I'm Having a Moment.

It's a great day! Not only am I on the radio tonight but a friend, Jeff Sharlet, has a new book out with an essay in it about yours truly and--this is big--I've been awarded a fellowship with USC's Annenberg School of Journalism, the Knight Grant for Reporting on Religion in American Public Life, to write about how American's die. Now if I could just get a date....

Details!

11 pm tonight on WBAI (99.5 FM) I'll be talking to the amazing Barbara Glickstein about how Americans die, denominational healthcare, and hospice. Here are the details--and a picture of me in WBAI's studio. Catch the second segment of this two-part series same time and place on August 25th.

A new book of essays by New York Times bestselling author Jeff Sharlet, a friend and my predecessor at The Revealer, is not only cover-to-cover full of brilliantly written essays about "faith and faithlessness," but one's even about me. Buy Sweet Heaven When I Die: Faith, Faithless, and the Country in Between here. Right now. Hurry up. Chop-chop.

And here's exciting news: I've been given a fellowship by USC's Annenberg School of Journalism, the Knight Grant for Reporting on Religion in American Public Life, to report about how American's die--prison, end of life and hospice care, denominational health care. Over the next nine months I'll be traveling to Montana, California, Arizona and Alabama to investigate how state and religious regulation effect health care choices by the dying. Here's more on the fellowship and the humbling field of other winners.

I Told You So: Catholic Church Comes After Catholic Bioethicists

Cross-posted from The Revealer, a publication of The Center for Religion and Media, NYU.

I shouldn’t take any credit for predicting the actions of the most predictable institution on the globe, but I’ll take it anyway. I made the case at The Nation last week that the USCCB’s recent statement on aid in dying would lead to broader crack-downs on end of life rights, privacy, and awareness. I was right. According to a new report at Crisis Magazine and a press releasefrom the bishops today, they’ve targeted Catholic professors at four universities: Georgetown, Marquette, Santa Clara and Boston College. How did the bishops identify the academics they wanted to discredit? Writes Patrick J. Reilly at Crisis:

The professors’ efforts came to light during a Cardinal Newman Society investigation in 2005, following news reports of a legal brief filed by 55 bioethicists in opposition to “Terri’s Law,” a Florida measure that empowered Gov. Jeb Bush to ensure that the comatose Terri Schiavo received water and nutrition. As reported in “Teaching Euthanasia,” an exclusive report in the June 2005 issue of Crisis, multiple professors at Catholic universities had taken positions on end-of-life issues that seemed to conflict with Vatican teaching.

That’s right. Conscience aside, if you don’t exactly teach–or even in your personal life espouse– the Vatican line, you’re not Catholic. And it’s a seething mission among Catholic Church leadership to reign in not only Catholic bioethicists and professors but also Catholic hospitals. Only two years ago, the USCCB changed the Ethical and Religious Directives that are used to manage all 625 of their hospitals to limit a patient’s ability to be removed from artificial nutrition and hydration.

These actions are a direct response to the Terri Schiavo fiasco — which I’ve written about at Religion Dispatches and AltNet — and the Church’s desire to more directly guide health care policy in the US. The USCCB is still smarting over dissent of nuns and the Catholic Health Association during the recent health care debate. By rooting out dissenters, they hope to present a more unified voice on issues of the body.

Who’s their next target? It’s hard to say. While the church cleans out universities, hospitals, agencies and schools, “pro-Life” organizations prepare their on-the-ground election-time efforts and renewed pressure.

The Catholic Church well knows that even a statement addressing “assisted suicide” will serve as a political map for “pro-life” activists and their allies who have long seen “euthanasia” as one item on their platform. Think legislation governing advanced directives (already moot at Catholic hospitals if you’ve got a feeding tube, where a webwork of conscience clauses prevents them from complying with state and federal laws), hospice and palliative care regulations, inheritance laws for families of suicides, drug regulations….

