End-of-Life Choice, Palliative Care and Counseling

An Idea Whose Time Has Comeby Barbara

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Sometimes a movement’s opposition is its best friend.  And an opposition commentator is the first to tell the world transformative social change is underway.

A recent National Review cover story warns of a dangerously potent cultural shift. It seems Americans are moving out of frank denial and blind fear of death into a position of empowerment and choice in our end-of-life experiences.  This is a bad thing, from National Review’s perspective.

The article bemoans a “creeping culture” of suicide and euthanasia. Of course those are their inflammatory words to describe the emerging culture. Our words would be that a culture of dignity, human liberty and personal choice is finally gaining ground.

On the way to arguing against us, the National Review makes some keenly perceptive observations. First, the author acknowledges our movement has “come a long way” in twenty years, and credits Compassion & Choices as the “premier advocacy group” to make that happen. He deplores that today members of “the social and political elite” readily voice their support. And he opines that when they do this “as openly as they would with charities like the United Way, we have reached a new cultural moment.”

Hooray for that! I, too, sense that human mortality is no longer the political third rail it used to be.  For all the “death panel” hysteria this August and September, those charges never did really get any traction. And the fear monger politicians peddling “kill granny” hyperbole have joined those who embarrassed themselves a few years ago by elbowing their way into the Schiavo family tragedy. They just look silly, opportunistic and mean.

The author also acknowledges our movement’s recent successes and calls 2008 a “banner year.” Finally, he writes that as individuals, we are “passionately committed, work hard, and feel time is on [our] side.” All true, and we are truly grateful for the praise!

As one might expect, the writer opposes personal choice in most important life decisions. A believer in intelligent design, he opposes contraception, stem cell research and choice in dying.  The vigor of his opposition highlights the power of end-of-life choice to move society to a new level of respect for personal autonomy and human dignity. His intense focus tags our movement, with Compassion & Choices in the lead, as an especially potent force for liberty.

Social progress takes concerted, sustained effort. For fifty years individuals and foundations concentrated on the key issues of civil rights, equality for women and reproductive choice, to promote human dignity and liberty. Equal opportunity for women and minorities, together with reproductive freedom, were the dominant fields of battle for twentieth century struggles around human dignity, individual autonomy and self determination. Now, at the dawn of the twenty-first century, new battle lines are drawn between patients who struggle for control over unnecessary suffering at the end of life and authoritarians who would keep control elsewhere.

The opposing forces remain essentially unchanged from last century to this. Individuals asserting their own values and beliefs seek control over important decisions in their lives, especially healthcare decisions. Dogmatic churches, autocratic institutions and authoritarian politicians fight to limit individual authority over self.

Who decides if a couple can purchase birth control devices? The most powerful church in the world wants to decide, and, until 1965, enlisted states to enforce bans on contraceptives.

Who decides whether people may opt for treatments developed through stem cell research? Right-to-life organizations decide and enlist Congress to keep federal money away from scientific breakthroughs.

Who decides whether dying patients may ask their doctors to help them experience a humane and peaceful death? The American Medical Association decides, and uses its formidable political power to pressure lawmakers into ignoring the will of the people.

End of life choice is the human liberty movement of the twenty-first century.  This is the arena where dignity and liberty stride forward today. People who care about core principles of justice and human dignity feel drawn to this movement. The struggle for end-of-life choices is a movement whose time has come.

No army can withstand the strength of an idea whose time has come..”

- Victor Hugo.