Universal Hemlock Care: America’s Suicide Lobby
By Neil Maghami (Organization Trends, September 2009 PDF here)
Summary: Dr. Jack Kevorkian is out of jail and is the subject of a forthcoming HBO movie starring Al Pacino and Susan Sarandon. In Oregon and in Washington state (as of last November) you have a legal right to kill yourself with assistance from a physician. Some U.S. appeals courts have ruled that you have a constitutional “right” to assisted suicide. They were overruled by the U.S. Supreme Court in 1997. But the political and legal movement for assisted suicide is not giving up.
Call it voluntary euthanasia, assisted suicide, or “self-deliverance.” Whatever you call it, it has come to represent one of the most controversial concepts debated in legislative chambers and at hospital bedsides.
Assisted suicide and euthanasia have been front page news lately as Americans express serious reservations about President Obama’s plans to restructure the U.S. health care system. The rationing of care that is the hallmark of all socialist health care systems the world over is envisioned in many proposals currently being considered by Congress.
Americans, and senior citizens in particular, have been concerned about how government bureaucrats would ration end-of-life health care. President Obama may not support killing off the old and the infirm to save tax dollars, but some people fear that ObamaCare would leave patients with medically hopeless cases at the mercy of cost-cutting bureaucrats.
The president did not calm the fears of many Americans when he suggested at a town hall meeting in June that in the case of the terminally ill and the elderly, “Maybe you’re better off not having the surgery, but taking the painkiller.”
President Obama’s own comments helped build a backlash to plans to nationalize the health care system and at the same focused the public’s attention on end-of-life issues.
This sudden public interest may help activists favoring the right to assisted suicide—physician-assisted suicide in particular—who have already made major inroads in recent years. For example, in May this year Linda Fleming of Sequim, Washington became the first woman to end her own life using drugs prescribed by a physician under her state’s new “Death with Dignity” law. The law permits physician-assisted suicide. Fleming had been diagnosed with cancer.
In 1994 Oregon was the first U.S. state to enact a law permitting physician-assisted suicide. But even proponents of that law expressed surprise when a woman named Barbara Wagner went to the media last year to talk about a disturbing letter she received from her state’s medical insurer. Wagner’s physician had prescribed a $4,000 a month drug to treat her lung cancer. The Oregon Health Plan turned down her request, but offered to cover the cost of drugs ($50) for a physician-assisted suicide.
“It was horrible,” Wagner later told ABCNews.com. “I got a letter in the mail that basically said if you want to take the pills, we will help you get that from the doctor and we will stand there and watch you die. But we won’t give you the medication to live.”
The legislative accomplishments of the pro-assisted suicide movement are well known. What is not so well known, however, are the tax-exempt organizations that have noisily promoted the “right” to assisted suicide.
A January 1999 Foundation Watch by Patrick Reilly (“Subsidizing Despair”) looked at some of the players behind the assisted suicide movement. That report is available on CRC’s webpage at capitalresearch.org.
Let us make a clear distinction up-front. By “assisted suicide,” we are not referring to groups promoting palliative care. As attorney Wesley J. Smith points out in his book Forced Exit, these groups have as their purpose the provision of “whatever care patients need to die naturally, in peace and with dignity…on control[ling] pain and alleviat[ing] symptoms,” as well as “emotional support” for patients and their families.”
This is distinct from assisted suicide which, according to Smith, has the goal of “induc[ing] death artificially.” Hospice and palliation attempt to bring comfort at the end of life. Assisted suicide is intended to speed up the end of life. These are two very different goals.
What began as a bizarre and abhorrent concept has developed over the past few decades into a worldwide social movement and a set of public policies on the ‘right-to-die’ that are increasingly accepted by large segments of the American public. To understand why this is happening one needs to know the role of Derek Humphry and groups he has founded or inspired—the Euthanasia Research & Guidance Organization (ERGO) and the Hemlock Society and the Final Exit Network. These are fringe organizations, but they have set the stage for an ongoing national debate over assisted-suicide that is winning legislative battles state by state.
Euthanasia Research & Guidance Organization
Founded in 1993, ERGO is a 501(c)(3) nonprofit based near Eugene, Oregon that promotes research on “assisted dying for persons who are terminally or hopelessly ill and wish to end their suffering.” According to ERGO, “voluntary euthanasia, physician-assisted suicide, and self-deliverance, are all appropriate life endings depending on the individual medical and ethical circumstances.”
