The Shifting Debate About Euthanasia and Eugenics: Some Other Words for Murder

While I was researching the death of King George V of Great Britain (for When a Royal Physician Killed a King), I discovered another surprising twist to that shocking story. If you read that post, you might recall that Lord Bertrand Dawson, King George V's physician, on January 29, 1936, made two injections of fatal amounts of, first, morphine, and then cocaine into the king's jugular vein, so he could time the king's death for announcement in the Times of London. King George's nurse, Catherine Black, who had administered a non-fatal dose earlier in the evening, was cursed by the King while she did it, before he lost consciousness for good, and she refused to give the fatal injections herself; she never spoke publicly of the events of that night up to the day she died.

Dawson's act only became public knowledge fifty years later when his matter-of-fact diary entry on the night of King George VI's death was widely published in 1986. Here is what the New York Times had to say about it in a report, titled "1936 SECRET IS OUT: DOCTOR SPED GEORGE V'S DEATH":

Lord Dawson wrote in his notes that  he had been told by Queen Mary and the Prince of Wales ... that they did not want the King's life needlessly prolonged if his illness was clearly fatal. There is no indication that the King himself had been consulted.

"It is not clear from the notes how explicit Lord Dawson was in the exchange he reported with the Queen and Prince about the method of ending the King's life, or whether this conversation had been initiated by the family or the physician. But there is circumstantial evidence, in a speech Lord Dawson delivered in the House of Lords in a debate on euthanasia 10 months later, to suggest that the discussion could have been prompted by the doctor."

This post is about that debate in the House of Lords and some thoughts it engenders about the tendency of  atrocities to come about when idolized ideals are pushed their logical but heartless conclusions.

Perspective from the Catholic Faith

Accurate terminology is important to every discussion. And accurate terminology is getting harder and harder to come by. As we all know from the description of what author George Orwell called Newspeak in his novel 1984, fine-sounding slogans are created to mask objectionable realities by those who want to control people's thinking.

To orient this discussion to the Catholic perspective, euthanasia and suicide are sins against the Fifth Commandment, Thou Shalt Not Kill. This is what the Catechism of the Catholic Church says about euthanasia: no one has the right to destroy an innocent human being. Whatever the motives, euthanasia is murder:

2258 Human life is sacred because from its beginning it involves the creative action of God and it remains for ever in a special relationship with the Creator, who is its sole end. God alone is the Lord of life from its beginning until its end: no one can under any circumstance claim for himself the right directly to destroy an innocent human being."

2277 Whatever its motives and means, direct euthanasia consists in putting an end to the lives of handicapped, sick, or dying persons. It is morally unacceptable.

Thus an act or omission which, of itself or by intention, causes death in order to eliminate suffering constitutes a murder gravely contrary to the dignity of the human person and to the respect due to the living God, his Creator."--Catechism of the Catholic Church

If a person voluntarily gets someone to help him or her die (which is sometimes called physician-assisted suicide) or requests someone else to actually perform the killing (which is commonly called mercy killing or euthanasia), that person actually commits suicide. Here is what the Catechism says about suicide.

2280 Everyone is responsible for his life before God who has given it to him. It is God who remains the sovereign Master of life. We are obliged to accept life gratefully and preserve it for his honor and the salvation of our souls. We are stewards, not owners, of the life God has entrusted to us. It is not ours to dispose of." --Catechism of the Catholic Church

The Catholic Church has always taught that suicide is against God's will. As Hamlet acknowledged in his To Be or Not to Be soliloquy, every believing Christian until quite recently knew that the Almighty had fixed his canon against self-slaughter.

Lord Dawson Against Euthanasia

With Dawson's act of regicide fresh in my mind, it was more than a bit surprising to find that ten months after he killed the king, Dawson delivered a speech in the House of Lords in which he spoke against a bill that would have legalized euthanasia! But then, after closely reading the speech, I realized that Lord Dawson was not actually against euthanasia. He had a more subtle reason for opposing the bill.

