WASHINGTON — U.S. Chief Justice John Roberts presided over the Supreme Court for the first time Oct. 5, and the issue was a hot one: assisted suicide.

Consider how much assisted suicide has been in the news:

— An attorney who helped the family of Terri Schindler-Schiavo claims euthanasia is “happening every day.”

— Authorities in New Orleans are investigating hospitals and nursing homes for reports of “mercy killings” of elderly and infirm patients in the hours before Hurricane Katrina approached

— Over the summer, a soldier who was severely wounded in Iraq died in a hospital in Wisconsin because he had signed a living will stating he would not want to be kept alive “artificially” on a feeding tube.

— Lawyers for the state of Oregon argued Oct. 5 at the U.S. Supreme Court not to strike down a law permitting physicians to hasten a person's death.

— Pope Benedict XVI beatified Blessed Bishop Clemens von Galen of Germany on Oct. 9. The anti-Nazi bishop once said, “Once we have the right to kill unproductive persons … then none of us can be sure of his life.”

Has the “death with dignity” movement created such a slippery slope that some doctors in emergency situations as in New Orleans automatically kill patients they once might have tried to save?

The Register spoke with leading legal minds, bio-ethicists and medical professionals to get a glimpse of the state of euthanasia in the United States.

Wesley Smith, an attorney and consultant for the International Task Force on Euthanasia and Assisted Suicide in Castro Valley, Calif., told the Register that studies don't indicate it's extensive.

“Some advocacy groups say that there is underground euthanasia, but in studies only 7% of doctors said they have actively killed a patient by overdose.” Smith said, “Only a few doctors who have ideological predispositions are willing to assist suicide regularly, even in Oregon; that's notable.”

What seem to be much more common are attempts to starve people to death, according to Dana Cody, attorney for Life Legal Defense Foundation in Napa, Calif.

“I would say we get 25 to 50 calls a year from people with loved ones in danger of having their feeding tube removed or being denied basic medical care,” she said.

Robert Destro, the attorney for the Schindler family and professor of law at The Catholic University of America in Washington, D.C., said in an interview in August with Anita Crane of American Life League that families like the Schindlers “exist all over this country.”

Key Distinction

Catholic Medical Association President Dr. R. Steven White, a pulmonologist in Daytona Beach, Fla., sees much confusion over the issue.

“I believe that the majority of Americans oppose euthanasia. But there is a lack of understanding regarding the difference between actively ending a person's life and allowing for a natural death,” he said. “There is no question that the majority of people express the opinion that they would not wish to be kept alive ‘artificially’ on a feeding tube if they had what they deemed to be a ‘poor quality of life.’”

The Catechism of the Catholic Church teaches: “Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable. Thus an act or omission which, of itself or by intention, causes the death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his creator.”

It goes on to say, “The error of judgment into which one can fall in good faith does not change the nature of this murderous act, which must always be forbidden and excluded. Discontinuing medical procedures that are burdensome, dangerous, extraordinary or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one's inability to impede it is merely accepted” (Nos. 2277-2278).

That principle seems to be reflected in a report issued Sept. 29, warning of an explosion in the size of the elderly and frail population and a looming crisis in caring for them. “Taking Care: Ethical Caregiving in Our Aging Society,” a report of the President's Council on Bioethics, said that medical treatment decisions must not focus exclusively on extending life and delaying death.

“Even as we must never seek or aim at the patient's death, so we are also under a positive obligation not to impose treatments that would unduly burden the patient, make his dying more difficult, or otherwise deprive him of a more peaceful end of life or of final hours in the company of those who love him,” the report said.

The report focuses primarily on the care of people with dementia — currently estimated at 4 million Americans, but expected to triple by mid-century. It says euthanasia and assisted suicide “are antithetical to ethical care giving” for those with dementia or who are otherwise disabled.

In his work fighting the tides of euthanasia, Smith found that Americans do not want to think a lot about the subject.

“Right-to-die advocates complain they can't get people engaged in the issue, and it's hard for me to oppose euthanasia for the same reason; people aren't excited about the issue,” he said.

Still, some progress has been made in the last months, according to Franciscan Brother Daniel Sulmasy, a physician who serves on the medical ethics committee at St. Vincent's Hospital in New York City.

“Since Terri [Schiavo] died, I've seen an increased interest in advanced medical directives; patients are bringing it up to me themselves instead of avoiding the question.”

Unfortunately, the case has also led to some confusion among Catholics, Brother Sulmasy said.

“Our medical ethics committee is getting many requests for clarification from people who think no matter what is wrong with someone, he or she needs a feeding tube. It's hard for people to distinguish between conditions at the end of life, and they think the Church now says everyone has to have a feeding tube,” he said.

A medical directive is one option for those who are concerned about their care when they are incapacitated. But Destro suggests another.

“Terri taught us that you had better appoint a power of attorney you can trust who will get in a doctor's face and force him or her to answer questions,” he said. “A living will is just a piece of paper; it can't have informed consent. A power of attorney can decide what's best under the circumstances.”

In an effort to educate and prepare Catholics for these important decisions, the National Catholic Bioethics Center in Philadelphia has issued “The Catholic Guide to End of Life Decision,” a document that explains the moral issues and provides forms to be filled out to designate a proxy or an advanced directive. National Catholic Bioethics Center President John Haas also encouraged Catholics to turn to the U.S. Bishops’ Secretariat for Pro-Life Activities for resources.

“Catholics should avail themselves of the carefully developed moral tradition of the Catholic Church in the area of health care,” Haas said. “There is no other institution out there with such a sophisticated approach to these difficult questions.”

Annamarie Adkins is based in St. Paul, Minnesota.