I hope Church leadership is overreaching. While their fight against abortion is aided by the fact that women’s reproductive rights have been shamed and ghetto-ized since time began, seniors vote. And the US population resoundingly supported the Florida decision in 2005 to remove Terri Schiavo’s feeding tube.

Yet, the Church is particularly skilled at over-representing its influence and voting base. Again and again, health care rights for women have been bargained away with deference to the Church. Why not seniors’? Neither party seems willing to press for a meaningful Patients’ Bill of Rights or real health care reform. And the obstacles to nuanced conversation about death are myriad; they include an uninterested, misinformed, or easily-distracted press.

Whether you think aid in dying should be legal or not, whether you abide by Catholic doctrine or the light of the moon, you should still question the health of a democracy where a church’s laws dictate the actions of the pluralistic societal body.

Cross-posted from The Revealer, a publication of The Center for Religion and Media, NYU.

What the USCCB's New Focus on Aid in Dying Could Mean

I have a new piece at The Nation that you can read in its entirety here. Here's an excerpt, below. It was posted Wednesday night but I'm still waiting for Kevin Drum and Ezra Klein to call....

A focus on aid in dying should illuminate failures in end of life care, of which the US has many. In our current state of crisis—52 million people are uninsured; the United States spends twice as much on healthcare than other developed nations, with inferior results; the population is growing older; the dying are often subject to debilitating futile care in their last days—we can hardly afford ideological diversion. As with the issue of abortion, when the Catholic Church shines a spotlight, Americans get blinding orders, not illumination.

Even typically astute writers miss the point on end-of life care. While Ezra Klein, the Washington Post's healthcare expert, didn't endorse Catholic pundit Ross Douthat's contention that aid in dying should be illegal (though Klein failed to acknowledge that it is legal in three states), he bought the same "slippery slope" argument "pro-life" groups have used for years to oppose and restrict abortion. While Mother Jones's Kevin Drum refuted Douthat’s religious arguments and Klein’s sources and logic, he too failed to connect the conversation on assisted suicide to the larger crisis in end-of-life care. Neither took meaningful issue with the outsized role the Catholic Church—which operates one-fifth of all hospital beds in the United States according to their own guidelines—plays in this or the healthcare debate.

Finding Someone to Blame

And yet, guns are legal.

Rita Marker, of the dubiously-named Patients Rights Council, is of course quoted.

UK Catholic Medical Association Goes After Palliative Care

The "double effect," supported by the American Medical Association, states that a doctor may prescribe pain medication to a dying patient in doses that are lethal because the intention of the doctor is to relieve pain, not end the patient's life. Palliative medicine, the specialty field that focuses on ways to alleviate pain, is often held to account by opponents of assisted suicide because of what fails to be a "bright line" during the process of dying. How much medicine is too much? Who decides? What if the patient has no advanced directive? Would they want to be in pain or to life a few hours or days longer?

A story in Saturday's The Underground, a UK publication on "Pop Culture from a Christian perspective" quotes the president of the UK Catholic Medical Association (and a lot of excerpts from the U.S. based LifeNews) on the unfounded accusation that "mercy killing" is rampant in that country. A clip from the article, below. Note the muddling of end of life issues by confusing palliative care, hospice, assisted suicide and prevalent Catholic teaching on suffering, along with a restatement of the U.S. case of Terri Schiavo:

One reason for the occurrence of euthanasia, Walker told Scottish Catholic Observer, is that “The standards of medical ethics and of interpretation of existing legislation appear to vary greatly around the country and from one organization to the next, even in the same local area.”

Misuse of LCP

Another reason is the misuse of the Liverpool Care Pathway, which was developed in the 1990s at the Marie Curie hospice and royal Liverpool Hospital, so that palliative care for end-of-life patients could improve, the Scottish Catholic Observer said.

The LCP provides criteria that must be followed before ending life-sustaining treatment and applying palliative care, LifeSiteNews said. However, reports have indicated that LCP has been used in the cases of people who were not dying, such as dehydrating someone to death on the grounds of LCP.

