The Black Coats of Death Care

There is a side stream to the main flow of economic decay that is flooding Europe, a side stream of ethical decline. It is bringing changes to how people view fundamentally moral aspects of our society – our very lives. These changes, which I have in part covered in my essay Eugenics and the Welfare State, are driven by an artificially created need to ration health care services. Under single-payer, or otherwise heavily government-dominated health care systems, people’s universal right to health care stands in sharp contrast to the heavy rationing that always plagues such systems. In order to motivate who will get access to almost inaccessible health care, and who will be left to suffer or even die, economists, medical ethicists and politicians develop systems that allow bureaucrats to prioritize among individual patients.

The result is, as I explain in my aforementioned essay, that some lives are deemed too costly to live. The moral cynicism in this budget-driven sorting process, where lives worthy of living as spared and lives unworthy of living are discarded, bears strong resemblances to certain medical practices under the Third Reich. Those practices were summarized under the label Lebensunwertes Leben, i.e., life unworthy of living; to mark this strong resemblance I use the term Haushaltsunwertes Leben (life unworthy of the budget) for the rationing-driven practice where people are selected to die or suffer in order to keep a lid on the government’s costs for health care.

Regardless of whether a government-run health care system chooses people to die for reasons of “population hygiene”, which was the motivation in the Third Reich, or to “balance the budget”, as the motivation is in the modern welfare state, the practice creates entirely new moral standards for the notion of what a life is. It is no longer sacrosanct, even by the highest ethical standards applied in our modern, government-dominated health care. In addition to the use of tax money to fund abortions, health care systems in the modern welfare state are beginning to establish euthanasia as a form of medical practice on par with traditional forms of health care treatment.

Increasingly, life is being reduced to a utility function, where the decisions regarding what utility a person may be experiencing are in the hands of tax-funded bureaucrats, not patients and their doctors. Two stories from the excellent publication highlight this process of moral decay. The first one is from the Canadian newspaper the Canadian newspaper National Post, which reports:

Wim Distelmans is unusual among physicians: when one of his patients dies, it means his treatment was a success. A long-time crusader for euthanasia, which was legalized in Belgium in 2002, Dr. Distelmans has made his name delivering death.

A suggestion: physicians who perform abortions and practice euthanasia should wear black coats instead of white.

On Sept. 23, Nathan Verhelst invited his friends to an intimate farewell party. They danced and laughed, raised glasses of champagne “to life” and shed tears. A week later, the 44-year-old departed — for a university hospital in Brussels where he was given a lethal injection. Under Belgium’s euthanasia law, doctors approved Mr. Verhelst’s request because of the unbearable psychological and physical suffering he was experiencing following childhood abuse and a failed sex-change operation.

First of all, the sex-change operation was in all likelihood performed on taxpayers’ tab, which raises another question about the medical priority mechanisms at work in government-dominated health care systems. Secondly, if this man was so eager to die, why did he not simply do it himself? Why ask taxpayers to do it for him?

Third, if this story is actually true it means that the Belgian government-run health care system is ready to kill patients it fails to cure. This opens a frightening view of what may lie ahead as budgets tighten even further in Europe’s crisis-torn health care systems.

The National Post again:

His euthanasia … is just the latest death to raise questions about how Belgium’s euthanasia law is being stretched to include patients who are not terminally ill and whose suffering is primarily psychological. Mr. Verhelst’s death came less than a year after 45-year-old twin brothers, who were deaf and lived together in Putte, Belgium, were granted euthanasia after learning they had a genetic condition that would cause them to lose their eyesight. The same year, a 44-year-old anorexic Belgian woman identified as Ann G, a victim of sexual abuse by a prominent psychiatrist, was euthanized to end her mental suffering.

Or was it simply the case that it would cost the government-run Belgian health care system too much money to cure her?

[Dr. Distelmans] euthanized a despondent Godelieva De Troyer, 64, whose children learned of her death after the fact. And he acknowledges there are many more “borderline” cases that the public never hears about. To some, Dr. Distelmans has come to embody the dangers of legalized euthanasia. “What is he? Is he God or something?” Ms. De Troyer’s son, Tom Mortier, asked in a recent interview. But while he has his critics, more Belgians see the charismatic Dr. Distelmans as a hero.

