The Gospel According To Dr. Death

THE GOSPEL ACCORDING TO DR. DEATH

by Diane Sabom, Ph.D.

What do Derek Humphry, an avowed atheist, and Dr. John Pridonoff, a Christian theologian, have in common? Both have been exceedingly dedicated to the mission of the Hemlock Society, cofounded by Humphry in 1980 and led by Pridonoff, its executive director since October 1992. Headquartered in Eugene, Oregon, Hemlock is the first and most powerful of all the contemporary "right-to-die" organizations. Its main calling is to gain public acceptance of euthanasia, or as they say euphemistically, physician aid-in-dying.

Hemlock spearheaded the November 1994 victory of Oregon's Measure 16. This law, the first of its kind anywhere in the world, allows physicians to prescribe lethal doses of medicine to "qualified" patients who desire to end their lives. Because of the radical nature of this bill, a preliminary injunction against operationalizing the measure has been issued, while the Oregon courts study its constitutionality for a year. Hemlock is strategizing to bring assisted suicide legislation to a vote in other states as well.

For Christians, one ethical question is especially relevant in light of Hemlock's change in directorship and the recent success of Measure 16. Does a theologian at the helm, instead of an atheist, now signify that Christians can "keep the faith" and, at the same time, follow Hemlock in legalizing and in practicing euthanasia? After a brief review of the history of Hemlock, I address this question by examining aspects of several of Dr. Pridonoff's talks (including a "first-ever" forum with Mrs. Rita Marker, executive director of the International Anti-Euthanasia Task Force [I.A.E.T.F.]), his writings and my interview with him, with special emphasis on certain of his philosophical and theological statements. In the process this article dramatizes the clash between post- modern and theistic truth which shapes the culture war over euthanasia. Highlighted is the danger of allowing post-modern truth and an ethic of self-determination to forge public policy, especially in such crucial issues as that of euthanasia.

THE HEMLOCK LEGACY

In 1980, under Derek Humphry's leadership, the Hemlock Society began rather timidly by discussing living wills and the withholding of life supports, but ended with great temerity by publishing drug tables and practical tips for those who commit suicide in its journal, A letter to the editor entitled "Suicide at 88 Ends Pointless Life" (April, 1991) even appeared to openly condone assistance in the "self- deliverance" of the elderly who were bored, depressed but otherwise not terminally ill. ("Wasn't my father considerate to feel that he was going to become a burden?" quipped the "assisting" daughter following her father's suicide described in this letter.) Humphry's own assistance to his second wife, Ann, in the double suicides of her elderly parents and his subsequent legitimization of this act in Hemlock's , appeared to substantiate the radical turn taken by this organization.

In 1991, Hemlock published Humphry's best seller , a how to manual of suicide. Here Humphry clearly stated his atheistic underpinnings in a first chapter instruction: "If you wish to deliberately leave this world, then active euthanasia is your only avenue. Read on, carefully. If you consider God the master of your fate, then read no further." Later that same year, Humphry stepped down as executive director of Hemlock and the search began for his successor.

Of the three finalists vying to replace Humphry, two were theologians. One of these two, Dr. John Pridonoff, a man of apparently impeccable credentials, was selected. He holds a Ph.D. in psychology and has been an ordained congregationalist minister for thirty years, with most of his experience having taken place as a pastoral counselor "in the trenches"; that is, at the actual bedsides of terminally ill and dying patients. He is unmarried and, unlike Humphry, no scandals of a personal nature taint his background. (Humphry allegedly had smothered his first wife, Jean, while assisting in her "self-deliverance" and reportedly had abandoned his distraught second wife prior to her suicide.)

JOHN PRIDONOFF VERSUS RITA MARKER

I first met Dr. Pridonoff at a conference sponsored by the Physicians Advisory Council (an arm of Focus on the Family) and attended by generally skeptical, southern conservative Christian doctors and their wives in Birmingham, Alabama in August, 1994. I found him to be personable and well-spoken, with a kind, pleasant face; the kind of face in fact that a sick person might welcome at his bedside. Sharing the podium with Pridonoff for the first time ever was perhaps his most formidable opponent, Mrs. Rita Marker. The dialogue among Hemlock's new Christian leader, John Pridonoff; a Catholic anti-euthanasia advocate, Rita Marker; and conservative Christian physicians regarding issues relevant to euthanasia was both lively and informative.