Walker said, “If it is used out of context, then it could be used to the detriment of patients e.g. a patient comes into a resuscitation bay, and it is not always clear if a condition is acute and can be treated,” LifeSiteNews reported.

A recent report on crematorium records showed that 23% of all deaths in one city in the U.K. were people put on LCP without any definite diagnosis of their stage of life, LifeSiteNews said.

LifeSiteNews mentions the case of in the U.S. of Terri Schiavo, who was not dying, but who was withheld hydration, as an example of euthanasia. However, if a person is “actively dying and/or is unable to assimilate H & N, [t]hat person is actually dying and the provision of H & N provides little to no benefit and may cause suffering.” In such case, it would not be euthanasia.

Ban in Idaho

From The Republic, below, a quick piece on a new ban in Idaho on "helping somebody else commit suicide." I haven't read the bill but wonder what exactly this means. Is the ban against a doctor prescribing fatal doses of a medicine? Yes. LifeNews writes that the bill "would revoke licenses from physicians who prescribe a lethal cocktail of drugs for patients to use to kill themselves. The law also allows people to get injunctions to prevent others from killing themselves with a doctor’s help. If it becomes law, those found guilty face five years in prison." But what is lethal? And who is to say that the doctor is responsible for a suicide? Could doctors be under greater scrutiny for the actions of their patients? Is it an overly-enthusiasitic reaction to "pro-life" efforts to thwart the momentum of the assisted suicide movement? Absolutely. Again from LifeNews:

"David Ripley of Idaho Chooses Life told LifeNews.com, “No opposing testimony was presented at the hearing. During the Senate deliberations, the Idaho ACLU testified against the bill. Supporting testimony was provided by Cornerstone Institute, Right to Life, the Idaho Medical Association and attorney Bob Aldridge.”
“This is a tremendous victory for the pro-Life movement in Idaho. Such overwhelming votes should make it clear to the death lobby that they are not welcome in our beloved state,” he added.

Can the ban be used to prosecute those who remove PVS patients like Terri Schiavo from life support? Can the ban be used to punish spouses of those who commit suicide?

The House voted overwhelmingly to send a bill banning helping somebody else commit suicide to Gov. C.L. "Butch" Otter for signature.

Monday's 61-8 vote came after brief debate on the chamber's floor.

Republican Rep. Lynn Luker of Boise argued that outlawing assisted suicide was necessary to help prevent abuse of elderly residents by their caregivers who are seeking to profit from their patients' demise.

Luker says this bill, which foresees penalties of five years in prison for violations, protects "all concerned."

Democratic Rep. Grant Burgoyne complained this is inappropriate government intervention in a private decision.

Burgoyne says, "My life is mine. It's mine for me to decide when and how it should end. It's not the business of the government to tell me when and how I should end it."

Read more here, and here.

Montana and Assisted Suicide.

The Missoulian gives a run-down of the bills before the legislature in 2011 including one sponsored by Rep. Dick Barrett, D-Missoula that will reinforce the Supreme Court decision last year that ruled the state constitution did not prevent assisted suicide.

"My sense is that terminally ill Montanans really do want to have this choice available to them, not that large numbers of people take advantage of it," Barrett said when requesting the bill draft earlier this year.

"We'll be advocating for Montanans to continue to have access in aid in dying and to make those decisions with their doctor without government interference," Zupanic said.

***

Jeff Laszloffy, president of the Montana Family Foundation, said his group stands against physician-assisted suicide.

"I think one of the big ones we're really going to be fighting is the legalization of assisted suicide in Montana," he said.

Meanwhile, Sen. Greg Hinkle, R-Thompson Falls, is requesting a bill to ban physician-assisted suicide in Montana. He has referred to it as "elder abuse."

Aiding Assisted Suicide in Britain, Reviewing the Laws

Meanwhile (see prior post), Britain has created a committee that will review their laws regarding family members and friends who help loved ones travel outside the country for assisted suicide.