The ERGO website www.finalexit.org is extensive and gives an exhaustive account of the group’s activities. However, this is essentially a one-man operation run by Humphry, a former British journalist. Born in England in 1930, Humphry previously founded the better known Hemlock Society in California in 1980, left it in 1992 claiming burnout from overwork, and started ERGO a year later.
ERGO publishes guidelines for patients and their physicians on the ethical, psychological and legal issues involved in making a life-ending decision. It supplies literature to other right-to-die groups and does research for them, and it conducts briefings for journalists, authors, and students.
ERGO also promotes public opinion polling. In 1993, for example, ERGO published a report entitled “What’s in a Word?: The Results of a Roper Poll of Americans on How They View the Importance of Language in the Debate Over the Right to Choose to Die.” The report’s purpose was to determine how Humphrey & Co. could best word a referendum question on assisted suicide in order to secure majority support.
As Rita L. Marker and Wesley J. Smith summarized the story behind the ERGO poll in a 1996 article in the Duquesne Law Review:
“Following the abortive attempts in Washington and California euthanasia advocates went back to the drawing board to reframe their rhetoric. In preparation for a new initiative campaign then being formulated for Oregon, a poll was commissioned in l993 by the newly formed Euthanasia Research and Guidance Organization (ERGO). The poll – which was ERGO’s first activity – was designed to determine [as explained in the ERGO report] ‘if euphemisms allow people to come to grips with brutal facts which, stated another way, would be repugnant to them.’
“Not surprisingly, results indicated that people would be more inclined to vote for laws that were couched in euphemisms. The poll indicated that the greatest number of respondents (65 percent) would favor a law using the terminology ‘to die with dignity.’
“As the drafting process of what would eventually be known as Measure 16, Oregon’s ‘Death with Dignity Act,’ went on, information from the poll was incorporated to ensure the greatest possible chance of passage.” (The report is available at http://www.internationaltaskforce.org/fctwww.htm.)
ERGO’s sensitivity to language is well-founded. The Gallup polling company noted in 2005 that “while support for euthanasia has increased significantly over the past half-century, going from 37% in 1947 to 75% [in 2005]…the trend also shows that usually there is a significant gap in views between euthanasia and doctor assisted suicide…” – with support for doctor-assisted suicide trailing support for euthanasia by as much as 17% in some cases. (Source: The Gallup Poll: Public Opinion 2005, Volume 2000, By Alec Gallup, Frank Newport.)
As Gallup’s analysis points out, including the word “suicide” in an opinion survey often elicits a strong reaction and can influence answers. ERGO and other pro-assisted suicide groups are therefore careful to avoid emphasizing the term.
ERGO’s website indicates that it is “willing to counsel dying patients provided that they are competent adults and are at the end-stage of a terminal illness. Family members who want assistance are also welcome to make contact. Contact must be made by telephone, fax or e-mail.”
A review of past ERGO tax returns shows that its recent annual revenues are minuscule, varying from $40,000 to $70,000 during 2003-2007. The 2007 form shows assets of $33,000 and income of $66,000 ($25,000 in contributions and $40,000 in “program service revenue” (most likely publication and DVD sales). ERGO made contributions ($6,000 or less) to the following pro-assisted suicide groups in 2007-2008: Death with Dignity of Portland, Oregon; It’s My Decision of Seattle, Washington; and Compassion in Dying of Boulder, Colorado.
Compassion and Choices
ERGO’s notorious predecessor, the Hemlock Society, has broken into pieces. There still are local groups identifying themselves as the Hemlock Society. However, Humphry claims public relations experts and political strategists conducting focus groups were behind a 2003 decision to reincorporate his old group under a new name, Compassion and Choices. That group’s latest tax return is worlds away from ERGO’s: Its total revenue was $3.9 million for 2007-2008 with net assets of $1.9 million. Its mission: to “advance patients’ rights through laws that allow mentally competent, terminally ill adults the legal choice of physician aid-in-dying.”
Search the website of Compassion and Choices and you find no mention of Derek Humphry. The Denver-based group claims thirty local chapters and 40,000 members, and it is well-funded.
Top donors in 2007-2008 included the Irene Diamond Fund ($1.4 million), Kohlberg Foundation ($500,000), and the Richard A. Busemeyer Atheist Foundation ($20,000).