Lord Dawson, the Royal Physician

Lord Dawson described euthanasia as a ''mission of mercy,” but he wanted it to remain a matter left to the conscience of physicians. He stated that everyone knew physicians were doing it all the time without any censure. He didn't want it legalized. He wanted the decision to be left in the hands of doctors instead of God.

Dawson was quoted as saying, ''One should make the act of dying more gentle and more peaceful even if it does involve curtailment of the length of life. That has become increasingly the custom. This may be taken as something accepted."

Calling for a ''gentle growth of euthanasia,'' rather than a removal of all restraints by legislation, Lord Dawson went on to say, ''If we cannot cure for heaven's sake let us do our best to lighten the pain.''
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Dawson's mention of the laudable goal of making the act of dying more gentle and more peaceful, even if it shortened the person's life, used wording that is similar to that used the Catechism of the Catholic Church about palliative care:

2279 Even if death is thought imminent, the ordinary care owed to a sick person cannot be legitimately interrupted. The use of painkillers to alleviate the sufferings of the dying, even at the risk of shortening their days, can be morally in conformity with human dignity if death is not willed as either an end or a means, but only foreseen and tolerated as inevitable. Palliative care is a special form of disinterested charity. As such it should be encouraged."--Catechism of the Catholic Church

When he killed King George V, Dawson went far beyond the laudable goal of relieving pain, he murdered the person who was feeling pain, and he did it for the convenience of himself and others. The king was already unconscious from the smaller non-fatal dose Dawson had ordered administered in the evening, so when Dawson personally administered the fatal doses, he was clearly not trying to simply trying to mitigate his patient's pain.

It must be noted that there is a great deal of anecdotal evidence that involuntary euthanasia is often performed these day in the name of mercy. For one anecdotal example about euthanasia of dying patients, see my post "Hospice Care: Back Door to Euthanasia? and read the corroborating comments.

Archbishop of Canterbury Did Not Disagree

Cosmo Lang, Lord Archbishop of Canterbury

Cosmo Lang, the Anglican Lord Archbishop of Canterbury, followed Lord Dawson as a speaker in the euthanasia debate of 1936 in the House of Lords[1]. The archbishop praised the speech the royal physician had just given, and even though he was a clergyman in the Anglican Church, he did not disagree with Dawson’s clearly stated position that non-voluntary euthanasia was an acceptable medical procedure, and he did not deny Dawson's dubious contention that physicians had the right to kill patients as they deemed fit.

Lang might possibly have thought that Dawson was defending only the practices of refraining from onerous treatments and of mitigating pain with the inadvertent side effect of causing death, because Lang did not go as far as Dawson. Lang said: "If in some extreme instances a doctor decides, for example, that he will refrain from using means that will prolong life, or even that he will make use of means which he knows might possibly shorten it; if, in other words—they are the words of my noble friend—measures taken for the assuagement of pain may be known not improbably to lead to a shortening of life; is it not a perversion of language to say that such a doctor could regard himself as guilty of murder or manslaughter, or could ever be charged with it?"

Here is what the catechism says positively about the desirability of allowing the discontinuation of treatment:

2278 Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of "over-zealous" treatment. Here one does not will to cause death; one's inability to impede it is merely accepted. The decisions should be made by the patient if he is competent and able or, if not, by those legally entitled to act for the patient, whose reasonable will and legitimate interests must always be respected."--Catechism of the Catholic Church

Lang had his own objections to the bill, that there were other dangers in legalizing the practice of voluntary euthanasia which he admitted was suicide.

It is one thing to admit exceptions to the principle that a man may not lay down his life, and it is another thing to give public statutory authority to the counter principle and to say that in certain cases a man, in his own interests and for his own sake, may bring his life to an end. Can we dismiss from our minds the possibility that advantage might be taken of any such public recognition of the counter principle in cases, different indeed from those contemplated by this Bill but which would not be regarded as morally different?