The move follows a number of cases in which British people have travelled with friends or family to the Dignitas clinic in Switzerland, where terminally ill people are able to end their lives. Although police investigated the cases, none were taken to court. Last year, Debbie Purdy, who suffers from multiple sclerosis, won an historic judgment in the House of Lords that said she had a human right to know if her husband would face prosecution in such circumstances.

Falconer told the Observer: "It is probably a criminal offence to travel with someone to Switzerland to help them to die and yet it is so obvious that nobody on any side of the argument has the stomach to prosecute people like, for example, Dan James's parents." He was referring to the case of the 23-year-old whose parents helped him commit suicide after he was paralysed in a rugby accident.

Christian groups have already accused the commission of being biased.

Assisted Suicide in Scotland

The Scottish Parliament will vote on December 1 on a bill introduced by Margo MacDonald that would legalize assisted suicide.

Ms MacDonald, whose End of Life Assistance Bill faces a crucial vote in the Scottish Parliament next week, revealed details of a poll showing 77% of Scots agreed people with “intolerable terminal illnesses” should have the option of being helped to end their life.

Just 12% said they did not agree while 11% said they did not know.

A total of 1001 Scots were questioned for the survey, which was carried out for the Green Party in April by polling company Angus Reid Public Opinion.

The proposed legislation has split opinion with doctors’ leaders and religious groups opposed to it.

For more, read here.

Patholysis: Destroying Suffering.

So with all the terminology struggle that surrounds the "culture war" issues of abortion and assisted suicide, Thaddeus Pope makes us aware of Kevorkian's preferred term for what he did for more than 130 patients and ultimately went to jail for. Patholysis. The destruction of suffering. The term's been around for a while, notes Pope, but certainly hasn't made it into common language, even among those of us that watch end of life issues. Why?

Suffering has value to much of society. And I think this is the heart of the culture wars. Who suffers. A rape victim suffers a pregnancy. A teen female pays for having sex before marriage. A dying patient dies in pain. A mother of three who is abused by her husband suffers for the sake of her marriage and to keep her three children from being fatherless. Suffering is redeeming and reminds us of the unfairness of life, of the roles that we play in society, of God's awesome power, of Christ's pain on the cross.

A frank discussion of who should suffer - if anyone - and why would change the way we look at "culture war" issues. For this reason alone, Kevorkian's term has validity.

Smith False History and Leaps of Faith.

It's hard to believe that Wesley J. Smith has been watching the assisted suicide movement for the past 17 years and still has to publicly ask the question, "Why Now?" Yet this is the shallow and disingenuous hook on which he hangs his new article at the Catholic magazine Legatus. After spending three paragraphs spinning the recent history of the aid in dying movement as a powerful force railroading the sanctity of life -- and seemlessly sliping in a new usurpation of social activism terminology, "sanctity/equality of human life"! -- he writes:

A question amidst all of this Sturm und Drang naturally arises: Why now? After all, 100 years ago when people did die in agony from such illnesses as a burst appendix, there was little talk of legalizing euthanasia. But now, when pain and other forms of suffering are readily alleviated and the hospice movement has created truly compassionate methods to care for the dying, suddenly we hear the battle cry “death with dignity” as “the ultimate civil liberty.”

With respect to Smith's long years on the euthanasia beat, this is a laughable misrepresentation of history -- and one that he certainly knows better of. While Smith's essay concoctions are typically junk-science based, they're at least sincere. But, as any reader of Ian Dowbiggin will tell you, the roots of the aid in dying (or euthanasia or assisted suicide) movement are far longer and deeper than Smith is letting on. Simply noting the rise of Christianity's condemnation of suicide and assisted suicide doesn't change the rates of each in pre-, modern, and post-modern society. Condemnation of practice is necessarily precluded by said practice....

