Poll: No Majority for Assisted Suicide
A new poll by the national polling firm Baselice & Associates suggests that Americans’ support for assisted suicide may have peaked.
The telephone survey, conducted June 6-8, asked 1000 registered voters: “As you may know, physician-assisted suicide involves a doctor giving a patient the means to end their life, such as a prescription for a fatal dose of a drug. Do you think it should be legal or illegal for a doctor to help a terminally ill patient commit suicide?” Forty-eight percent said it should be “legal,” 40% said “illegal” and 11% were unsure.
The same question showed 50% support for legalization when asked by the Washington Post in March 1996 and by the Tarrance Group in October 1996 [see June 1996 and Oct.1996 Life at Risk].
The new poll shows lower than average support for legality among women (45%), voters aged 65 or older (40%), those with an annual income under $25,000 (36%), African Americans (27%), and weekly churchgoers (31%). Life at Risk, June-July, 1998
Poll: 50% Favor Assisted Suicide
A new Tarrance poll commissioned by the National Conference of Catholic Bishops confirms that public support for physician-assisted suicide stands at just 50%, not the 75% claimed in some news reports this spring.
The Tarrance poll asked a question identical to one used by the Washington Post in March: “As you may know, physician-assisted suicide involves a doctor giving a patient the means to end their lift, such as a prescription for a fatal dose of a drug. Do you think it should be legal or illegal for a doctor to help a terminally ill patient commit suicide?” Fifty percent favored legalization — exactly the same percentage as in the Post’s poll, despite six intervening months during which news media gave generally sympathetic coverage to the idea of a “right to die.” In the new poll, 35% wanted the practice to be illegal and 14% were unsure. The findings are also consistent with a September 1994 Tarrance poll, in which 46% favored and 39% opposed a law allowing terminally ill adults to obtain physician-assisted suicide, with 15% undecided.
Also of interest were demographic breakdowns. Support for legalization dropped below a majority among women (47%), adults aged 65 and older (44%), Republicans (43%), African- Americans (39%), and regular churchgoers (32%), with churchgoing Catholics showing the lowest support of any group (29%).
The Tarrance Group conducted the poll by phoning a representative sample of 1000 registered voters from October 13 to 16; the margin of error is plus or minus 3%, with a 95% confidence level. Life at Risk, October, 1996
Poll Results: Why Did Oregon Voters Reject Measure 51?
Measure 51, a ballot measure designed to repeal Oregon’s 1994 law allowing physician- assisted suicide, was defeated November 4 by a vote or 60% to 40%. To better understand this vote, the U.S. Catholic Conference commissioned the polling firm or Baselice & Associates to conduct a telephone survey of 500 registered Oregon voters on November 6-9. Key results follow:
Of the 449 respondents willing to say how they voted on Measure 51, 58% said they opposed the measure and 42% said they supported it. This reflects the actual statewide vote of 60% to 40%, given the poll’s margin of error of +4.5%. 83% of voters said they made up their minds on the proposal before the final weeks of the campaign. Reasons for Support/Opposition
When asked an open-ended question about the main reason they voted as they did, 57% of those who supported Measure 51 cited religious or moral reasons; another 17% cited the 1994 law’s lack of safeguards or its prospects for abuse.
By contrast, only 34% of those who voted against Measure 51 said they did so from a belief in a right to choose assisted suicide. Fully 24% said their chief reason for opposing the repeal measure was simply that the people of Oregon had already spoken on the matter; another 12% voted no out of concern for intractable suffering.
Voters were also asked a multiple-choice question.
For supporters of Measure 51:
People had various reasons to vote for Measure 51. which of the following reasons would you say was most important to you?
- Assisted suicide is morally wrong as a matter of principle — 59%
- The law allowing assisted suicide could lead to many undignified deaths from botched suicide attempts — 12%
- Allowing assisted suicide for vulnerable patients will place social and economic pressure on them to die — 9%
For those who opposed Measure 51:
People had various views on the 1994 law that Measure 51 would have repealed. which of the following would you say is closest to your own view?
- The law allowing assisted suicide has flaws, but legislators should fir these flaws instead of sending the whole law back to voters for repeal — 29%
- The law allowing assisted suicide is a good law, with adequate safeguards against abuse — 43%
- The vote was not so much about the merits of the law, but about the role of outside religious groups trying to tell Oregonians what to do — 19%
Ambivalent Answers on Assisted Suicide (Questions asked of all respondents)
Which do you think should be a higher priority for society?
