The Washington Post - Oct 7, 1989
Paralyzed from the neck down in a 1985 motorcycle accident, Larry James McAfee, 33, wants to be removed from the ventilator that keeps him alive. When those responsible for his treatment refused to abide by his wishes, McAfee went to Georgia Superior Court Judge Edward H. Johnson for permission to turn the ventilator off. McAfee could do this by himself, having helped design a mouth-activated timing device by which he can divert air intended for his lungs away from him. But that procedure would be painful and very frightening during those final minutes when he would be without air. Therefore, McAfee asked the court both for permission to turn off the ventilator and for someone to give him a sedative to ease his end. Johnson ruled that McAfee is competent and therefore has the common law right -- and the right under the Constitution of the state of Georgia -- to refuse any further medical treatment, including the use of the ventilator. McAfee, moreover, had very clearly stated his conviction that life no longer had any enjoyment for him. He finds total dependency "demeaning" and utterly "draining." But how far could the judge go to help McAfee accomplish his purpose? In his decision, Johnson said it was "highly problematical" that any court has "the authority to order a physician or other health care giver" to disconnect the ventilator "or compel a physician to administer a sedative." True, McAfee is able to shut off the ventilator by himself, so that should be no problem. But what about the sedative? At this point Johnson did something that apparently no other court in the country has yet done. He declared that any doctor who gives McAfee a sedative -- or, for that matter, helps him disconnect his ventilator if it turns out McAfee can't do it himself -- will not be "subject to any adverse legal consequences." The same immunity from civil or criminal liability will apply to workers in health care facilities and anyone else "who merely assists Larry McAfee in exercising his constitutional and statutory right to refuse medical treatment." This would seem to open the door to lawful assisted suicide, which is illegal elsewhere and is disapproved by most medical societies and even by some bioethicists. The fear of the objectors is that once it is lawful to help someone commit suicide, it will eventually be lawful to end the lives of those who have not asked for death but whose "quality of life" is considered no longer worth sustaining. Johnson, however, insists that McAfee -- if he does end his life -- would not be committing suicide. The judge cites friend-of-the-court briefs from the Roman Catholic Archdiocese of Atlanta and the Medical Association of Georgia. Both groups say that McAfee's shutting off his ventilator would not be the cause of his death but rather, as the medical association puts it, "the natural consequences of his motorcycle accident" would be the cause of his death. The accident, you see, resulted in McAfee's inability to breathe on his own, and that inability would cause his death. This has become a standard mechanical way of avoiding the fact that if, for instance, a feeding tube were removed and the person starved to death, the cause of death would be starvation. Most secular and religious bioethicists insist, however, that once these means of treatment are removed, death results not from starvation but from "nature taking its course." Nonetheless, if those means, including "extraordinary" ones, had not been removed, life would have continued. In any case, McAfee, using his mouth to mark an X on a document that was part of his petition to the court, certified he knew full well that he would die if his ventilator were turned off. And that is what he wanted to do -- end his life. Meanwhile, disability rights activists in Atlanta have been pointing out that McAfee, once his health insurance money ran out, became a ward of the state of Georgia, which then denied him the kind of support that enables other quadriplegics to work and live independently with home aides, as McAfee had begun to do when he had insurance money. "Maybe if I had had more control of things," he told Newsday, "maybe things would have been different." Paul Longmore, a historian and a quadriplegic who has used a ventilator for 25 years, notes mordantly, "The only people who are telling Larry McAfee they want him to try to live are other disabled people." They take Johnson's message to be that if your quality of life makes able-bodied people shake their heads in pity, you're better off dead.
