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Our Fight4Terri see Our Fight4Terri -By Cheryl Ford, RN and Dr. J. Craddock  Note: CHN Has created a special page for Our Fight4Terri, click hyperlink above Includes information on where to order your copy

FORCED EXIT; CULTURE OF DEATH;  & SEDUCED BY DEATH These books are available at your library - Reviewed on this page




BOOKS & REVIEWS  Click on title to read review





Wesley J. Smith is one of North America's most important writers in the area of the study of euthanasia, medical ethics, bioethics and disability issues.  As well as his most recent books, his articles are widely published. 
Wesley J. Smith's bio

Nat Hentoff says, "If only in self-defense, you ought to read "The Culture of Death" and discuss it with your doctors and your family. And put your wishes in writing."

CULTURE OF DEATH by WESLEY J. SMITH  Hardcover - 250 pages (February 2001) Encounter Books; ISBN 1893554066

Unbeknownst to most Americans, a small but influential group of philosophers and health care policy makers are working energetically to transform our nation's medical practice and health care laws. They are turning away from the "do no harm" model established by Hippocrates more than two thousand years ago, and toward a stark utilitarian system that would legitimize medical discrimination against -- and even in some cases, the killing of -- the weakest and most defenseless people among us.

The first time most people become aware of this development is when they or a loved one experience a health care crisis. It is then, when they are at their most vulnerable, that suddenly they come face to face with the monster they did not know was lurking in the shadows. Why are the long-standing ethics of our health care system suddenly so threatened?

 Part of the reason, no doubt, lies in the culture of the times, in which objective truths are passd and the very concept of right and wrong is under assault. But the problem involves more than societal drift or some slow-motion cultural evolution. The challenges to medical ethics explored in this book are purposefully promoted by a cadre of "experts": moral philosophers, academics, lawyers, physicians, and other members of an emerging medical intelligentsia, known generically as "bioethicists."

How does one become a bioethicist? It may sound like a demanding discipline--indeed the most demanding imaginable, given the profound, life-and-death nature of the issues with which bioethics grapples. But in fact it is surprisingly, even depressingly easy to hang out a shingle: no tests have to be passed, no specific qualifications met. Indeed, practitioners are not licensed, as are other professionals such as attorneys, physicians, real estate agents, or, for that matter, hairdressers. Bioethics is not a formal university discipline. (Most university bioethics professors were trained in the arcane field of philosophy.) And while more than thirty universities now offer degrees in bioethics, there are no standards of knowledge or achievement that apply universally.

Bioethics education may range from postgraduate university courses, to training seminars that take mere weeks or even days. Health care professionals such as licensed vocational nurses or community ombudsmen can be appointed to a hospital ethics committee, take a few training courses and then self-identify as bioethicists. Lay members of bioethics committees at hospitals and other health care institutions may receive no formal training at all. Indeed, after writing and lecturing extensively over the last eight years on issues such as assisted suicide and initiatives to permit doctors to withhold desired medical treatment unilaterally from dying and disabled people, I could claim--although I won't--that I am a bioethicist too. This is not to say that the title "bioethicist" automatically confers influence in the medical community or the ability to sway society toward or away from a certain public policy path.

Rather, power belongs to a relatively small "insider" clique of elite and powerful philosopher, academic, attorney and physician practitioners--the "name" bioethicists who write most of the treatises and books and who speak at the many national and international symposia through which bioethics advocacy advances. It is they to whom government often turns when seeking ethical opinions regarding the many dilemmas and controversies in modern health care policy.

They teach our future doctors and other societal leaders in the country's best universities. They materially influence the opinions and practices of the thousands of men and women who labor in the trenches of clinical medicine at hospitals, nursing homes, and HMOs. They testify as expert witnesses" in court cases or write "friend of the court" briefs in important litigation involving health care. And they exert a steady and growing influence over the public health laws, the application of medical ethics, and the protocols of hospital care.

Many bioethics agenda items--particularly the issue of personal autonomy--have already been set into the bedrock of law. The 1999 Montana Supreme Court's decision in James H. Armstrong, MD v. The State of Montana is a case in point. The state had passed a law requiring that only doctors perform abortions, which the court invalidated on the basis of the Montana Constitution and Roe v. Wade. That should have been the extent of the decision. But rather than limit the ruling to the case at hand, a 6-2 majority used the occasion to impose an audacious, radical philosophical imperative on Montanans, threatening their right to regulate the practice of medicine effectively through the rule of law.

The language of the decision seems innocuous enough: "The Montana Constitution broadly guarantees each individual the right to make medical judgments affecting her or his bodily integrity and health in partnership with a chosen health care provider free from government interference." But the two justices who objected to this aspect of the ruling, Karla M. Cray and Chief Justice J. A. Turnage, understood the danger. They rightfully worried that the ruling's radical scope strongly suggested that "the Legislature has no role at all in matters relating to health care to be provided to the people of Montana." 

If under Armstrong almost anything goes medically in Montana, so long as a patient wants it and a health care professional is willing to do it--a reasonable interpretation considering the expansive language and philosophical thrust of the majority's decision--then the ruling could be construed to permit a doctor to amputate a patient's healthy limbs upon request when the patient wants to satisfy a neurotic obsession (a macabre surgery that has actually occurred in England); to allow patients to ask doctors to kill them for organ donation purposes; to permit infanticide of disabled newborns at the request of caregivers or parents; or, to allow people to be experimented upon in dangerous ways that are currently illegal. Indeed, the court's ruling is so broad, it decrees that only "a compelling interest ... to preserve the safety, health and welfare of a particular class of patients or the general public from a medically-acknowledged bona fide health risk," warrants state involvement in medical decision making.

 In other words, regardless of the individual or societal consequences and absent extraordinary exigencies such as preventing a plague, virtually any medical procedure is possible in Montana if it can be construed to involve obtaining "medical care from a chosen health care provider." How was such a sweeping decision justified?