- Guaranteeing that dying patients can die as quickly as they want to die – 29%
- Guaranteeing that dying patients can receive pain control and good hospice care for as long as they live– 50%
- Terminally ill patients who want to commit suicide should be helped with their problems, not helped to die: 53% agree (34% strongly agree); 35% disagree (19% strongly disagree)
- Laws should not keep people from getting help to take their lives, whatever their reasons — it’s their choice: 52% agree (37% strongly), 43% disagree (30% strongly)
Views on Measure 51 did not vary based on whether the respondent or a loved one had experienced a serious chronic or terminal illness. They did vary by religious commitment. For example, support for Measure 51 rose to 53% among all Catholics, and 87% among churchgoing Catholics. Life at Risk, November, 1997
Lies, Damn Lies and Statistics: Opinion Polls on Assisted Suicide
A perplexing feature of the debate on assisted suicide has been the apparent divorce between public sentiment and legislative action.
It is commonly felt that public support for legalization is high: “Three of four Americans support it,” says a recent headline in USA Today [6/7/96, page 4A]. Yet voters and legislators in almost all states continue to reject proposals to legalize assisted suicide. Why the discrepancy?
One explanation lies in a regrettable tactic of some pollsters that might be called the “bait and switch.” Respondents are asked a question in vague euphemisms, inviting a positive response; then poll results are reported to the public in blunt and accurate terms never used in the poll itself.
A case in point is a Gallup poll of April 9-10, 1996, which asked: “When a person has a disease that cannot be cured, do you think doctors should be allowed by law to end the patient’s lift by’ some painless means if the patient and his family request it?” This elicited a “yes” from 75% of respondents and “no” from 22%. Gallup then reported 75% support for “physician- assisted suicide,” and newspapers uncritically repeated this claim. (When Gallup asked this question again on April 25-28, it received a response of 68% to 29%; yet USA Today was still repeating the obsolete “three of four Americans” line in June.)
The problem with this poll is that it never did ask about physician-assisted suicide. Setting aside the question of “soft” versus harsh language, it is not at all clear that most respondents understood what they were being asked. Some could have taken a question about “ending life” as referring to ending life support, which is morally and legally accepted. A question about whether people should be able to end life in a “painless” way may be taken as referring to pain control:
Few people would prefer reaching the end of life in a “painful” way. Gallup also “sweetened” the question by specifying a request by “the patient and his family” — although the Oregon law does not require family notice, and the recent Ninth Circuit ruling in Compassion in Dying said any law requiring family consultation “would raise constitutional concerns.
What happens when Americans are asked about assisted suicide? Recent polls by a major newspaper and by groups on both sides of the issue suggest an answer:
- A March 22-26 poll by the Washington Post asked: “As you may know, physician- assisted suicide involves a doctor giving a patient the means to end their life, such as a prescription for a fatal dose of a drug. Do you think it should be legal or illegal for a doctor to help a terminally ill patient commit suicide?” With this question, 50% favored making it legal, with 40% saying it should be illegal and 9% undecided [Washington Post, 4/4/96, page A18. Majority support for keeping it illegal was found among voters over 65 years old (54%), those with incomes under $15,000 (54%), and black Americans (70%).
- A Tarrance poll conducted for the National Conference of Catholic Bishops in September 1994 asked about “a law to allow terminally ill adults to obtain physician-assisted suicide.” Such a law was favored by 46% and opposed by 39%, with 15% undecided. A different sample, asked about “a law to allow terminally ill adults to obtain a physician’s prescription for lethal drugs to end life, ” opposed such a law 47% to 43%. Support for “physician-assisted suicide” also dropped to 43% once respondents learned more about the Oregon bill.
- An August 1993 Roper poll, commissioned by Derek Humphry’s “Euthanasia Research & Guidance Organization” and supported by the Hemlock Society, asked Americans whether they would be for or against a law “that allowed a terminally ill person to choose physician-aided suicide rather than prolonging life.” The poll showed 44% for and 36% against (with women divided 40% to 39%). Changing “physician-aided suicide” to the vague euphemism “physician’s aid in dying” elicited only 51% support.