Paralyzed from the neck down in a 1985 motorcycle accident, Larry James McAfee, 33, wants to be removed from the ventilator that keeps him alive. When those responsible for his treatment refused to abide by his wishes, McAfee went to Georgia Superior Court Judge Edward H. Johnson for permission to turn the ventilator off. McAfee could do this by himself, having helped design a mouth-activated timing device by which he can divert air intended for his lungs away from him. But that procedure would be painful and very frightening during those final minutes when he would be without air. Therefore, McAfee asked the court both for permission to turn off the ventilator and for someone to give him a sedative to ease his end. Johnson ruled that McAfee is competent and therefore has the common law right -- and the right under the Constitution of the state of Georgia -- to refuse any further medical treatment, including the use of the ventilator. McAfee, moreover, had very clearly stated his conviction that life no longer had any enjoyment for him. He finds total dependency "demeaning" and utterly "draining." But how far could the judge go to help McAfee accomplish his purpose? In his decision, Johnson said it was "highly problematical" that any court has "the authority to order a physician or other health care giver" to disconnect the ventilator "or compel a physician to administer a sedative." True, McAfee is able to shut off the ventilator by himself, so that should be no problem. But what about the sedative? At this point Johnson did something that apparently no other court in the country has yet done. He declared that any doctor who gives McAfee a sedative -- or, for that matter, helps him disconnect his ventilator if it turns out McAfee can't do it himself -- will not be "subject to any adverse legal consequences." The same immunity from civil or criminal liability will apply to workers in health care facilities and anyone else "who merely assists Larry McAfee in exercising his constitutional and statutory right to refuse medical treatment." This would seem to open the door to lawful assisted suicide, which is illegal elsewhere and is disapproved by most medical societies and even by some bioethicists. The fear of the objectors is that once it is lawful to help someone commit suicide, it will eventually be lawful to end the lives of those who have not asked for death but whose "quality of life" is considered no longer worth sustaining. Johnson, however, insists that McAfee -- if he does end his life -- would not be committing suicide. The judge cites friend-of-the-court briefs from the Roman Catholic Archdiocese of Atlanta and the Medical Association of Georgia. Both groups say that McAfee's shutting off his ventilator would not be the cause of his death but rather, as the medical association puts it, "the natural consequences of his motorcycle accident" would be the cause of his death. The accident, you see, resulted in McAfee's inability to breathe on his own, and that inability would cause his death. This has become a standard mechanical way of avoiding the fact that if, for instance, a feeding tube were removed and the person starved to death, the cause of death would be starvation. Most secular and religious bioethicists insist, however, that once these means of treatment are removed, death results not from starvation but from "nature taking its course." Nonetheless, if those means, including "extraordinary" ones, had not been removed, life would have continued. In any case, McAfee, using his mouth to mark an X on a document that was part of his petition to the court, certified he knew full well that he would die if his ventilator were turned off. And that is what he wanted to do -- end his life. Meanwhile, disability rights activists in Atlanta have been pointing out that McAfee, once his health insurance money ran out, became a ward of the state of Georgia, which then denied him the kind of support that enables other quadriplegics to work and live independently with home aides, as McAfee had begun to do when he had insurance money. "Maybe if I had had more control of things," he told Newsday, "maybe things would have been different." Paul Longmore, a historian and a quadriplegic who has used a ventilator for 25 years, notes mordantly, "The only people who are telling Larry McAfee they want him to try to live are other disabled people." They take Johnson's message to be that if your quality of life makes able-bodied people shake their heads in pity, you're better off dead.
The Washington Post - Oct 7, 1989
Paralyzed from the neck down in a 1985 motorcycle accident, Larry James McAfee, 33, wants to be removed from the ventilator that keeps him alive. When those responsible for his treatment refused to abide by his wishes, McAfee went to Georgia Superior Court Judge Edward H. Johnson for permission to turn the ventilator off. McAfee could do this by himself, having helped design a mouth-activated timing device by which he can divert air intended for his lungs away from him. But that procedure would be painful and very frightening during those final minutes when he would be without air. Therefore, McAfee asked the court both for permission to turn off the ventilator and for someone to give him a sedative to ease his end. Johnson ruled that McAfee is competent and therefore has the common law right -- and the right under the Constitution of the state of Georgia -- to refuse any further medical treatment, including the use of the ventilator. McAfee, moreover, had very clearly stated his conviction that life no longer had any enjoyment for him. He finds total dependency "demeaning" and utterly "draining." But how far could the judge go to help McAfee accomplish his purpose? In his decision, Johnson said it was "highly problematical" that any court has "the authority to order a physician or other health care giver" to disconnect the ventilator "or compel a physician to administer a sedative." True, McAfee is able to shut off the ventilator by himself, so that should be no problem. But what about the sedative? At this point Johnson did something that apparently no other court in the country has yet done. He declared that any doctor who gives McAfee a sedative -- or, for that matter, helps him disconnect his ventilator if it turns out McAfee can't do it himself -- will not be "subject to any adverse legal consequences." The same immunity from civil or criminal liability will apply to workers in health care facilities and anyone else "who merely assists Larry McAfee in exercising his constitutional and statutory right to refuse medical treatment." This would seem to open the door to lawful assisted suicide, which is illegal elsewhere and is disapproved by most medical societies and even by some bioethicists. The fear of the objectors is that once it is lawful to help someone commit suicide, it will eventually be lawful to end the lives of those who have not asked for death but whose "quality of life" is considered no longer worth sustaining. Johnson, however, insists that McAfee -- if he does end his life -- would not be committing suicide. The judge cites friend-of-the-court briefs from the Roman Catholic Archdiocese of Atlanta and the Medical Association of Georgia. Both groups say that McAfee's shutting off his ventilator would not be the cause of his death but rather, as the medical association puts it, "the natural consequences of his motorcycle accident" would be the cause of his death. The accident, you see, resulted in McAfee's inability to breathe on his own, and that inability would cause his death. This has become a standard mechanical way of avoiding the fact that if, for instance, a feeding tube were removed and the person starved to death, the cause of death would be starvation. Most secular and religious bioethicists insist, however, that once these means of treatment are removed, death results not from starvation but from "nature taking its course." Nonetheless, if those means, including "extraordinary" ones, had not been removed, life would have continued. In any case, McAfee, using his mouth to mark an X on a document that was part of his petition to the court, certified he knew full well that he would die if his ventilator were turned off. And that is what he wanted to do -- end his life. Meanwhile, disability rights activists in Atlanta have been pointing out that McAfee, once his health insurance money ran out, became a ward of the state of Georgia, which then denied him the kind of support that enables other quadriplegics to work and live independently with home aides, as McAfee had begun to do when he had insurance money. "Maybe if I had had more control of things," he told Newsday, "maybe things would have been different." Paul Longmore, a historian and a quadriplegic who has used a ventilator for 25 years, notes mordantly, "The only people who are telling Larry McAfee they want him to try to live are other disabled people." They take Johnson's message to be that if your quality of life makes able-bodied people shake their heads in pity, you're better off dead.
