A Lesson in Selling Death: California Legalizes Suicide

In the encyclical Evangelium Vitae (which, given recent events, Catholics would do well to revisit in earnest), St. John Paul II warned of the tendency to obscure the true nature of certain dehumanizing acts through ambiguous or overly technical language:

“Given such a grave situation, we need now more than ever to have the courage to look the truth in the eye and to call things by their proper name, without yielding to convenient compromises or to the temptation of self-deception…there is a widespread use of ambiguous terminology…which tends to hide [the procedure’s] true nature and to attenuate its seriousness in public opinion…But no word has the power to change the reality of things.” (n. 58)

While the Pope was speaking specifically about abortion here, the tactic of employing mellifluous language to mask uncomfortable (indeed, unfathomable) realities has proved remarkably successful in convincing an otherwise unwitting public into accepting things to which, were we honest with our language, few would give willing assent.  The most recent example…on March 25 (ironically and chillingly the 20th anniversary of the promulgation of the encyclical in 1995), the California senate health committee voted 6-2 (all Democrats voting for, both Republicans against, with 1 Democrat non-vote) to pass SB 128, the so-called “End of Life Option Act”, which would effectively legalize assisted suicide in the state. The bill moves next to the senate judiciary committee.

Consider the carefully crafted name of the bill: “End of Life Option Act”.  It sounds innocuous enough.  In fact, it sounds good.  After all, who wouldn’t want “options” at the end of life? That sounds good enough; who could possibly be opposed to “options”?  Most people won’t read the bill past its name in a news headline and so the bill becomes unconsciously agreeable in the mind.  Continuing to obfuscate through linguistic sugar-coating, the bill even refers to the potent drugs used to kill the terminally ill as “Aid-in-dying medication” (443.1(b)).  See?  It’s not suicide, it’s “aid-in-dying” and it’s “medicine”, and we all know that medicine is good.  If it weren’t talking about drugs used to kill a vulnerable population, it would be laughably euphemistic, LOL-ably euphemistic, even.

An honest headline might say something as chillingly blunt as, “California passes bill allowing doctors to kill the sick and vulnerable” and it would still be more accurate than the empty euphemisms lawmakers employ to guilt the public into accepting turning doctors into death-dealers.  We might be accused (unjustly) of being insensitive and calloused to the pain and suffering of the terminally ill in speaking so bluntly (read: honestly, clearly, accurately, etc.) but where is the outcry against the almost comical word-smithing suicide advocates employ?

One telling sign that something is amiss, that someone isn’t telling the truth, is the refusal on the part of suicide advocacy groups to actually use the word “suicide”.  It’s difficult to get public support for suicide (for good reason), but it’s relatively easy to get people to agree to “options” and “choices”, and even death when accompanied by the words “dignity” and “aid”.  All of this to mask the reality: someone has helped a sick and vulnerable person to kill themselves.  And the terminally ill are a vulnerable population that deserve heightened care and attention.  The Declaration on Euthanasia recognizes that requests for death-dealing drugs often mask a need to have deeper, underlying human needs met:

“The pleas of gravely ill people who sometimes ask for death are not to be understood as implying a true desire for euthanasia; in fact, it is almost always a case of an anguished plea for help and love. What a sick person needs, besides medical care, is love, the human and supernatural warmth with which the sick person can and ought to be surrounded by all those close to him or her, parents and children, doctors and nurses.” (II)

Suicide advocacy groups have made adept use of brain cancer patient and suicide victim Brittany Maynard’s celebrity status in advancing their cause.  Her own mother testified in support of SB 128.  Brittany’s death certificate claims “brain tumor” as her cause of death.  But Brittany didn’t die from her brain tumor.  She died because she committed suicide, with the help of her physician and after implied approval from the individuals and organisations who called her act “courageous” and “brave”.  SB 128 requires physicians to lie concerning cause of death, like Brittany Maynard’s death certificate.

Section 443.7(b) of the bill reads, “The cause of death listed on an individual’s death certificate who uses aid-in-dying medication shall be the underlying terminal illness.”  In other words, physicians would be required to lie about a patient’s cause of death by falsely listing the patient’s illness as the cause of death.  If this is such a good thing for the terminally ill, why cover it up?  Why tell doctors to lie on death certificates?  John Paul II was right when he observed, “Perhaps this linguistic phenomenon is itself a symptom of an uneasiness of conscience.”  (EV, 58)

If we were to examine causes of death from a particular state hospital from, say, a century ago, and were to observe that a large number of patients all died from the same particular cause of death (“acute infection”, for example), we might question the hospital’s sanitation practices and procedures for reducing the spread of infection.  Now imagine someone in the future looking over cause of death information in records of patients from today who had committed suicide.  There would be nothing surprising about seeing causes of death listed such as “brain tumor”, “stomach cancer”, “ALS”, and the like.  The observer would not even know they had committed suicide.  But if the listed causes of death were honest, the researcher would see something like, “suicide by physician-prescribed drugs.”  Would this not raise very serious questions about the state of medical care at the time such as, “why were these sick and vulnerable people committing suicide?” and “why were physicians killing people?”  What on Earth was going on?  Cause of death information is valuable public health information and requiring doctors to lie about causes of death is an affront to their professional integrity and to public health.

The American Medical Association opposes assisted suicide on the grounds that it is “fundamentally incompatible with the physician’s role as healer, would be difficult or impossible to control, and would pose serious societal risks.” The World Medical Association also opposes euthanasia and assisted suicide, finding it to be “in conflict with basic ethical principles of medical practice.”  It should be noted that, consistent with the Declaration on Euthanasia (and the wider body of Magisterial teaching), neither the AMA nor the WMA oppose honouring a patient’s request to discontinue aggressive, futile, or disproportionate medical procedures at the end of life.  There is nothing unethical about refusing or discontinuing such procedures and doing so should never be conflated with euthanasia or assisted suicide, which by definition, seek to actually cause or hasten death.

Health care should be aimed at healing, not harming, at curing, not killing.  But even when it cannot cure a patient of a pathology, the obligation to care for the patient’s human needs remains.  That SB 128 and its proponents have so blatantly worked to sell death through clever word-smithing is an insult to the medical profession, the rule of law, and to the real cries for basic care on the part of the terminally ill.