Yet death activists are tenacious and won't give up without a fight. What they cannot get from voters they will try to get from state legislatures (an increasingly difficult task) or from the courts. Smith believes that euthanasia's supporters derive their power from a deliberate effort to blur traditional moral categories. Their primary argument, that killing disabled or elderly people is a benevolent act, is heard over and over again in the medical community. This argument fosters a moral confusion that opens the social spaces where the dark work of intentional killing takes place.
According to Smith, death activism obliterates communal values. It jettisons the traditional belief that the strong should bear the burdens of the weak, and replaces it with the utilitarian precept that the weak have value when they are not a burden to the strong. "Ordered liberty" dissolves into the cost/benefit calculus of the medical technocrat. Life and death become economic decisions.
This drift into a "euthanasia consciousness" is part of a larger cultural decay that is aided and abetted by political activists and informed by theorists like Princeton's Peter Singer. Singer's Rethinking Life and Death can "fairly be called the Mein Kampf of the euthanasia movement," writes Smith. Singer rejects all appeals to moral universals or the received moral tradition when valuing life. His moral ground, according to Smith, is strictly utilitarian.
Adding to this social drift is what Smith calls "terminal non-judgmentalism." He writes, "Our society has become so steeped in relativism, so unable to distinguish right from wrong, that it fails to react to and criticize truly reprehensible conduct." Silence in the face of intentional killing makes the killing acceptable, thus silence is the soil for advancing the euthanasia ideology. Moral courage, not politically correct "non-judmentalism", is what our culture sorely needs to reverse this dehumanizing trend.
"Death fundamentalist" is a strong term but one Smith applies to the euthanasia activist. This fundamentalism is revealed in a quasi-religious fixation with death that many activists share. Smith chronicles the work of Dr. I. van der Sluis, a Dutch doctor who "has opposed Holland's slide down euthanasia's slippery slope for more than twenty years". Van der Sluis reports that euthanasia advocates "…are like a little church, a cult of death…always obsessing on dying and the suffering that may be part of dying." (Interestingly, before becoming famous, Dr. Jack Kervorkian was fired from a hospital because he sneaked into the rooms of dying patients to watch them die.)
That death activism takes on a cultic character is not surprising. When rejecting the moral precepts that guide how Judeo/Christian precepts view life and death, the activist must necessarily reject the religion from which the morality was drawn. However, since the activist needs to reference the transcendent if he wants to understand death in any meaningful way, he is forced to create a religion of his own. A deeper look at this cultic dimension would likely reveal articles of faith that function to justify the activist's public declarations and public actions to himself.
Nevertheless, light dispels darkness, and Smith marshals plenty of examples to expose the lie that the euthanasia movement is driven by benevolence towards humanity. Particularly revealing are cases where people are killed even though their illnesses are treatable, or when they are depressed or mentally ill.
Smith describes medical professionals who favor euthanasia as biased against their patients. Several years ago in San Francisco, a nine-year-old was intentionally injected with potassium chloride to stop her heart when she suffered brain damage because of medical neglect arising from jaw surgery. The case is still shrouded in secrecy. The anti-life bias can affect the diagnoses of unconscious patients as well. A study published in the June 1991 Archives of Neurology reported that out of 84 patients diagnosed with persistent vegetative state (PVS), fifty-eight percent recovered consciousness within a three year period. If the death activists have their way, patients with PVS could be killed before they awaken.
In the chapter "Common Arguments for Euthanasia," Smith effectively dispels ten dominant myths about euthanasia. For example, death advocates want to characterize euthanasia solely as a religious issue (tearing a page from the abortion activist's playbook), thus marginalizing their opposition as moral cranks. But euthanasia, while drawing on deeply-held moral precepts, is nevertheless a vital public policy question which groups like "Not Dead Yet" (a group of disabled people organized against intentional killing) make abundantly clear.
Another myth Smith tackles is that euthanasia concerns only the "hard cases". Hard cases (by which he means situations where a patient's pain cannot be alleviated through standard therapies) are extremely rare. Smith quotes Dr. Linda Emmanuel, director of the Institute of Ethics for the American Medical Association: "I have never seen a case nor heard of a colleague's case where [euthanasia] was necessary. If there is such a request, it is always dropped when quality care is rendered."
Forced Exit is valuable for any reader who is looking for a comprehensive but accessible book about the euthanasia movement's ideology, tactics, and goals. Smith doesn't pull punches. His critique is sharp, well documented, contains scores of examples, and rings with moral clarity. Anyone who values life should read it.
Fr. Johannes L. Jacobse is a Greek Orthodox priest and manages the website www.orthodoxytoday.org.