He writes that there are two reasons why the aid in dying movement has scored some successes since 1994 (Death with Dignity is legal in two states, Oregon (1994), Washington (2008) and in Montana (New Year's Eve, 2009) the Supreme Court ruled that nothing in the state constitution prohibits doctor prescriptions of legal drugs for the terminally ill). Well, really he gives three:

First, the perceived overriding purpose of society has shifted to the benefit of assisted suicide advocacy, and second, our public policies are driven and defined by a media increasingly addicted to slinging emotional narratives rather than reporting about rational discourse and engaging in principled analysis. Add in a popular culture enamored with social outlaws, and the potential exists for a perfect euthanasia storm.

I've bolded the points. For someone lamenting the lack of "principled analysis" and "rational discourse," Smith seems to rely heavily on some "emotional narratives" himself! One can't combat poor logic with more of the same (The media promotes assisted suicide? Kevorkian (the assumed social outlaw, noted at the start of the article) is a boon to the assisted suicide movement?) Nor can one condemn "slinging emotional narratives" when advocating for Terri Schiavo's family and touting the "discovery" of Rom Houben, clear examples of Smith's own effort to sling "emotional narratives."

But let's play Smith's game of "Why Now?," but use facts like: the relatively recent advent of widely accessible palliative care and pain cessation; the lightening-quick advancement of technologies like defibrillators and respirators which have changed the definition of death (once the almost simultaneous cessation of lung, heart and brain function, now something that happens when machines are removed); the prevalence of CPR, 9/11 and other resuscitating procedures that, despite public understanding (thanks in part to medical shows) work about 15% of the time (to be released from the hospital) and often leave surviving patients with broken ribs and/or in persistent vegetative states; the rise of patient autonomy activism to give patients the ability to make their own decisions regarding health care, against the prevailing influence of a paternal medical system (women in the 70s were often given full mastectomies without being consulted); a medical and social culture that condemns dying patients as weak, unable to fight, and doctors as failures, as if death can be put off indefinitely; a "survivor" culture that celebrates those who recover from debilitating disease and, as with breast cancer, thus focuses fundraising and research on cures rather than preventions.

Yes, these developments have all occurred since the 1970s. Yes, they have jeopardized our economic stability by reducing health care to a privilege. Yes, they have been ignored by ideologically motivated individuals like Smith who would rather go on about emotional narratives, the fall of man, the horrors of media and Jack Kevorkian, a decline in human virtue, and the "culture of death." Yes, the powerful "pro-life" groups that have supported the rise of the Medical Right and the Legal Right have continued to cry persecution as they've worked to impose their idea of morality and ethics on the whole of society.

Smith's proof that he's right about the three causes of the movements recent escalation? Suffering! Virtue!

Social commentator Yuval Levin, a protégé of ethicist Leon Kass, described the new societal zeitgeist in his recent book Imagining the Future: Science and American Democracy. While not about assisted suicide per se, Levin hit the nail on the head when he described society as no longer being concerned primarily with helping citizens to lead “the virtuous life.” Rather, he wrote, “relief and preservation from disease and pain, from misery and necessity” have “become the defining ends of human action, and therefore of human societies.” In other words, preventing suffering and virtually all difficulty is now paramount.

Smith's extrapolation from that elegistic longing for (persistent) paternalistic, white, Christian-dominated, authoritarian times? "In such a cultural milieu, eliminating suffering easily mutates into eliminating the sufferer." How? He doesn't say. And he doesn't show examples beyond his own fact-less assertions. But he is toeing the same illogical line that we often hear from those who find glory in suffering (of the dying, of sexually active teens, of coerced women, of gays.) "If we could only save these sinners from themselves?!" he seems to say. Because ultimately, Smith and those who refuse to examine the effects of their "pro-life," discriminatory advocacy are really working to make all of society ascribe to their values, their rules, their false narratives and their beliefs. The fight over aid in dying (and abortion and gay rights, etc.) is really a fight for power; power for a select and moralistic few to tell all the citizens of our country what we should be doing.

As Tony Judt writes, there's another objective behind obscuring facts and thwarting serious, statistics-based discussion in the public square:

Today, we are encouraged to believe in the idea that politics reflects our opinions and helps us shape a shared public space. Politicians talk and we respond—with our votes. But the truth is quite other. Most people don’t feel as though they are part of any conversation of significance. They are told what to think and how to think it. They are made to feel inadequate as soon as issues of detail are engaged; and as for general objectives, they are encouraged to believe that these have long since been determined.