The court did look to Roe v. Wade and a smattering of other cases; but the primary authorities that the majority relied upon in expanding the reach of its ruling were philosophical treatises. Indeed, the most frequently cited authority was not a statute, a law case, or even a legal essay, but a philosophical discourse on the modern meaning of the "sanctity of human life" contained in a book--Life's Dominion: An Argument about Abortion, Euthanasia, and Individual Freedom--written in 1993 by the influential attorney/bioethicist, Ronald Dworkin.

His thesis: a true adherence to the sanctity-of-life ethic requires that we all should be permitted to "decide for ourselves" about abortion and euthanasia (and presumably, all other such life and death decisions), and that such "choices" must be accepted by society and tolerated by those who disagree if society is not to become "totalitarian." The Montana majority opinion cited Life's Dominion so frequently and applied its reasoning so enthusiastically that it is no exaggeration to say the decision transformed Dworkin's philosophy into the court-mandated health care public policy of the entire state of Montana, without a single citizen or legislator having the opportunity to cast a vote.  Dworkin's influence upon the Montana Supreme Court epitomizes the growing power of the bioethics movement.

What makes this development especially worrisome is that the movement's leaders generally reject what until now has been the core value of Western civilization: that all human beings possess equal moral worth. That denial leads bioethicists--and through them, us--into very dark and dangerous places, as this book will reveal. Our culture is fast devolving into one in which killing is beneficent, suicide is rational, natural death is undignified, and caring properly and compassionately for people who are elderly, prematurely born, disabled, despairing, or dying is a burden that wastes emotional and financial resources.

 Indeed, it is alarming how far the movement has already pushed medical ethics away from the ideals and beliefs that most people count on to protect them when they or a loved one grows seriously ill or disabled. Cutting edge bioethics now holds that there is nothing special per se in being human, and thus bioethicists have generally abandoned the sanctity-of-life ethic that proclaims the inherent moral worth of all people.

 The favored term for humans used by movement advocates is not "people" or even "individuals," but "beings"--a term that includes nonhumans. According to the movement's leading lights, a "being" may or may not be entitled to membership in the "moral community," which is what truly matters. As we shall see, one earns this status by possessing certain "relevant characteristics"--usually a minimum level of cognitive functioning--that bioethicists consider essential for significant moral standing. Those with sufficient cognitive qualifications to achieve membership in the moral community are often called "persons," who have moral rights.

Those who fail this test, on the other hand, are denigrated as nonpersons, who have little or no moral worth. Why is this important? Because theoretically--and in our era, theory too easily becomes practice--non-persons can be killed, abandoned medically, experimented upon, or otherwise exploited as a natural resource. It is as if we are being pushed, slowly but steadily into a Salvador Dali painting. By disparaging the sanctity of human life, bioethics has already led us into some shadowy ethical back alleys:  

    * Desired medical treatment is refused in hospitals and nursing homes around the country to patients who are dying or disabled. This abandonment is justified as ethical under a new theoretical construct Imown as Futile Care Theory, which proclaims the right of doctors (and health care executives) to refuse to provide wanted care based on their subjective views of the quality of patients' lives.  

    * Doctors, nurses, and other hospital staff in hospitals and nursing homes often pressure family members to permit their seriously brain-damaged relatives (stroke victims, demented patients, and others with profound cognitive disabilities) to be dehydrated to death by the removal of tube-supplied food and water, a practice now occurring in all fifty states. Research animals enjoy greater legal protection of their welfare under federal law than do many human subjects who participate in medical experiments. 

    * Oregon, which has legalized assisted suicide, has decreed that the act is a form of "comfort care," i.e. pain control, that must be paid for by Medicaid--although the state's Medicaid health rationing scheme denies some curative treatments to late-stage cancers and very low birth-weight babies. 

    * In New York, a man who smothered his wife with a plastic bag after her purported assisted suicide attempt failed, and who then covered up the crime with a falsified death certificate and a quick cremation, was given a mere two-week jail sentence. In Canada, Robert Latimer was convicted of murdering his twelve-year-old daughter by asphyxiation because she had cerebral palsy. Instead of receiving significant punishment, he was embraced by a majority of Canadians as a "loving father," which resulted in his "mandatory" ten-year sentence being reduced to one year by a judge who labeled the girl's murder "altruistic." In England, the parents of an infant born with Down's syndrome and the treating doctor who intentionally allowed the baby to starve to death were acquitted of all criminal wrongdoing.

The growing indifference to the value of the lives of aged, ill, and disabled individuals within the health care system, academia, and the courts should be big news. Yet, with the exception of assisted suicide--due mostly to the widespread media coverage of the bizarre antics of Jack Kevorkian--most people are but dimly aware of what is happening. Popular culture promotes many of these practices as a compassionate response to the trials and tribulations of illness and a necessary adjustment to an obsolete, religiously based ethical system.

The growing relativism of our culture increasingly incapacitates people from "imposing their own beliefs on others" by making well-honed ethical judgments. The mainstream media do not cover these important issues adequately (or sometimes even cover them at all), and when they do, the issues are rarely placed in a proper and understandable context. While stories involving death culture issues sometimes make the news, they are typically covered as if they occurred in a vacuum. Thus we are like the proverbial frog slowly boiled to death in a pot: it doesn't perceive the water growing progressively hotter.

This book is intended to prove that we are really being cooked. It is primarily about how bad ideas hurt real people. Although I quote many philosophical treatises, this is not a study in philosophy. And while I explore many laws and ethics protocols, I have tried to avoid getting bogged down in specific policy proposals.

My purposes are these: to alert my readers to the intentional undermining by bioethicists of the fundamental moral principles that have long governed our society, and to invite them into the crucial, ongoing debates about their health care--debates that will, quite literally, determine the future of Western medicine.  The steam is rising. The water is already scalding. Unlike the poor frog, however, we can do more than simply stew. We can feel the heat, sense the danger, and hop quickly away.