I suggest that we cannot dismiss from our minds the possible unforeseen effects upon the public conscience of, for the first time, giving definite legal encouragement to the principle that there are circumstances in which a man for his own sake may bring his life to an end."

Anglican Archbishop Lang seems to have been a modern-thinking churchman who believed there was an exception to every moral law. He denied there was a religious component to his objection, since bringing the laws of God into the discussion would not be considered a valid argument among the British Lords. I understand Lang as having meant that "we" who have special knowledge about these things do admit exceptions to the prohibition of suicide, but that we should not make suicide legal, because by doing so we would publicly state that people can take their own lives. Period. If we do so, "advantage might be taken."

Lang was aware of the human tendency to ignore subtleties. If suicide is made legal for hard cases, he was saying, the average person will soon come to believe that suicide is permissible in all cases.

Whatever You Legalize You Normalize

This goes along with one of my personal observations, that whatever you legalize, you normalize. Changes to the laws about morality are always supported with slogans that call upon our compassion with arguments based on the hard cases, but then once the law changes, the exception becomes the norm. During my lifetime, cohabitation, contraception, divorce, and abortion were all legalized. Before legalization, the only people who did these acts were those who were willing to be lawbreakers and risk social censure. After legalization, all of these formerly exceptional things became normal, frequent, and almost universally approved for just about any reason. Just for one example, the legalization of abortion has led to the routine murder of around a million babies in their mothers' wombs in the United States alone every year. And few of those abortions are for "hard cases."

Back to Archbishop Lang's speech before the House of Lords. Lang went on to express quite valid specific concerns about the capacity of anyone in pain to make a sound judgment about whether or not to choose euthanasia and about how relatives might put pressure on a weakened person to choose euthanasia for their own nefarious reasons. And he ended with another prophetic phrase, “if the door is once unlocked it will soon be opened wide.” Indeed.

Lang gave his arguments only six years after the 1930 Lambeth conference[2] released a resolution that reversed the Christian teaching of the immorality of birth control.

The 1930 Lambeth resolution essentially read: 'Where there is a clearly felt moral obligation [by married men and women Ed.] to limit or avoid parenthood, complete abstinence is the primary and obvious method," and it expressed "strong condemnation of the use of methods of conception-control from motives of selfishness, luxury, or mere convenience." But it admitted the legitimacy of these methods if there was morally sound reasoning for avoiding abstinence. "The Conference agrees that other methods may be used, provided that this is done in the light of Christian principles.'"

The use of hard cases opened the door. Of course, the average person did not pay attention to the restrictions, and most people just saw that contraception was now allowed. As Lang himself could have predicted, over the ensuing decades the door swung wide open. By the end of the 1950s, "contraception was a way of life" for most Anglicans.  And today the "Contraception" page on the Church of England website reads, "Contraception is not regarded as a sin or going against God's purpose.  Anglican thinking changed during the 20th Century from concern about increased use of contraception to official acceptance of it."

By the time of the 1958 Lambeth Conference, contraception was a way of life among most Anglicans, and a resolution was passed to the effect that the responsibility for deciding upon the number and frequency of children was laid by God upon the consciences of parents 'in such ways as are acceptable to husband and wife'.

In 1968, the Lambeth Conference considered the Papal Encyclical Humanae Vitae and while recording their appreciation of the Pope's deep concern for the institution of marriage and family life, the Bishops disagreed with his idea that methods of contraception other than abstinence and the rhythm method are contrary to the will of God."

All the other denominations followed, and only the Catholic Church maintained this consistent Christian teaching that use of artificial methods of limiting births is a grave sin.

For another example, it has gotten to the point, forty-three years after abortion was legalized in 1973 for hard and difficult cases, that abortion is now being celebrated as a positive good (instead being described by those who believed it was acceptable as a sad decision best left to the mother), celebrities are bragging about having had abortions, tee shirts advertising the wearer's abortion are being worn, comedienne, such as Margaret Cho and others, are telling stories of their abortions to get laughs as part of their stand-up comedy routines, and a #ShoutYourAbortion hashtag is making its way around Twitter.