Please look again, Gallup and USA Today. Life at Risk, June, 1996
Background: Euphemisms and Euthanasia Polls
It has been claimed in recent years that two out of three Americans support legalization of physician-assisted suicide. Recently Kris Larson of the national Hemlock Society claimed that public support is increasing further (UPI, “Lifestyles,” 2/7/94).
But a new Roper poll partly funded by Hemlock paints a different picture: An ambivalent and closely divided populace that significantly shifts its response depending on the wording of the question.
The August 1993 poll of about 2000 Americans was commissioned by the Euthanasia Research and Guidance Organization (ERGO!), a new group directed by Hemlock founder Derek Humphry. Half the sample was asked questions using euphemisms, while the other half was polled using blunter language. Commenting on the results, Hemlock’s newsletter concludes that “Americans would be more likely to vote for a law allowing physician aid-in-dying if that law were written using euphemisms instead of more direct language” (Time Lines, Jan.Feb.1994, p.9)
Asked whether they would support “a law that allowed a terminally ill person to choose physician-aided suicide rather than prolonging life,” 44% of the respondents supported the law and 36% opposed it (with women about evenly split, 40% to 39%). But a law allowing a terminally ill person “to choose a physician’s aid in dying rather than prolonging life” obtained a 51% to 29% margin of support (46% to 33% among women). Similarly, a law allowing the patient to “choose a lethal injection” was supported 44% to 36% (40% to 39% among women), while a law allowing the person “to choose to die by way of a medical procedure” was supported 50% to 29% (45% to 33% among women) (Derek Humphry, “Do certain words frighten voters?” World Right to Die Newsletter, No. 23 (1993), p. 7].
Whether this poll tested only for the emotional appeal of different words is another matter. For example, many Americans may not know that “aid in dying” is a euphemism for assisted suicide — they may think it refers to less controversial forms of care for the dying. In this regard it is unfortunate that even the “blunt” questions expressed a bias, by assuming that the only alternative to euthanasia is an active effort at “prolonging life.” The humane alternative of hospice care, which neither shortens nor prolongs life, is oddly ignored.
Another finding of the Roper poll is that Americans over 60 years old are far more opposed to this agenda — for example, they opposed “physician-aided suicide” 45% to 35%. “In fact,” notes Hemlock, “the younger the person, the more likely he or she is to favor this legislation, with the highest approval being in the 18-29 year old range.”
A generational split was also found in a recent survey of patients at two physicians’ offices in New Jersey. The poll, conducted by the Center for Aging at the University of Medicine & Dentistry of New Jersey, found that two-thirds of patients aged 65 and over opposed physician- assisted suicide, while 80 percent of the patients in their 30s supported it. The results were presented at a meeting of the American Geriatrics Society in November (Washington Post Health Section, 2/1/94, p. 5]. Life at Risk, March, 1994
Survey: Doctor-Assisted Suicide is Rare
A new survey published in the April 23 New England Journal of Medicine finds that few doctors have ever assisted a patient’s suicide — but that over a third would do so if the practice were legalized.
“This is really not happening very often,” says survey co-author Dr. Diane Meier of New York’s Mount Sinai School of Medicine. “That’s the most important finding. It’s a rare event” [Associated Press, 4/23/98].
The survey was based on a questionnaire sent in 1996 to 3,102 physicians under the age of 65; 1,902 doctors responded anonymously. In all, 11% of respondents said they had ever received a request for a lethal injection (euthanasia) and 18% said they had been asked for a prescription for an overdose of pills to end life (assisted suicide). Five percent said they had ever given such an injection, while 3 % had written a lethal prescription; since some doctors had done both, the cumulative total of doctors who had ever helped deliberately end a patient’s life was 6%. While most of those who engaged in such behavior had done so only once or twice, one doctor claimed to have written 25 prescriptions and given 150 lethal injections.
While responses were confidential and untraceable, the authors note that the survey may under report these practices. On the other hand, the surveys were deliberately sent to doctors in ten specialties identified in previous surveys as “those in which physicians are likely to receive requests from patients for assistance in hastening death” [New England J of Medicine, 4/23/98, p.1193]. Thus the survey may overestimate the percentage of all U.S. physicians who have assisted suicides or performed euthanasia. The survey found that these practices are most common on the West coast, where one state, Oregon, voted to legalize assisted suicide in 1994.
