Denise J. Hunnell, MD

Do no harm?: Medical journals show increasing support for euthanasia

Denise J. Hunnell, MD
By Denise Hunnell MD
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August 24, 2012 (Zenit.org) – Primum non nocere. First do no harm. This edict has been part of medical ethics since the time of the ancient Greek physician, Hippocrates, in the fifth century B.C. It is found in the Hippocratic Corpus, a collection of medical writing attributed to Hippocrates. The original Hippocratic oath includes:

I will apply dietetic measures for the benefit of the sick according to my ability and judgment; I will keep them from harm and injustice.

For millennia the physician has been charged with being an advocate for the patient. Part of the impetus for the original Hippocratic oath was to ensure that doctors would not be paid by an enemy to give poison instead of medicine. Patients should be able to come to their doctor when they are sick and weakened, and have no fear that their vulnerability will be exploited.

Unfortunately, the sacred trust of the doctor-patient relationship is being strained by a new ethical model. Physicians are being urged to place the “greater good” above the needs of their individual patients. A disregard for the sanctity of human life as well as a utilitarian philosophy that judges the value of a patient to society is becoming more mainstream in the medical profession. This is evidenced by the increasing number of articles in respected medical journals that call for approval of assisted suicide and euthanasia, euphemistically called “assisted dying.”

The British Medical Journal (BMJ), a publication distributed to the members of the British Medical Association, devoted much of its June 14, 2012, issue to endorsing voluntary euthanasia and physician assisted suicide. Raymond Tallis, emeritus professor of geriatric medicine at the University of Manchester, argues in this issue that respect for patient desires and autonomy renders irrelevant any opinion on the matter by the Royal College of Physicians or the British Medical Association. Therefore, all opposition to euthanasia is merely inappropriate paternalism and should be dropped.

In this same issue, Tess McPherson relates the difficult last days of her mother, Ann McPherson, and uses this painful experience as a call for legalized physician assisted suicide and euthanasia. Rather than seeking better pain control, she argues that death is the best option for those suffering at the end of their lives.

Finally, Fiona Goodlee, editor in chief of the BMJ, rounds out the arguments by declaring that legalization of assisted dying is not a medical decision, but rather a societal question. She argues that the role of the physician is compatible with providing euthanasia or assisted suicide and if society wants it, they should get it.

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Amid these scholarly endorsements of euthanasia come the claims of British physician Patrick Pullicino that the National Health Service (NHS) is effectively killing 130,000 patients every year when doctors place these patients on the Liverpool Care Protocol (LCP) and deny them nutrition and hydration. According to the Daily Mail:

Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.

He cited ‘pressure on beds and difficulty with nursing confused or difficult-to-manage elderly patients’ as factors.

Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated.

The medical literature from the United States also shows an increasing acceptance of physician assisted suicide and euthanasia. The July 12, 2012, issue of the New England Journal of Medicine (NEJM) included an article by Dr. Lisa Soleymani Lehmann and Julian Prokopetz that suggested physician opposition to assisted dying was an unreasonable barrier to patients seeking lethal medications. They recommended that all patients who met the legal criteria for assisted suicide as outlined in the state laws of Oregon, Washington, and Montana should be able to obtain the drugs necessary for suicide without a physician’s prescription or approval.

Perhaps the most chilling example is the enthusiastic endorsement in the Journal of the American Medical Association (JAMA) for the book Death, Dying, and Organ Transplantation: Reconstructing Medical Ethics at the End of Life, by Drs. Franklin Miller and Robert Truog. This book seeks to do away with two core principles of medical care. The first is that a physician cannot intentionally cause the death of his patient. The second is that donors of vital organs for transplantation must be dead before the organs are harvested.

Catholic health care ethics, in accordance with natural law, holds that when the burden of life-sustaining extraordinary care such as a ventilator is greater than the benefit it provides, such care can be withdrawn. This is not seen as causing the death of the patient, but rather allowing the patient to die from his underlying illness. Miller and Truog disagree and assert that such an act directly causes the death of the patient. They then begin their descent down the slippery slope by claiming that if causing death by withdrawing life-sustaining care is acceptable, then active voluntary euthanasia by lethal injection should also be acceptable. Further, if voluntary euthanasia by injection is acceptable, then voluntary euthanasia by removal of vital organs to be used for transplantation should be equally acceptable. This radical argument could be disregarded as fringe thinking had it not been so prominently and positively recommended in JAMA.

It is reasonable to say that the notion that physicians should not kill their patients is still widespread among medical professionals. Indeed, several of the aforementioned authors take their colleagues to task for opposing euthanasia and physician assisted suicide. The growing numbers of prestigious medical journals that are routinely publishing support for all forms of “assisted dying” are, however, a clear indication that this approach to end of life “care” is making significant inroads in mainstream medical ethics. The foundational principles of health care that date back to Hippocrates are in jeopardy.

