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THE SUN, SUNDAY, MARCH 9, 191H.
PAINLESS DEATH FOR INCURABLES SUGGESTED Opinions of Physicians and Others Re garding Euthanasia as a Means of Relief From Hopeless Disease Shall the. State allow science to end painlessly the lives of incurablis? Again the. question has Ixen raiseil by recent eases of persons sicminyly doomtd to hopeless Rufjcrhi'j while life lasted To throw liyht on the. suhj(ct the "Medical Hcvicw of llcvicws" has yalhend the opinions of physicians and other men eminent in science and other fulds to form n "Symposium on Kuthanasia." Extracts from it arc given here, It is eopyriyhlid by '. . Ilobinson. ABOUT furty years ago l)r. S. D. Williams of London sought to establish the proposition: "Thnt In all cases of hopeless anil painful Illness It should ho the recognized duty of the medical attend ant, whenever so desired hy tho patient, to administer chloroform, or such other nnii'sthetlc as may hy nnd by supersede chloroform so ns to de stroy consciousness at once and put the sufferer to n quick and palnlcsi death; nil needful precautions being taken to establish, beyond the possibil ity of doubt or question, that the remedy was applied at the express wish of the patient." The doctor's col leagues promptly Informed him that It would have been better if nniesthetlcs had never been discovered than that they should be tucd for such vile pur poses. A few years ago Dr. II. H. Gregory sought to Introduce In the State Legis lature of Iowa a bill to legalize eu thanasia. Dr. Gregory further en raged his profession by declaring tha many physicians already passed the draught of mercy to their suffering nnd Incurable patients. The Ilrltlsh Med ical Journal retorted by calling Dr. Gregory "a liar of the basest kind," nnd directed attention to an article In a St. Louis paper which contained the case of a wmnm who had been given up by the doctors nnd soon afterward was the winner In a tennis teurna-mcnt. About the same time a bill similar to Dr. Gregory's was brought to tho notice of the State Legislature of Ohio, the Instigator being Miss Anne S. Hall of Cincinnati, who expressed the wish thnt she might be allowed to put her mother, who was suffering from an Incurable disease, to death with chloro form. These proposed laws created xuen reeling tnat a counter mil camo before the New York Assembly, de--lnrlng that any one who advocated "Uthnnasla, either by word of mouth t written document, wis guilty of a 'elony. Hut very soon the entire matter wis dropped. Now the question has been brought up again. Some of the opinions col lected by the Medical Itcvlcw of He victcs follow : GEORGE KENNAN. whose "Siberia ind the Exile System" first acquainted (he world with the methods of the Husslan Government So far as the matter concern", or might concern, me personally 1 feel quite sure that I -hnuld 1 grateful to the State nnd to elence for such a service. My personal 'eellng, however, or tho personal fcel 'jig of n hundred Incurables, might not be n safe basis for legislation, because legalized cutlnn.isla would probably affect society as well as the Individual. HORACE FLETCHER, whose theo ries of mastic.it ion have made Fletcher Ism a familiar word We humanely nut nnlmals to death If it is not profit able for them to live longer, nnd espe cially If so doing will end their suffer ing; why not nccord human beings Mmllar relief? Hut In tho case of the human sufferers their consent should tie hnd, and the Incurability of tho disease or accident should lxs established by competent authority on good evidence. I do not consider death to be a dls dvantage unless one desires to live 'or some worthy purpose. Mere curl slty to live so as not to miss what s going on In tho world, or fear of death because of uncertainty relative to, what may happen nfterwnrd are not very good reasons for hanging on to life. There Is danger, to be sure, In dclo :atlng authority to hasten demise, 'nit ns a matter of fact nil medical prac Itloners hold this license anyhow. It s n question of expediency, humanity .md Justice. Prof. CHARLES AUSTIN BEARD of Columbia University I sec no ob jection on moral grounds to euthanasia ind believe that the Idea Is a sound one. I do not know, however, whether the practical administration of tho prin ciple could bo adequately safeguarded against ubusc. rrof. G. FRANK LYDSTON of the 'College of rhyslcians and Surgeons of Chicago Euthanasia for the "better dead" and for the hopeless sufferer from disease sounds pretty nnd as a euphemism Is not objectionable, but Its practical application Is quite another matter. There are certain Insuperable objections to It which I would tabulate as follows, viz.: 1. ltellgious sentiment: This would not weigh with some. There are thoso who doubt the soul theory nnd doubt especially that to suffer hopelessly or to clog tho wheels of our social system by physical nnd mental usclessness Is part of God's general plan for human Itv'a weal. Hut n the other hand there arc millions who believe that God sends such nflllctlons to man for some Inscrutable purpose of His own and the "God's will bu done" argument Is n difficult ono to overcome. 