What’s in a Name: Learning Advocacy from the Opposition

During the most recent conference of the California Hospice and Palliative Care Association (CHAPCA), much of the discussion centered on the recent success of a group now called “Compassion and Choices.” They were repeatedly referred to as “the most effective advocacy organization ever seen.”

They are advocates. They are effective. And they don’t mind making it clear that they are opposed to the current options available: either curative (seeking to restore the patient to health) or palliative (seeking to relieve the dying patient’s symptoms).

How effective are they? So much so that in a presentation on how to construct policy relative to California’s new law facilitating physician-assisted suicide, the spectrum of attitudes was described at one end as “embracing” the practice of self-administered euthanasia, while the other end of the spectrum was labeled “denial.” Now, most of us can imagine that “embracing” is a good thing. And even outside the ranks of those who work most closely with the dying and bereaved, you may be aware that “denial” is considered inevitable, but only as a temporary measure to buffer the sudden realities of crisis, trauma, or loss.

"The Death of Socrates"
by Jacques-Louis David

How opposed is Compassion and Choices to the status quo? Their six objectives (found here) include pursuing legislative innovations, exerting influence over medical professions, and establishing a litmus test for elected officials in making “aid in dying…a prime motivator in voter decision-making.”

But the most telling of their objectives is to “Normalize accurate, unbiased language throughout the end-of-life discussion (‘aid in dying’ instead of ‘assisted suicide’).” Taking them at their word, the intent here is insidious. While California has become the sixth state to legalize physician-assisted suicide (with legislation pending in at least fifteen others among these United States), the eventual goal is to allow active euthanasia—the proactive intervention by doctors and other in ending the lives of others, which under European health-care practitioners often occurs without the patient’s consent (noted here).

The word “semantics” signifies the art of choosing proper terminology to convey specific meaning. The term also gets used to describe those same talents when being used to obscure and mislead as well. With Compassion and Choices, however, the only word-games of which they could be accused involve being so clear as to be incredible. That is, thinking “I must be reading this wrong” would be a reasonable response to their desire for “accurate, unbiased language.”

A close-up view of Socrates.

You see, part of the argument against physician-assisted suicide is that of “the slippery-slope.” Some worry that if we allow patients to use physician-prescribed medications to end their own lives, it is only a matter of time before we move from describing “who could die, if their life is no longer of sufficient value to them” to prescribing “who should die, if their life is no longer of value to us.” The safeguard written into each state’s laws, so far, is that the patient must self-administer their own death. This is the essence of “assisted suicide,” that the means may be made available, but the final act to end a life should be taken only by the one whose life would be ended.

But the semantics are clear, and Compassion and Choices wants us to stop pretending that they mean anything other than what they say. They seek that we “normalize accurate, unbiased language” to communicate that their goal is something beyond what the current laws allow. Patients should receive “‘aid in dying’ instead of ‘assisted suicide.’”

Not Socrates. But you should still
take a close-up view.

Perhaps, though, the more accurate, unbiased name by which “Compassion and Choices” was previously known might help us understand their origins and intentions. When Derek Humphry, author of the infamous Final Exit (1984) which explored the field made more popular through the exploits of Dr. Jack Kevorkian, founded the organization, it was called “The Hemlock Society.” (The debate and decision to abandon the historic name is described here.)

Referencing as it does the story of Socrates, it might be good to remind ourselves of the Greek philosopher who was condemned to death and forced to drink hemlock, the deadly poison. Thus, as we face the continued efforts of “the most effective advocacy organization ever seen,” the chilling question we must face is this: “who will be making whom drink what?”

Where does this leave the student of effective advocacy? The mixed messages of what was until relatively recently The Hemlock Society, and has since become Compassion and Choices, make it difficult to adopt their strategies, even before issues of integrity, authenticity, and transparency eliminate them from consideration. An organization that promotes as a goal “to mean what they say” would, ironically, need to “say what they mean” just little more clearly, and certainly far more fully.

Otherwise, the only ones likely to drink their poison are those who fail to listen to them as carefully as we should.