Linda Chavez

Of death and details

IT WAS A picture-perfect death -- an elderly woman, surrounded by her family, drifting peacefully into her final slumber. At least, that's how "Compassion in Dying," a Portland-based pro-euthanasia group, portrayed the first acknowledged death last week under Oregon's recently implemented physician-assisted suicide law.

For a few days anyway, the euthanasia movement could bask in some good publicity, as newspapers around the country reported the fate of the octogenarian, suffering from terminal breast cancer, who chose to end her own life by taking a lethal dose of barbiturates prescribed by a physician for that very purpose. But not for long.

By week's end, stories of a different kind of "mercy killing" captured headlines. A hospital worker in Glendale, Calif., confessed to taking the lives of 40 to 50 severely ill patients over a 10-year period. Efren Saldivar, a respiratory technician at Glendale Adventist Medical Center, told police that he viewed himself as an "angel of mercy," who sometimes hastened the death of patients "who looked like they were ready to die."

Saldivar made his confession as a result of an investigation by a state licensing board, which revoked his respiratory technician's license on March 13. According to the transcripts of the board hearing, Saldivar was very careful in choosing which lives to end. He claimed only victims who were unconscious and whose medical files indicated a "do not resuscitate" order. According to Saldivar, other hospital workers sometimes encouraged his activities by giving him the room numbers of patients who "needed" lethal injections.

In response to the publicity, the hospital has suspended (with pay) its entire 44-member respiratory-care staff in an effort to allay public fear. So far, however, Saldivar remains free. Glendale police say they cannot hold the man on the basis of a confession alone, although their investigation continues and may soon lead to exhuming the bodies of patients who died while under Saldivar's care.

If police are able to corroborate Saldivar's account, they will, one hopes, arrest him. Most people still balk at the idea that it is permissible to kill terminally ill patients without their consent, even if they look "ready to die." But wait a few years and this, too, may change, especially as assisted suicide becomes more common -- and legal -- in jurisdictions beyond Oregon.

The experience of the Netherlands in this arena suggests that it is surprisingly easy for a society to slide down the slippery slope from permitting physician-assisted suicide to involuntary euthanasia. An official Dutch study of euthanasia in 1990 reported that nearly 12,000 patients were euthanized that year, including 5,941who had not given permission to physicians to end their lives.

Of course, the Dutch try to regulate the procedure with strict rules governing the circumstances under which physicians may administer life-ending drugs, but the practice is far messier than the regulations suggest. Many Dutch doctors and other health professionals simply take it upon themselves to determine when their patients should die, much as Saldivar apparently did. And the Dutch people -- not to mention the legal system -- have come to accept the practice. The Dutch authorities prosecute few medical personnel for killing patients, so long as the victims were seriously ill.

The Dutch, like their counterparts in the euthanasia movement here, regard themselves as compassionate, caring people intent on helping hopelessly ill people die with dignity. Indeed, the Oregon statute legalizing physician-assisted suicide is called the Death With Dignity Act. But a decision by any human being to end a life --his own or another's -- ultimately flies in the face of human dignity, for it treats human life as if it were a commodity to be dispensed with when it is no longer pleasant or comfortable or "meaningful."

In the Netherlands today, more people die under circumstances that more closely resemble those of the victims of Saldivar than of Oregon's first doctor-assisted suicide. In 1990, only 400 patients opted for physician-assisted suicide, while more than 25,000 others were either denied life-saving treatment or euthanized. What began there as an experiment to solve, in the words of The New York Times, "the desperate need of terminal patients and their loved ones to find a better way of ending life" has turned into medical hubris, with medical personnel now deciding who lives and dies. It could happen here, too -- all in the name of compassion.

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