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One of the most important forces working in the culture of death is the field known as "bioethics"—that is, the ethical standards being embraced to deal with medical and biological questions. 

In his new book, appropriately entitled The Culture of Death, J. Wesley Smith chronicles what he calls "the assault on medical ethics in America." Smith analyzes the practices and philosophies that have taken the medical profession away from the moral certainty provided by the maxim of the Hippocratic Oath, "First, do no harm."

As Smith tells readers, the bioethics establishment "[rejects] what until now has been the core value of Western civilization: that all human beings possess equal moral worth."

As a result of this rejection, bioethicists increasingly embrace the idea that there are lives that are not worth living—that the right to life is contingent on an arbitrary idea known as "quality of life." 

This idea leads to the conclusion that some patients, especially the elderly, have an affirmative duty to die, so as not to waste scarce resources. Unbelievable.

Well, this is more than theory. As Smith points out, the fruits of this worldview are visible in the increased talk about "patient autonomy," a term used to justify abandoning patients to hasten their deaths. We see it in the increasingly routine withdrawal of feeding tubes from disabled or terminal patients. 

If talk of "lives not worth living" reminds you of the Third Reich, you’re not alone. Columnist Nat Hentoff makes the same connection in a recent column. He reminds readers that it was the Nazis who coined the expression "lives not worth living," to describe the incurably ill and disabled. They called them "useless eaters"—a phrase that anticipates the removal of feeding tubes.

Unfortunately, Smith doesn’t make the connection between abortion and the "assault on medical ethics" he describes. It’s unfortunate because it was legalized abortion, more than anything else, that taught Americans that human beings—especially at the beginning and end of life—don’t all possess equal moral worth. It was abortion that introduced Americans to the concept of disposable human life. 

Still Smith’s book provides an invaluable service to the cause of life. It’s both a warning as to how much our culture has embraced the culture of death, and it’s a resource for helping us to spread the word about the deadly consequences of this fatal embrace. 

Even if our neighbors roll their eyes at the mention of the words "pro life," they’ve still got a stake in this debate. As Smith concludes: 

"We all age. We fall ill. We grow weak. We become disabled. A day comes when our need to receive from our fellows adds to far more than our ability to give in return. When we reach that stage of life . . . will we still be deemed persons entitled to equal protection under the law?"

And all that stands between us and that bleak prospect is the Gospel of Life.

  • FORCED EXIT: Book Review:  
    Smith.gif - 7681 Bytes Wesley J. Smith

FORCED EXIT : The Slippery Slope from Assisted Suicide to Legalized Murder by Wesley J. Smith  Hardcover - TimesBooks Random House May 1997 304 pages

Euthanasia is first step to legalized murder By John Attarian

Proponents of euthanasia and physician-assisted suicide often invoke the "slippery slope" - a small initial change resulting in more and more, producing unintended, far worse outcomes. Thus, euthanasia on request for terminally ill patients would lead to euthanasia of many other patients against their will. Put another way, euthanasia is the entering wedge for legalized murder. Alarmist nonsense, advocates scoff.

But attorney and anti-euthanasia activist Wesley Smith argues urgently in Forced Exit that the slippery slope exists - indeed, we're already on it - and he makes an overwhelmingly persuasive case. The euthanasia movement, Smith acknowledges, was provoked by real problems: families' despair at the sufferings of loved ones inadequately medicated for pain; the "very reasonable" fear of victimization by our heath care system; and community breakdown.

But far from solving these problems, euthanasia is "a surrender to them." Moreover, something sinister is happening, Smith argues: repudiation of the "equality-of-human-life ethic," which holds that all human lives have "equal inherent moral worth." Traditionally, "protecting human life has been viewed as the central purpose of organized society," with intentional killing by individuals and state alike severely restricted. Instead, we now have a "death culture" unequally weighting lives.

Underlying this are a radical individualist obsession with autonomy, and what Smith calls "terminal nonjudgmentalism," a failure to acknowledge or condemn evil beliefs and actions. Of his persuasive examples, the case of journalist Lonny Shavelson - passively weighing the complexities while watching a Hemlock Society member asphyxiate a would-be suicide who'd changed his mind and was resisting - is especially appalling. So is Smith's history lesson. Doctors, not Adolf  Hitler, took the initiative in German euthanasia and practiced it ever-more indiscriminately, even after Hitler suspended the program. The Netherlands' example is more alarming still. Proving that "the slippery slope is very real,"

Dutch euthanasia, while formally illegal, has expanded from terminally ill patients who request it, to the chronically ill who request it, to the depressed who request it, to newborns with birth defects. Euthanasia guidelines are routinely flouted and seldom enforced. Moreover, medical killing in Holland is often involuntary. Of the 11,140 patients euthanized or assisted in suicide in 1990, 5,981 - more than half - were involuntary lethal injections or intentional overdoses. These probably understated figures would translate into more than 170,000 American euthanasia cases or assisted suicides, including 85,000 murders.

Worst of all, America is sliding down the slippery slope. Food and fluids are being withdrawn from terminally ill, unconscious but not terminally ill and conscious but cognitively disabled patients.

Some bioethicists, doctors and others are arguing that patient and family treatment requests should be denied, and patients allowed to die, if the "experts" deem the care futile. This "futilitarianism" is already operating.

Elderly patients and newborns have been denied desired lifesaving care. State bureaucrats have even stripped parents of their parental rights for wanting to continue "futile" life support for their children.

Given this, claims that euthanasia will only be a last resort ring hollow. "What would prevent doctors from coming to believe they were entitled to actively kill patients whose continued care they deemed futile?" Smith argues. "It is a very sort stride from refusing wanted lifesaving care to actively killing patients without request, as Dutch doctors already do."

