Euthanasie en Français (Euthanasia in French): The Dramatic Case of Vincent Lambert & the Case for Advance Directives

The heartbreaking case of Vincent Lambert has produced a consequential plea for urgent action by the United Nations Committee on the Rights of Persons with Disabilities.    This unexpected yet welcome development is the latest chapter in a French version of the Terry Schiavo case that riveted national attention in the United States in 2005. 

Vincent Lambert, 42, was critically injured in a motorcycle accident in 2008.  He sustained severe brain damage and has been diagnosed as being in persistent vegetative state (PVS), a condition that presumes no self-awareness and no conscious response to external stimuli. He requires assisted nutrition and hydration (ANH) in order to survive but he does not require a ventilator. 

Adding to the tragic circumstances is an intra-family dispute that pits his wife and some siblings against his parents and other siblings. The former want ANH withdrawn, asserting that he would not want it. The later insist that euthanasia must be rejected and ANH provided. The conflict is possible because Vincent never prepared what L.I.F.E. provides: an advance medical directive, or an appointment of health care representative. Even our short form directive would eliminate doubt as to the patient’s wishes and provide the necessary foundation to protect life. 

PVS is not a terminal illness. Nor is it a state of permanently unconscious. Patients in PVS experience waking and sleeping cycles, typically do not require a ventilator, and frequently open and close their eyes. Disputes and uncertainty persist as to the precise nature of the condition as well as the accuracy of diagnosis. But what is undisputed is that PVS is not a terminal condition. 

A 2016 French law applicable to terminally ill patients allows physicians to withdraw life sustaining treatment – including ANH – in purportedly hopeless cases while administering powerful sedatives until the patient dies from the lack of food and fluids. 

The European Court of Human Rights and France’s top administrative body had upheld the doctors’ earlier decision to stop Lambert’s life support. His parents filed a petition with the UN Committee on the Rights of Persons with Disabilities and, according to news reports, a French court ordered that his feeding be resumed until the UN body resolves the petition filed in that forum.

In the media storm that surrounds the case there has emerged a strong statement from the Vatican. Consistent with a statement from Pope John Paul II in 2004 and a ruling on the issues from the Congregation for the Doctrine of the Faith in 2007 [link is in the bioethics library], the most recent Vatican statement affirms the essential norm that ANH is ordinary and proportionate care that must be provided to a PVS patient “as long as the person is able to receive nutrition and hydration, provided this does not cause intolerable suffering or prove damaging to the patient.”  It continues by stating that its “suspension … represents … a form of abandonment” and describes ANH in the specific context as “an inescapable duty.”

L.I.F.E. on the Radio: Inter Vitam et Mortem

L.I.F.E.’s Founder and President, Deacon Tom Davis, appeared on the WCAT Radio program Inter Vitam et Mortem on Monday, May 20, to discuss the Liberty Institute’s web resources and the aims of its various initiatives. Host and bioethicist Mary Ann Urlakis and Deacon Tom explored a lot of ground in their free wheeling dialogue. Get to know L.I.F.E. better by listening in on their exchange.  

Something To Do With Character

New York State now champions abortion to birth and Governor Northam of Virginia nonchalantly advocates infanticide. It’s really all so old. Abortion on demand to birth has been the mandate of a legislating Supreme Court for almost fifty years. Still, something in the condescending tone of New York’s governor and the Virginia Klan fan has disturbed a long dormant fury previously manifest in many as resignation. It reaches deeper now that they have stepped from behind the curtain and made so bold a thrust into the heart of virtue. 

On February 25, 2019, several 2020 presidential candidates signaled their lock-step alliance with Northrup by voting to block the Born-Alive Abortion Survivors Protection Act. Senators Sanders, Harris, “Spartacus” Booker, Gillibrand, Klobuchar, and Warren voted against the bill. They opposed criminal penalties for those refusing to provide the same level of care given any other baby born at the same gestational age. The bill also required immediate hospital admission of a “child born alive” following an attempted abortion. 