Marker spoke first. Despite her petite size and soft-spoken warmth, she aimed with deadly precision to unmask, to demystify, and to expose the seemingly innocuous and harmless ideas in the strategy of her opposition. Her solemn warnings of the nuts and bolts consequences of passing euthanasia into law resonated harmonically with the forebodings of her audience. Quoting professor of moral theology William B. Smith, Marker emphasized that "Social engineering is preceded by verbal engineering...." She warned, "The right to die, death with dignity, and physician's aid-in-dying are really about the right to kill." Charging to what she regarded as the heart of the matter, she added, "Euthanasia is not about plumping someone's pillow. It means people die, to make them die. This is a debate about whether doctors are to be given the right another group of people." Furthermore, "We are talking about drafting into law a medical procedure that would soothingly, painlessly, guiltlessly and eternally end the life of a qualified patient." She paused ever so slightly after each word to allow the gravity to sink in.

Following Mrs. Marker to the podium, Dr. Pridonoffs voice evoked the tension of the moment, as he spoke of "a humorous note" that fell flat. No one laughed as he remarked that on that same day 2000 years ago, Cleopatra killed herself with an asp. He then began what Marker had identified as verbal engineering: "First of all, the right to die is not about the issue of killing people. Killing is really a misnomer. It is an inappropriate word to use. We're not talking about euphemisms here but of what words mean in the understanding of the general public but also in the law." Pridonoff implied that the consensually agreed to killing that occurs with acts of euthanasia lacks the imposition of one's will upon another. He pointed to the biblical commandment "Thou shalt not kill" as denoting in the Hebrew that "Thou shalt not " The killing accomplished by one's euthanizing is not murder—the taking of one's life against his will—according to Pridonoff's logic.

He reported on the findings of various polls that appeared to confirm that a majority of Americans approves of physician assisted suicide and then disarmingly offered the following disclaimer: "Am I saying therefore [that] what this is telling us is that these laws should be passed and that everybody is saying this is a wonderful idea? I'm saying 'No'. What this is telling us is that there's a lot of dialogue going on and people want more information." He argued right out of Hemlock's mission statement that "[People] should be able to have dignity, integrity, self respect, whether it be in living or dying or death." No one could object to more "dialogue", "dignity, integrity, and self respect".

One of Pridonoffs consistent arguments was that back alley euthanasia goes on behind closed doors and that laws need to be passed to allow euthanasia to be practiced without secrecy, shame, and the fear of persecution and prosecution. These laws would make safeguards enforceable, according to him. Marker countered, however, that while Hemlock and other Right to Die advocates tout the protective safeguards as being practically ironclad in trying to sell their various state initiatives, they are really like the emperors new clothes. These "safeguards" simply are not there! Or they easily can be sidestepped. For instance, Oregon residency can be established for Measure 16 with a voter's registration, which requires no proof of residency. Similarly, the family need not be contacted until the person's actual death occurs. While three requests must be made by the person desiring to die, the doctor's word is all that is necessary to "verify" the two oral requests and the witnessed written request. Perhaps the most frightening aspect of the Oregon measure is that listing "physician assisted suicide" as a cause of death on the death certificate is not required. Built into the initiative is a rule that none of the information regarding such suicide cases shall "be [open to] the public" [sec. 3.111. In other words, a mechanism for monitoring is built into the legislation.

Marker stressed the example of the Netherlands where abuse of euthanasia has reportedly become the norm. She invoked the hard data of the Remmelink report, an official study of the Dutch government published in September, 1991 which granted anonymity to doctors in an attempt to establish the true state of the practice of euthanasia in Holland. Remmelink actually showed that doctors have largely taken over end of life decisions.

According to its data for the year of 1990, physicians intentionally ended the lives of 11,840 patients in one year by lethal injections or prescriptions (9.1% of the total deaths of the country that year). Only 2300 had requested to die, and only 400 of these self administered their own ends. In 45% of the hospitalized cases involuntarily euthanized, patients' families were unaware of their cause of death. These figures did not include instances of passive euthanasia (that is, the withdrawal of life sustaining treatment), newborns, children, and psychiatric patients. (I.A.E.T.F. "Fact Sheet" on "Euthanasia Practice in Holland", March 1994.)