I predict that in a similar way, as euthanasia is made legal in more and more places and when euthanasia is normalized, as it then will be, people will put down their sick relatives as easily as they now put down their ailing pets, even though the young hip ones may not go so far as to create a Twitter hashtag #IPutDownMyMom or #IPutDownMyToddler.

Agatha Christie and Euthanasia

I found another good example of cultural acceptance of euthanasia in that era among the English upper classes, when I was doing research for It’s Curtains for Poirot! I Wept, But Not for the Reasons You Might Think. Voluntary and involuntary euthanasia and suicide were discussed throughout Agatha Christie's book Curtain: Poirot’s Last Case. This book, which was to written to end the Poirot mystery series, was written by Agatha Christie in the 1940s during WWII when thought she might die in the London bombings, and she put it away in a bank vault. It was finally published in 1975, the year before Christie died.

In the book, Judith, Captain Hastings' twenty-one year old daughter, who was loved by both her father and by "Uncle" Poirot, was one of a group gathered together at Styles. The grand private home called Styles had been the site of Poirot and Hastings’ first collaboration, and in the ensuing years had been turned into a guest house. Judith was in love with a doctor who she worked with, who was married to a wife who was "somewhat of an invalid," and the doctor and his wife were also paying guests at Styles.

Judith quite vehemently expressed her extreme Darwinist eugenics views on getting rid of undesirables several times without authorial comment or much displeasure from the other characters, beyond a mild, "Oh, I say," from her father, or a brief attempt to reason with her by Poirot. Judith was adamantly sure that when anyone is making anyone's life miserable or is useless, that person should be eliminated. She even said, “Unfit lives, useless lives — they should be got out of the way.”

The character of Judith went much further than Dawson. While Dawson’s murder of King George V shortened the life of a man who was not going to live much longer, Judith praised the murder of people who were unfit, useless, either "ruining" or controlling the lives of others, apparently without the people at the dinner table disagreeing or thinking much the less of her. While Dawson was a proponent of euthanasia, headstrong Judith proposed her own variation of eugenics, which would have led to the elimination of anyone who stood in her way.

What Shut the Door Again, For a While

As the death of King George V, the novel Curtain, and the historical record indicate, euthanasia was quite a popular idea in the 1930s and 40s, at least in the upper classes of Great Britain. The eugenics movement was also very popular before WWII. The popularity of these ideas illustrates for me how one seemingly plausible idea can often lead to another and another, and then somehow the leap is made to a tragically erroneous conclusion, when people don't notice that their ideas are being used to rationalize grave moral evils. After Darwin, the theories of Social Darwinism (survival of the fittest) gained popularity, with the growing related conviction that undesirables should be eliminated from the gene pool with the goal of perfecting the human race. To that way of thinking, the elimination of the unfit would remove an unfair burden on the healthy and strong, who should not be forced to care for the weak and unfit.

For one example, Margaret Sanger, the founder of Planned Parenthood, strongly urged that mentally or physically unfit individuals should either be isolated from those who were deemed worthy of propagating themselves, or sterilized, as in this quote from her papers that was written in 1932:

. . . keep the doors of Immigration closed to the entrance of certain aliens whose condition is known to be detrimental to the stamina of the race, such as feeble-minded, idiots, morons, insane, syphiletic, epileptic, criminal, professional prostitutes, and others in this class . . . apply a stern and rigid policy of sterilization, and segregation to that grade of population whose progeny is already tainted or whose inheritance is such that objectionable traits may be transmitted to offspring. Margaret Sanger (Jan. 17, 1932 [Margaret Sanger Papers Microfilm, Library of Congress, Washington, D.C. 130:198].)