And herein lies the most frightening part of all of this. This man’s deeds become morally praiseworthy in the eyes of the general public:

On one Wednesday night last month, more than 300 people turned out in Zemst, north of Brussels, to hear Dr. Distelmans talk about dying. Dressed in jeans, a polo shirt and a black sweater, he explained how to request euthanasia in a two-hour presentation peppered with jokes. One audience member, 76-year-old Simone Vleminckz, hailed Dr. Distelmans as someone who has devoted his career to ending people’s suffering. “I think he knows the pain people feel,” she said. “You see it in his face.” Polls here show broad support for euthanasia, and the number of cases has grown steadily every year, from 235 in 2003, the first full year it was legal, to 1,432 last year.

The medical professionals of Nazi Germany who euthanized people also did it because they allegedly knew the suffering of the people they killed. The question missing here is: who determines the suffering?

As the National Post continues, we learn that the dark art of euthanasia is making headway in North America:

While the Quebec government pushes forward on a euthanasia law modeled after Belgium’s — the province’s Bill 52 passed second reading last month and is now under study by a legislative committee — the current debate here in Belgium is about expanding the euthanasia law rather than restricting it. And Dr. Distelmans is on the front lines. In an interview at a clinic he runs in the Brussels suburb of Wemmel, Dr. Distelmans defended his actions and argued that Belgian euthanasia law — which some argue has opened the door to abuses — should be expanded to cover children and people suffering from dementia.

And then what? Disabilities? Depression? High BMI?

Once euthanasia is elevated to the same level as the practice of actual medicine it will expand just like other forms of medicine. Where cancer treatment has expanded from alleviating the pain to exceptional cure rates, euthanasia will expand from its current narrow practice on the outer rim of medicine to an established choice across broad segments of medicine.

What is happening in Belgium is nothing short of the reversal of medicine itself, from saving lives to taking lives.

From a moral viewpoint, the expansion of euthanasia goes hand in hand with the expansion of abortion practices. There is also a fiscal side to it: both practices can be shown to save a tax-funded health care system a lot of money over a person’s (terminated) life span. On the abortion end of this modern budget-driven death spectrum, we have this story from Australia, reported by

The internet was ablaze last week with the news that health authorities in Western Australia (WA) have given approval for IVF clinics to ‘screen’ embryos to reduce the chances of a couple having a child with autism. The Reproductive Technology Council will now allow certain women undergoing IVF treatment to be selectively implanted with female embryos only. The rationale for this practice is that autism is more likely to affect males than females (approximately 4 males for every 1 female), and by selecting female embryos, the chances of this child developing autism are reduced.

Prostate cancer is more common among black men than among white men; alcohol abuse is more common among certain native peoples in North America and Aborigines in Australia than among people of European origin. Suppose a government-run, tax-funded health care system allowed the replacement of black, Native or Aboriginal embroys with white ones to reduce prostate cancer and alcoholism.

That would, for very good reasons, not go over well with most people. Yet in this case the same moral standards simply do not apply. Back to the story from

The West Australian reported that: “only families at high risk of having a child with autism, such as families who already have two boys with severe autism, would be considered for embryo screening”. The reaction to this report was swift and furious, and came from all corners of the globe. Some were concerned about the science underpinning this approach, and pointed to recent evidence that autism may be under-diagnosed in females, and that the gender imbalance in autism may not be as skewed towards males as we once thought.

These critics may very well be right, and if so they make a valid point. However, there is an even more serious problem here, namely that cost-cutting bureaucrats in the Australian health care system could easily expand the practice of this embryonic treatment method – effectively a form of abortion – far beyond deselecting children that may become autistic.

As the welfare states of the industrialized world continue to deteriorate, fiscally and morally, the practice of authoritarian medicine continues to grow. As it becomes more accepted, and more prominent, its expanding shadow slowly but inevitably eradicates the differences between a life deemed unworthy of living by totalitarian ideologues, and a life deemed unworthy of living by budget-balancing bureaucrats.