Incapacitated in health-care facilities, isolated from the world at large, Dorothy Livadas and Bill White were among the unlikeliest of candidates for becoming front-page news. And yet their wishes to be disconnected from life support at Rochester’s Strong Memorial Hospital — Livadas died Aug. 29, and White died in 1999 — sparked considerable public debate over it is ethically and legally permissible to fulfill such requests.
On the nation’s West Coast, meanwhile, some folks are experiencing difficulties of an opposite nature : They’re finding it all to easy to die legally, when they actually wish to stay alive.
An essay posted Aug. 8 on the U.S. Conference of Catholic Bishops Web site (www.usccb.org) chronicled the plights of Randy Stroup and Barbara Wagner, who reside in Oregon — the only state to permit physician-assisted suicide for the terminally ill. State-sponsored health-insurance plans denied the treatment requests of both cancer patients — but readily offered to assist them in committing suicide at no cost.
“Imagine if your state of residence put a price tag on your life. Though it sounds like something out of “The Twilight Zone,” that’s exactly what happened to Randy Stroup and Barbara Wagner,” noted the essay’s author, Mary J. McClusky, special-projects coordinator at the USCCB’s Secretariat for Pro-Life Activities.
Oregon has allowed physician-assisted suicide since 1997. It may soon be joined by the state of Washington, where voters will decide Nov. 4 on a bill known as the Death With Dignity Act.
These developments leave Jann Armantrout, diocesan life-issues coordinator, concerned as to just how far such legislation might eventually spread.
“There is no question that there are advocacy groups throughout the country who seek expansion of assisted suicide and euthanasia, under the guise of ‘death with dignity,'” she said.
Church guidelines
Bill White had survived for 30 years on a ventilator, but at age 50 he told his doctors that he no longer wanted to live in such a way. His request was honored and he died a few days later, but not before local activist groups strongly questioned whether White’s wish was granted too readily because he was disabled.
Armantrout characterized White’s case as the first in local history to get people confronting the right-to-die issue on a large degree. She, for one, supported White’s decision.
“At what point do you say, ‘Enough.’?” It was his choice to remove the ventilator and that is, indeed, a very burdensome treatment,” she remarked.
More recently, the daughter of Dorothy Livadas fought in court this summer to keep the 97-year-old woman alive on a ventilator, even though her mother reportedly had put in place advance directives barring the use of extraordinary measures to keep her alive.
“Mrs. Livadas’ advance directives were very, very clear. No one really has the right to override that — and the courts in their decisions affirm that,” Armantrout said.
Armantrout said the decisions of both White and Livadas fell within the bounds of Catholic teaching, based on the U.S. bishops’ Ethical and Religious Directives for Catholic Health Services, No. 57: “A person may forgo extraordinary or disproportionate means of preserving life. Disproportionate means are those that in the patient’s judgment do not offer a reasonable hope of benefit or entail an excessive burden, or impose excessive expense on the family or the community.”
Forgoing extraordinary or disproportionate means of preserving life in the context of church teaching is what Armantrout says separates the cases of White and Livadas from euthanasia and assisted suicide, which are both deliberate medical means of bringing about a person’s death and are both opposed by the church. In euthanasia, another person performs the procedure, whereas in assisted suicide the individual commits the act himself but the church forbids both practices.
“It is one thing for your body to expire because of natural causes. It is another thing to hasten death,” Armantrout said.
A slippery slope
Based on what’s happening in Oregon and Washington — as well as Belgium, the Netherlands and Switzerland, where euthanasia and assisted suicide are legal in varying degrees — the USCCB’s McClusky is wary that these procedures stand to gain greater acceptance and ultimately be used against patients who want nothing to do with them.
“The ‘slippery slope’ may expand our notion of who is falsely considered a burden to society,” McClusky wrote, adding that the next step might be to target elderly people who are supposedly tired of living.
One Washington resident — who some might think would benefit from proposed physician-assisted suicide legislation — is actively opposing the Death With Dignity Act. Seattle’s John Peyton, a Lou Gehrig’s disease patient who over the summer was given three to six months to live, told Catholic News Service he sees the measure as “just the first step in putting into law the lie that there is such a thing as a life not worth living.”
Armantrout said proponents of assisted suicide and euthanasia use such jargon as “death with dignity,” “comfort care” and “palliative care” because the word “suicide” is too negative. She compared that to the way abortion is sold to people as “a woman’s right to choose.”
“The reason we don’t hasten death is that it’s not ours to judge,” she said, noting that “all life is a gift from God which is to be treated with the utmost respect.”
Armantrout and McClusky agreed that a person’s last breath is far too closely linked today with bottom-line economics.
“Physician-assisted suicide laws contribute to the overall devaluing of human life. Rather than recognizing the inestimable worth of every individual, they promote the erroneous idea that life is a commodity up for cost analysis by the state,” McClusky wrote.
“So much of the concern is, ‘Well, who’s going to care for all these people? Who’s going to pay for all this?’ The economic value — that becomes precariously close to asking if a life is worth living,” Armantrout added.
Take action on advance directives
Have you thought about writing advance directives, but not quite gotten around to it?
Don’t delay. Regardless of age or health condition, any person can become incapacitated either gradually or suddenly. Advance directives give patients a say in decisions about the medical treatments they will receive even when the patients are too sick to make decisions on their own behalf. These advance directives come in three forms:
* A living will, in which an individual provides written instructions about his or her specific health-care wishes.
* A health-care proxy, which allows an individual to appoint a trusted person to make decisions on that person’s behalf if he or she becomes incapacitated. This is the preferred advance directive in New York state. Proxy forms may be obtained from doctor’s offices, hospitals and nursing homes.
* A do-not-resuscitate order, or DNR. This order is signed by a doctor and placed in a patient’s medical records, stating that cardiopulmonary resuscitation will not be used if the person’s heart stops.
Jann Armantrout, diocesan life-issues coordinator, noted that the Rochester Diocese has conducted two major campaigns over the past 10 years to encourage freer discussion about advance directives, and is planning another campaign for 2009 “in light of the controversy over Dorothy Livadas (see related story). We feel it’s an important teaching moment.”
Armantrout credited the Appellate Division of the State Supreme Court for ultimately upholding Livadas’ wishes as stated in her advance directive. On the other hand, she cited the famous case involving Terri Schiavo, whose family members fought bitterly for years about whether the brain-damaged Florida woman should have had her feeding tube removed. Armantrout said that the conflict surrounding Schiavo — who died in 2005 at age 41 — could have been avoided if she had filed advance directives.
Armantrout added that discussing one’s advance directives can be an unpleasant, but nonetheless wise move.
“People don’t really want to talk about this,” she said. “(But) people should spend time contemplating with someone they know and trust, and making these issues clear.”
