“We hope that you will understand what we have done even though some of you will disapprove of it and some be disillusioned by it.” The plea was contained in a letter (see box) sent out to their friends. With that, church leader Dr. Henry Pitney Van Dusen, former president of the Union Theological Seminary, and his wife, Elizabeth, swallowed an overdose of sleeping pills last month in their Princeton, N.J. home. Mrs. Van Dusen, 80 and suffering from arthritis, died within hours. Her 77-year-old husband, who had had a devastating stroke five years ago, died 15 days later. The Van Dusens’ suicide because of declining health added to the debate over a person’s right to end his life under conditions of his own choosing. Mrs. Katharine Mali, a close friend of the Van Dusens, is now president of the Euthanasia Educational Council, of which Dr. Van Dusen was a member. She talked with Christopher P. Andersen of PEOPLE about the right to die with dignity.
What is a good working definition of euthanasia?
The word is from the Greek eu, meaning good, and thanatos, death. Hence a “good death.” A lot of people mistakenly call it mercy-killing. Then, of course, Hitler sullied the word by using it to describe his atrocities in the extermination camps.
What is the aim of the Euthanasia Council?
We take the position that supporting measures should not be used to prolong dying cases or terminal illness with intractable pain or irreversible brain damage, and that medication should be given the dying in sufficient quantity to eliminate pain, even if it tends to shorten life.
Did Dr. and Mrs. Van Dusen consult the Euthanasia Council before their suicide?
Yes, but we went to Dr. Van Dusen first. Eight years ago we asked his advice on the moral rightness of euthanasia. In 1968 he moderated a conference on the topic, and Dr. Van Dusen was among the first of our members to draw up a Living Will. As it turned out, he was a great leader in death as well as in life.
Didn’t the ancient Greeks and Romans actually approve of euthanasia and suicide?
No, there was as much difference of opinion in those times as today. Plato was against it at first, but eventually changed his mind. Socrates made no objection to taking the hemlock. Seneca the Stoic said, “As I choose the ship in which I will sail and the house I will inhabit, so I will choose the death by which I leave life.” Pythagoras, on the other hand, was ferociously opposed to euthanasia, and I believe that the Christian notion that suicide and euthanasia are wrong may have been adapted from the Pythagorean approach—that we are “the chattels of God and without his command we have no right to make our escape.”
Isn’t it true that most Christian denominations are against taking one’s own life?
Don’t confuse suicide with euthanasia. Granted, they are extremely hard to keep apart, and I am not taking a position on suicide per se. That’s strictly up to the individual. Euthanasia is definitely not a religious issue. “The removal of pain and consciousness by means of drugs,” said Pope Pius XII in 1957, “is permitted by religion and morality to both doctor and patient, even if the use of drugs will shorten life.”
How do you respond to those who argue against euthanasia on religious grounds?
There is a fatal flaw in that argument. If you want to say euthanasia in effect tampers with God’s law, then you must also recognize that this is what modern medicine is doing all the time. For example, pneumonia was always called “the old man’s friend,” because usually it meant comparatively quick death. No longer. Now an elderly person suffering from terminal cancer can be saved from pneumonia, but to what purpose? Until recently we did not have antibiotics, transfusions, kidney machines, pacemakers and respirators. These are wonderful developments, of course. But they “tamper with God’s law,” and raise a host of questions. When and how should such powers be used? Just because we can, must we?
How do most doctors feel about euthanasia?
Some are outspokenly in favor of it, others are just as strongly opposed. The rest won’t talk about the subject but quietly do what they think best in each individual case, even if it means ceasing to prolong life needlessly.
Why is it that some physicians feel they must keep their patients alive at any cost?
Strangely enough, some do this strictly for scientific reasons. They want to maintain what they feel is a good track record by keeping a person technically “alive” as long as possible. Also, there is a tremendous amount of personal pride involved. There is a deep feeling of failure exemplified by the phrase, “I just lost a patient.” Why should a doctor feel guilty? Everything has to die.
Doesn’t euthanasia give rise to some rather sizable legal problems?
From the criminal standpoint, active euthanasia—say, a lethal injection of a drug administered to a terminal patient—can result in a charge of murder. So far as I know, what few such cases there have been over the years ended in acquittal. But the real legal obstacle is malpractice in the case of passive euthanasia, that is, when a physician pulls the plug on life-support mechanisms to allow his patient to die. Angry relatives or friends might charge the physician.
What has been the consequence?
Medicine is practiced defensively, with every known technique used. Thus a hospital administrator or a doctor can say that he did everything possible to save the patient—regardless of whether it means torture for the patient, financial ruin for his family and the waste of facilities that could be used to treat a curable patient.
What then is the solution?
We think it is the Living Will, a document that simply reads: “If the time comes when I can no longer take part in decisions for my own future, let this statement stand as the testament of my wishes: if there is no reasonable expectation of my recovery, I request that I be allowed to die and not be kept alive by artificial means or heroic measures. I do not fear death as much as I fear the indignity of deterioration, dependence and hopeless pain.”
How does the Living Will work?
If, for example, you are hit by a truck and are unable to make the decision for yourself, your physician and relatives will know what to do on your behalf. The document is a way of informing them of your wishes in a clear and concise way, without sounding morbid. So far, we have had a half-million requests for free copies of the Living Will. One Texan wrote and said that he wanted to fill out a Living Will because “When Gabriel blows his horn, no S.O.B. is going to keep me from going.”
Is it legally binding?
Not yet. But there have been statutes proposed to give it the force of law before the legislatures of 13 states—Delaware, Florida, Hawaii, Idaho, Illinois, Maryland, Massachusetts, Montana, Oregon, Virginia, Washington, West Virginia and Wisconsin.
Doesn’t this open a Pandora’s box of possible abuses?
I guess anything can be abused. I suppose if your relatives can’t wait to inherit your fortune, you are in trouble. The only safeguard is trust. Before contemplating a Living Will, be sure you have absolute trust in your doctor and your relatives.
What kinds of people appear to be most interested in euthanasia?
There didn’t used to be anybody but old crocks. A century ago, people were often exposed to death at a rather early age. Today people often don’t experience a death in the family until middle age, and then it is hidden away in a sterile hospital room. Even medical and nursing students complain bitterly that they are not given any training to prepare them for the moment when they face a patient’s death. They may dissect a cadaver that they’ve named Alphonse, but that’s the extent of it. This is just another one of the reasons why dying in a hospital is so impersonal and degrading. If you possibly can, die at home.
Have you noticed a significant change in public attitudes toward death in recent years?
In the past there was not much opposition to euthanasia because people didn’t even want to talk about death. Death followed sex as the last taboo. The average person is beginning to realize that death is the final great experience. Why do we celebrate birthdays? What has a year-old baby done to deserve it? We should emulate the Chinese, who venerate old age and celebrate death, for in a sense you are celebrating the life that went before it.