Others include: George Soros’s Open Society Institute ($9,000); the Samuel S. Johnson Foundation ($20,000); Gifts of Time Charitable Foundation ($15,000); Blum-Kovler Foundation ($10,000); the Clinton H. and Wilma T. Shattuck Charitable Trust ($10,000); Polly Annenberg LeVee Charitable Trust ($5,700); Wyss Foundation ($5,000); Norman Raab Foundation ($5,000); and the Hawksglen Foundation ($5,000).
Foundation Support for Assisted Suicide
The George Soros connection to the movement should not surprise anyone. As Neil Hrab wrote in “George Soros’ Social Agenda for America” (Foundation Watch, April 2003), “in a November 1994 lecture at Columbia Presbyterian Medical Center in New York City Soros revealed one motive for his interest [in assisted suicide]: ‘Voters in Oregon just approved a law that makes it the first state to lift the prohibition against physician-assisted suicide. As the son of a mother who was a member of the Hemlock Society … I cannot but approve.'”
Other Compassion and Choices donors are similarly predictable.
The Kohlberg Foundation (2007-2008 assets: $319 million) donates heavily to environmental groups, including EarthJustice, the Nature Conservancy’s Minnesota chapter and the Natural Resources Defense Council. According to its latest tax return, the foundation also donated to the National Abortion Rights Action League (NARAL), Planned Parenthood and the Alliance for Justice. The foundation is named after its president, Jerome Kohlberg, a founding partner of the Kohlberg Kravis Roberts private equity firm.
The Samuel S. Johnson Foundation, located in Redmond, Oregon, claimed total net assets of $7.6 million as of May 2008. Its donation to Compassion and Choices was earmarked as “support for Death with Dignity education in Washington State.”
The Irene Diamond Fund (net assets: $78 million) is named after a prominent New York City philanthropist who was a major funder of AIDS research.
The Wyss Foundation (net assets: $4 million), located in Portland, Oregon, also contributes to Planned Parenthood, the ACLU, and the ultra left-wing Center for Constitutional Rights.
Based in Cincinnati, Ohio, the Richard A. Busemeyer Atheist Foundation (net assets: $4.1 million) made grants to Planned Parenthood, Amnesty International, the Freedom from Religion Foundation and the ACLU.
A discussion of foundation links would not be complete without mentioning the Wallace Alexander Gerbode Foundation. It gave $40,000 to Compassion and Choices in 2006. Based in San Francisco (net assets: $79 million), its association with the assisted suicide movement goes back nearly two decades. Thomas Layton, its president, recalled in a 1998 interview with Foundation News:
“In 1990, there was an initiative in Washington state which advocated a patient’s right to aid in dying, under certain circumstances. It failed. In 1992, a similar proposition in California, Proposition 161, failed. Both came extremely close to passing, with no money for a campaign and with a highly organized, well-funded opposition. After Prop. 161 failed, we convened a meeting of the leadership behind the initiative to see what, if anything, might move the issue along. Out of that meeting came a number of organizations that we helped fund. That’s how we got into it. […]
“We [have] worked closely with the Oregon Death with Dignity Legal Defense and Education Center. [The organization is now known as the Death with Dignity National Center, or DDNC.] This group has worked hard, and I’d say effectively, to educate Oregon citizens regarding the implementation of the law, which is known as Measure 16. The center has had to defend the law, too, because it was challenged…We are deeply concerned about the quality of end-of-life care. But the piece we have taken on is to assert the right of individuals, under carefully controlled circumstances, to be able to hasten their death if they are suffering intolerably. (Source: http://www.foundationnews.org/CME/article.cfm?ID=1409)
Lobbying and Litigation
A quick word about the Portland, Oregon-based DDNC: this 501(c)(3) tax-exempt group acts as the litigation arm of the pro-assisted suicide movement. DDNC credits itself with having “led the legal defense and education of the Oregon Death with Dignity Law for more than 11 years.” DDNC reported net assets of about $633,000 in 2008.
A separate 501(c)(4) lobbying group, the Oregon Death with Dignity Political Action Fund, promotes assisted suicide initiatives elsewhere in the U.S. These two organizations give the pro-assisted suicide movement “the flexibility to rapidly respond to both legal and political challenge,” according to DDNC’s website.
Compassion and Choices reports that it spent $250,000 on lobbying in 2007-2008. Its legal and legislative work seeks to legalize “aid in dying” through laws such as Washington state ballot initiative I-1000, which won passage in a 59%-41% vote in November 2008.