2. Parentnl love: Man Is not less loving of his own than are other nnl mals. Foolish they may be, but how many mothers of the "belter dead" could be mndo to see their offspring with tho eyes of an euthanasia com mlttce? 3. Hope: No ono who has not prno tlscd metllclno can fully nppreeintp tho way In which human lovo clings to cvcn a shadow of hope. Human sen tlmcnt nslde, human experience nnd scepticism regarding human Judgment nro feeders for hope that endures whllo llfo lasts and longer, A. Tho fallibility of scientific Judg tnent: According to n well known au thority CO per cent, or moro of tho rases that go to tho postmortem tablo of a celebrated Eastern hospital nro found to have been the subjects of a wrong diagnosis. As to foretelling whether or how long a patient will llvo only rash doctorx indulge very often In that prognosis Is a risky habit, 6, Tho dllilculty of securing compe tent nnd skilful "euthanasia dis pensers": Nobody wants that sort of Job. C. Tho dangers of criminal abuse of cuthannsla: How seductive the eu thanasia proposition would bo to pros pective heirs with callous consciences nnd to Venal doctors, who can always be found to do criminal work If It ap pears to be safe. 1 am In favor of euthanasia as u scientific theory even science should be permlted to "dream dreams" but as to its practical appli- that few human beings nro fitted to assume cither by wisdom or courage but would also open the door for dangerous nbusc, and perhaps many murders. Prof. VIRGIL 1'. GI11NEY of Colum bia University Whllo I huve In tho course of n long experience encountered Instances where I thought euthanasia was greatly to be desired 1 huvo been opposed to tho doctrine for tho follow ing reasons: Wo as professional men claim to Interest ourselves In tho relief of human suffering nnd tho euro of disease. The pharmacopoeia ought to supply us with these needed means. Suffering and pain should lie If not completely relieved mitigated, so ns to make It tolerable. I havo seen cripples too whoso minds were wrecked, make good recovery, and In view of tho fallibility of medical men I do not see how one or n commission even could de cide the question. Personally I am lighting nil tho time to save human life; in fact life In any form. PP.nP. AltPAD O. GEIISTER of tho New York Polycllnlt Tire agllallon of and conscientious physician to declare that nny concreto case of tho most desperate malady Is really Incurable. Every malady Is curable so long ns tho patient Is alive. Hut wero tho principle granted of our moral right to end life hy judicial decision In cases of so-called Incurablo Illness whero would the practice of this right lead us In a country where In spite of tho mushiest scntlmcntnllty that prevails as to all forms of Inevitable suffering among men nnd beasts the dlsrcgnrd of human llfo Is greater than In nny other civilized country. To what enormities would tho laxity of tho legal conscience of tho public lead us? How ready would bo a certain proportion of tho men In tho legal and medical professions to extinguish the sufferings nnd tho life of certain elderly nnd rich patients, unhesitatingly producing the necessary declaration of tho patient nnd the required proof of the hopeless outlook on his malady? Thoso that nro the nctual sufferers nnd thoso whoso duty ami business It Is to relieve suffering do not clamor painlessly to tho lives of those believed to bo mulcted with Incurable disease or Injury, Physicians, moro than the lay public, are, I believe, alive to the uncertainties and dangers of the recognition nnd ap plication of such n principle so contrary to tho traditions nnd practice of our profession. Dr. JACQUES LOEB of the Rocke feller Institute for Medical Research, tho biologist 1 think the medical pro fession has only a right to exist on the nnd rstandlng that Its mission Is to euro or prevent disease. Tho deliberate killing of patients, even