Crisply, Smith dispatches several euthanasia arguments. Guidelines can prevent abuses. They don't. Euthanasia would only be for "hard cases." Its expanded application is pushed constantly. We put animals to sleep, don't we? Humans are not animals. Besides, he rightly argues, there's no need to take the socially risky step of legalizing euthanasia. Medicating adequately for pain, hospice care and independent living for the disabled are better alternatives. We should improve control over health maintenance organizations (HMOs), make pain control more accessible and improve hospital ethics committees.

Forced Exit's appendix lists organizations offering information, guidance and referral service on pain control, hospice care, disability issues and advance medical directives. Money, Smith claims, is "perhaps ultimately the most influential and dangerous force driving the euthanasia juggernaut." America's shift from a fee-for-service health care system to one dominated by for-profit HMOs that make money by cutting costs will create strong pressure save money by killing terminally ill or disabled patients.

Undeniably, Smith has fingered a problem. Obsession with money increasingly dominates American life, and manic cost-cutting dominates business. But his answer, national health care, is no answer. Budget constraints would impose an analogous pressure to minimize costs by denying treatment - especially once America gets swamped with retirees. And the Dutch euthanasia that so horrifies him is occurring under socialized medicine. Egalitarianism also is an unconvincing rationale for valuing life and opposing euthanasia. We do so because it's self-evident that life is precious, not out of belief in equality. Nevertheless, Smith's evidence of "terminal nonjudgmentalism," nihilism and, especially, the slippery slope is outstanding. After Forced Exit, dismissing the slippery slope argument will be impossible.

Wednesday, July 30, 1997  Copyright 1997, The Detroit News We welcome your comments. E-mail us at

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Published by:
W.W. Norton & Co.

Seduced by death is an eye-opening book that blows the lid off the mask of euthanasia in Holland. Using documented information, Hendin proves that doctor-assisted suicide in Holland is anything but. And that at least 2,300 deaths per year are just plain "euthanasia". A useful book that belongs in the library of everyone battling the pro-euthanasia forces.  See also "In the wonderfully titled Seduced by Death . . ." reviewed below

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Published by:
Basic Books

This powerful study, the result of ten years of painstaking research and extensive interviews, casts new light not only on the origins of the Holocaust, but explains how physicians, sworn by oath and conviction to ease suffering, were transformed from healers to systematic killers.

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The Standard Reader
Dean Koontz meets Wesley Smith.
04/08/2002, Volume 007, Issue 29


The Weekly Standard doesn't review much mass-market genre fiction, figuring such books manage to find readers all by themselves. But you may want to check out Dean R. Koontz's latest. Koontz is the bestselling author of such black thrillers and horror stories as "The Servants of Twilight," "Darkfall," and "Phantoms"--to say nothing of "Ticktock," "Icebound," "Dark Rivers of the Heart," "Sole Survivor," and nearly 80 other books.

His new thriller, "One Door Away from Heaven" (Bantam, 608 pp., $26.95), interweaves two plots: one in which a woman tries to save a crippled girl from being euthanized by her wicked stepfather, and another in which an odd boy is hunted across America by both the FBI and a gang of murderers. Along the way, Koontz denounces bad medicine, assisted suicide, and believers in extraterrestrials. But it was the author's note that caught our eye:

"Utilitarian bioethics as portrayed in 'One Door Away from Heaven' is unfortunately not a figment of my imagination, but a real threat to you and to everyone you love. This philosophy embodies the antihuman essence of fascism, expresses the contempt for individuals' freedom and for the disabled and the frail that has in the past marked every form of totalitarianism. One day our great universities will be required to redeem themselves from the shame of having honored and promulgated ethicists who would excuse and facilitate the killing of the disabled, the weak, and the elderly."

We couldn't have said it better ourselves--and Koontz goes on to pay tribute to Wesley J. Smith, a frequent writer for The Weekly Standard:

"As I was finishing this novel, Encounter Books published a nonfiction work offering the best survey of utilitarian bioethics written for a general audience that I have yet seen. If, for your own protection and for the sake of those you love, you want to know more about the subject than I've covered herein, I highly recommend 'Culture of Death: The Assault on Medical Ethics in America' by Wesley J. Smith. You will find it more hair-raising than any novel you've ever read."

We should mention that Wesley Smith is also the author of a new book, cowritten with Eric M. Chevlen, an Ohio physician specializing in pain relief who has written for our pages as well. Called "Power Over Pain: How to Get the Pain Control You Need" (ITFEAS, 235 pp., $12.95), it's mostly a consumer's guide for patients who are seeking effective pain medication from their doctors, with chapters on the origins of pain, the differences between acute and chronic pain, the effectiveness and side effects of morphine and other drugs, and the failure of physicians to treat pain correctly. But Chevlen and Smith also use the occasion to attack the current medical protocols that would rather control pain by helping patients die than by prescribing pain-relief medicine. We don't expect the book to sell quite as well as Koontz's "One Door Away from Heaven," which reached number three on the New York Times bestseller list. But for patients threatened by the latest trends in bioethics, "Power Over Pain" fills an important gap.

--J. Bottum

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Published by the Canadian Abilities Foundation

Join Daryl Rock on his journey across Canada and through time as he brings you the stories of eleven Canadians with disabilities who have gone the distance. Prepare to be uplifted and proud of being part of a society that is enriched by its diverse citizens. Discover why Canada is considered the best country in the world in which to live.

Plus -- as an added bonus -- read fifteen profiles from fifteen years of ABILITIES, Canada's Lifestyle Magazine for People with Disabilities. You will be inspired by the difference people with disabilities are making to our communities and our future.


Lisa Bendall
Managing Editor

Canadian Abilities Foundation
489 College St., Ste. 501
Toronto ON  M6G 1A5
Phone: (416) 923-1885
Fax: (416)

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"They wanted his organs for transplant purposes as there was no real hope of his recovery. They said if he lived, he would never walk or talk...."

