WATCH YOUR LANGUAGE!
A continuing series discussing
the terms we use in the right-to-die debate
"medication"—"life-ending chemicals"
OUTLINE:
A.
"MEDICATION"
WAS ORIGINALLY A EUPHEMISM
B. USING THE WORD "MEDICATION"
MAKES SUCH LAWS
VULNERABLE TO ATTACK USING DRUG-CONTROL LEGISLATION
C. GIVING ONLY PHYSICIANS THE
POWER TO PRESCRIBE DEATH
MAKES SUCH LAWS VULNERABLE TO LAWS LICENSING PHYSICIANS
D. WOULD REPLACING THE WORD
"MEDICATION" WITH SOME OTHER EXPRESSION
MAKE SUCH LAWS LESS VULNERABLE TO ATTACK?
1. "LIFE-ENDING
DRUGS"
2. "LIFE-ENDING CHEMICALS"
3. "DEADLY DRUGS"
4. "GENTLE
POISON"
5. "PEACEFUL
PILL"
6. "DEATH PILL"
7. "PEACEFUL-DEATH CHEMICALS"
8. "POISON"
E. EXACTLY WHICH ALTERNATIVE
EXPRESSION WILL BE USED
WILL BE DECIDED BY LEGISLATORS WHO WRITE NEW LAWS
F. HOUSEHOLD DANGER FROM HAVING
DEATH
PILLS ON HAND
A. "MEDICATION" WAS ORIGINALLY A
EUPHEMISM
Beginning with the Oregon Death with Dignity Act in
1994,
laws permitting physicians to prescribe drugs
for the purpose of achieving a voluntary death
have described these drugs as "medication".
This is a misleading use of the word "medication".
And it could lead to some unintended consequences.
When doctors prescribe pharmaceuticals for a patient,
it has always been for the purpose of
curing or treating
some disease or condition,
to enhance or preserve the life
and health of the patient.
But now the laws of some places on Earth
permit physicians to write prescriptions for
the same chemicals with the intent of causing the patient to die.
Most people will not be misled
by having the prescribed means of death described as a "medication",
but there might be a few
people who will be confused
by this way of speaking and/or writing.
For example, what happens when
the doctor, nurse, or family members says:
"It's time to take your medication."?
Might the patient think: They are trying to kill me!
Have they decided it is time to bring my life to an end?
When the same word "medication"
is used for chemicals that
can cure and chemicals
that can kill,
what is the sometimes-confused patient to think?
Similar expressions, which should also be avoided
for the same reasons,
include "medicine", "prescription", and other expressions
drawn from the use of these chemicals in the healing arts.
Even tho the exact same drugs in smaller amounts
might be prescribed to help a patient to sleep,
the only purpose for these chemicals in right-to-die laws
is to produce a peaceful and painless death.
Therefore the drugs prescribed should be correctly
described:
They are chosen because they will produce death
within a few hours at
the most.
Therefore they are lethal drugs, life-ending chemicals,
a lethal
prescription, or gentle
poison.
No dictionary contains this use for the word "medication".
B. USING THE WORD "MEDICATION"
MAKES
SUCH LAWS
VULNERABLE TO ATTACK USING
DRUG-CONTROL LEGISLATION
Some opponents keep trying to overturn Oregon's
Death with Dignity Act
by complaining that this is not a legitimate use of prescription
medications.
One such case went all the way to the US Supreme Court.
The Court ruled that the federal drug-control law
was not intended to apply to drugs prescribed by physicians.
If it had been legitimate for the federal drug-control legislation
to apply to prescription medications,
then every prescription
written by a doctor anywhere in the United
States
could be reviewed by the Attorney General of the United States.
This would have been an intolerable extension of the power of that
office.
To overturn this ruling by the Supreme Court,
federal and state legislation has been introduced
to prevent using prescription
drugs to produce death.
Opponents of the right-to-die claim that
using prescription drugs to
produce death
is never a legitimate use of pharmaceuticals.
If any such prohibitive legislation were to pass,
or if any government agencies succeed
in controlling such use of
'medications',
then any laws that depend on physician-prescribed drugs
might be overturned in that jurisdiction.
Right now it does not seem likely
that any such
attempts will succeed
in taking away the power of doctors to prescribe life-ending drugs.
But the tide of political power can always shift.
And if we have a high-profile case
involving the misuse of prescription
drugs,
public opinion might shift against
laws permitting lethal prescriptions.
Whenever this form of right-to-die law is created
anywhere in the world,
the legislators who oppose the practice
will attempt to tighten regulations concerning prescription drugs
so that they cannot be used to cause death.
