Today’s proponents of euthanasia argue that it is responsible healthcare in uncertain economic times. Some believe we should not unnecessarily burden society by providing care for dependents whose healthcare will cost too much – the elderly, the disabled, the chronically or terminally ill. They would rather see healthcare funds rationed and given only to those who can contribute economically to society. This is a utilitarian / Darwinian approach to evaluating which of the “fittest” should survive, and one that is quickly gaining acceptance as global economic insecurities mount.

It should be seriously considered that the potential abuses of legalized euthanasia far outweigh any possible benefits. Medical costs are rising and elderly patients account for more and more of the expenditures as the “baby boomers” reach retirement.  Physicians and other medical personnel are increasingly required to justify interventions or are pressured to encourage early death based on cost savings and ‘quality of life’ concerns.

The intentional termination of the life of one human being by another -mercy killing- is contrary to that which the medical profession stands and is contrary to the policy of the American Medical Association.

The cessation of the employment of extraordinary means to prolong the life of the body when there is irrefutable evidence that biological death is imminent is the decision of the patient and/or his immediate family.  The advice and judgment of the physician should be freely available to the patient and/or his family. House of Delegates of the American Medical Association, December 4, 1973

More than once we have seen that the ideal of the above statement has been ignored.  In 1997, the Oregon Death with Dignity Act (ODWDA) spurred the country in a debate about the morality, legality, and practicality of physician assisted suicide.  Legal cases and legislative efforts have begun in many different parts of the country advocating for the practice of mercy killing on a large scale.

The potential for the misuse of statistical data and subjective evaluation of patient viability is clearly documented in history…most notably in Hadamar Germany prior to WWII (which came to full implementation in Hitler’s T4 program) when the economic situation was dire and the government began instituting methods of weeding out “useless eaters” – the elderly, young children, the disabled, the mentally ill, the poor, the unborn, non-Germans – using the local hospitals’ own processes for gathering patient information. History has shown that legalizing euthanasia is the worst kind of slippery slope.

Today many of the same techniques of the gleaning health and economic information about citizens are being employed in the US via the Patient Protection and Affordable Care Act (PPACA) commonly known as Obamacare. A simple web search on PPACA’s Independent Payment Advisory Board (IPAB), a group of 15 presidentially-appointed healthcare decision makers, shows that once Americans sign on to government-run healthcare, their information will be gathered by IPAB (and other government institutes doing “studies” on health such as the new Patient-Centered Outcomes Research Institute and the Federal Coordinating Council for Comparative Effectiveness Research) and medical care will be streamlined (read: rationed) to determine how best to invest the nation’s money for medical intervention in such a way so as to get the most “bang for the buck.” If the PPACA IPAB follows the U.K.’s National Institute for Health and Clinical Excellence (NICE) model, each American will be assessed in terms of their “quality-adjusted life year” (QALY) to determine their measure of “disease burden,” including both the quality and the quantity of life lived. The QALY score is then used in assessing the value for the cost of a medical intervention – a cost-utility analysis to calculate the ratio of cost to QALYs saved for a particular health care intervention. This is then used to allocate healthcare resources, with an intervention with a lower cost to QALY saved (incremental cost effectiveness ratio or “ICER”) being preferred over an intervention with a higher ratio. PPACA will make it so that only those who are most likely to contribute economically to society will be given preferential treatment.

Think this sounds too much like a conspiracy theory? One of the first steps taken in Hitler’s T4 program was directed at disabled children:

In the spring and summer months of 1939, a number of planners–led by Philipp Bouhler, the director of Hitler’s private chancellery, and Karl Brandt, Hitler’s attending physician–began to organize a secret killing operation targeting disabled children. On August 18, 1939, the Reich Ministry of the Interior circulated a decree compelling all physicians, nurses, and midwives to report newborn infants and children under the age of three who showed signs of severe mental or physical disability. Beginning in October 1939, public health authorities began to encourage parents of children with disabilities to admit their young children to one of a number of specially designated pediatric clinics throughout Germany and Austria. The clinics were in reality children’s killing wards where specially recruited medical staff murdered their young charges by lethal overdoses of medication or by starvation.

At first, medical professionals and clinic administrators incorporated only infants and toddlers in the operation, but as the scope of the measure widened, they included juveniles up to 17 years of age. Conservative estimates suggest that at least 5,000 physically and mentally disabled German children perished as a result of the child “euthanasia” program during the war years. http://www.ushmm.org/wlc/en/article.php?ModuleId=10005200

In recent years we have seen a groundswell of support for infanticide. Our president supports the practice. Budding secular bioethicists, Alberto Giubilini and Francesca Minerva, following in the footsteps of their mentor, Peter Singer, have published a work in the Journal of Medical Ethics in support of infanticide as an extension of abortion…and been taken seriously by peer reviewed medical journals which have stood by their publication of such ideas (also see http://www.lifenews.com/2012/02/28/ethicists-in-australia-call-for-after-birth-abortions/). Peter Singer is not only in favor of abortion and infanticide, but wholeheartedly embraces healthcare rationing. He is a world renown, highly esteemed utilitarian “ethicist” famous for his talks on “speciesism” and his debates on the economic value of human life many of which can be seen on YouTube (http://en.wikipedia.org/wiki/Peter_Singer ). His articles on “bioethics” and the subject of rationing healthcare are frequently published in the New York Times. Singer is also a reputed top contender for IPAB.

There are many big questions to consider here…. Have we learned anything from the history of euthanasia? Are a citizen’s economic contributions the only contributions to society that matter? Even if you presume that today’s leaders who favor euthanasia have our best interests at heart…does it follow that all our leaders in the future will have the same benevolent intentions toward their fellow Americans? What kind of a legacy does a utilitarian approach to healthcare – one in which those who are healthy are supported and those who are unhealthy get euthanized – set up for our children?

To be a truly compassionate society, we must provide for those who built the country before us and for those who will come after us.  Regulations and rationing will undoubtedly create challenges.  We must remain vigilant so that our best intentions do not pave the proverbial road to hell because we forgot the immeasurable value of each and every human life far outweighs its cost. Suicide is always a tragedy…but assisted suicide is often nothing more than homicide dressed up in a false sense of “mercy.” We must guard our right to live and die naturally or others will take it from us.