The perverse effects of this suppression of genuine debate are all around us. In the US today, town hall meetings and ‘tea parties’ parody and mimic the 18th century originals. Far from opening debate, they close it down. Demagogues tell the crowd what to think; when their phrases are echoed back to them, they boldly announce that they are merely relaying popular sentiment.

Ultimately, Smith tries to accomplish a number of things in his article, though his success is reliant on his readers' lack of curiosity about the real changes that have heightened discussion about futile care, aid in dying, living wills and advance directives, provider refusals, patient autonomy, organ donation and discrimination in health care. If he can paint them all as an offense to the "sanctity of life" he mis-frames and misleads the discussion from the facts. The agenda of his article is:

- make a case for "virtuous" suffering, as if "virtue" and "suffering" are clearly defined by all members of our racially, culturally, functionally diverse society

- conflate Kevorkian with the aid in dying movement when, while supporters of each may overlap, they are hardly a monolithic advocacy movement

- usurp rights, equality, and autonomy language (long the province of left-leaning advocacy) to his own "pro-life" purpose; this conflation of terms (particularly regarding abortion and feminism) has proved a successful "pro-life" juggernaut for true rights advocates

- stymy meaningful, substantive public discussion by narrowing, limiting, falsely framing the ways in which we discuss human autonomy, suffering, futile care, life, faith, and death; Smith has no interest in examining the facts surrounding superior end of life treatment and planning in states where Death with Dignity is legal; in looking at the ways medicine has until recently failed those who faced painful deaths; no facts on the cases of suicide or mercy killing that occur in the US because of extreme suffering; no discussion of futile care "tracks" that push suffering patients into one unhelpful treatment after another

- he pretends that history is static, that the idea of "traditional values" actually once represented the whole of society; an old tactic by those who wish to continue discrimination against gays, women, elders and those who do not live by dominant culture's rules

I often tackle Smith's vacuous, over-simplified articles; we can hardly ignore him when he has so much influence and plays such an important -- if self-aggrandized -- role in the "pro-life" movement. But I think singling out Smith is instructive for those of us who believe in human rights and liberty. He represents the larger thinking in anti-choice movements; he works for the Discovery Institute, a well funded promoter of bunk science like "Intelligent Design"; and he serves as a case study for how organized, influential, well-funded and well-promoted foes of individual rights are. He and others can cry persecution all they want; but I'm hopeful that the increasing prevalence the aid in dying (and other human rights) movement(s) will help the public discourse. We can't deny death forever.

Denying Death in Montana's Legislature

Here we go: Montana Republican state senator Greg Hinkle has introduced a bill that would make it illegal for a doctor to give a mentally competent, terminally ill patient a lethal prescription. The bill is a reaction to the New Year's Eve decision by the state supreme court that aid in dying is not prevented under the current state constitution. Those of us watching the state since the New Year have been noting the battle brewing there. Compassion and Choices, participants in the Baxter v. Montana case, have been running ads to make more citizens aware of the dying process and the way aid in dying works. They've rightly anticipated moves like this by legislature and "pro-life" groups to temper that ruling. Hinkle's statements in this article are, I think, very telling of the mindset he represents.

Hinkle says a family member was told he only had a short while to live. That was over 30 years ago and he's still alive with great grand kids. He thinks people could take advantage of a sad person for malicious purposes. He says "If you're in a depressed state, which some people can be, then they might say I give up instead of fighting it. Look at how many cases of people with debilitating diseases who are going to fight .

The common argument against aid in dying takes these points as evident, moral and worthy of state enforcement:

1. Doctors misdiagnose and miracles do happen (meaning God can reward us with a reprieve from a terminal illness)

2. Society, termed the "culture of death" by "pro-life" groups, is out to kill. Hinkle and others see themselves as protectors of moral and religious behavior.