It is generally agreed in articles that discuss the history of the movement to legalize euthanasia, that it became politically incorrect to talk about euthanasia for years after World War II, after word got out about the atrocities performed by the Nazis, who used involuntary euthanasia, actually outright genocide, to get rid of vast numbers of the "unfit" and other "undesirables." For a long time after WWII, proponents of euthanasia had difficulty explaining that what they wanted to do was to legalize mercy killing, and that it wasn't the same thing as what the Nazis did.

Nazi Propaganda Poster. Translation: "60,000 Reichsmarks is what this person suffering from a hereditary disease costs the People's community during his lifetime. Countryman, that is your money too."

The whole discussion went underground, for a time. But the so-called benefits of euthanasia began to be touted loudly once again after the outcry against the Nazis died down. The discussion was then framed again around the notion of killing people to give them a merciful cessation of pain, and the load word "right" began to thrown around.  Sentiment built in favor of  mercy killing and suicide as part of every free individual's "right to die." The "right to refuse treatment" also gained acceptance and even though it was a good thing in itself, it led to a lot of pressure on old and sick people to refuse treatment, as I know myself from personal experience after my mother had a stroke. The "right to refuse treatment" led to some managed-healthcare providers treating it as an "obligation to refuse treatment."

Pressure Tactics Against One Vulnerable Old Person, Namely My Mother

For one personal example, here's a summary of what happened after my mother had kidney failure in 1995. She started dialysis, and then she had a stroke. She went into a coma and the doctor told me she was brain dead, without performing any tests besides a CAT scan that showed a stroke that took out 75% of the right side of her brain. If I had not flown from California to be with her in Minneapolis, the hospital staff would have closed the door to her hospital room and let her die.

I was fortunate that my manager at Sun Microsystems let me take six weeks of leave to stay with my mother and then let me spend two or three weeks at a time in Minneapolis as long as my mother lived, letting me work out of the Minneapolis Sun Microsystems office in the daytime and being free to be with my mother after work and on weekends.

When my mother shocked us all and came out of her coma a few days after her stroke with her brain fully alive, the doctor did not apologize for his mistake. Instead he continued to come by once a week with a nurse practitioner to try to get my mother to refuse to continue dialysis, because, they told her, since she was paralyzed on the right side of her body, her quality of life wasn't any good. The nurse practitioner would tell my mother pointedly that she personally wouldn't want to live if she couldn't climb mountains any more.

My mother might have agreed to what they proposed, if she was a meek Midwestern lady who worried about being a burden to anyone. But she was feisty. My fireman father had died in a firetruck accident in South Boston in December of 1947, and she had been all alone and without family or friends  the three daughters my father left behind: me, a two-year old, my middle sister, one year old, and my youngest sister who was born the month after he died. Besides, giving up was inconceivable to her. She was raised in a time when people fought for their lives, so she wasn't about to give up without trying every available medical option. She insisted on continuing dialysis, and she resolved to recover from the effects of the stroke. Even though she never got over the paralysis on her right side, she did live another year; I was glad to be able to be closer to her than I had ever been before, and she was glad to be alive. Between us we shared a more sweeping definition of quality of life than the doctor we started to call Dr. Death and his assistant embraced--a definition that did not involve climbing mountains.

The Mercy Killers May Have Succeeded in the End

But if a story I heard from my cousin is to be believed, and I don't see any reason for him to make up the story, even though representatives of the managed healthcare plan she was on did not succeed in pressuring my mother to refuse life-sustaining treatment, a representative of mercy killing ideology finally got to my mother at the end of that year.  I had recently been visiting my mother for a couple of weeks over Christmas in Minneapolis at an impressively well run Catholic care home for seniors, and I had flown back to work in Silicon Valley.  One night a few weeks later, I got a call from the home, and I was told that my mother was getting close to death. One nurse had told me before the last time I'd left Minneapolis that my mother had edema in her ankles, one possible sign of approaching death, but when she pressed her finger into my mother's emaciated ankle to supposedly show me the edema, I saw no signs of it myself.  Her skin seemed smooth and taut to me, and I saw no signs of swelling.