Journey with Jay published by Vantage Press Inc. in New York.  December 20, 2000 which can be ordered at   Jacket of the book

Do miracles still occur today? Jan Peine, a rehabilitation specialist was skeptical until she was asked to work with Jay Basselin, an extraordinary Christian man who was recovering from a catastrophic brain injury. Jay's uncanny survival, which could be deemed miraculous, left him with a rare amnesia, which deprived him of recognizing everyday food items, and even his own reflection in the mirror. Jan's challenge was to teach this gentle giant, who was now limited in mental function and void of all memories, how to function in today's world. She did not realize that in the end he would teach her more! Jay's colorful antics, which are delightfully innocent, should amuse the most somber reader, while his unsettling, inquisitive questions regarding our society evoke soul-searching answers. This is the intriguing, true story of Jay Basselin's recovery---an inspirational must for anyone who doubts the healing power of faith.

In a letter to CHN, author Jan Peine wrote: 

I have written to most of our media here in Birmingham to apprise them of the [Robert]Wendland situation. I am hopeful that Jay's story can make a difference in how others perceive disability. " She also said, "As a rehabilitation specialist, I am appalled about the pending California supreme court case involving brain injured Robert Wendland. This is a very personal situation for me, as I worked one on one for two years with another brain injured patient who had similar deficits as Mr. Wendland. His name is Jay Basselin and his recovery became miraculous and is chronicled in a book that I have written which was recently released. It is entitled Journey with Jay and it details Jay's recovery process from coma to work resumption. Our society is a paradox. On the one hand we continue to develop the medical technology to salvage broken bodies, and on the other hand, we devise creative ways to terminate life once we have successfully sustained it. More and more, we are evolving to a society that assumes one has to be perfect in order to have purpose. This simply is not so, and Jay Basselin's life and recovery proves this point. The Basselin family and I want to help the Robert Wendland's of the world.

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Dr. Sally Rogow  has worked in the field of Special Education for many years. She developed and directed a preparation program for resource teachers working with students who are blind, visually impaired and /or multiply disabled at the University of British Columbia. She has written books and articles on language and social development, literacy and play. Currently she is director of "The Person Within", a project designed to prevent abuse and neglect of children and young people with disabilities.

She is the author of books and articles on the development of language, communication and literacy. The guiding philosophy of this site is a strong belief in the power of supportive environments to enable all children and young people to reach their full potential. Disability may be a characteristic but it cannot be allowed to be a determinant in the lives of children.

Born in New York City, Sally Rogow received a BA (University of Wisconsin) an MA in Anthropology (Columbia University). She attended Bank Street College to become a teacher and earned an MA ( Michigan State University) and an Ed.D. in Special Education (University of British Columbia)

Select Bibliography of Dr. Sally Rogow

Books by Rogow:

Rogow, S.M. (2000) Communication and Language: Issues and Concerns. The Lighthouse Handbook on Vision Impairment and Vision Rehabilitation. Vol. 1 New York: Oxford University Press. pp. 395-408

The Impact of Visual Impairments on Psychosocial Development. In V.L. Schwean and S.H. Saklofske ( Eds). Handbook of Psychosocial Characteristics of Exceptional Children. New York: Kluwer Academic/Plenum Publishers. pp. 523-542.

Rogow, S.M. (1997) Language, Literacy and Children with Special Needs. Toronto, Canada, Pippin Publishing.

Rogow, S.M. & Hass J. (1993) Shared Moments: Learning Games for Young Children with Disabilities. Greensboro, NC: Tudor Publishers.

Rogow, S.M. (1988) Helping the visually impaired child with developmental problems: Effective practice in home, school and community. NY: Teachers College Press, Columbia University.

Winzer, M., Rogow, S.M., David C. (1986) Exceptional Children in Canada Toronto: Prentice Hall.

Refereed Articles

Rogow, S.M. (2001) Child Victims in Nazi Germany. Journal of Holocaust Education, 8:3 (in print)

Rogow, S.M. (1994) Language development in a non-vocal child, Child, Care, Health and Development 20: 339-348.

Rogow, S.M. (1994) Literacy and children with severe visual problems, B.C. Journal of Special Education 18: 101-109.

Rogow, S.M.and Rathwell, D. (1994) Visual perception and interpretation by children with severe visual impairments, B.C. Journal of Special Education 18: 165-173.

Rogow, S.M. (1992) Narrative out of silence: The importance of language and story in the lives of children who cannot speak, Canadian Journal of Special Education 8: 145-163.

Rogow, S.M. (1992) Visual perceptual problems of children with developmental disabilities. RE:view 24:2:57-64.

Rogow, S.M. & Rathwell, D. (1989) Seeing and knowing: An investigation of visual perception among children with severe visual impairments, The Journal of Vision Rehabilitation, 3:3, 55-66.

Sally Rogow by e-Mail  

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Published by:
Oxford University Press

This fascinating book shows how efforts to improve human heredity (eugenics) became linked with euthanasia, and with race, class, gender and ethnic hatreds. While focused on the formative years of the early 20th century, The Black Stork traces these issues from antiquity to the rise of Nazism, and to the "Baby Doe", "assisted suicide" and human genome initiative debates of today.

Shocking, Troubling, Valuable...

Patients, Physicians, and the
License to Kill in the Third Reich

Revised Edition
by Hugh Gregory Gallagher

Introduction by Senator Bob Dole

ISBN * 09!8339-36-7 * Revised Edition * Hardcover * 365 pages * 6 x 9 * Acid Free Paper * index * $21.95

A searing account . . A valuable contribution to the history of the Nazi era, as well as to the literature on the struggle for the rights of the disabled.


This shocking log account of disabled people's fight for their lives has lessons for today. Read it."