This has serious implications for patients. No longer can a patient assume that his physician has his best medical interests at heart. Now physicians are being urged to consider the cost to society of a patient’s care and judge whether a patient is worthy of such expense. Instead of seeking to provide comfort and authentic compassion at the end of life, there is increased support for hastening death as an expedient solution to suffering.

It is now incumbent upon every patient to explore the ethical principles of his doctor. Does he uphold the sanctity of life from conception to natural death? Does he understand that treatments can be deemed burdensome, but human life is never burdensome? Does he view nutrition and hydration as ordinary care as long as a patient can derive a benefit from it? Does he reject all justifications for intentionally causing the death of his patients?

If your physician does not answer unequivocally “yes” to each of these questions, can you really trust him with your life?

Denise Hunnell, MD, is a Fellow of HLI America, an initiative of Human Life International. She writes for HLI’s Truth and Charity Forum. This article appeared on Zenit.org and is reprinted with permission.


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African denounces Western elites pushing population control in his country

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By Ben Johnson

An op-ed in one of the leading publications in Uganda has denounced the promotion of IUD use and other long-acting reversible contraceptives (LARCs) in the nation as a colonialist form of population control.

An article published in New Vision, which bills itself as “Uganda's leading daily,” and which was posted online after being translated into broken English, contradicts the frequent claim that there is a desperate cry from Africans and brown people generally to provide the “unmet need” for contraception in the Third World.

Programs to convince African women to use the IUD or other forms of contraception “are projects of multibillion international agencies distributing them under the guise of helping the poor countries to control birth rates,” Stephen Wabomba wrote.

The use of the IUD leads to an increase in “the spread of STIs/HIV/AIDS, infections or increased rates of Pelvic Infection Diseases (PID),” and other maladies, he said. The IUD, which is inserted into the uterus and may work for years at a time, offers no protection against sexually transmitted diseases and often does not prevent fertilization.

Western governments and NGOs are very much “aware of the side effect[s] but still force them on us through sensational marketing strategies by claiming that there is unmet need” for contraception “in Uganda,” he wrote.

He instead suggested the use of Natural Family Planning methods as the “best alternative” for married couples, as well as increased “funding of chastity and abstinence education in Uganda.”

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He called on every citizen of Uganda “to stand up and be counted as a lover of life” and become a “protector of the voiceless and defenseless unborn children being aborted every day.”

Wabomba is heeding his own advice by acting as director of the Pregnancy Help Center in Jinja, the second largest city in Uganda. The town of 87,000 is perched on the shores of Lake Victoria.


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UN tells Chile and Peru to legalize abortion

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By Guilherme Ferreira Araújo

On July 7 and 8, the United Nations Human Rights Commission (UNHCR) discussed Chile’s abortion laws and issued a report asking for liberalization of those laws.

According to the report, Chile “should establish exceptions to the general prohibition of abortion, contemplating therapeutic abortion and in those cases in which the pregnancy is a consequence of a rape or incest.”

Chile is one of the few countries that prohibits abortion in all cases.  So far, the country has managed to stand against internal and external pressure to legalize abortion.

But during her campaign, President Michele Bachelet promised to make the legalization of abortion a priority.  Indeed, last May she stated that her intention was to reopen the debate so that the government could approve therapeutic abortion before the end of this year.  The U.N. report also said that Chile “should make sure that reproductive health services are accessible to all women and adolescents."

One of the reasons the UN is using to pressure Chile’s government to change their abortion laws is the high number of clandestine abortions allegedly taking place in Chile. The UNHRC points to “official data” showing 150,000 annual clandestine abortions. However, not only is it impossible to corroborate that figure, but other sources show that this number could be exaggerated by a factor of 10.  According to an article published in the Chilean news publication, Chile B, the annual number of clandestine abortions in Chile may vary between 8,270 and 20,675.

Inflating the number of illegal abortions and maternal mortality is a common tactic of the pro-abortion movement’s effort to legalize the deadly practice. Dr. Bernard Nathanson, founder of the National Abortion Rights Action League (NARAL), famously admitted the tactic after becoming pro-life.

“We claimed that between five and ten thousand women a year died of botched abortions,” he said. "The actual figure was closer to 200 to 300 and we also claimed that there were a million illegal abortions a year in the United States and the actual figure was close to 200,000. So, we were guilty of massive deception."

Chile has also been used as a prime example that legalized abortion does not reduce maternal mortality.

A study published in 2012 by Plos One Institute found that since 1989 when Chile banned abortion, there has been an annual decrease in maternal death. That study, and others compiled and published by the Chilean MELISA Institute strongly challenge the myth that abortion is safe or even necessary to increase maternal health.