under the cuph mlstlc name of euthanasia, opens tho barrier to legalized murder, TJlshop WILLIAM CROSWELL DOANl! of Albany, ono of the most conspicuous Episcopalians In the coun try I have no hesitation In saying that In my Judgment even tho thought of tho uso of science In painlessly ending tho llfo of an Incurable Is an Intolerable outrage. Nobody knows what work God may bo doing nnd may havo to do, Is the Deliberate Killing of a Patient Ever Justified ? Medical Men Divided on the Subject quest to those Incurables who aro n burden to themselves. JACK LONDON, tho novelist Man possesses hut one freedom, namely tho anticipating of the day of his death. Should collective man (the State) nib Individual man of this ono freedom? I believe not. I believe In tho In dividual's right to cense to live. I believe In euthanasia. I believe that the State should make legal tho painless ending of helpless Incurables who deslro to die. Tho State kills men who do not deslro to die. Then let It permit thoso to d'o who desire to die. GEORGE GORDON RATTLE, the lawyer I am disposed to think that GUNS THAI CAN GO WHEREVER A MAN CAN INFANTRY ARTILLERY WAR'S MODERN INNOVATION " 4 '' 'gjjjjj "Sll? or Imbecility cannot express his wishes. Lxcludlng tho theologian, who main tains that llfo must not bo shortened for n day or an hour under nny circum stances, no matter how full of horrors It Is, and even If tho case Is absolutely nopeiess, u terns to mc thnt here all rational thinkers should bo ablo to como to an agreement. Prof. ROSWELL PARK of the Uni versity of nuffalo announces that ho not only believes In but that ho has praitised eulhunnsla. Hero Is his con tribution: "Euthnnlsla haa nlwnys commended Itself to mo us being kind to the pro posed subject of It and humane In tho highest degree, In fact ns being practi cally applied altruism. It Is hedged about by one moro moral dllilculty; namely, the question of wise and tu- dlclous discretion as to Its application. .jiisl now a decision should be reached In general, or even In a particular case, offers tho greatest complication. "Doubtless tho verdict should be m;tdo up by a Jury or committee comoosnd mainly of experienced practitioners, who may do nnio to act without prejudice. in mis mater llie clergy shou d havo no voice. In nddltlon there shout,! h at least one lawyer of equal ability. "My own preference would bo for ii committee of two nractlt medicine and one of law, who might be appointed by a Supreme Court Judge or In some nuthorltatlvo way, or per haps better yet would It be to have legislative enactment authorizing the formation of a Stato commission made UP, sny, of eight physicians and four lawyers selected from different parts of mc Hime, nny thrco of whom might serve In their respective localities. Ob viously such commission should bo com posed of men of the highest standing. "I know that others have assumed the responsibility, which I have my self taken In more than ono case, of producing euthanasia when In tho ter minal stage of life a patient was suffer ing the tortures 'of tho damned1 nnd has pleaded for a method of escape, tho pleadings being seconded by tho family. Under these circumstances I think that to administer a lethal dose of morphine or of chloroform Is to 'do as one would be done by.' "I havo been told by high legal authority that to do this is equivalent In tho eyes of the law to committing murder. Nevertheless no one need allow his consclcnco to trouble him on this score. I am positive that It Is ono of tho kindest acts thnt a medical man can ever jerform. If ono must die why should ho dlo in agony when death can be made painless nnd in a sense nappy 7" Pruni the Dr.iulntr by It Oat on Vt'oodvlllr ItcproJurtil by courtesy of the Illustrated London .News. THESH SMALL PORTABLE QUICK-FIRERS USED By THE BULGARIAN INFANTRY AGAINST THE TURKS ARE CARRIED BY TWO MEN. THE GUNS FIRE 00 SHOTS A MINUTE. cation well, read my series of olista cles again. Dr. JAMES PETER WARBASSE, surgeon of tho German Horpit il of Brooklyn No human life should bo destroyed or Its termination abetted unless tho two following conditions maintain: 1. Tho Individual, in a clear stato of mind, shall deslro nnd express his deslro In unmistakable terms that ho wishes llfo artificially terminated; 2. Tho hastening of tho termination of his llfo shall not result In harm to nny other individual, which would bo greater than tho lotul good accruing. When tho two rcqulslto conditions nro present then euthanasia Is Justified. There should bo u reasonable certainty that nature