In a few countries, this is likely to succeed.
And if chemicals prescribed by a physician
is the only means of death included in such a law,
the law becomes completely useless, null, & void.
A completely different kind of right-to-die law
outlaws causing premature
death
and permits
deaths that are not premature.
Because this new approach to securing the right-to-die
does not depend on physician prescriptions at all,
it is not
vulnerable to drug-control legislation.
C. GIVING ONLY PHYSICIANS THE
POWER
TO PRESCRIBE DEATH
MAKES SUCH LAWS VULNERABLE TO LAWS
LICENSING PHYSICIANS
When right-to-die laws are written in
such a way
that only licensed physicians
have the power over granting the means of death,
then opponents of the right-to-die
will attempt to take away the
licenses of physicians
who break the Hippocratic Oath by "giving deadly drugs".
The argument will be that physicians
are licensed
only for the practice of
medicine.
And if physicians turn to murder,
their licenses must be revoked
by the government authority that grants licenses to physicians.
The language of such new legislation will be more
subtle,
but the impact will be identical:
Doctors who want to keep their licenses
will stop prescribing drugs that are intended to cause death.
Or they will return to underground methods
of helping their patients to
die,
which cannot be detected by any law-enforcement agency.
Some right-to-die organizations are already trying
to work around such roadblocks.
New methods of producing death are being proposed,
which do not depend on doctors
(who are vulnerable to government
control)
or on chemicals that are already controlled by laws.
Another approach to securing the right-to-die
—namely laws against causing
premature death—
does not depend on the exclusive
power of doctors to prescribe drugs.
Such right-to-die laws are not vulnerable to attack by the opposition
using the power
of government to license physicians.
D. WOULD REPLACING THE WORD
"MEDICATION" WITH SOME OTHER EXPRESSION
MAKE THESE LAWS LESS VULNERABLE TO
ATTACK?
Let's examine some possible alternatives to
"medication":
1. "life-ending drugs"
2. "life-ending chemicals"
3. "deadly drugs"
4. "gentle poison"
5. "peaceful pill"
6. "death pill"
7. "peaceful-death chemicals"
8. "poison"
1. "LIFE-ENDING
DRUGS"
Instead of using the word "medication",
we could
substitute "life-ending drugs".
This would make the discussion more honest and forthright.
We should not use euphemisms
when we are discussing something as
serious as death.
Patients for whom English is not the primary language
could possibly be led into a serious mistake
if the chemicals are
described as "medication"
and translated into the patient's native language
as something that is
intended to cure.
An even more honest expression would be:
"lethal drugs" or "deadly
drugs".
Oregon physicians are now permitted to prescribe lethal drugs
with the explicit intention of helping their patients
to achieve a
voluntary death.
If "lethal drugs" seems too stark, "life-ending drugs" is more gentle,
but it does say exactly the same thing:
These substances are intended to bring death.
Our laws should always say
exactly what they mean.
Other terms besides "lethal drugs" might make such
state laws
less vulnerable to attack using the drug-laws
and/or drug-enforcement
agencies.
What if doctors were
permitted to prescribe some special chemicals
that are NEVER prescribed for any other purpose than to produce death?
Then opponents would not be able
to use the laws intended to control
narcotics
as means of preventing people from claiming the right-to-die.
In other words, the chemicals used to produce death
would never be listed in any laws intended to control the recreational
use of drugs.
And if the chemicals were not
prescription drugs,
they would not fall under the laws controlling prescriptions.
But opponents of the right-to-die might still
attempt
to use the government power to license physicians
as a way of preventing physicians from prescribing
the chemicals intended only for producing death.
Laws like Oregon's Death with Dignity Act
grant a special power to licensed physicians
—the exclusive power to write a prescription for death.
The basic reason for giving doctors this power
is that we want doctors to review the life-ending decision
from the perspective of someone who deals professionally
with life-and-death questions
and based on the knowledge that medical training provides.
In short, the doctor's participation is a safeguard to prevent premature
death.
If we were able to devise some other combination of
safeguards,
perhaps we would not have to depend on this exclusive power of
physicians
to prescribe controlled substances.
Or perhaps only a certain sub-set
of licensed physicians
would also be authorized to provide chemicals intended to cause death.
2. "LIFE-ENDING CHEMICALS"
An alternative to "life-ending
drugs" would be "life-ending chemicals".
This might be preferred because even the word "drugs"
could be misunderstood, especially in translation.