To Marker, the Dutch experience with euthanasia teaches that, however much patient autonomy and choice figure in the establishing of the practice of mercy killing, a significant number of persons wind up having no choice. Moreover, euthanasia will not remain a "right" only for the terminally ill. Others will inevitably, according to this logic, have the same claim to end their suffering "even if they do not or cannot voluntarily request death." Dr. Cor Spreeuwenberg, editor of the journal of the Royal Dutch Medical Association, makes this claim on behalf of newborns by stating:

[While some liberals think only voluntary euthanasia is acceptable,] I concur that autonomy ought to be the point of departure in euthanasia decisions, but it should not be the only principle considered. Because newborns cannot exercise autonomy does not mean that they should be denied beneficence.

There are many less important decisions we make in their behalf, why should they be denied perhaps the most caring choice of all?" (, April 1994, p. 64).

How Mrs. Marker would pummel Spreeuwenberg for calling the calculated murder of infants "caring choice" and "beneficence", one can only imagine.

Marker's message challenged her audience to think about how the doctor/patient relationship would be changed once physicians are given the power to kill. Medical schools would require training in the area of administering lethal medications. Specialists would likely develop to whom doctors would then refer patients. Suicide would have to be presented to patients as a medical or treatment option. Some patients would no doubt feel pressure to accept that option, if presented with the stamp of medical authority. Marker dramatically and effectively held up a green card now being carried by some Dutch patients to notify their doctors that they do not want to be euthanized.

Pridonoff did not focus on the experience of euthanasia in Holland, nor bring it up as a glowing example of liberation, as do many proponents of aid-in-dying. He spoke as if he would deplore a situation in which the statistics are as Marker represented them. Yet, he later admitted to me that he had not specifically been to Holland for the purpose of investigating the reality of the abuses as they were reported. One who does know first hand the spectre of the abuse of euthanasia is Dr. Pieter Admiraal, a Dutch anesthesiologist who has arguably euthanized more persons than anyone else on earth. According to Patrick Cooke, contributing editor of the medical journal . the following quotation applies to Admiraal:

I know a doctor who is very dedicated to euthanasia and one of his fears is that if there are no young people to care for the elderly in the next generation, they will decide to kill a person because he is demented. And do you know the name of that famous doctor I am speaking of? It is Admiraal (p. 58, Sept./Oct.).

From Admiraal's vast experience in Holland, he apparently questions his own safety from being euthanized against his will in old age. If this is an anxiety for him, how much more so for others. This supposition is only underscored by the green card carried to hospitals by frightened Dutch.

Pridonoff acknowledged the importance of the question "Are we playing God" in determining a person's attitude toward euthanasia. "If one believes that this is God's life to give and to take away; then, such a person would be uncomfortable with what Hemlock advocates. That would violate God as they understand him to be." (This last statement is exceedingly close in character and meaning to Humphry's words from to the effect that if one believes that God is the master of his fate, then active euthanasia is not an option for him.) Pridonoff proceeded, "Where we [at Hemlock] become concerned is when someone takes their [sic] particular view and imposes it on others." Continuing noncommittally, "Others believe God has given mankind a brain to be able to make decisions to hopefully improve the nature and quality of life for the human race."

Though Pridonoff raised theological issues in his talk, he categorically refused to answer doctrinal questions. One physician, for example, theorized that physician assisted suicide presupposed that the patient would be better off and would suffer less once he were dead. Therefore, he deduced, was it not necessary to consider what is going to happen to the patient after he dies? The doctrinal question he was asking Dr. Pridonoff was whether or not he believed in an afterlife and what its nature might be. Pridonoff answered, "I would be very concerned if physicians or other health care professionals were using, as part of their process of making a decision, what's going to happen to the patient after they [sic] die. That would be bringing in theology or at the least, some degree of spirituality."

PRIDONOFF AND THEOLOGY

Following Pridonoff's and Marker's talks, I interviewed Dr. Pridonoff and examined several articles concerning his statements regarding God and the nature of truth. Also present during this interview was my husband Michael Sabom. In my interview, I was not allowed to penetrate his personal belief system head-on. I made multiple attempts to elicit answers to such questions as "do you believe in the Trinity or hell or judgment," but was met each time with a facsimile of the following reply: viz., "I do not want to get into theological doctrine; because as the director of the Hemlock Society, that's not why I'm here."