Senator Ben Sasse was dumbfounded: “I want to ask each and every one of my colleagues whether or not we’re OK with infanticide.”

It calls to mind one of the most memorable defenses of decency in recent American political history:  

“Watch a fully formed fetus on the table, its heart beating, its legs kicking, while someone says ‘we have to keep it alive to harvest its brain.’ This is about the character of our nation.”

Carly Fiorina, GOP Presidential Debate, September 16, 2015. 

Her words need no elaboration. To those unacquainted with the particular malice of Kermit Gosnell or infanticide, Fiorina’s indictment startled. As it should. 

This kind of slaughter has become so ubiquitous that almost nothing shocks. Almost. In 2007 Justice Anthony Kennedy, writing for the majority in one of the Supreme Court’s momentary lapses into social sanity known as Gonzales v. Carhart,  described a typical second trimester abortion: 

The doctor grips a fetal part with the forceps and pulls it back through the cervix and vagina, continuing to pull even after meeting resistance from the cervix. The friction causes the fetus to tear apart. For example, a leg might be ripped off the fetus as it is pulled through the cervix and out of the woman. The process of evacuating the fetus piece by piece continues until it has been completely removed.  550 U.S. at 135-136.

The procedure has its alternatives, as Kennedy noted: 

Some doctors … may kill the fetus a day or two before performing the surgical evacuation. … Once dead, moreover, the fetus’ body will soften, and its removal will be easier. Id. at 136. 

In other second trimester abortions, when the baby’s head is too large to pass the partially dilated cervix, a variation may be utilized in which the child is delivered breach (feet first) until only the head or head and shoulders remain within the mother. Justice Kennedy provided the liberating details from the vantage point of a nurse who actually participated in the procedure performed on a 26 week human being:       

[The doctor] went in with forceps and grabbed the baby’s legs and pulled them down into the birth canal. Then he delivered the baby’s body and the arms—everything but the head. The doctor kept the head right inside the uterus… .

The baby’s little fingers were clasping and unclasping, and his little feet were kicking. Then the doctor stuck the scissors in the back of his head, and the baby’s arms jerked out, like a startle reaction, like a flinch, like a baby does when he thinks he is going to fall.

The doctor opened up the scissors, stuck a high-powered suction tube into the opening, and sucked the baby’s brains out. Now the baby went completely limp.

Kennedy described other methods used to kill a baby once its head lodges in the cervix.

One doctor squeezes the skull after it has been pierced so that enough brain tissue exudes to allow the head to pass through. Still other physicians reach into the cervix with their forceps and crush the fetus’ skull. Others continue to pull the fetus out of the woman until it disarticulates at the neck, in effect decapitating it. These doctors then grasp the head with forceps, crush it, and remove it.

“Disarticulates.” Almost nothing shocks. Almost. Justice Kennedy continued, quoting one abortionist’s testimony: 

Another doctor testified he crushes a fetus’ skull not only to reduce its size but also to ensure the fetus is dead before it is removed. For the staff to have to deal with a fetus that has “some viability to it, some movement of limbs,” according to this doctor, “[is] always a difficult situation.” (Id. 139-140)   

Gee, that really does sound difficult. 

What Carly Fiorina presented to the nation during the 2015 GOP debate was the most significant diagnosis of social malignancy in a generation. Not since Eisenhower ordered the filming of concentration camps in 1945 had there been such disgust. Not the killing fields of Pol Pot. Not the Biafrian genocide. Not the slaughters in Rwanda. “I dare anyone … watch a fully formed fetus on the table, its heart beating, its legs kicking”. Eisenhower knew that others would deny the barbarity of the camps. Fiorina knew that many would deny that Planned Parenthood murders babies or that America sanctions harvesting baby parts. But we do. Watch the videos. While you’re at it, don’t miss “Eclipse of Reason,” an equally disturbing but valuable object lesson in what we have become: 