Earlier surveys, usually confined to a particular state or region, had produced higher estimates for the frequency of assisted suicide or euthanasia [e.g., “1 in 5 Doctors Say They Assisted a Patient’s Death, Survey Finds,” Boston Globe, 2/28/92]. The new survey differed from these in having its questions tested beforehand with focus groups of physicians, to minimize confusion between these practices and medical actions which may indirectly or unintentionally hasten death.
Noting that 36% of doctors in the survey said they might assist suicides if the practice were legal, the Hemlock Society declared that the results support its position favoring legalization. “The survey demonstrates that compassionate doctors want to help their patients but hesitate to do so under threat of legal and professional sanctions,” said Hemlock executive director Faye Girsh news release, 4/23]. In fact Hemlock and other supporters of assisted suicide have generally claimed just the opposite: That legalization would not significantly increase the total number of assisted suicides, but simply bring a covert practice out into the open where it could be limited and regulated. The survey results contradict that claim.
Simultaneously with the publication of the survey results, co-author Dr. Diane Meier published an opinion piece in the New York Times explaining her own change of heart on the assisted suicide issue. She says that she once favored legalization, but “after caring for many patients myself, I now think that the risks of assisted suicide outweigh the benefits.” Proposed safeguards in laws like Oregon’s, she argues, are “unrealistic and largely irrelevant to the reality faced by the dying” — for example, ensuring that a patient’s choice is not coerced is “an impossible task.” She adds that “legalizing assisted suicide would become a cheap and easy way to avoid the costly and time-intensive care needed by the terminally ill” [Diane Meier, “A Change of Heart on Assisted Suicide,” The New York Times, 4/24]. Life at Risk, April, 1998
Survey Probes Spiritual Concerns About Dying
A new national survey by The Gallup Organization finds that most Americans think about their own death “hardly at all” or “not at all” — but when they do think of it, their concerns about death and dying are more emotional and spiritual than medical in nature.
When asked about the kinds of support that would be most important if they were dying, at least half the respondents ranked the following as “very important”: Having someone with whom you can share your fears or concerns (55%), having someone with you (54%), having the opportunity to pray alone (50%), and having someone pray for you (50%). Yet when asked about people who would be comforting during the dying process, 81% said a member of their family would be comforting in “many” ways and 61 % said this of “a close friend,” while only 36% said this of “a member of the clergy.” Commenting on the poll, George Gallup says this is “a wake up call for the clergy,” because “not many see the clergy in providing broad spiritual support in their own dying days.” Even fewer thought they would receive comfort in many ways from a doctor (30%) or a nurse (21%).
Emotional concerns about death that worry the respondents “somewhat” or “a great deal” include: not having the chance to say good-bye to someone (with 70% saying they worry about this), and thinking that your death will be the cause of inconvenience and stress for those who love you (64%). The most widely shared practical concern was how family or loved ones will be cared for (shared by 65%). Spiritual concerns included: not being forgiven by God (57%), and not reconciling with others (56%). Out of six medical concerns, the only two that worried more respondents were: the possibility of being vegetable-like for some period of time (73%), and the possibility of great physical pain before you die (67%). While 32% worried “a great deal” about physical pain, more respondents worried a great deal about loved ones being cared for (44%), God’s forgiveness (42%), and not having the chance to say good-bye (39%). Generally, 38% rated spiritual concerns as worrying them the most about their death, with medical concerns rated fourth (14%) after practical concerns (21%) and emotional concerns (19%).
Respondents were also asked what kind of care they would choose if they had a serious illness with only a 25% chance of survival. The option of “relieving pain and discomfort as much as possible, even if that meant not living as long” was chosen by 70%, while “extending life as much as possible even if it meant more pain and discomfort” was chosen by 23%. Over two-thirds of the latter group still chose aggressive treatment if the chance of survival was 10%. Somewhat to the surprise of the researchers, more deeply religious respondents were not more willing to let go of life but were more likely to want aggressive treatment at the cost of more pain and discomfort.
Overall, 67% said they believe they will exist in some form after death; 72% believe in Heaven, and 56% in Hell; and most said that religious faith is “the most important influence” (21%) or “a very important influence” (39%) in their life. When asked about ownership of human life, only 18% agreed with the statement that “your life belongs to you,” while 56% agreed that “your life belongs to God or a higher power” and 20% said that “your life belongs to your family.”