Despite Pridonoffs reluctance "to get into theological doctrine" in his talk and in my interview, he clearly abrogates this stance with his Hemlock readers in an article entitled "How 'Right' Is the Religious Right?" in the April 1993 issue of the . Here, relying on his credentials "as an ordained Christian minister", he accuses the "misguided zealots" of the "Roman Catholic Church and the fundamentalist extreme right wing of the Protestant Church" of "using 'God' and the 'Name of God' as their invocation and justification" for "pontificat[ing] about the sins of [those favoring right to die options]". His hostility toward such opposition is readily apparent. He calls those same zealots who oppose euthanasia in the name of God "the radical dimension of Christianity" (p. 4). An analysis of some of his key statements provide important clues to his theological beliefs.

In his article, Pridonoff is no longer noncommittal to the question of whether this is God's life or man's to do with as he sees fit. Rather, he writes, "If God truly has given me a gift of life, then it is mine to do with as I wish." He amplifies that a true gift has no strings or attachments. The moral compass to help man captain his ship, so to speak, Pridonoff describes as follows: "God gave us each a . We have the ability to and to the relationship between cause and effect, action and reaction, freedom and responsibility, choice and consequence. We have ... that guide us in decision-making and help us establish parameters within which to live" [emphasis in the original]. Where, then, does scripture fit into this view? Pridonoff continues:

Recognizing that there are scores of translations and revisions of the various texts and scriptures of the books of the Bible, if one were to "quote" the Bible, one would also have to prove the version, translation or revision used was the "authentic" one. Such proof has been impossible throughout the hundreds of denominations within the Christian Church — not to mention the varied approaches in the Jewish faith.

In short, one's quoting of the Bible is problematic because of its textual unreliability. Unreliable scripture lacks authority no matter what it says. Naturally, then, man must use his own interpretive apparatus—his mind, feelings, understandings, etc.—to sift data without the plumb line of reliable scripture.

A misconception of the religious right, according to Pridonoff, is that the Bible condemns suicide. In his own words, "The Bible does not take any moral, religious or ethical stand on suicide. Some of the writers of books of both the Old and New Testament have acknowledged the existence of suicide (such as when Judas committed suicide after betraying Jesus). Neither God nor Jesus make any judgments on the taking of one's life."

Having taken the position that scripture is unreliable, is noncommittal on suicide, and does not directly contravene the act of euthanasia, it is no surprise that Pridonoff resists any notion that physician aid-in-dying could be against "God's will". Furthermore, the question underpinning the phrase "God's will", in his words, is "which God? The God of the Jews? The Christians? The Moslems? The Buddhists? The Hindus? What about the major religions of the World that don't have a single God, but Multiple Gods." Here Pridonoff invokes an obfuscating pluralism, as if to say that there is no way of deciding between such conflicting ideas of God. Therefore, he concludes that the place of religion is "in the hearts, minds and lives of believers—where it should be."

He thus banishes religious truth from the public sphere of policy making to the private realm where it cannot significantly influence moral decisions for good or evil. Pridonoff would make euthanasia—physician aid-in-dying—"a personal issue" between a person and his physician. Emphatically, then, he writes, "What is 'right' for me may not be 'right' for you. Each of us should be able to determine what is appropriate for ourself" [sic]. The egregious sin of the religious right is in believing in the reality of a God whose truth is real beyond our own hearts and minds; and whose truth, therefore, it is wise to consider. To Pridonoff, this is merely the intolerance of taking one's own view and attempting to impose it on others. In the name of Tolerance, religious truth should be silent.

In a January 1995 book review in (the renamed ), Pridonoff writes: "(T)he Catholic leadership fails to remember that their power is derived from the people, not from their robes, and that they are invested with that power predicated on the foundation that they will maintain an active dialogue with the general membership of the Church." While this viewpoint is attributed to the author of the book under review (Dick Westley, ), Pridonoff endorses the statement as a "salient point [made] in a most persuasive manner" and recommends the book to "anyone who wants to effectively debate the Catholic opposition, or to alleviate fear or guilt imposed by others." In so doing, he seeks to undermine the spiritual authority of the Catholic Church and opens the door even more widely for his views on truth, which have more in common with secularism than theism.

TRUTH AND THE NATURE OF MAN

With Pridonoff, truth shifts on the sands of pluralism to acquire a small "t". It, like God, is what our particular perspectives tell us what it is. This view tends to reduce truth— especially as it operates within the public policy arena—to the status of preferences or opinions. For all practical purposes, this is nothing short of a definition of ; that is, truth from the perspective of an individual without the binding force of external authority with the power to direct morality.

