Tuesday, March 24, 2015

Doctor-Assisted Suicide: Some Useful Clarifications (6 March 2013)

            On her National Public Radio show on 5 March 2013, Diane Rehm got into an exchange that helps clarify the issues with doctor-assisted suicide.

            Early in the show, Ms. Rehm talked with Krayton Kerns, who, uses his doctorate with his name and stresses it on his website, and thereby made himself fair game for a line of questioning that started with his being a practicing veterinarian, and a vet definitely willing to euthanize animals: "Oh yeah, without a doubt. We do it all the time."

            Krayton Kerns, DVM, is relevant to discussing doctor-assisted suicide with humans because he is also the Honorable Krayton Kerns, Representative in the Montana Legislature for House District 58, and Rep. Kerns recently pushed through the Montana House of Representatives a bill that could — if approved by the Montana Senate and signed by the Governor — impose on any Montana physician assisting in a suicide (1) a fine of up to fifty thousand dollars and/or (2) ten years in jail.

            In response to Dr. Kerns's robust reply on his professional willingness to put down animals, Rehm asked, "And how do you see the treatment, the care and treatment of those animals as being different from the treatment of humans who wish to die?" Kerns responded that the situation with animals is "entirely different." He explained, "Number one, they can't give their consent […]." Since the non-human animals' lack of choice here seemed to work against Kerns's position, Rehm pushed the point, and Kerns replied that "The animal has no choice. That would be correct. And the human being does have the choice. Yeah, I think that would be a correct assessment."

            Rehm pushed on: humans have choice and what "if the human being says, I choose to die" and adds, "I really am asking you, my doctor, to assist me in dying" — how would Kerns "regard that as different"?

            Kerns's immediate answer was rambling but instructive: "Well, you're also asking the doctor to go against their oath above all, do no harm, and […] they're no longer an agent of healing. You know, it's a different circumstance then. And this also gets discombobulated as this nation degrades into a single-party payer health care system where everything is controlled by the government. And then we have a very frightening situation where the government controls the diagnostic end of your disorder, the treatment end of your disorder. And due to the power of the inheritance tax, it is to their advantage for you to select suicide as early as possible before you exhaust your resources."

            To help clarity — clarification is my goal here — Kerns raises the important points of (1) the possibility of harming someone by failing to act, (2) money, and, crucially, (3) of control: who gets to decide what.

            Like a good teacher or most excellent interviewer, Rehm prompts Kerns with "But suppose I am really suffering from something as debilitating as, say, Parkinson's disease or ALS or an invasive cancer that is bringing me so much pain and suffering that I no longer wish to live and wish to die in as humane a fashion as I would treat my dog." And then we get to the heart of the matter.

            "Well, of course, Kerns responds, "I view it as you're interfering with a decision that is not yours to make, it's God's. He'll take your life when it is time. And until that time, it's your obligation to press on and make the best that you can with what you have available."

            Rehm moves from a prompt to a bit of a goad, though pronounced without sarcasm: "So as a veterinarian, you bring in the religious element." Kerns says, "Well, I don't because I don't think it plays in in the veterinarian end because we're dealing with the animal and not a human life."

            On his website (www.KraytonKerns.org), Kerns handles the abortion issue succinctly: "*Abortion:  I am a Christian.  I am Pro-Life." And we can use this assertion to make clear that Kerns has a coherent position, an important position, and a position pretty radically opposed to those held by people likely to read anything by a commie-liberal-pinko-pretty-secular-humanist-registered-Democrat like me.

            I've got $50 to bet that by "Christian" Kerns means something like the student of mine meant when he said, "I used to be Catholic, but now I'm Christian" — but I'll just put it that what Kerns says makes sense in terms of a "Bible Christian" for whom Adam — Man — became a living being when he received the breath of life from God (Genesis 2.7), someone who believes that when we say "choose life" it means choose a life following God. Or, as God puts it, "[…] I have set before you life and death, blessing and curse; therefore choose life, that you and your descendants may live, loving the Lord your God, obeying his voice, and cleaving to him; for that means life to you and length of days […]" (Deuteronomy 30.19-20).

            Human beings live and have choice and free will because we have within us a special life-breath, one different from non-human animals: a direct-from-God kind of ruach, anima, spiritus: words that (roughly speaking) evolved from "wind, breath" to more or less "spirit," and then to soul.

         Kerns can kill dogs and cats and all without qualm if not literally "all the time" but objects to even suicide by humans because with a dog "we're dealing with the animal and not a human life," not a real life, not the life of a creature ensouled.

            One of the reasons he can so readily kill non-human animals is precisely because they have no choice in the matter and are innocent in their deaths and in all else. Humans should be prohibited from killing ourselves precisely because we have free will as a gift from God and have souls from God and damn well better be willing to put up with any shit God sends us. Or else.

            And that's "or else" you will be damned to eternal Hell, you and, in this case, the physician you rode in on: indeed all those risk damnation who aided you in succumbing to the unforgiveable sin of despair.
            God has set before us life and death, but we don't — in the traditional Christian view — we don't get to choose death in the sense of suicide because that is "a decision that is not yours to make, it's God's. He'll take your life when it is time. And until that time, it's your obligation to press on […]," even if doing so subjects you to misery we would not inflict on a gerbil.

            Indeed, you're to "press on" even if it bankrupts your family, and definitely without getting advice that you'd do better to shuffle off this mortal coil before you and the other codgers bankrupt a single-payer health system.

            I'm serious about the family bit, and about money. However much Christianity — definitely here including Catholics and Orthodox and all the traditional Church — however much the churches have long been big on the family, you do have the musical injunction from Martin Luther, "Let goods and kindred go"; and Jesus was emphatic that "[…] he who loves son or daughter more than me is not worthy of me" and enjoined his followers, "Do not lay up for yourselves treasures on earth" (Matthew 10.37, 7.19). Nor for the kids.

            God gave you the breath of life and freedom and the promise of eternal life. Immortal God put on flesh and became human — Yuck! — and was tortured to death willingly for your sins, so you, you ingrate, can bloody well die miserably and bankrupt your kids and help bring down the economy rather than disobey a jot or a tittle of God's word which, traditionally (uh, actually, without a whole lot of scriptural warrant) says man up, press on, and die a lingering death if that's what God wants for you and from you.

            That may not be what mere mortal reason and compassion says — see Saint Thomas More's rational but non-Christian Utopians on the matter — but that's why we have Revelation to supplement, and sometimes over-rule, mere mortal reason (and occasionally compassion).

            Personally, when "It's time," as the vets say, I want to be put down like a dog. Or, since my dog was killed by a train and that would be hard to arrange — more exactly, I'd like to be put down like my cat Lilith, who died in my arms Christmas Eve a while back, from lethal injection.

            Still, there are reasons to carefully hedge assisted suicide. We do want to ensure that the family doesn't send grandpa off to the needle the first time he breaks a hip or that a fascist State doesn't start a program in racial hygiene by slaughtering the infirm. More immediately relevant here, secular sorts must understand that Representative Krayton Kerns has a coherent code behind him and one agreed to more quietly by a lot of people.

            The question is control. Mr. Kerns doesn't want the US Federal Government to be the single-payer for health care; a lot of us don't want Mr. Kerns and Church or State in any of their forms getting too coercively involved with what we do with our bodies.

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