herself would soon bring death or that tho unhappy stato Is Irremediable, Too much has been said In this con nection of so-called Incurablo Ilia. None aro Incurablo; no living person Is over so w rlously ill that ho may not recover. No euthanasia Is Justified unless desired hy tho Individual himself. To take tho llfo of an unconscious person or one who has not Intelligently asked for death Is murder and unjustifiable. Prof. SOLOMON SOLIS COHEN of tho Jefferson Medical College To place in any man's hands the unrestricted power of llfo nnd death would not only be to place upon him a responsibility tho question of the legal execution of incurables, euphemistically called eu thanasia, Is characteristic of the neu rotic tendencies of tho phaso of civiliza tion of this day. It Is a sign of moral weakness and deficiency, not In thoso to whom this old novelty Is to bo ap plied I mean tho Incurablo patients but In those whoso delicate moral fibre cannot accept the Inevitable share of living (lesh, suffering nnd death. It Is not tho pity for tho poor Incur nblo but tho pity for tho delicate sen sibilities of tho witness of Inevitable suffering that Is Impelling this move ment. Wo medical men know too well how rarely an Incurablo patient wishes to bo relieved of his sufferings by death, especially such a ono whoso advanced age has not made him famil iar with tho thought of death. I per sonally havo found with ono or two exceptions In a practice of forty years that In splto of most pnsslonato dec larations of a deslro for death when ever tho matter was discussed scrl sously with the patient the sincerity of his spoken wish was easily refuted by his own actions. Tho overwhelming majority of Incur ablo patients do not wish to havo tho Inevitable end hastened. They are right too In this their attitude, as there Is so far no trustworthy criterion which would permit a well Informed for euthanasia by extinction of life.1 It Is tho Itchy, selfish nnd Idle senti mentality of the ago that demands It. Prof. JOSEPH D. BRYANT of tho University nnd ltellevuo Hospital Medi cal College I nm unalterably opposed to tho proposition and have llttlo pa tlenco with thoso who would plan to rclcaso unkind or unflllal persons from their vital human duties, thereby, ns It seems to me, lessening correspondingly tho force of tho senso of duty that fosters and perpetuates tho true spirit of brotherly and paternal respect nnd lovo nnd sympathy for tho suffering everywhere. In comfortless and hope less instances therapeutics provides n remedy without tho need of human sacrifice. Prof. JOHN R. MURPHY of North western University, tho distinguished surgeon I nm decidedly opposed to euthanasia. Money and thought should bo expended In endeavoring to transfer a largo number of the present in curables to the curable class of tho fu ture, by advancing science through re search and experimentation. Prof. WILLIAM II. WELCH of Johns Hopkins University I am op posed to tho acceptance by tho medical profession or the State of tho doctrine of euthanasia In tho senso that It Is right or pcrmlssable to put an end even In tho Intest hours of life. I often think of tho Intense depth of meaning there Is In tho prayer of our burial sermons, "thnt wo may have grace In our last hours, not for any pains of death to fall away from Thee." EUGENE V, DEBS, four times tho candidate of tho Socialist party for President of tho United States Tho prolonging of human llfo In utterly hopeless circumstances Is an Inhuman ity, which final human enlighten ment will not countenance, and is scientifically and humanely Indcfcn-. slble. JOHN BUROUGHS, tho naturalist, poet and proso writer Thero aro con ditions of hopeless human suffering In which I think euthanasia is Justifiable nnd to be recommended conditions In which I should want it applied to my self. Prof, R. BURTON OPITZ of Columbia University Tho State pos sesses tho rlglit to rid Itself of tho criminal by confining him in prison or by putting him to death. Similarly tho State possesses the moral right to rid itself of incurables, and especially of I hose who, quite capablo of reproducing their like, would Anally endanger the existence of the State. Euthanasia should first be extended to the hopelessly Insane, and upon re- cuthannsla should Lo permitted, but only under two conditions; 1, Where tho patient, being incur ably 111, Is yet mentally sound and con sents to tho proposed expedition of the Inevltablo end. 2. Whero tho patient, being incurably ill, Is unconscious or Is In such mental condition ns to bo