Fiorina exposed callousness, banality, evil, and indifference. They speak not of bad behavior but of vicious character. She opened a festering wound desperately in need of debridement: our national character is rotting. It is not the language of political discourse that needs a cure; it is merely a symptom. The cancer is malice against nature that denies reason or purpose or truth if there be any chance that they may challenge the ideology of radical autonomy with duty, biological normalcy, or humility. Exhibit A: Governor Cuomo. Exhibit B: “a fully formed fetus on the table, its heart beating, its legs kicking …” 

Defunding Planned Parenthood is the minimum any healthy society would demand. But ours is not a healthy society.  Defunding a baby body parts harvesting machine is reflexively inexplicable to those committed to the protection of infanticide:

  • Hillary Clinton, Joe Biden, and Bernie Sanders, all of whom cast congressional votes to preserve the particular grotesquerie of partial birth abortion.
  • Bill Clinton, who twice vetoed partial birth abortion bans.
  • Barak Obama, who repeatedly cast his state senate vote against the Illinois version of the 2002 Born Alive Infant Protection Act.

How did we get here? L.I.F.E.’s Tom Davis presented much of the of the backstory in an article last summer: Treating Embryocide with White Gloves. Margaret Sanger and Planned Parenthood were at the genesis of the eugenic movement that swept across the nation and eventually found welcome embrace in the Nazi pogroms of racial purification. It was not long before the eugenic spirit crossed the threshold from sterilization and breeding houses to abortion and infanticide. 

In 1942, Eugenicist Foster Kennedy, a member of the Medical Advisory Board of The Birth Control Review, writing in the American Journal of Psychiatry opined:

I believe when the defective child shall have reached the age of five years – and on the application of his guardians – that the case should be considered under law by a competent medical review board; then it should be reviewed twice more at four-month intervals; then, if the board, acting, I repeat, on the application of the guardians of the child, and after three examinations of a defective who has reached the age of five or more, should decide that that defective has no future or hope of one; then I believe it is a merciful and kindly thing to relieve that defective – often tortured and convulsed, grotesque and absurd, useless  and foolish, and eventually undesirable – of the agony of living. 

E.F. Kennedy, The problem of social control of the congenital defective: education, sterilization, euthanasia, Am. J. Psychiatry, 99:13-16. 

In the same issue of the Journal, an unsigned editorial endorsed Kennedy’s view and urged that the proper role of psychiatrists was “the evaluation and melioration of [the] parental attitude” of “fondness” for such a child “and their ‘want’ that he should be kept alive.” Euthanasia  (Am J Psychiatry, 99:  141-43 (1942).

At the end of the Second World War widespread revulsion over genocidal murder and human rights violations in national socialist Germany repressed the eugenic spirit of the age. But the idea that certain lives were simply not worth living was etched in the mind of state planners, medical professionals and social engineers.          

By the time Roe v. Wade was decided in 1973, a thoroughly secular understanding of human value based solely on materialist criteria had reasserted itself. Nobel Prize winning scientist James Watson, who together with Francis Crick discovered the double helix structure of DNA, opined that children should not be declared alive until three days after birth so that parents may have the option of allowing defective offspring to die, thereby saving “a lot of misery and suffering.” For his part, Francis Crick went even further in 1978: “No newborn infant should be declared human until it has passed certain tests regarding its genetic endowment … If it fails these tests it forfeits the right to live.” Lest the impression be left that these are fringe opinions it is worth noting that from 1989-1992 Dr. Watson was the director of the National Center for Genome Research, later renamed the National Human Genome Research Institute, within the National Institutes of Health. 

