years ago, he abandoned and divorced this woman when she was diagnosed as having cancer.

3 Euthanasia and assisting suicide are still illegal in Holland, but the authorities have decided not to enforce the law. Here at home, happy reports about the Dutch practice played a large part in a campaign to make the state of Washington the first jurisdiction actively to legalize killing-on-request practiced by physicians.

4 The Free Press, 172 pp., $19.95.

5 Portions of the report have been translated for me by a Dutch acquaintance.

6 See my essay, “Neither For Love Nor Money: Why Doctors Must Not Kill,” Public Interest, Winter 1989.

7 See my essay, “Death With Dignity & the Sanctity of Life,” COMMENTARY, March 1990.

8 There is not a word in this book about the current economic crisis in health care and the pressures that already throw people with chronic illness prematurely out of the hospital. The partisans of “right to die” and the partisans of “cut the costs,” strange bedfellows, are incubating a deadly outcome for the vulnerable, the elderly, and the powerless.

About the Author

Leon R. Kass, the Hertog fellow at the American Enterprise Institute and professor in the Committee on Social Thought at the University of Chicago, served from 2001 through 2005 as chairman of the President’s Council on Bioethics. In somewhat different form, this essay will appear in a volume on religion and the American future to be published later this year by the American Enterprise Institute.




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