Senator Robert Dole

Hugh Gregory Gallagher's moving study of the systematic murder of the physically and mentally disabled in the Third Reich is a riveting account that covers the subject from the larger social and historical context to the smallest details of how the killing centers functioned. It is based on extensive research, including captured Nazi documents, transcripts of testimony of the doctors and other participants in the killing program, and personal interviews. By Trust Betrayed provides new insight into the honor of ordinary people doing monstrous things under the aegis of ''science'' in Nazi Germany. It also raises troubling questions about many contemporary theories and ideas dealing with euthanasia, health care, and medical ethics.  Call 1-800-551-7776  for our catalog or to order

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By Thomas Szasz, Syracuse, N.Y., Syracuse University Press, 2002, 200 pages, $19.95, ISBN 0-8156-0755-5 • By Herbert Hendin, New York, W.W. Norton & Company, 1996, 256 pages, $27.50, ISBN 0-3930-4003-8

Lewis M. Cohen, M.D.

When was the last time you read a psychiatry book for pleasure? As someone who admittedly cannot recall when I picked up anything other than a required text or journal, these two books combine intellectual stimulation with total enjoyment. Both authors are passionate and erudite in their attempts at illuminating the modern phenomenon of suicide. As American medicine has advanced to the point that it can prolong the lives of literally millions of individuals, psychiatry is challenged to understand what constitutes suicide and how to conceptualize and manage people's wishes when they are dying.

Before I go on much further with this review, I should acknowledge my connections to the authors. Although I have met neither, their writings have actively influenced my thinking as I conduct research and try to make sense of patients who discontinue the life-support treatment of dialysis. Dr. Hendin is the Executive Director of the American Foundation for the Prevention of Suicide, an organization that has provided me with a grant to study suicide in renal disease. In a section on the termination of dialysis in Fatal Freedom, Dr. Szasz quotes and gently chides me for having written, "When I determine that a dialysis cessation request is motivated by depression or other forms of psychopathology, I have not hesitated to institute vigorous psychiatric treatment, including hospital commitment."1 Frankly, I feel complimented to be the object of Dr. Szasz' critique. (Incidentally, in the couple of cases where I involuntarily hospitalized a psychiatric patient who wished to stop dialysis, this usually involved bipolar affective disorder. My experience has consistently been that the patient's judgment and delusions invariably improved with treatment, and it was possible to rapidly resume maintenance dialysis.)

Dr. Szasz, a true iconoclastic psychiatrist, has published more than 600 articles and 24 books in which he regularly lambasted the psychiatric establishment for being a tool of society/government and especially for the use of coercive forms of treatment. I recall reading his The Myth of Mental Illness (1961) during residency and being inspired but not entirely convinced by the strongly worded opinions. Now a professor emeritus at the State University of New York Health Science Center in Syracuse, his current thinking about suicide resonates more with that of my own. Even where we disagree, it is a pleasure to follow his thought processes and absorb the anecdotes drawn from history, philosophy, and theology.

Dr. Szasz subtitles the first chapter, "Our Self-Mutilated Vocabulary," and quickly makes the point that, "For killing others, we have a richly nuanced vocabulary; for killing ourselves, we have only a single word, which we hate to utter." He underscores that our linguistic self-paralysis results in the word, suicide, expressing two very different meanings—the mode of death and a simultaneous denunciation and condemnation of the act as being sinful, criminal, and irrational. Like matricide and patricide, use of the suffix "cide" implies that suicide is a wrongful act.

On the other hand, our society approves or even applauds certain types of homicide—acts that cause the death of other human beings. For example, killing in self-defense or in combat are considered to be meritorious, and not criminal offenses. When the judiciary does get involved, it distinguishes between various degrees of murder, manslaughter, involuntary manslaughter, etc., each depending on the motivation and circumstances.

Dr. Szasz defines suicide as being "any behavior motivated by a preference for death over life that leads directly (perhaps only after the lapse of several days) to the cessation of one's life." He points out that suicide, self-killing, or autohomicide—interchangeable terms throughout the book—was recognized by the Greeks and Romans to be courageous or cowardly and legitimate or illegitimate depending on the circumstances. Different societies, including that of our own, have lauded self-sacrifice for great causes. Judaism and Christianity have had contradictory and changing views on suicide. Each religion has interpreted the Biblical commandment of "Thou shalt not kill" to also include suicide. Both theologies have celebrated their martyrs, while they have also punished those who kill themselves by denying burial in holy ground. Both have found a way in modern times to excuse the prohibition of suicide: by employing a psychiatric defense. Burial in Jewish and Christian cemeteries of suicides is now commonplace, as theologians explain that the individual was mentally ill and accordingly not responsible for the behavior. Dr. Szasz is incensed at this intellectual solution and use/misuse of psychiatry.

The shift in thinking and practice also represents an interesting application of the principle of double effect. This was eloquently articulated by St. Thomas Aquinas (1225–1274), who wrote in a chapter titled, "Whether it is lawful to kill a man in self-defense?" the following:

Nothing hinders one act from having two effects, only one of which is intended, while the other is beside the intention. Now moral acts take their species according to what is intended, and not according to what is beside the intention. Accordingly, the act of self-defense may have two effects, one is the saving of one's life, the other is the slaying of the aggressor. Therefore this act, since one's intention is to save one's own life, is not unlawful.2


The same principle is invariably cited in bioethical discussions of all medical acts that serve to accelerate dying, whether it is intermittent use of opiates for symptom management in catastrophically ill patients, terminal sedation, or cessation of life-support treatments. Dr. Szasz suggests that by changing a few words the formula equally applies to and justifies the killing of oneself.

Advocates of physician-assisted suicide have justified the practice by also quoting the principle of double effect, an approach which Dr. Szasz strongly disputes. He argues vociferously that joining the words "assisted" and "suicide" is "cognitively misleading and politically mischievous," and that it results in a euphemism that is as misleading as "pro-choice" for advocating abortion and "right to life" for prohibiting abortion. He would not only reject the term physician-assisted suicide but also the social policy. This last opinion is one of the reasons that I chose to link these two books in a review: although Drs. Szasz and Hendin would likely square off like heavyweight boxing contenders on most matters, they agree that legalization of physician-assisted suicide is a problematic solution to our wish to help patients receive compassionate end-of-life care.