The groundwork for Governors Northup and Cuomo was laid long ago. A more recent yet similarly radical view of human worth has been offered by Peter Singer, Ira W. DeCamp Professor of Bioethics at Princeton University. In his book Practical Ethics, Singer argues that human life has value only so long as it is conscious. He holds that any sentient being with consciousness is within the sphere of “equal consideration” of interests. (P. Singer, Practical Ethics, 2d ed., Cambridge University Press (1993) p. 74).  By that he means that, human or animal, a conscious, sentient being has a greater interest in life than a fetus, a new born baby or a person diagnosed in persistent vegetative state: 

I have argued that the life of a fetus (and even more plainly, of an embryo) is of no greater value than the life of a nonhuman animal at a similar level of rationality, self-consciousness, awareness, capacity to feel, etc., and that since no fetus is a person no fetus has the same claim to life as a person. Now it must be admitted that these arguments apply to the newborn baby as much as to the fetus.

If we can put aside these emotionally moving but strictly irrelevant aspects of the killing of a baby we can see that the grounds for not killing persons do not apply to newborn infants. (Practical Ethics at 169-171).

If we can put aside these emotionally moving ... aspects of the killing of a baby …  He is serious. This is about the character of our nation. 

Singer defends his position by arguing that “our present absolute protection of the lives of infants is a distinctively Christian attitude rather than a universal ethical value” and that several ancient cultures considered infanticide, “the natural and humane solution to the problem posed by sick and deformed babies” and concludes that their “superior” moral sense was subverted by the Christian “doctrine of the sanctity of human life“. His thought is mired in his own subjectivism:

[T]he fact that a being is a human being, in the sense of a member of the species Homo sapiens, is not relevant to the wrongness of killing it; it is, rather characteristics like rationality, autonomy, and self-consciousness that makes the difference. Infants lack these characteristics. Killing them, therefore, cannot be equated with killing normal human beings, or any other self-conscious beings.

When the death of a disabled infant will lead to the birth of another infant with better prospects of a happy life, the total amount of happiness will be greater if the disabled infant is killed. The loss of a happy life for the first infant is outweighed by the gain of a happier life for the second: Therefore, if killing the hemophiliac infant has no adverse effect on others, it would, according to the total view, be right to kill him. (Practical Ethics at 182-186). 

Given Singer’s notion of reflective self-consciousness as the critical element of personhood, it is not surprising that he dismisses any idea of intrinsic value for the  newborn infant:

I cannot see how one could defend the view that fetuses may be “replaced” before birth, but newborn infants may not be.

It all began here, in the United States, championed by Sanger and carried on today by Planned Parenthood and a cadre of abortion zealots who cannot see the humanity in treating a newborn that survives an abortion as a person. It has something to do with character.  

Loving Life At The End of Life

Embracing life as the earthly vessel fades presents unique challenges. End of life medical decision-making strikes many as an uncomfortable topic. But loving life includes nurturing it and, when the inevitable approaches, assuring that the values and integrity that marked more robust seasons are not sacrificed to pressures, expediency, or despair. 

L.I.F.E. maintains a series of advance medical directives and proxy appointments that are morally sound, fully in accord with Catholic doctrine, and flexible enough to allow individualization. 

We have heard some voices object to the very concept of advance directives as opening a Pandora’s Box best left to compassionate decision making by loved ones. That may be adequate for some people in some circumstances. But the risks are plentiful. What if you are critically injured in an accident in Vermont, New Jersey or Washington where assisted suicide laws hover over end-of-life health care decisions? What if you don’t have next of kin who share your values? What if your spouse or children face the prospect of pressures that may lead them to mistaken judgments? What about your peace of mind that may accompany knowledge that you have spoken your heart and made clear to your medical providers what your decisions are, or would be, based on your underlying values and beliefs?  

L.I.F.E. offers a comprehensive life protective Advance Medical Directive that assures ordinary care will be provided if you become incapacitated, yet recognizes that futility has no place in continued life support in the final stage of terminal illness. It provides for a proxy decision maker who will have full access to your medical team and records and full authority to direct care in accordance with your wishes. It also offers the option to make an anatomical gift (organ donation). 