Paralyzed from the neck down in a 1985 motorcycle accident, Larry James McAfee, 33, wants to be removed from the ventilator that keeps him alive. When those responsible for his treatment refused to abide by his wishes, McAfee went to Georgia Superior Court Judge Edward H. Johnson for permission to turn the ventilator off. McAfee could do this by himself, having helped design a mouth-activated timing device by which he can divert air intended for his lungs away from him. But that procedure would be painful and very frightening during those final minutes when he would be without air. Therefore, McAfee asked the court both for permission to turn off the ventilator and for someone to give him a sedative to ease his end. Johnson ruled that McAfee is competent and therefore has the common law right -- and the right under the Constitution of the state of Georgia -- to refuse any further medical treatment, including the use of the ventilator. McAfee, moreover, had very clearly stated his conviction that life no longer had any enjoyment for him. He finds total dependency "demeaning" and utterly "draining." But how far could the judge go to help McAfee accomplish his purpose? In his decision, Johnson said it was "highly problematical" that any court has "the authority to order a physician or other health care giver" to disconnect the ventilator "or compel a physician to administer a sedative." True, McAfee is able to shut off the ventilator by himself, so that should be no problem. But what about the sedative? At this point Johnson did something that apparently no other court in the country has yet done. He declared that any doctor who gives McAfee a sedative -- or, for that matter, helps him disconnect his ventilator if it turns out McAfee can't do it himself -- will not be "subject to any adverse legal consequences." The same immunity from civil or criminal liability will apply to workers in health care facilities and anyone else "who merely assists Larry McAfee in exercising his constitutional and statutory right to refuse medical treatment." This would seem to open the door to lawful assisted suicide, which is illegal elsewhere and is disapproved by most medical societies and even by some bioethicists. The fear of the objectors is that once it is lawful to help someone commit suicide, it will eventually be lawful to end the lives of those who have not asked for death but whose "quality of life" is considered no longer worth sustaining. Johnson, however, insists that McAfee -- if he does end his life -- would not be committing suicide. The judge cites friend-of-the-court briefs from the Roman Catholic Archdiocese of Atlanta and the Medical Association of Georgia. Both groups say that McAfee's shutting off his ventilator would not be the cause of his death but rather, as the medical association puts it, "the natural consequences of his motorcycle accident" would be the cause of his death. The accident, you see, resulted in McAfee's inability to breathe on his own, and that inability would cause his death. This has become a standard mechanical way of avoiding the fact that if, for instance, a feeding tube were removed and the person starved to death, the cause of death would be starvation. Most secular and religious bioethicists insist, however, that once these means of treatment are removed, death results not from starvation but from "nature taking its course." Nonetheless, if those means, including "extraordinary" ones, had not been removed, life would have continued. In any case, McAfee, using his mouth to mark an X on a document that was part of his petition to the court, certified he knew full well that he would die if his ventilator were turned off. And that is what he wanted to do -- end his life. Meanwhile, disability rights activists in Atlanta have been pointing out that McAfee, once his health insurance money ran out, became a ward of the state of Georgia, which then denied him the kind of support that enables other quadriplegics to work and live independently with home aides, as McAfee had begun to do when he had insurance money. "Maybe if I had had more control of things," he told Newsday, "maybe things would have been different." Paul Longmore, a historian and a quadriplegic who has used a ventilator for 25 years, notes mordantly, "The only people who are telling Larry McAfee they want him to try to live are other disabled people." They take Johnson's message to be that if your quality of life makes able-bodied people shake their heads in pity, you're better off dead.
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