unnblo to form n decision on tho question. Tho condition precedent to tho appli cation of this drastic remedy should bo not only that tho disease Is Incurable but tlmt It Is so painful or so loathsomo us to makn llfo a burden, so that death would bo a relief to the patient as well as to his friends and relations. I should think, therefore, that boforo tho remedy Is applied there should Ikj a Judicial Investigation and an adjudica tion after publicly taking testimony. WILLIAM C. DE MILLE, tho dram atist As long as tho Stato is ethically Justified In putting tho Individual to death ns a punishment I fall to see why It should not havo the power to confer death as a blessing. Dr. WItiLTAM J. ROBINSON Thero nro two conditions in which euthanasia may be thought of: 1, Where tho patient is incurably ill, is suffering cruelly and begs to be re lieved of his sufferings by gentlo death. 2. Where the patient Is Incurably 111 mentally, and on account of his insanity FLATDWELLER IS HAPPY "The city Is my home," the flat dweller said, "and I havo never thought that I could bear to live anywhere else; but yesterday a friend of mine nsked mo to go out and spend the night with him at his home In tho country nnd I went. "It Is a pleasant house ho lives In, and In a pleasant locality. It Is modern in every way, with electric lights and so on, and with a heating plant that kept It warm, with a degree of heat that you could control. You didn't have to look here to tho Janitor and alternately roast nnd freeze. And certainly a good dinner tasted ns good thero ns It did in the city, and so uid tho after dinner cigar, and then when wo had talked long enough to get tho affairs of tho country all com fortably settled and my friend told mo he d show me my room I began to realize even moro vividly than I had bo- fore that this was a house he lived in. "Wo sauntered out into tho hall and up a flight of stairs what would you think of that, upstairs! I lived In a house once myself some years ago, where we used to go upstairs to bed. but It was so long ago that really I had forgot how it seemed to do that. Going up theso stairs now to bed woji a pleasant novelty to me, but It had begun to seem a little natural to me before wo got to tho top. "There my friend opened a door and. stepped in and pressed a button in tho wall, nnd, 'Hero you are,' ho said, and then he walked across tho room and opened a door on the other sldo nnd said, 'Here's whero you hnng your clothes,' in a closet big enough to walk into, and I did walk Into It, Just for fun, nnd smiled as I thought of the closets In my own flat home. "And then ho left me, and I looked around tho room. Not Just an 8x10 onvo room this In a mountain of brick and stone and with ono window open ing on an alrshaft, but a generous sized room with windows on two sides opening Into all outdoors, a room with plenty of fresh nlr and ventilation. "As It happened It was a rainy night, and I could hear tho rain, nnd then presently thero struck my ear a sound that I hadn't heard for years before, namely, tho gurgling of the water In a rain water conductor from tho roof; for this, remember, was a house, a regular house, and I liked that musical I'urgle. Then thero wns a railroad train passing on tho lino not half a mile nway llfo and company In that, I lovo tho bustlo of tho city, but I never feel lost In any placo whero I can hear tho click of a telegraph Instrument or tho sound of a railroad train, and so hero now I went to sleep most comfortably. "My friend Is an early riser. He doesn't take his train till 8 o'clock, but ho gets up at 6, I had asked him to wako mo when ho got up and I was out on tho veranda, to get a breath of the country nlr, by 6.30 o'clock. "A cloudy morning, and so In these winter days nt that hour still dark, but lights beginning to show in tho houses around In tho kltcthens. And then wo began to get lights hero and thero above stairs, In bedrooms, city workers ris ing nnd getting ready for breakfast and their several trains, and then, ns I walked tho veranda "A rooster! The crowing of a rooster, and two or thrco moro answer ing; dearly somo people around here kept chickens; but when I'd heard a rooster crow beforo this morning I couldn't remember. And then, In tho distance Puff! puff! uff! uff! uff! ffffffff! A train camo up tho road, gathering headway. More daylight was coming now, and tho houses around shaped themselves Into clear view, and tho trees. And now at 7:15 a call to breakfast, and then when my friend had lighted his plpo we wero off for the train."