COLDWATER, Mich. — A number of end-of-life issue stories coalesced in early June, beginning with the release from prison of “Dr. Death.”

Though he promised not to assist in any more suicides, which is what got him sent to prison, Dr. Jack Kevorkian said he would continue advocating legal assisted suicide.

Advocates of the practice might not want the help. Many don’t appreciate Kevorkian’s “ghoulish” approach to killing patients. One California lobbyist for assisted suicide believes Kevorkian is the equivalent of a “back alley abortionist.”

Supporters of assisted suicide emphasize their belief in a “right to die” and their concern for having “compassionate choices” for the suffering and those near death.

Looking closely at the situation in Oregon — the only state with legalized assisted suicide — gives one a different perspective on possible motivations.

Dr. William Toffler said that “Kevorkian is really the personification of the kind of thinking [that is] trying to institutionalize situational killing by presenting it not only as being reasonable, but as a loving act.”

National director of the Oregon-based Physicians for Compassionate Care Educational Foundation, Toffler suggested: “We are turning compassion — which means to ‘suffer with’ — upside down. It has become ‘dispassionate care,’ where killing occurs for utilitarian motives.”

The information on the website for Physicians for Compassionate Care illustrates Oregon’s slide into assisted suicide.

The law states that patients must be competent, capable of self-dosing the pills, not depressed, have made the choice without coercion, and have life expectancies of less than six months. According to media accounts, however, the patients who have died by lethal dosage are depressed, have dementia, have been coerced, have swallowing problems, and have lived over a year after being determined eligible.

Between 2003 and 2006, less than 5% of those who have died received any psychological counseling. In 2002, the organization Last Acts reported that good pain management and palliative and hospice care are disappearing in Oregon.

A total of 85,000 poor and seriously ill patients were dropped from the rolls of the Oregon Health Plan between 2003 and 2004. Toffler remarked that Oregon Health Plan “limits in-home hospice care, but offers 100% coverage for assisted suicide, listing it as ‘pain management.’”

The government depends on reports by attending physicians, but they are rarely present for these deaths as the lethal drugs are self-administered. Actual death rates are unknown.

Other States

Physicians for Compassionate Care noted that Oregon’s annual reports on deaths are missing “critical data;” reports from previous years were destroyed by the Department of Human Services.

These facts, however, have not dampened an ongoing campaign for similar legislation around the country.

Since 1991 when Washington failed to pass a “death with dignity” bill, other state legislatures have repeatedly introduced assisted-suicide legislation without success. This year, Arizona, Hawaii and Vermont made unsuccessful attempts, with Wisconsin presenting a bill in April.

In 1992, California voted down a law similar to Washington’s. Recently, it tried again, for the third time, but California’s Compassionate Choices Act was shelved June 7 because it lacked enough votes for passage.

But the bill might be resurrected in January, according to Will Shuck, chief of staff for Assemblywoman Patty Berg.

Carol Hogan, communications director of the California Conference of Catholic Bishops, was distressed that the bill was perceived by opponents as merely “bad public policy.”

“It sounds cold-blooded,” she remarked, but some people support the idea that “it is cheaper to have patients kill themselves than to pay to keep them comfortable.”

A large coalition fought the legislation in California, including all 35,000 members of the California Medical Association. The association proclaimed that assisted suicide was “unethical, unacceptable, and is fundamentally incompatible with the physician’s role as healer. … The association believes in humane and compassionate care for the terminally ill … appropriate pain control and counseling for the dying and their families.”

On to Washington

A ballot issue in November 2008 for an Oregon-style assisted-suicide bill in Washington state is the goal of former Gov. Booth Gardner, who suffers from Parkinson’s disease. “When I go, I want to decide,” he announced as his reason for starting an initiative drive.

Dominican Sister Sharon Park, executive director of the Washington State Catholic Conference, said that “nothing is certain” on the future of Gardner’s initiative, but the effort is being carefully watched.

Dan Kennedy, CEO of Human Life of Washington, said that Compassion and Choices, the renamed Hemlock Society, is pushing assisted-suicide initiatives. And he believes that coalition building, especially with disability groups, creates a powerful voice in opposition.

The main antidote, according to Church teaching, is support, not abandonment of the dying. That was addressed most recently in a pastoral letter Maryland’s Catholic bishops issued June 6. “Comfort and Consolation: Care of the Sick and Dying” aims at helping Catholics apply their faith to end-of-life decisions.

Caregivers must never be indifferent to human suffering, the bishops said. If a dying person needs increasingly greater dosages of pain medication, the bishops said it is morally acceptable for the patient or caregiver to provide the medication “even if the patient is made less alert or responsive, or if this increase should hasten death.”

“Pain medication, however, must never be given for the purpose of hastening death,” they said.

In his 1995 encyclical Evangelium Vitae (The Value and Inviolability of Human Life), Pope John Paul II emphasizes good palliative care that seeks “to make suffering more bearable in the final stages of illness and to ensure that the patient is supported and accompanied in his or her ordeal.”

This is mirrored in the work of Eileen Brown Geller, a hospice nurse and the past director of Washington’s 1991 “119-Vote No” campaign. She said that all these initiatives will stop “when we finally realize why people feel a need to have it available.”

Geller referred to her solution as “networks of lived compassion in action.”

Elenor Schoen is based in

Shoreline, Washington.