Asked to choose among three options on legalization of physician-assisted suicide, 33% said they support making it legal “under a wide variety of specific circumstances”; 32% support making it legal “in a few cases” but “oppose it in most circumstances”; and 31% oppose making it legal “for any reason.” Half the respondents could imagine a situation in which they themselves might want a doctor to end their life by some painless means. Opposition to physician-assisted suicide was highest among those who are deeply religious, those who are age 55 or over, and those who are black or members of another racial minority. (Source: George H. Gallup International Institute, Spiritual Beliefs and the Dying Process.’ Key Findings From A National Survey Conducted for the Nathan Cummings Foundation and Fetzer Institute (October 1997) Life at Risk, December, 1997
Background: Public Opinion on Euthanasia
In November 1991, Americans were treated to two apparently contradictory readings of public opinion on euthanasia. On November 3, the Boston Globe published a poll claiming that 64% of Americans support legalizing physician-assisted suicide. But on November 5, the voters of Washington state — generally seen as one of the most libertarian and progressive states in the nation — voted down just such a proposal by 54 to 46 percent.
There are surely many reasons for the discrepancy. For example, Washington voters were more informed on the issue after a long campaign. But the same factors that affect all poll results were also at work — most notably the format and wording of poll questions. The Boston Globe, for example, actually gave respondents a choice among three options: Should physicians be required to provide lethal doses on request (16% said yes), “allowed but not required” to do so (48%), or prohibited from doing so (30%)? This approach invites people to choose the middle option as a “moderate” policy; the pollster can then combine the first two answers and report a high total figure of 64%
Reflections on the vagaries of public opinion are again prompted by two recent polls on “right to die” sentiment. On February 10 the Detroit Free Press published a survey in which 310 Michigan residents were asked, “Do you favor or oppose legislation that would permit doctors to help a person commit suicide if the patient is terminally ill?” Fifty-eight percent said they favored such a law, and 31% opposed it, while 11% gave no answer or were undecided. There was a significant “gender gap”: The law was favored by men 68% to 22%, but women supported it only 53% to 35%. One might speculate that in Michigan this issue is closely linked with Jack Kevorkian, a man who has specialized assisting the deaths of women.
A recent national poll by Parade magazine indicates greater ambivalence. The magazine mailed questionnaires to 3750 adults asking various questions about “right to die” issues; 2203 persons responded, and the results were published in Parade on February 9. The survey showed high support (around 80 percent) for patients’ and families’ decisions to refuse various forms of life support in a range of situations.
Respondents were then asked to react to the statement: “In case of fatal illness, a doctor should be allowed to help that person end his or her life.” Only 49% agreed with the statement, and 35% disagreed, while 16% were uncertain or chose no answer. The low support here is surprising in one way, because the phrase “end his or her life” would seem softer and vaguer than a phrase like “kill oneself” or “commit suicide.” But it may indicate that people were distinguishing between allowing a person to die (which they strongly supported) and causing death.
Moreover, when asked whether a person diagnosed as having a fatal illness “should be allowed to take his or her own life,” only 39% agreed and 45% disagreed, with 16% uncertain or giving no answer. Perhaps the reference to “taking life” signaled to some that direct causing of death was being discussed — or perhaps this question’s failure to mention a physician removed a veneer of professional legitimacy from the act. Life at Risk, February, 1992
Background: The AMA on Euthanasia
Because legalizing physician-assisted suicide would place enormous power in the hands of physicians, health care professionals’ views are of special interest. The American Medical Association has taken a clear position.
The AMA’s formal position is stated in “Decisions Near the End of Life,” a report by its Council on Ethical and Judicial Affairs adopted by the AMA House of Delegates at its June 1991 annual meeting.
While affirming patient autonomy and allowing wide latitude for decisions to withhold or withdraw life support, the report notes a “long-standing prohibition against physicians killing their patients” and says: “Weakening this prohibition against euthanasia, even in the most compelling situations, has troubling implications.” Such a move “might undermine public trust in medicine’s dedication to preserving the life and health of patients,” and “physicians and other health care providers may be more reluctant to invest their energy and time serving patients whom they believe would benefit more from a quick and easy death.” Moreover, if some patients and not others have a right to euthanasia, then “value judgments about patients’ lives will be made by a person or entity other than the patient,” generally by “physicians and the state.” Citing the “societal risks” of such a fundamental change in medicine, the report concludes that “physicians must not perform euthanasia or assisted suicide” (JAMA, April 22/29, 1992].