Drugs are generally prescribed to cure the patient, not to kill him or
her.
If the word "drugs" is used for both purposes,
some confusion is certain to arise.
But the word "chemicals" does not carry any meanings
related to curing.
Chemicals are used for thousands of purposes.
And these chemicals would be described as "life-ending".
The expression "life-ending chemicals" might be a little long,
but are there any problems of understanding?
Consider the following sentence:
"We are now considering whether or not to use life-ending chemicals."
3. "DEADLY DRUGS"
The expression "deadly drug" has a
very long history in medicine.
The Oath of Hippocrates has the new physician
vowing never to give a "deadly drug" even if asked.
Thus for thousands of years, physicians have known
what substances to give in order to produce death.
This doctors' oath will have to be changed, of
course,
but the ancient vows have already been changed in a number of ways.
Putting these two words together "deadly" and "drugs"
should make clear what
the chemicals are intended to do.
But an even clearer expression would leave out the word "drugs",
because that word has other very important meanings.
4. "GENTLE POISON"
If the specific substances used to achieve a
voluntary death
are NEVER used for any other purpose,
then they would not be described as "medication".
"Gentle poison" might be a good description.
Medical science can create the best ways
to turn off the
functions of
the body,
beginning with the functions of the brain,
so that the patient will have a completely peaceful and painless death.
A "gentle poison" would first render the patient completely
unconscious,
perhaps with so much certainty
that there would be no
possibility of consciousness ever returning.
After the patient has become permanently unconscious,
the gentle poison would stop the heart and lungs.
And the patient would be declared dead.
"Gentle poison" is such a striking expression
that it might be used by the media when they discuss laws
that they have routinely called in the past "physician-assisted
suicide" laws.
The headlines might say instead: "Legislature Passes Gentle Poison Law".
The news media will play a major role in any new legislation.
And journalists always need a dramatic headline to catch the readers'
attention.
That drama used to be contained in the phrase "physician-assisted
suicide":
We get the image of our family doctors helping patients to commit
irrational suicide.
At least the new dramatic expression "gentle poison"
takes the focus away from the doctor.
And this dramatic expression does not mention
irrational suicide.
In every era some people kill themselves
for foolish 'reasons' or no reasons at all.
"Gentle poison" does not refer to committing irrational suicide.
"Gentle poison" is intentionally paradoxical:
If a substance is going to produce death, how can it be gentle?
But it should be possible to create methods of bringing death
that first render the
patient completely unconscious
and then turn off some vital function
so that the unconscious body
suffers nothing when death occurs.
This term will probably not be selected by
advocates
of the right-to-die,
since none of us likes the idea of putting someone we love to death
by using any kind of poison.
And we might not like to think of ourselves ending our own lives
by taking "poison".
But the very fact that we have considered this
striking alternative
shows that we are serious about the process of making life-ending
decisions.
And if by some unforeseen historical development
"gentle poison" does become an everyday expression,
its repeated use will make it seem less threatening.
Even when we use the less-shocking expression "life-ending chemicals",
we are still talking about a decision to draw one human life to a close.
5. "PEACEFUL
PILL"
The metaphor "peaceful pill" points in the same
direction.
There is actually no such pill in existence.
But the concept
encapsulates our dream
of a peaceful and painless end of our lives.
We wish there were a simple way to make today the last day of our lives.
Of course, if there were a "peaceful pill",
there would be great danger of people using it to commit irrational
suicide.
It has been said that if
each human body had a suicide
button,
almost everyone would use it sooner or later.
If it were too easy
to kill ourselves,
we would do it capriciously and when in despair.
We need safeguards for
life-ending decisions
to protect us from ourselves in our darker moments.
Because "peaceful pill" is a figure of speech
rather than an actual capsule of chemicals,
it is not likely to be used in any legislation concerning the
right-to-die.
But some longer and more accurate expression might be invented
to describe the life-ending process intended.
6. "DEATH PILL"
The concept of a "death pill"
seems natural
when we consider exactly what actions we are planning.
We are hoping that we can simply take a pill at the end of our lives
in order to insure that we will have a peaceful and painless death.
As said before, there probably will never be a single pill that would
produce death.
But the bottle or box that contains the chemicals might be labeled
"death pill".
This concept shares with others the problems
associated
with using the word "pill" in this context.
Pills are normally what we take in order to improve our health
and to save ourselves from premature death.
So we need clear ways to say that these "death pills"
are definitely NOT
like any of the other pills we have ever taken.