After I booked a flight back to the Twin Cities, I contacted my cousin who lived nearby to ask him to go to be with her until I got there. By the time I arrived, I was sad to learn my mother had already died, and her body had already been taken away to a funeral home.  And I was even sadder when my cousin told me what he had witnessed. That same nurse who had told me my mother was nearing death when I'd last been there gave my mother a shot of morphine after my cousin had arrived. He heard my mother begin the death rattle after the injection, but she rallied and started breathing normally again.  To his surprise, he saw the same nurse administer another dose of morphine a few minutes later, and that second dose is what killed her.

To make it even more bizarre, that same nurse spoke to me the next day when I was clearing out my mother's furniture and elephant knickknack collection at the nursing home, and still trying to process what I'd heard from my cousin, and she told me that she'd had a dream about my mother the night she died. In the dream, my mother, who hadn't even walked in a year, was dancing in heaven with my father, who had died 48 years earlier.  If that nurse really did what my cousin told me she did, she must have been subconsciously glorifying herself in her sleep because she had sent my mother to heaven!

Recently I told this story to a retired nurse who recently converted to Catholicism. She told me she had done the same thing when a patient was dying of cancer. She said, "I just couldn't stand seeing her in pain," so she had administered a dose of morphine that was legally prescribed, but she knew in advance was going to be enough, not just to kill the pain, but to relieve the patient's physical sufferings permanently.  It seems obvious to me that both nurses, and who knows how many countless more medical professionals, are largely motivated by self-interest.  By killing a patient they are sparing themselves pain and trouble too.

As I said, anecdotal evidence abounds.

A Few More Observations

Support for euthanasia and eugenics was wide-spread in the early twentieth century, but it became unmentionable for decades in light of Nazi genocide and their systematic elimination of those they deemed to be mentally, morally, or physically unfit. Now that euthanasia no longer brings up pictures of Nazi atrocities in the public mind, assisted suicide and voluntary euthanasia are being legalized in more and more places. I see and hear more and more stories about how even healthy people who are in no immediate danger of death are being killed in the name of mercy because of their mental or physical limitations, sometimes merely because they are unhappy with their lives, or lonely. And eugenics is being performed under another name: by abortion. Babies in their mothers' wombs are routinely screened for defects, and their mothers are pressured to get rid of their defective children. By some perverse logic, women are encouraged to kill their children so they won't suffer. What pain is worse than death?

The normalization effect is at work in this and other cases, as the public changes its mind about what is considered to be acceptable once legal barriers are removed.

Involuntary euthanasia, such as that performed by Lord Dawson, has never been brought up for legalization, as far as I know, even though there is anecdotal evidence that it is being widely practiced by overuse of morphine in treatment of the ill without their consent. Besides actual fatal doses, another common practice is to sedate the patient into unconsciousness; without water, the patient dies predictably within three days.

As is true in Dawson's day, legalization is still not actually needed when a practice is commonly performed under the direction of the medical experts, who probably remain convinced that it is better to keep things like that out of the public eye. It would still be a hard sell to get a law on the books that would state that a medical professional can decide based on special wisdom when a person should be put out of his misery. People are often more than willing to trust the experts and to just to look the other way. Especially when it relieves their own pain.

[1] "1936 – Archbishop Lang and the Voluntary Euthanasia (Legalisation) Bill," at the Anglican Church at Parliamentwebsite which notes, "In 1936 the House of Lords debated the Voluntary Euthanasia Legalisation Bill, the first of its kind to come before the UK Parliament. Its rejection set the pattern for future Bills in both Houses for the eight decades to come."

[2] The Lambeth Conference is a gathering of Anglican bishops that is held at the Archbishop of Canterbury's Lambeth Palace at approximately ten-year intervals, except in special circumstances.