When truth begins with a little "t", life begins with a little "l". Pridonoff speaks about life as "sacred": "We believe that life is sacred as is death and the dying process." Its sacredness, however, is a subjective rather than an objective determination and hinges on how a person defines "life" and at what point one's "quality of life" ceases to be worth the pain and/or suffering of living, according to that individual.

Nowhere is this thinking more pervasive than in Pridonoff's response to the death of Janet Adkins by Dr. Kevorkian and how this act fits into Hemlock's view of euthanasia. In our interview, Dr. Pridonoff told me unequivocally that "the only people who should be able to ask for aid-in-dying should be mentally competent, adults who have fulfilled the safeguards that would be written into legislation that would be passed" (emphasis mine). He stated that as long as Hemlock has been incorporated (1980) that that is all that they have ever advocated. Yet, the following dialogue betrays a more ambiguous position in relation to Janet Adkins, the Altzheimers' patient whom Dr. Kevorkian made the first victim of his suicide machine in late 1989. (Now there have been 21.) Only recently diagnosed, she had played a game of tennis that week and did not fit the criterion of having only six months to live. The conversation proceeded as follows:

Dr. Pridonoff: Okay, I think that Janet Adkins is a good example where I think that [euthanasia] has to be up to the individual in relation to themself [sic] and their God and how they perceive it. Janet wanted to be able to have aid-in-dying while she still had control of her mind.... It does get down to the individual and where they stand theologically.

Interviewer: So, you and Hemlock don't really take a position on what you consider to be "life"?

Dr. Pridonoff: We don't take the position of what life should be for each individual. We feel that others, the individual has to be able to define that. Hemlock is not a theological organization. It's an educational organization.

What is probable is that Dr. Pridonoff is being disingenuous when he says that he and Hemlock desire to limit those qualified to receive aid-in-dying under the law to those who are terminally ill and have only six months to live. In addition to extending the option of aid-in-dying to Janet Adkins (and, presumably to those in similar situations), Dr. Pridonoff has indicated an openness to an even further extension in (April 1994, p. 425): "I think we should " (emphasis mine).

His language indicates a preliminary position, to be followed by a less conservative one. He goes on to add, "And if it's found that the medical community and so forth have the maturity to handle it, then, perhaps a somewhat more liberalized policy—such as —could be discussed." Although Dr. Pridonoff is not here advocating the adoption of nonvoluntary active euthanasia but rather is theorizing on the conditions of possibility for such a discussion to take place, it must be pointed out that nonvoluntary active euthanasia involves killing patients who have not requested to die!

Killing the unconsenting generally has been recognized by ethicists as the absolute bottom of the abyss of the slippery slope (cf. , April 1994, p. 64). The ground on which to broaden policy would once again be the right of self determination. As Pridonoff has said, "What is right for me may not be right for you. Each of us should be able to determine what is appropriate for ourself' [sic.]. However, with nonvoluntary active euthanasia, the "self' in "self-determination" has been removed.

The comment of one physician during the question and answer session at Birmingham is appropriate. He asked Dr. Pridonoff, in effect, if someone experiencing mental distress or maybe "just a bad hair day" would be allowed to have help in committing suicide. Dr. Pridonoff answered that persons who are suffering from depression should not be allowed this option. But in Holland, the courts have rendered depression an acceptable reason to receive aid-in-dying. Moreover, it is well documented that physicians in general practice regularly miss the diagnosis of depression in patients who are chronically ill (Jennifer LaBarbera, "Efforts Underway to Aid Generalists in Detecting, Treating Mental Illness" in , Feb. 15, 1995, p. 1). Is each candidate for physician assisted suicide, then, to be psychiatrically evaluated? This is not being recommended in Oregon's new law; nor is it standard procedure in Holland.

Even if each person contemplating euthanasia received a psychiatric evaluation, Pridonoffs philosophy, which allows each person to define "life" for himself, is dangerously flawed. In order for one to know the mind of another thoroughly enough to be able to stamp a person as "qualified" to end his own life, without such distortions, for example, as depression or the pressure of family members having entered into the decision, is, according to post-modern notions of truth, impossible at the outset. An epiphenomenon of modernism and of post-modernism has been to dissolve the self as a rational center from which action can be categorized as generated entirely and only from the person. The person is more akin to a sponge, absorbing linguistic messages from a culture which is coextensive with him.