Compassion and Choices illustrates what happens when a controversial idea promoted by a fringe group goes mainstream. What used to go by the frightening terms “euthanasia” or “mercy-killing” is now referred to as “aid-in-dying.” Panels at “end-of-life care” conferences frequently include assisted-suicide as one of many topics that need to be discussed along with hospice care and living wills.
In 2006, in a display of that sensitivity towards the word “suicide,” Compassion and Choices pressured Oregon’s Department of Human Services to stop using the phrase “physician-assisted suicide” in official communications.
Kathryn Tucker, Compassion and Choices legal affairs director, crowed, “this will be a sea change because how you speak of things strongly influences how you think of them.”
In the 1990s U.S. federal courts of appeal ruled that there are circumstances where there is a constitutional right to assisted suicide—a view overturned by the U.S. Supreme Court in 1997. During the 2008 presidential campaign both Hillary Clinton and Barack Obama straddled the issue during campaign stops in Oregon, which has an assisted suicide law.
Clinton told the Eugene Register-Guard (April 6, 2008) that states needed to grapple with “this very difficult decision.” Obama told the Medford Mail Tribune (March 23, 2008) that states must be careful not to “slide from palliative treatments into euthanasia,” but that Oregon had done the nation a “service” by recognizing that we have to “think about issues of end-of-life care.”
Compassion and Choices will hold an international symposium in Washington, D.C. at the National Press Club on October 12-14 featuring presentations by Elmer Huerta, president of the American Cancer Society, New York Times columnist Jane Brody and Spain’s prime minister, Jose Luis Zapatero. There will be panels about how laws and policies restrict the terminally ill from making end-of-life decisions. Participants will tell poignant stories about the long and difficult deaths of loved ones in uncaring medical facilities. It is uncertain, however, whether this sort of advocacy will sway Americans to support active assisted suicide.
But Derek Humphry will keep trying.
Derek Humphry and the Hemlock Society
Derek Humphry was a London journalist whose first wife’s battle with breast and bone cancer ended in 1975 when she took her own life with his help. In his 1978 book, Jean’s Way, Humphry described how she drank a cup of coffee containing a mix of barbiturates he had prepared.
Humphry remarried and moved to California in 1980 where he and his new wife formed the Hemlock Society to further public debate over euthanasia and set the stage for political change and legal reforms. Humphry would go on to write or co-author many books on assisted suicide, including Freedom to Die, Right to Die, Final Exit, Dying With Dignity, Lawful Exit and the Good Euthanasia Guide. In 1982, the Hemlock Society published Humphry’s Let Me Die Before I Wake, the first openly-sold “how-to” book on suicide. “This paperback sold a steady 25,000 copies for the next ten years and was the foundation of Hemlock’s reputation and income,” reports a Humphry biographical statement. Final Exit (1991), another Humphry book on how to kill oneself, sold nearly one million copies and was on the New York Times best-seller list for 18 weeks.
The Hemlock Society earned a reputation as the most radical of the ‘right-to-die’ groups. While other groups endorsed the right to withhold life-saving technology from terminally ill patients or withdraw food and water from dying patients, Hemlock supported active assisted suicide—and not only for the terminally ill, but also for the “hopelessly ill” (i.e., those who have a debilitating disease). By 1990, after Humphry had moved from California to Eugene, Oregon, Hemlock had 13 employees and was raising $70,000 to $80,000 a month. It had 30,000 members, 51 U.S. chapters, and was promoting its cause in state ballot initiatives and legal cases across the country.
At the peak of its influence, the organization was left scandalized and shaken when Humphry’s second wife Ann developed breast cancer and he left her four days after she began chemotherapy following surgery. According to a (Feb. 8, 1990) New York Times story, she says he panicked at the thought of losing another wife to cancer. He says she had bad mood swings and demanded that he cry for her as he had for his first wife. Divorce, charges of Hemlock Society financial mismanagement, lawsuits and confidentiality agreements followed. The organization never recovered.
Nonetheless, the Hemlock Society played a key role in getting physician-assisted suicide initiatives before Washington and California voters in 1991 and 1992 and it help pass the landmark 1994 Oregon measure (by a 51%-49% margin). Humphry’s personal problems weakened the Society and the failure of the Washington and California ballot measures (both by 54%-46% margins) seems to have convinced most right-to-die activists that they should move away from hard-edged assisted suicide and instead promote the more passive “dying with dignity” and “aid-in-dying” advocacy that is prominent today. (See Liberalism’s Troubled Search for Equality, by Robert Patrick Jones, 2007.)