Before shifting to Seduced by Death, I would be neglectful if I did not underscore Dr. Szasz's central theme, if for no other reason than it runs entirely counter to how most of us have been trained to think about suicide. In Fatal Freedom, he writes that "we cannot decide whether killing oneself is right or wrong, an element of our inalienable personal liberty, or an offense of some sort that ought to be prohibited and perhaps punished. We are too uptight about suicide to recognize that sometimes killing oneself is the right thing to do and sometimes the wrong thing to do." Dr. Szasz firmly believes that suicide, or what he also occasionally calls "death control," should be a personal choice and responsibility and neither hindered or facilitated by law and medical practice. By way of contrast, until recently the field of psychiatry has largely held the view expressed by Dr. Hendin and the late Dr. Klerman that "95% of those who kill themselves have been shown to have a diagnosable psychiatric illness in the months preceding suicide. ... Our efforts should concentrate on providing treatment ... and, in the case of terminal illness, helping the individual come to terms with death."3

In the wonderfully titled Seduced by Death, Dr. Hendin vividly presents his view of society's difficulty in navigating between "the Scylla of either excessive or neglectful medical care and the Charybdis of euthanasia." When he assumed the helm 15 years ago of what was then called the American Suicide Foundation, the organization was concerned with neither assisted suicide nor euthanasia. Dr. Hendin was witness to the wave of interest in the United States that manifested itself in publication of Final Exit, a book that laid out specific recommendations and a prescription for ending one's life, and the referendum and legalization of physician-assisted suicide in Oregon. Concerned about the direction medicine was moving, Dr. Hendin traveled to the Netherlands in order to examine the Dutch experience.

In the Netherlands, de facto legalization of euthanasia and physician-assisted suicide had already existed for two decades. Over half of Dutch physicians admit to practicing euthanasia, and Dr. Hendin states that euthanasia estimates range from 5,000 to 20,000 of the 130,000 annual deaths. However, in the next paragraph, he cites the 1991 Remmelink Report that found only 2% (i.e., 2,300) of the deaths were caused by frank euthanasia. Dr. Hendin later argues that official numbers underestimate the true prevalence.

Of greater interest to me was another finding of the Remmelink Report: 49,000 of the yearly deaths involve a medical decision at the end of life. Ninety-five percent of these are evenly split between those that follow withholding or discontinuing life-support treatments and those involving administration of analgesic medication for pain that secondarily hastens dying. Although these deaths are of less direct interest to Dr. Hendin, according to Dr. Szasz many of them would also qualify as being suicides.

Most of the publicity surrounding Seduced by Death centers on Dr. Hendin's discussion of "involuntary" or "nonvoluntary" euthanasia—what the Remmelink Report calls "termination of the patient without explicit request." This refers to euthanasia performed without consent on competent, partially competent, and incompetent patients. The capacity to participate in life-and-death decisions is of obvious interest to psychiatrists, and our field has not sufficiently investigated, defined, or made recommendations about this issue. Certainly when it comes to discontinuation of life-support treatment in the United States, the majority of cases in our intensive care units involve patients who cannot meaningfully participate in the discussion because of dementia, delirium, medication effects, encephalopathy, or reliance on ventilatory support. Among patients stopping dialysis, one-third of the decisions are made by families and staff on their behalf (I actually think this number is an underestimate).

These issues directly lead to the intriguing chapter, "Who Should Decide? Coma and Dementia." The discussion presages this year's highly publicized case of Terri Schiavo, whose family feud attracted the attention of a strange coalition of conservative politicians, the religious right, antiabortion groups, and disability organizations. The chapter is, however, most notable for Dr. Hendin's moving account of his own decisions to provide "aggressive" medical treatment for his mother, who had previously resided for 9 years in a nursing home with progressive dementia. He openly questions the subjectivity of his judgments and the capability of any loving family member to make a rapid series of decisions regarding hospitalization, transfer to intensive care, ventilation, tracheostomy, gastrostomy, and intravenous hydration.

I do not know if this is apocryphal, but colleagues have told me that in order to better comprehend the situation in the Netherlands, Dr. Hendin learned Dutch. If so, it explains the wealth of details and interviews that fill this book. It is also a clue as to the single-minded devotion and scholarship that he brought to the quest of illuminating this subject.

Neither of the books that I chose to review was written to provide a balanced perspective of the subject. Dr. Hendin's chapter, "Selling Suicide" is an inspired polemic of the "take-no-prisoners" flavor, and Dr. Szasz has long railed against psychiatric commitment and the curtailment of freedom and liberty. However, both authors have staked out positions that need to be seriously considered as the field of medicine struggles to reach a consensus regarding end-of-life care. When I entered medicine the goal was to preserve and extend life at any cost. That is no longer the medical imperative, and our specialty now desperately needs to debate the legitimacy of allowing or even helping people to die—what Dr. Szasz would broadly include in his definition of suicide. Both of these books are daring and gutsy in staking out positions on the question of just who should control when and how we die. Both books should provide the reader with an intellectually stimulating alternative to plowing through the latest issue of The American Journal of Psychiatry.



Dr. Cohen is Medical Director, the Renal Palliative Care Initiative, and Staff Psychiatrist, Consultation Psychiatry Service, Baystate Medical Center, Springfield, Mass.



  1. Cohen LM: Suicide, hastening death, and psychiatry, Arch Intern Med 1998; 158:1973–1976 [Free Full Text]

  2. Aquinas T: The Summa Theologica of St. Thomas Aquinas. Translated by Fathers of the English Dominican Province. London, RT Washbourne, 1918, p 209

  3. Hendin H, Klerman G: Physician-assisted suicide: the dangers of legalization. Am J Psychiatry 1993; 150:143–145 [Abstract]

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Published by:
Cambridge University Press

A study into the mindset of the German medical community well before the rise of Nazism. Includes the propaganda techniques used to convince the German people of the logic of euthanasia. The horrific children's euthanasia program is also covered, as well as the well-known 'Aktion T-4', the Nazi euthanasia program that saw scores of the mentally infirm be victimized.