Furthermore, the idea of a disinterested interpretation has been thrown out of much contemporary knowledge. Under this scheme, there is no such thing as an objective, valueless opinion from which to determine the mind of another. "Safeguarding" the subliminal would surely be an impossible task. In an economy that abjures even the possibility of objective truth, it is a given that evaluating motivation will at best achieve only an asymptotic approximation. Yet the stakes of correctly perceiving mental states could hardly be higher. Wisely, the Bible observes that only God can judge another's heart. Measure 16 (and Pridonoff) would require doctors and others to do just that!

When I asked Dr. Pridonoff if he believed that the nature of man is basically good, his affirmative response conveyed an almost reverential conviction. This deeply held idea, in conjunction with his faith in the power of man's reason to control outcomes may well contribute to his tendency to see physician assisted suicide in such positive ways. He speculated, for instance, "Let's hypothesize for one moment and let's say [legalization] turns out to be bad legislation.... I believe that people will act. I believe that they will correct it; they'll tighten it up; they'll make it appropriate."

Dostoevski recognized that the problem of truth and morality is more complicated in his nineteenth century maxim from that "Without God, all things are lawful." Here he is recognizing that the "why not" is missing. More recently, in "Fashioning An Ethic for Life and Death in a Post-Modern Society" bioethicist H. Tristram Engelhardt, Jr. has written that "In a secular, pluralist society one will need to accept euthanasia by default"; not because it is good, but "because one does not have the authority coercively to stop individuals from acting together in such ways." ("A Special Supplement" to the [January-February], 1989, p. 9). In other words, punishment requires a norm of the acceptable. If the standards of truth are so individually and so subjectively determined that consensus is not possible, then how can anyone judge when life ceases to have meaning for another?

In Holland, for example, euthanasia is not being prosecuted because the right to death is based, among other things, on an individually defined criterion of "intolerable suffering". Post-modern society, with its "subjectivized" truth cannot intervene with any compelling justification. The "right" to suicide can easily run amok under such criteria, as many claim is happening in Holland. Pridonoff implied that we have protection in the U.S. in a stronger religious tradition. But Pridonoffs theology without authority hardly strengthens that tradition.

The German philosopher Nietzsche recognized more than a hundred years ago that without God as an absolute foundation, all issues of truth and morality become interpretations and questions of power: that is, they become my (arbitrary) opinion vying against your (arbitrary) opinion for the right of control. (See, for example, Friedrich Nietzsche, , #481, and , #13.) Pridonoff is attuned to this issue of power in relation to the subject of euthanasia. In fact, he urges membership in the national Hemlock Society "as a power weapon against hate, fear, guilt, prejudice, and bigotry." He writes, "Doctors are looking to you to give them permission to promote changes in the law. The general public often has been intimidated by fear mongers who try to control their minds and lives 'in the name of God"' (, July 1993, p. 8). Pridonoff would make of Hemlock the power weapon against those who would invoke God's name or His will as a reason not to support physician assisted suicide. Pridonoff's call is to galvanize power in numbers among those who see truth as he does: that is, as a private, personal matter. He invites that power into an adversarial relationship with those whose truth is undergirded with the moral force of God's interdiction: namely, the religious right.

THE NEAR DEATH EXPERIENCE

Pridonoff's strict adherence to the notion of "self-determination" is repeatedly emphasized in his talks and publications ( "Personal beliefs, decisions and desires should be respected. What is 'right' for me may not be 'right' for you.") What he does not address, however, is whether or not there is a time during the act of euthanasia when these "personal beliefs, decisions and desires" of the dying should be respected during the assisted suicide. For example, in his recent article in (Nov./Dec. 1994), he emphasizes the "difficulty and danger" of using a plastic bag:

If the patient is alone, he or she may instinctively respond with flailing hands in a desperate attempt to rip the bag from the face — even if unconscious... [I]f another person is in attendance, that individual may be forced to physically restrain the patient—with a benefit to the dying person but filled with traumatic psychological consequences for the surviving loved one. (emphasis mine)

Pridonoff's concerns at this point are with assuring the death of the person and with the psychological well being of the survivors. He takes for granted that the person's desire to end his life remains constant. When the dying person is physically restrained from aborting his own death, however, "self-determination" becomes "other-determination." This is true .

Research into the experiences of dying persons (e.g. near death experiences) has shown that powerful, life changing events frequently occur in people while unconscious and near death (Michael Sabom, , 1982). Moreover, when a suicide attempt is accompanied by a near death experience, the survivors of the suicide uniformly are left with the strong conviction that the suicide was wrong and should not to be repeated. The recidivism rate among these suicide attempters is nearly zero and has been attributed to insights gleaned from the near death experience per se (Bruce Greyson, ; 140:5, May 1983; pp. 618- 620).