AMA president Dr. John Ring also broached this subject in a major address at the 1991 annual meeting. Stressing the importance of “the doctor-patient relationship,” Dr. Ring said: “We can accept nothing that threatens this relationship by trying to make us agents of any effort that would violate our duty ‘to do no harm’ — by asking us to ration needed care, to assist in suicide, or to kill people, even in state-sanctioned executions” (JAMA, Sept. 25, 1991].
In a recent interview he added: “Medical ethics and the AMA are both four-square against physician-assisted suicide.. .1 have great fears for my profession if we became involved in the deliberate termination of human life, regardless of the motivation, even if it’s mercy.. To have in the back of your head, if you’re a patient, ‘Is this doctor helping me or is he going to bump me off?’ I think is a strong argument for the maintenance of the ethical principle that physicians should never kill” (American Medical News, 3/16/92).
Another member of AMA’s Board of Trustees, Dr. Nancy Dickey of Richmond, Texas, spoke against euthanasia this year before the American Bar Association (see February Life at Risk). She reaffirmed her stance April 10 at a conference on “Life and Death After Cruzan” at the Loyola New Orleans School of Law, where she debated Cheryl Smith of the Hemlock Society. “Besides threatening one of the basic underpinnings of the profession,” she said, “allowing physicians to kill –even with patient consent — threatens the patient’s trust.. the belief that the physician is there for the well being of the patient and not to make judgments about the quality of one’s life and therefore the value of continuing that life.” Life at Risk, April, 1992
Background: Recent Editorial Comment on Assisted Suicide
Steve Forbes: “A cornerstone of American civilization is the idea that the law should protect the weakest of us, not just the strong and the rich. Assisted suicide would turn that principle upside down. When a person stands on the ledge of a building, we try to pull him back. Legalizing assisted suicide would say, “Jump!” — and if you hesitate, society will find someone to push you…. If assisted suicide is legalized, people suffering severe illnesses will be pressured to end their lives rather than to fight on. Otherwise, they will be told, they are selfishly consuming scarce resources. Greedy relatives will hammer home a similar theme. Doctors, in the interest of keeping down expenses in order to earn managed-care bonuses, will feel pressured to urge the gravely sick to give up.” – Steve Forbes, “Don’t deal us a deadly decision,” Forbes, 2/10/97, p.27.
The Atlantic Monthly: “Broad legalization of physician-assisted suicide and euthanasia would have the paradoxical effect of making patients seem to be responsible for their own suffering. Rather than being seen primarily as the victims of pain and suffering caused by disease, patients would be seen as having the power to end their suffering by agreeing to an injection or taking some pills; refusing would mean that living through the pain was the patient’s decision, the patient’s responsibility. Placing the blame on the patient would reduce the motivation of care givers to provide extra care that might be required, and would ease guilt if the care fell short. Such an easy, thoughtless shift of responsibility is probably what makes most hospice workers so deeply opposed to physician-assisted suicide and euthanasia.” – Ezekiel Emanuel, “Whose Right to Die?”, The Atlantic Monthly, March 1997, p.79.
The Nation: “Very ill people may be vulnerable to suggestions from family members that they could make everyone’s life easier by ending their own. As families are more financially pressed and their living standards decline … they will be less able to support aging relatives. Even now, the medical system that helps keep alive patients who would once have died delegates the care that nurses would once have provided to overburdened and isolated relatives. Who could blame a wife, herself elderly and in poor health, for suggesting suicide to her terminally ill husband? But how free would his choice then be?” – Editorial, “Death and Dignity,” The Nation, 2/3/97, p.3.
Wall Street Journal: “We shudder at the news of 39 cultist suicides in San Diego not because we knew any of them, but because the mass act is a chilling affront to our bedrock notion of life as worth preserving. This shocking event is no doubt a blow to the cult movement, but it probably will have a less certain effect on another movement peculiar to our times –assisted suicide…. To oppose state-sanctioned suicide is not necessarily to deny anyone’s right to die. People can and do make that private decision every day. But do not ask the rest of us to say that it is a good thing, to use the abstractions of law to announce that some lives are simply not worth living.” – Editorial, “Against Assisted Death,” Wall Street Journal, 4/1/97, p. A18. Life at Risk, February-March, 1997