3. A patient who "gives up" on life by asking for aid in dying doesn't deserve to have their suffering alleviated. In other words, those who accept that death must come are not victims of a terminal disease but victims of their own lax morals. And yet, those who request aid in dying have most often fought their disease for years - in Baxter's case it was 12 years - with a strong will to live.

4. By legislating that all patients refuse to "give up," Hinkle is arguing for futile care, that each of us deny the likelihood of death and accept the physically, emotionally and financially costly treatments that can't save life but can only prolong death, if not for themselves then for a society that works to deny death.

Love's Demand.

From Thaddeus Pope at Medical Futility Blog: "Hastening Death Can Be Love's Demand."

Here is an abstract of a presentation that I will make at the 2010 Film and History Conference, this November, in Milwaukee.

For several years, I have been writing about the mechanisms for resolving medical futility disputes. One of the primary causes for such disputes is the firm conviction of family members that love demands continued life support for the patient. Love requires not “giving up” on the patient.

More than four decades after the introduction of technology (such as dialysis, ventilators, artificial nutrition & hydration) that can prolong life but not cure or reverse disease, many individuals still hold unrealistically optimistic notions about what medicine can offer chronically critically ill patients. And even those who believe and understand the prognosis often cannot let go.

Hospital clergy, ethics consultants, and social workers spend significant time counseling families, and help them appreciate that consenting to palliative care or hospice is not only consistent with love but even required by love. Three movies beautifully exemplify this re-conceptualization of love: The Event (2003), It’s My Party (1996), and My Life (1993). In each, family members oppose the patient’s decision to forgo therapy or to hasten death. They feel that love demands biological life be prolonged as long as possible. But as the ongoing or inevitable decline becomes increasingly obvious, the family realizes that love demands supporting (and even helping) the patient make a peaceful exit.

Some Questions for Us -- From Jack.

Amber Wolleson, MD, reviews "You Don't Know Jack" for Pallimed and asks the right questions, to which I add some of my own:

He pleads a sympathetic case for his cause. The terms he uses are ones that we would be familiar with: death with dignity, quality of life, end suffering. He speaks about why must someone make the decision to have their feeding tube removed and die slowly when we could just end things quickly, humanely. Who are we as doctors to make someone go through that when we have the ability to spare them?

Why is it so easy to paint Kevorkian as a buffoon, a lunatic, and a murderer?

One statement I found interesting: "terminally ill is not a definable term". I would love to hear what everyone thinks of that.

The importance of the question is undeniable. Death with Dignity laws rely on the definition. Yet we work hard to believe in miracles -- or at least miraculous recoveries -- when we personally face loss. Is this not the area where the unquantifiable variables of medicine and the unknowable aspects of the human body are most profound?

I wondered when I started watching the film how the story would be slanted. It was clearly pro Dr. Kevorkian. I was left wishing for more balanced view of the issues. I felt those against what he had done were vilified and painted as overly religious. (I know very nonreligious people who are against assisted suicide.) I have always seen this as a very complex issue. To just get one side does not do it justice. I was left feeling a bit like the media was trying to manipulate my views rather than just trying to entertain me or even educate me. I would like to see a palliative care perspective. Is death all we have to offer?

What fear and bias against death -- the existence of which often impedes a good death -- causes us to ask that question with such humility? Is death all? When it comes it is everything. For everyone involved.

One line in the movie describes Dr. Kevorkian as "the last doctor you'll ever need". My thought was, does that describe me too?

And if it does, is there a problem with that?

British Doctor First to be Charged Under New Assisted Suicide Guidelines

An excerpt from the article in the Telegraph:

Dr Irwin has written a letter to Keir Starmer QC, the Director of Public Prosecutions (DPP), effectively inviting criminal charges within weeks, for which the former GP could be jailed for up to 14 years.

Dr Irwin, who admits he had accompanied two other previous strangers to the Dignitas clinic to help them take their own lives, wants to make a test case out of his assistance in helping Raymond Cutkelvin to commit suicide three years ago.