Of course, in order for us to know whether or not such a change of heart has taken place in a person attempting suicide, assisted or not, the person must survive. If survival is prevented (especially in someone using "flailing hands in a desperate attempt to rip the bag from the face"), then none will ever know if suicide was truly the last wish of the deceased. With such uncertainty, Pridonoff's ideal of "self- determination" is terrifyingly wanting.

"THE SILENT SHUNNED"

At the annual conference of the Hemlock Society in Kansas City on October 22, 1994, I saw Dr. Pridonoff again. He spoke impassionately to the audience about prejudice and pre judgment against "the silent shunned"—those persons (including professionals and others—doctors, social workers, chaplains, nurses, friends, family members or loved ones) who assist others to kill themselves or who sit at the bedside while the suicide is carried out. He noted their sense of trauma from the visual impact of what they witness; their fear of rejection and/or of prosecution that compels them to silence; their internalizing of the event alone; and their being stigmatized and "shunned" by close friends and relatives. They may even shun themselves. To the director of the Hemlock Society, the silent shunned are a major reason why attitudes and prejudices must be changed.

Pridonoff was acknowledging that people have a hard time living with their complicity in assisting in suicide: , "They wonder whether they've done something wrong." He did not emphasize, however, the possibility that they are having their own pangs of conscience. Rather, he blamed others for imputing wrongdoing. His implication was that their consciences would not bother them, if only other people would not point the finger.

There is some truth to Pridonoff's assessment. As Rita Marker pointed out, "the law is a great teacher." In a pluralistic society what is legal eventually becomes moral. In addition to changing the law, Pridonoff and right-to-die advocates want acts of euthanasia to be deemed acceptable. Consciences are less likely to be pricked, if people avoid pricking them.

Consciences, however, will not altogether be silenced. For example, ABC's "Primetime Live" on December 8, 1994 aired an actual physician assisted suicide in the documentary film "Death on Request". Here, Antoinette de Joode asks her physician for confirmation that they are doing the right thing in killing her 63-year old husband who has Lou Gehrig's disease (ALS). This question occurs within Dutch society which lacks a strong religious tradition. Aware that euthanasia is effectively condoned within her society, Mrs. de Joode is nevertheless asking a question and not making a statement. Presumably not religious, neither of the couple mentions religion in discussing the imminent event of the husband's induced death. The question of the morality of killing her husband in this manner apparently wells up from within Mrs. de Joode.

PRIDONOFF AND CHRISTIANITY

To return to the question of whether or not a Christian can "keep the faith" and follow Pridonoff in supporting and in practicing euthanasia, it is important for Christians to know that Pridonoff has, from all indications, adopted a man-centered rather than a God centered theology. Believing in the basic goodness of man, Pridonoff has, in effect, made this same man to be his own moral compass, attributing to him the power to assess parameters and to make decisions using his mind, understandings, and feelings. At the same time, declaiming the near impossibility of deciphering authentic scripture from the maze of texts, translations, and revisions, Pridonoff implies that the "quoting" of the Bible is futile without first establishing such authenticity. This position would contradict wide agreement among traditional theologians that textual errors in the Bible are not essential to its basic meaning. Seeing the Bible as inherently unreliable would preclude from the outset its worth as a plumb line against which to test reality.

Certainly, no orthodox interpretation of Scripture stresses anything other than the fallen state of man. In this view man's reason and feeling alone are inadequate indices for him to perceive and to do what is right. According to the Bible, the human heart, above all things, is deceitful; able to mislead and to be misled. It warns against doing what seems right in one's own eyes, but wrong in God's. Such conduct led to the collapse of society in the times of the Judges in the biblical book by the same name. God's thoughts and ways are not man's. We are to walk by faith (in His truths) and not by sight (that is, by our own assessment of what appears to us to be right and wrong). In the Genesis account, original sin begins when the serpent deceived Eve into believing that she could be wise like God in deciding this for herself.