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Notwithstanding the empirical data, the United Nations is also hard at work to pressure Chile’s neighbor to the North, Peru, to liberalize its own abortion laws.  In the case of Peru it is the Committee on the Elimination of Discrimination Against Women (CEDAW) that has issued the report, not the UNHRC.  CEDAW representatives examined Peru’s case on July 1 and suggested that Peru should legalize abortion in case of rape and severe abnormalities of the unborn child.

The organism suggested that the government eliminate all laws that punish women who abort and asked that Peru “urgently” adopt a law to fight violence against women, a notion often used as a euphemism for legalizing abortion.  

The CEDAW commission presented the conclusions of the report on July 22 and put special emphasis on the abortion issue. This happens despite the strong opposition to abortion in Peru. A recent survey showed that 79 percent of Peruvians support the Catholic Church’s position on abortion.

The CEDAW pressure on Peru is not new. In 2011, after the UN sanctioned Peru for denying an abortion to a teenager, Carlos Polo, Director of the Population Research Institute’s Latin American office, stated that the UN organism doesn’t have the right to force Peru to approve abortion.


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People ask me all the time, “How do you live with your past?” My answer is silly, but it is a true story. Youtube screenshot
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I helped so many women abort their babies. Now how do I live with that?

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By Abby Johnson
Abby Johnson business card Planned Parenthood

I have many memories of my time with Planned Parenthood. I spent eight years of my life there. Some memories are good, some are not. But they are contained in my mind. It’s easy to forget them. I have forgotten so much about my time there in just four and a half short years. 

I found my old business card the other day. That is a tangible memory for me. It made me think of the day that I heard I had been promoted to direct the clinic. I was so happy…hugging and jumping up and down with my supervisor. She was so proud of me.

I thought about the day I moved everything into my new, big office. I put pro-choice stickers all over my file cabinet. I called my parents to share the news. They were, of course, proud of me, but hated my work. I can’t imagine how conflicted they were in their minds and hearts. Human resources sent me my new paperwork. There was my new title, my new and amazing salary. 

A few days later, my new business cards came. I remember putting them in my new business card holder on my desk. I filled up the business card holder that I kept in my purse. I had already become used to hearing myself say my new title.

I was proud of myself. I was proud of the hard work I had put in to earn that new title. I worked so many hours, sacrificed so much time from my family. But I knew it would be worth it. And now I had the job title to prove it.

I remember proudly passing out my new business cards to anyone that would take one. Being pro-choice was not just a movement to me; it was a lifestyle. I wholeheartedly embraced that lifestyle and loved being a part of it. 

These tangible reminders that I occasionally find are sometimes hard to work through. I remember receiving the records from my medication abortion. That tangible reminder of my past was difficult to manage. I look at my “Employee of the Year” award that I received from Planned Parenthood and think back to the night I received it. I ended up putting that old award on my desk as a reminder of where I came from and how much my life has changed. Seeing that plaque no longer brings back those tangible memories. 

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One of the reasons I was so taken aback when finding my old business card was not just because it was a reminder of how proud I had been to run an abortion clinic…something I find deplorable now. It was because of the things I took part in while I had that big title.

The memories of handing women small monetary checks in order to pay for their silence after we had left them with a serious infection after their abortion. The memories of watching women bleed out on our abortion table and being instructed not to call the ambulance because we didn’t want to let the pro-lifers know that we had a medical emergency. The memories I have of “joking” about the babies that died in our facility by abortion. The memories I have of training our abortion facility employees on the “normalcy” of abortion and how to convince women that abortion is the best choice for them.

Part of being a former abortion clinic worker is learning how to deal with your past sin. It may be the lady who came to your clinic for an abortion that you bump into at the store. It could be standing in front of your former abortion facility and remembering all of the damage your words and actions did to so many women. It could be finding that old business card that reminds you of the pride you felt when you became the director of an abortion facility. 

People ask me all the time, “How do you live with your past?” My answer is silly, but it is a true story. 

One day I was watching the kid’s movie “Kung Fu Panda” with my daughter. In the film there is a wise, old tortoise named Oogway. He is talking to one of his students who is frustrated with his current situation. Oogway asks his student, “Do you know why today is called the present? Because it is a gift.”

That little line by an animated tortoise hit me like a ton of bricks. Today is a gift. There is absolutely nothing we can do with our past. And there is very little we can do to control our future. We live NOW. We serve NOW. We choose to move on from our past NOW. 

I don’t know what your past sins are. And I don’t know how frequently you are reminded of them. But as someone who has to face their past sins on pretty much a daily basis, I can tell you that you can be free from their burden. Being reminded of your past doesn’t mean that you have to live with constant grief. It simply means that you have been given the opportunity to transform your past into something positive…maybe you can help others make different choices than you did, maybe you can help others heal from the same struggles that you lived through. I don’t know what you are being called to do, but as the saying goes, “God can turn our mess into a message.” 

Carrying around past burdens doesn’t help us in any way. Know that you can be forgiven. Accept that forgiveness. Use your life to help others. The present is indeed a gift.

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