7. "PEACEFUL-DEATH CHEMICALS"
Instead of
"death pill", we could say "peaceful-death chemicals".
This expression does not use either the misleading word "pills"
or the misleading expression "drugs".
"Peaceful-death chemicals" is a cumbersome
expression,
but it does seem to describe exactly what is happening:
We are putting chemicals into our own bodies
or into the bodies of people we love
for no other purpose than to
produce a peaceful death.
Also, this expression, does not suggest
that the chemicals need to be taken by mouth.
The "peaceful-death chemicals" could also be provided by some other
means,
such as injecting
them into the body of the patient
for whom death now is
better than death later.
8. "POISON"
If a right-to-die law were to use the word "poison",
the debate would gain a new tone of seriousness.
First, the particular chemicals or other substances
would not fall under any drug-control legislation
because people who want to take recreational drugs are not intending to
die.
Thus all laws that attempt to control named chemicals
because they are harmful to the recreational users
will not apply to other chemicals that might be taken
by patients who have wisely decided to shorten the process of dying.
Life-ending poisons are non-prescription,
non-recreational substances
taken with the explicit purpose of bringing peaceful and painless
death.
And doctors are not the gatekeepers for all poisons.
Perhaps some laws permitting voluntary death
will say that the patient may use a poison
that was obtained in some
other way
than being prescribed by a doctor and bought from a pharmacist.
Or the law could leave it to the dying patient
to decide exactly what poison he or she wants to use.
Opponents of the right-to-die might try to enact new
laws to control poisons.
But whenever they prevent one substance from being sold,
other poisons will be suggested.
The whole chemical industry would be subject to control by government
agents
intent on preventing people from using specific chemicals to cause
death.
Such poison-control methods
of attempting to prevent people from
claiming the right-to-die
would create such chaos in the chemical industry
that such efforts would be
quickly abandoned.
Replacing the word "medication" with the
word "poison"
takes the process out of the hands of physicians.
Physicians are licensed to prescribe and/or dispense medicines,
which were always invented to cure diseases
or control physiological conditions that patients do not want.
We know that when taken in large amounts,
most medicines will have toxic
effects.
This is one reason that doctors are given the power to decide
how much medicine to
prescribe at any given time.
But poisons have never been associated with doctors.
And doctors do not control access to all poisons.
When we have rationally decided to draw our lives to a close
(probably based on medical information provided by our doctors),
we do not need to ask our doctors to provide the means
by which we choose to end of our lives.
The same psychological objections to using "gentle
poison"
also apply to the shorter expression, "poison".
We will probably not use this expression because it seems so
overwhelmingly negative.
We do not want to end our own lives using poison.
And we do not want to cause the deaths of people we love using poisons.
E. EXACTLY WHICH ALTERNATIVE
EXPRESSION WILL BE USED
WILL BE DECIDED BY LEGISLATORS WHO
WRITE NEW LAWS
Other suggestions besides the eight above are
welcome.
If and when there are new laws
allowing chemicals to
be used to cause death,
the legislators will be in charge of the exact wording.
And if any new law gives doctors the exclusive power to control the
chemicals,
they will probably not be called either "poison" or "gentle poison".
The less-dramatic but still accurate expression would be "life-ending
drugs".
But the fact that we have seriously considered
"deadly drugs", "poison", & "gentle poison"
has caused us all to consider more carefully
exactly what we are talking about.
We are discussing the intentional
termination of a human life.
Let our laws say exactly what they mean.
Choosing a voluntary death
for ourselves or a merciful
death for others
has nothing to do with taking "medication".
F. HOUSEHOLD DANGER FROM HAVING DEATH
PILLS ON HAND
Once the life-ending chemicals have been
obtained,
they will be a hazard within each household
that has such means of
causing death.
Death pills in the household are even more dangerous than a loaded gun.
Therefore, they should never be described as a 'medication'.
That could lead to the drugs being accidentally taken by some
other
family member.
If the drugs are dispensed in an ordinary medicine bottle,
accidents
will happen,
as now happens when people take pills from medicine bottles
without
reading the labels.
What does the label on the bottle say?
I hope there are serious warnings to prevent accidental use.
Even if the bottles say "DEATH PILLS",
"LETHAL
DRUGS", "GENTLE POISON", or just "POISON",
there is danger that other members of the household
will use these powders, pills, or liquids to commit irrational
suicide.
Created March 16, 2007; revised
3-22-2007; 3-29-2007; 3-30-2007; 4-4-2007; 4-10-2007;
6-3-2007; 9-4-2007; 10-2-2007; 1-18-2008