The Basics of Euthanasia

One of the most serious questions America faces is the question of legalizing euthanasia, or physician-assisted suicide. Dr. Jack Kevorkian has led the way into this territory, "assisting" in over forty suicides to date. Many of his "patients" were not terminally ill. The concern with Dr. Kevorkian's actions and the legalization of euthanasia is a trend in the courts to rule that doctors and surrogates have the right to withdraw food and water from unconscious patients, even in the absence of evidence that this would be what the patients would want. Two federal courts of appeal, ruling on assisted suicide cases, have erased the distinction between passive and active euthanasia. They have hinted that it would be acceptable to kill patients, against their will, if their "quality of life" is unacceptably low. The "right to die" is becoming the "right to kill," and with an aging population and calls to contain medical care costs, it may soon become the "obligation to kill."

Pro-life groups, the American Medical Association, and many in the disability rights community oppose the legalized euthanasia and physician-assisted suicide for many reasons: 1) A request for assisted suicide is often a cry for counseling, assistance, and positive alternatives. 2) Suicidal intent usually passes. Of those who attempt suicide, but are stopped, less than 4% will go on to kill themselves within 5 years; less than 11% will commit suicide within 35 years. 3) Terminally ill patients who desire death are depressed, and this is treatable. In one study, of the 24% of terminally ill patients who desired death, all had clinical depression. 4) Pain is controllable through modern medicine. A person who seeks suicide to avoid pain does not need to be killed, but a doctor better trained in alleviating pain. 5) In the U.S., legalizing "voluntary" active euthanasia will legalize nonvoluntary euthanasia. State courts have ruled that if competent people have a right, the Equal Protection Clause of the Constitution's Fourteenth Amendment requires that incompetent people be given the same "right." This means that a third party would be given the power to decide if the person would be "better off dead," posing an unacceptable risk to children and others with disabilities who never asked to die. 6) In the Netherlands, legalizing voluntary euthanasia for the terminally ill has spread to include nonvoluntary euthanasia for many who aren't terminally ill. Currently, half of their killings are nonvoluntary, and death is the legal "solution" for the "problems" of mental illness, permanent disability, and old age! Lonnie Bristow, M.D. President of the American Medical Association stated, "The AMA believes that physician-assisted suicide is unethical and fundamentally inconsistent with the pledge physicians make to devote themselves to healing and to life."

What about HMOs? HMOs, or health maintenance organizations, may ration care to their members in order to save money. Here is what you need to know to protect yourself and your family: HMO doctors often make more money by denying you care. Ask your HMO, "How do you compensate the doctor?" If the doctor is "capitated," he receives a set amount of money per month for every HMO member in his care. "At risk" doctors lose money if the cost of care exceeds the monthly stipend. HMO doctors may be asked to treat conditions they are not trained to treat. In some cases, doctors must do procedures they would not be allowed to perform in a hospital since they don't have the training. HMO doctors can be fired if they provide "too much" care. HMOs often reserve the right to fire doctors without cause. These may fire doctors who provide too much expensive care for their patients. HMO doctors may not be allowed to speak about the HMO. This prohibits complaining, telling patients what is wrong with the HMO, saying anything negative about the HMO to a public body, and fighting with an HMO administrator who is refusing care to a patient. To get the best possible care from your HMO, follow these guidelines: Don't surrender your legal options. Don't sign an HMO contract requiring arbitration for disputes -- it often works in the company's favor . Find out how your HMO compensates your doctor. Doctors who are on a salary or who are paid a fee for each service have less of a financial incentive to ration. Get copies of claims filed on your behalf. Supply any missing information to the HMO's central office. Keep these records. Confront you doctor if he won't order a test or refer you to a specialist. Ask him how he is compensated -- if he stands to gain money from denying you care. If he still refuses, have him put it in writing. Contact the HMO to verify that you're covered for the treatment you want. Get it in writing. Go outside the network for a second opinion. If necessary, pay for the test yourself. Some conditions can't wait for the appeal process. File an immediate appeal. Follow the HMO's instructions exactly. Communicate by registered mail and keep copies of everything. Even if the first response is negative, pursue the appeal until you've exhausted all possible avenues. Let the HMO know you are willing to seek a solution in court. File a complaint. Hire a lawyer. Consider alternatives. A fee-for-service plan may require higher out-of-pocket costs. However, you could stand a better chance of covering expensive medical costs.