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Whatever Happened to the Human Race?
schaeffer.gif - 1997 Bytes Francis Schaeffer
C. Everett Koop

Published by:
Crossway Books

Dr. Francis Schaeffer and former U.S. Surgeon General Dr. C. Everett Koop speak out on issues such as abortion, infanticide, and euthanasia. Confronting the 'culture of death' mentality of this century, both authors provide a frightening look at society if it does not change the direction it is travelling, making this century one of the bloodiest in human history. The authors address the wonder and beauty of human life, from the developing unborn child, to the disabled, both newly born, child and adult.



                      Reviews  from back cover of  CHRISTIAN PRINCIPLES FOR PALLIATIVE CARE  by Philip Ney, MD, FRCP(C), MA 


Review by Cheryl M Eckstein


Dr Ney, a psychiatrist who has been in practice over 40 years, routinely treated suicidal patients.  Of the thousands he has treated, he says he has “never met anybody who wanted to be dead.”  We then ask why are euthanasia and assisted suicide becoming a desirable option instead of accepting the process of natural death?”  Why do the most vulnerable in our society, the elderly, and the disabled, feel they are a burden and have a duty to die?  The most troubling concerns relating to death, the dying and the condemned to die are the focus of this book.  This is an extraordinary contribution to the subject of life, death and dying.  Dr. Ney takes us seamlessly from our first beginnings to our God given destiny, should we choose right.  The twelve principles outlined are not sugar coated.  They are serious, no nonsense, innovational principles, that challenge us to re-evaluate our motives, convictions, and how we conduct our lives.  Whether the reader is a physician or a patient, we are given substantial reasons why we need to examine how we live and how we contemplate dying and death.  To live by these well defined principles can surely lead to a restored reverence and appreciation of human life.   Cheryl M Eckstein, founder and CEO The Compassionate Healthcare Network (CHN)


Review by Mel Hoskyn.   

Dr. Ney is a very experienced psychiatrist, professor and author. He has thought and taught for many years about the concepts presented in this book. He writes on some familiar themes like forgiveness and reconciliation, though with new insight from the Scripture in light of his long experience and struggle to understand people. Also presented here are many original ideas eg. the impact of abortion on other children in the family and the Universal Ethic of Mutual Benefit – which he has discovered through research and clinical practice. More than that, however, he gives a wonderful and powerfully positive view of the dignity of the person based on Christian principles. These teachings will change your perspective on end of life issues. The Ten Ultimate Tasks for a Healthy Ending of Life outline the fundamental goals of palliative care in a unique blend of human realism and Scriptural hopefulness.  Otherwise I will refund your money myself!

 Mel Hoskyn is a public school teacher and pastor and now a certified Hope Alive counselor putting these principles into practice.


Order by visiting  or write to: Pioneer Publishing: Victoria, Canada. 2007.

150 pages
$9.00 each plus postage or if you purchase 10 or more the cost is $8.50 each.


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Turning the Tide uses a personal story style to focus on the vulnerability of the person when one experiences disability, depression or symptoms related to degenerative and/or end of life conditions. The video also focuses on issues related to pain and symptom management and proper end-of-life care.


Groups that have viewed Turning the Tide have been incredibly impressed by the production quality of the video and the profound comments by the people featured in the DVD.


Catherine Frazee, disability studies professor at Ryerson University comments in Turning the Tide that: "People like to frame this debate in the language of autonomy, or individual choice. They'll say to me that it's all right, you can say no, but other people will want to say yes, but I don't think individual autonomy should ever be permitted to trump the safety and well-being of the community."


Wesley Smith comments in Turning the Tide that: "You have a situation in Canada and certainly in the United States, where people are having difficulty getting access to ... good pain control, good psychiatric involvement and good social services. Are we going to say that the answer for these problems is assisted suicide?"


Senator Sharon Carstairs, former chair of the Special Senate Committee on Euthanasia and Assisted Suicide answers the question on why people want euthanasia and assisted suicide by stating: "sometimes the pian is just too horrible, but we can deal with that. The other reason is ... they want their personal dignity. Well that says something pretty awful about each and every one of us. Why have they lost their sense of dignity? It is because we have made them feel less than dignified?"


Jean Echlin, winner of the Dorothy Lea award for excellence in palliative care in 2004 comments in Turning the Tide that: "I could never advocate for someone to suicide when I can offer them pain management and symptom management right where they are."


Turning the Tide features: Bobby Schindler (Terri Schiavo's brother), Wesley Smith (Attorney, International Task Force on Euthanasia and Assisted Suicide), Catherine Frazee (former chair of the Ontario Human Rights Committee), Adrian Dieleman (counselor, rehabilitation clinic for spinal cord injuries in Hamilton), Jean Echlin (palliative care nursing consultant), Senator Sharon Carstairs (Senator from Manitoba), Alex Schadenberg (executive director, Euthanasia Prevention Coalition), Reg Hancock (spinal cord injury survivor) and more.


A Discussion Guide for small group or classroom presentations has been designed for use and included with the DVD package. The discussion guide enables groups and individuals who share our concerns about vulnerable people to organize effective presentations on the issues. It is our hope that Turning the Tide will be used to facilitate many discussion forums throughout North America.


The Turning the Tide DVD package includes all the DVD, the Discussion Guide, a recording sheet and all the resources that are necessary for making a presentation on euthanasia and assisted suicide.


The Turning the Tide DVD package can be ordered from the Euthanasia Prevention Coalition for $50.00 for 1 package, $70.00 for 2 packages, or $100.00 for 4 packages by contacting the Euthanasia Prevention Coalition at: Box 25033, London ON, N6C 6A8, email:, or calling: 1-877-439-3348. Further bulk rates exist upon request.