Pridonoff denies that the Bible condemns suicide and boldly states that "Neither God nor Jesus make any judgment on the taking of one's life." He adduces the example of Judas, of whom the Bible says only that he hanged himself, as evidence of its neutrality. However, in context and by direct inference, the Bible conveys that Judas' act of suicide is one of great desperation and hopelessness, which its teaching is meant to overcome (discussion with Rev. Stephen Jackson, East Cobb Presbyterian Church, Marietta, Georgia, Nov. 1994). To erect Judas' behavior as a model of neutrality, as does Pridonoff, is a perversion of the biblical message. Judas' suicide betokens poetic justice to a man who betrayed moral law to seek his own way.

Pridonoff professed concern about professionals who would invoke their belief in an afterlife to steer patients to end-of-life decisions one way or another. He, however, shared freely with Hemlock supporters in Kansas City his unequivocal conviction that those who choose to end their lives by an act of euthanasia are at peace after death: "If the patient is successful in being able to have delivery from this life, and its pain and suffering if they are terminally ill; they're no longer in pain; they're no longer suffering; they're no longer existing; they're at peace." This is nothing less than a theological presupposition; one which is consistent with there being a lack of conflict between suicide and one's ability to be at peace beyond death.

But can one keep theology out of the debate over euthanasia altogether and evaluate it on purely secular grounds, as suggested by Pridonoff? As the executive director of Hemlock, certainly he has attempted this non-theological stance when he claimed that "Hemlock is not a theological organization. It's an educational organization"; and when he himself refused to address doctrinal questions of theology. Using his credentials as a theologian and his own theological arguments, he nonetheless vigorously derided the "misguided zealots" of churches which oppose euthanasia. But, in fact, suicide is often viewed as self-murder by an orthodox interpretation, and as such, the person's "peaceful" afterlife (Heaven?) is open to debate. This is a , and not an educational issue, as Pridonoff would maintain. The act of euthanasia begins in the physical realm of life, but ends in the theological realm of what is beyond life (the afterlife?). Both are integral to a discussion of its merits.

Why does the public so much fear legalizing euthanasia, asked Pridonoff at the Kansas City meeting. He denied emphatically that the fear of abuses were the true reason. Abuses, he argued, can too easily be monitored. No, the real reason for people's fear was the fear of accepting the increased responsibility for themselves that such a change in the law would mean. In effect, they feared becoming the captains of their own ships instead of being controlled by the prevailing mindset of those who would make God the ultimate master of their fate. His "autonomous self" navigating its course according to its own standards (inevitably its own constructed truths) is pitted against the self dependent upon the truths of a sovereign God.

Pridonoff is right about much of the public fearing more than abuses. They fear that they and others cannot be trusted to do what is right according to their own eyes: that is, specifically, to determine who should and should not die, according to physician assisted suicide. They are afraid of man's lack of intrinsic goodness, of his selfishness and greed and are afraid of denying God as the ultimate authority over man. They are afraid of finding that they are indeed accountable for their actions in whatever is beyond life. They fear finding out, for example, that God's meaning of "Thou shalt not kill" may not agree with that of "verbal engineering". Pridonoff, on the other hand, is himself not afraid because he believes that, since man is good, he can be trusted to control his own life and to make good laws. It stands to reason, furthermore, that if man is basically good, he need not fear accountability in the beyond. In Pridonoff's theology, then, one must question the role of Christ to reconcile sinful man with a holy God. The need for Him quite simply collapses.

While on the surface there would appear to be a great gulf between an atheist and a theologian, in reality Pridonoff offers Hemlock more cosmetic refinement than practical difference. Both Humphry and Pridonoff look to man for ultimate answers about reality. Pridonoff, however, with his more credible integrity and knowledge of theology, stands to be exceedingly more effective, and therefore more dangerous, in (mis)leading Christians of a relative or of a confused persuasion to follow him.

Though it is unfortunate that more compassion is not being shown toward "the silent shunned" who no doubt have attempted to be honorable toward the wishes of their patients, friends and family members, Pridonoff is absolutely correct to focus on the public's fear of those involved in acts of euthanasia as an indicator of the utmost importance. He is likewise right to perceive the fear of the silent shunned as the fear of man's absolute freedom over himself. But when, by his verbal slight of hand, he calls the fear of God "fear-mongering," he misses the point. The fear of God, we are told, is the beginning of wisdom.

Dr. Diane Sabom is a writer from Atlanta, Georgia.

Taken from the June 1995 issue of "Fidelity" Magazine, 206 Marquette Avenue, South Bend, IN 46617. Subscription price is $25.00 per year. Letters to the editor may be sent by fax, 219-289-1461, or by electronic mail ton CompuServe 71554,445.