The typical living will is a generalized and inadequately nuanced binding legal document entered into without adequate reflection or understanding that may predetermine the withholding of life sustaining treatment when it is otherwise warranted. Would you want all antibiotics withheld if suffering from pneumonia just because you previously opted for a Do Not Resuscitate (DNR) order in the event of a cardiac arrest? Can anyone confidently anticipate all the factors to be weighed in making such critical life decisions before the actual circumstances arise?

Visit L.I.F.E.’s easy to understand medical directive page. In addition to the comprehensive directive there is also a Short Form Advance Medical Directive, operative in the event you are unable to make informed decisions for yourself, as well as Short Form Appointment of a Health Care Representative who is authorized to make decisions on your behalf. 

To dive deep into the issues arising in end of life medical-moral decision making and the development of legal instruments to assert various levels of control and clarity about whocontrols such decisions, as well as the forces are work in society and law driving developments, don’t miss this extended study of the topic by LIFE’s Tom Davis.

The Inequality of the Equality Act

L.I.F.E. has been following the wildfire of transgender advocacy. The latest chapter is the misnomered “Equity Act,” a proposal currently pending in the House of Representatives. The Bill would amend portions of federal statutes including: 

  • Civil Rights Act of 1964 (42 U.S.C. 2000a, et. seq.) 
  • Civil Rights Act of 1968 (42 U.S.C. 3631),
  • Fair Housing Act (42 U.S.C. 3601, et. seq.), 
  • Equal Credit Opportunity Act, 15 U.S.C. 1691), 
  • Religious Freedom Restoration Act of 1993 (42 U.S.C. 2000bb) 
  • Civil Service Reform Act Of 1978 (5 U.S.C. 110), 
  • Congressional Accountability Act of 1995 (2 U.S.C. 1301 et seq.), and 
  • Judiciary Act (28 U.S.C. 1862) 

The unquestionable aim of the Bill is to insert LBGTQ theory into Federal civil rights law and thereby compel LBGTQ claims as a social norm. It would accomplish that end by adopting questionable Congressional findings of fact embracing the terms “Lesbian, gay, bisexual, transgender, and queer (referred to as “LGBTQ”) people” and then adding “sexual orientation and gender identity” to the protected classes identified by pre-existing law. That would elevate LGBTQ claims to equal status with “race,” “color,” “religion,” “national origin,” and “sex.”

The consequences would be dramatic. Excellent background and analysis have been provided by The Heritage Foundation addressing adverse impacts on women and women’s sports, the early hyper-sexualization of children, and parental custody.

Not to be missed is this superb video of a panel assembled by Heritage of feminists and lesbian advocates who recognize in transgender theory a menace to women and society:

Baby Art: Designing Humans

Christ is Risen! Happy Easter to all. 

L.I.F.E.’s Tom Davis recently published a short essay in Deacon Digest magazine entitled Technological Reproduction and Human Dignity.  Limited space for publication necessitated abbreviated treatment of the topic, but L.I.F.E.’s Bioethics Library has a rich collection of essays on point, including an expanded version of the online Deacon Digest article. Other related insights from the John Paul II Lecture Series in Bioethics include the late William May’s Begotten Not Made, Donald Demarco on Technologized Parenthood, and Raymond Dennehy’sThe Biological Revolution and the Myth of Prometheus.

Just last week The New York Times ran a Sunday editorial on three parent embryos as a path to cure certain diseases.  L.I.F.E. is a step ahead. Must reading is Kevin Semataska’s Truth and Cloning: Political Ideology, Scientific Integrity, and the Advent of Three Parent Children from the 2018 JP II Journal of Bioethics exposing deceptive “clone and kill bills” masquerading as ethical restraint and the developing clash between those supporting “reproductive” cloning and those determined to call it anything but. The Times assures us that three parent embryos are not a path to designer babies – we’ve heard that pitch before. The ugly truth remains: the western industrialized nations are in the midst of a eugenic cleansing that began almost a century ago. Read more about it here in Crisis Magazine’s Treating Embryocide with White Gloves  (also a .pdf in our L.I.F.E. bioethics library here).