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.