Mr Cutkelvin, 58, a post office clerk from north London who was suffering from advanced pancreatic cancer, chose to die in the "suicide clinic" in February 2007.

Mr Cutkelvin is one of some 140 terminally-ill Britons who have died with the help of Dignitas, which was founded in 1998. In Switzerland, "suicide clinics" are legal despite widespread criticism internationally and internally.

Just two months ago, Mr Starmer clarified the Suicide Act of 1961 which makes it an offence to assist a suicide. He published six "public interest factors against prosecution" and 16 "public interest factors in favour of prosecution".

The Legacy of Jack Kevorkian.

Lewis M. Cohen at HuffPo on the legacy of Jack Kevorkian:

While there's little doubt that he has been a galvanizing figure on both sides of the right to die movement, when it comes to his actual role in alleviating suffering, the reality is far murkier. Kevorkian's legacy has long threatened the ongoing and truly compassionate efforts of hospice and palliative medicine, a medical specialty that focuses on symptom and pain management for the terminally ill. Over the past decade, widespread acceptance of palliative care has contributed to a dramatic change in how people die. Even in America's intensive care units -- our country's most medically aggressive settings -- more than three-quarters of an estimated 400,000 deaths are now preceded by treatment limitation decisions. In 2008, 1.45 million Americans died while making use of hospice services, and according to Dr. Steven Miles, a Professor of Medicine at the Center for Bioethics at the University of Minnesota, fully eighty-five percent -- or approximately two million -- of the 2.4 million deaths occurring annually in the United States medical system are preceded by a structured decision to limit life-sustaining treatment. Throughout the nation it is now both legal and ethical for people to refuse to initiate or to discontinue life-support treatments.

Far from being their leader, palliative care practitioners consider Kevorkian to be a dangerous distraction. Yet despite this disavowal, palliative care is sometimes maligned -- primarily by a coalition of sanctity of life and anti-euthanasia organizations -- because of the legacy of Dr. Death. In the early 1990s, Kevorkian came to the public's attention after retiring from his profession as a pathologist -- a doctor who provided no clinical care, but instead performed autopsies on the dead -- to become a physician-assisted suicide activist. However, in a notorious broadcast of the CBS program, 60 Minutes, Kevorkian showed the world that he had shifted from physician-assisted suicide to active, voluntary euthanasia -- injecting a patient suffering from Lou Gehrig's disease with a fatal combination of three medicines -- a crime for which he received an eleven to twenty year sentence for second-degree murder.

The New York Times Review of You Don't Know Jack.

It's pretty good, I have to say.

*The View* on Assisted Suicide/Kevorkian

http://abc.go.com/watch/clip/the-view/SH002253950000/20817/258412

The V Word Is the New N Word.

Wesley J. Smith on an interview on Larry King Live with the creator of Family Guy, Seth McFarlane:

MacFarlane’s elliptical answer indicates to me that he has never considered the question. He wasn’t asked about the show, he was asked about the epithet. Moreover, the scene did not have people appalled: The audience of the supposed play laughed uproariously when, “Terri” having been called a V, responded, “We hate vegetables!” Moreover, if the show had the kids put on an old fashioned minstrel show that used the N-word–which he almost certainly would never do, and if he did, it is unlikely it would ever be aired–would he ever just reply that the denigrating nature of the word is “for the viewer to judge?” Not on a bet.

Some concerted consciousness raising is clearly required. We have to help people understand that using the V-word to describe people with serious cognitive disabilities is as hateful and dehumanizing to them as using the N-word is to people of color, the F-word to gays, or the C-to women. The time has come to retire it from common and acceptable usage, just as we have (or are doing) with the others.

Kevorkian's Death Bus for Sale.

In an instance of perfect timing, as HBO promotes the hell out of their new Kevorkian movie with Al Pacino, "You Don't Know Jack", Ebay witnesses the auction sale of the infamous "death bus" in which Kevorkian assisted a number of patients to kill themselves.