A disturbing bill proposing to expand physician-assisted killing in California has, at least for now, been withdrawn. If it were to have become law, the Golden State would have followed Canada in expanding the practice to include those in merely a “grievous and irremediable medical condition” — in other words, not dying.
Significantly, the proposed legislation explicitly included those diagnosed with dementia.
One of the key reasons for the bill’s defeat was that Compassion and Choices, the most powerful lobbying organization in favor of physician-assisted killing, came out against it. This is a big deal, given that they are in favor of allowing PAK “tourism,” in which people from where the practice is illegal can travel to other states where it is legal.
But we should be suspicious of their motives, given their national strategy for broad legalization. It was more likely a strategic way to avoid the critique of a “slippery slope” argument. Thus, there is good reason to think that the push to kill people with dementia in California will come up again in the near future.
For instance, not long after PAK was legalized in 2016, calls to make it available to people with Alzheimer’s disease appeared in the pages of The Los Angeles Times. And it is very much a live issue in Canada.
In the world of academic bioethics, calls to use PAK have become more pronounced and urgent in recent years.
Part of that urgency has to do with the ongoing dementia crisis. We already refuse to care for this vulnerable population adequately, often putting them in terrible conditions in understaffed nursing homes — which very often put residents in “chemical straitjackets” just to manage an otherwise unmanageable situation.
And if you think the problem is bad now (and it is really bad), the population of people with dementia is set to double in 20 years and triple in 30, given that we are living longer and our diets and environment continue to deteriorate.
As I argued in my book “Losing Our Dignity” (New City Press, $22.95), the problem will simply become unmanageable, and PAK (along with straight-up-no-chaser euthanasia) will be used to kill those deemed unworthy of life in light of a crisis of health care resources.
That is, of course, if we do nothing.
In thinking about what to do, I cannot help but think of Mother Cabrini, the subject of a recent incredible biopic film from Angel Studios, in which she mobilized an “empire of hope” to address a similarly massive affront to human dignity in the U.S. related to poverty, immigration, and discrimination. Cabrini even started a new order — the Missionary Sisters of the Sacred Heart of Jesus — in order to do the work God was clearly calling her to do.
The results were extraordinary. In the end, she founded nearly 70 institutions — including housing structures and hospitals — at the service of the least among us. These populations were degraded and discarded by society because those who had power over them found them inconvenient. Her fight for their equal dignity is at the very heart of the Gospel.
Something very similar is happening right now with dementia populations and it will only get worse. We need an all-hands on deck approach to address this problem.
Yes, it involves our individual choices and how we relate to our parents and elderly loved ones. Yes, it involves working to change the broader culture — including offering resources to care homes and to families who want to properly care for their loved ones at home.
But the institutions that the Church runs must join in as well. Social justice institutions — like Catholic Charities — and pro-life groups must do their part. Dioceses and religious orders with empty buildings (perhaps old rectories, convents, and schools) should repurpose them to house and care for populations with dementia as fully dignified individuals, made in the image and likeness of God in precisely the same way as able-bodied populations. Catholic hospitals and clinics — which run a high percentage of health care beds in the U.S. — must never participate in violence against these populations.
Even beyond these substantial responses, we will likely need another Mother Cabrini. We will need someone to create a new religious order out of nothing to address this problem with the kind of tenacity, holiness, and love she did. Perhaps the person being called to do this is reading these words right now. If so, please heed God’s call. We need you now. Those bearing the Holy Face of Christ as the least among us, as those despised by our culture, need you now.