The movement for active assisted-suicide is not giving up. One Jan. 2, 2009 Derek Humphry posted a blog at his ERGO website that explained how “terminally ill or hopelessly physically ill, competent adults” can order a “helium hood kit” to end their own lives. Now almost 80, Humphry maintains a keen interest in the cause of assisted suicide. In 2007, when Dr. Jack Kevorkian was released from jail after serving nearly a decade for murder, Humphry used his blog to welcome the physician’s release. “Kevorkian’s hugely popular voice could be influential in future attempts at law reform,” Humphry noted. Earlier, he opined on the strategies the movement should take, recalling that “I tried to persuade Kevorkian in the 1980s to make his platform one of law reform. But he was hell bent on changing the minds of the medical profession on assisted dying. I argued that law reform must come first because otherwise U.S. doctors were too nervous to help.”
“Self-Deliverance”: The Final Exit Network
If the phrase “assisted suicide” is too harsh, advocates have a better euphemism: “self-deliverance.” That concept is promoted by a tax-exempt group known as the Final Exit Network (FEN) based in Kennesaw, Georgia. Its website is www.finalexitnetwork.org. Humphry’s blog claims that at its inception in 2004, FEN drew on the energy of several “of the original Hemlock hardcore people.” Humphry serves on the group’s advisory board.
FEN aims to “serve people who are suffering intolerably from an irreversible condition which has become more than they can bear” by fostering “research to find new peaceful and reliable ways to “self-deliver” death.” It has endorsed the inhalation of helium as a peaceful and reliable method. The website invites inquiries from people suffering from cancer, Alzheimer’s, Parkinson’s Disease, ALS, multiple sclerosis, muscular dystrophy, congestive heart failure and emphysema.
In February police arrested four FEN members. According to AP, they face “charges of assisted suicide, tampering with evidence and violating Georgia’s anti-racketeering act.” Nationwide, police believe as many as 200 people linked to FEN may have committed suicide. Arizona police are believed to have seized a FEN training document that describes how to commit suicide by inhaling helium. AP reported that the document counsels readers on how “how to dispose of the equipment used in the death and position the bodies so they look like they died of natural causes.”
Tax records show that FEN has annual revenue of over $500,000 from membership dues and contributions. FEN works with activists around the country. It made financial contributions (all less than $4,000) in 2007-2008 to affiliates in New York, Alaska, Illinois, New Jersey, Florida, Blue Ridge (North Carolina) and a group known as “Great Endings – Final Exit” located in Williamsburg, Virginia. Membership in FEN costs $50, which provides access to FEN’s “Exit Guide services.”
“The Ultimate Civil Liberty”?
Humphry says “The right to choose to die when in advanced terminal or hopeless illness is the ultimate civil liberty.” He is never shy about denouncing his opponents, comparing them to Nazis for questioning the mental competence of those requesting assistance. He complains that churches have abandoned the “Christian doctrine of free will” and that government prohibitions are signs of a police state.
In his book Freedom To Die he says. “It is virtually only in those cultures where the Judeo-Christian sanctity-of-life and redemption-in-suffering arguments predominate that behavior like this is prohibited.” He adds:
Research shows that in many ‘primitive’ societies, once an elder’s life has no further economic value to the community and may indeed be an economic liability, the community hastens death by refusing financial and other support to the dependent elder. Eskimo elders are highly revered and nurtured by the community as long as they can contribute to the general good of the group and add to its resources. Once they are no longer productive, they are abandoned by the community or assisted in their death. Necessity, rather than indifference or animosity, motivates this behavior.
The implication: Not only should assisted suicide be permitted, but medical care for the elderly ought to be rationed once they come to represent “an economic liability.”
In his 1999 Foundation Watch article, CRC author Patrick Reilly explained that the assisted suicide movement went beyond the actions of Dr. Jack Kevorkian and a few others like him. “While Kevorkian grabs the headlines,” Reilly reminded readers, a variety of other actors were working quietly to “significantly alter the American way of life – and death.”
Today, it is more important than ever for the media and government officials at all levels to take a “big picture” view of the assisted suicide movement – including the activities of tax-exempt groups such as ERGO and FEN, and the ideas they are helping circulate.
Neil Maghami, a freelance writer, last wrote for Capital Research Center in the July 2009 edition of Foundation Watch (“The Goldman Sachs List”).