Good without God?

The right-to-die movement has a theme song. And it’s a pretty lively tune. In the video for “This Is Your Show,” Carmen Ruby Floyd and eight members of the Harlem Gospel Choir are stacked like the Hollywood Squares, grooving as a ukulele player plinks out the cheery opening melody. By the chorus, the orchestra has joined in:

This is your show!
Before the curtains close,
Before the lights go low,
You’re gonna take control!
You’re awake right now.
And when you take your bow,
You’re gonna sing out loud: “This is my life!”

Composed for the right-to-die advocacy group Compassion & Choices, the song is supposed to inspire “joyful messages” about suicide. It’s about “personal empowerment, autonomy, gratitude and planning for an end-of-life experience aligned with your values and priorities,” the group’s website says.

Proponents of “death with dignity” have championed the right of people suffering from terminal illness to die when—and in whatever way—they choose. From the doctor-sanctioned death of a newborn boy in 1915 to the court-sanctioned deaths of three young women—Karen Ann Quinlan, Nancy Cruzan, and Terri Schiavo—right-to-die activists have fought for more than a century to turn a fringe ideology into mainstream thinking and mainstream medical care.

And they’re rapidly gaining ground.

Vermont: On April 27, Gov. Phil Scott signed a bill amending the state’s right-to-die law. It ends the required in-person medical consultation when requesting a lethal prescription. Now, a telemed exam will do. The bill also removes the final 48-hour waiting period for obtaining the drugs.

Oregon: In March, state health authorities ditched the law’s residency requirement. The change could open the state to suicide tourism. Some jurisdictions are awaiting legal guidance. For example, questions remain about giving lethal prescriptions to nonresidents, who then ingest the drugs back home, in a state where assisted suicide is illegal.

But the new rules mean that, in general, non-Oregonians can plan a final trip to the Beaver State. They must meet the remaining criteria before being able to obtain the deadly drugs, including a 48-hour waiting period between their first and second requests.

California: Beginning in January, the state shortened its waiting period to only 48 hours between requests.

Hawaii: The Aloha State is hashing out details in a bill that would add “advanced practice registered nurses and physician assistants” to the list of people who can write lethal prescriptions. The bill also allows telemedicine exams.

Assisted suicide is now legal in the four states above, plus Washington, Colorado, New Jersey, Maine, and Washington, D.C. The state of Montana doesn’t have a statute that specifically authorizes doctors to help patients kill themselves. But in a 2009 case, the state Supreme Court found that Montana doesn’t have a law making it illegal, either.

The assisted suicide revolution is accelerating. Ever-progressive Oregon blazed the trail, becoming the first state to legalize physician-assisted suicide in 1994. It took 14 years for Washington to follow suit in 2008, followed by Vermont in 2013. But a 2021 Pepperdine Law Review analysis notes that it took just five more years for five states and the District of Columbia to legalize physician-assisted suicide.

Since last year, 21 state legislatures have introduced right-to-die legislation.

A New Religion

“For all of human history there have been two competing philosophies about human life,” said James Bopp, an attorney for the National Right to Life Committee.

“One is the Judeo-Christian belief in the sanctity of each individual human life,” Bopp said. “That each individual human life should be protected and not taken. The competing view is that the value of life is relative to your functioning level.”

The seeds of this view began to take root in mainstream science in 1883. Inspired by his cousin Charles Darwin, the British polymath Sir Francis Galton coined the term eugenics. Boiled down, eugenics is the study of how to breed desirable humans. The term knits together the Greek words for “good” and “origins.”

Galton came to view human development pragmatically—as a kind of husbandry. He referred to the men and women doing the reproducing as “stock” and believed that controlled breeding could improve successive generations.

In a 1904 article published in The American Journal of Sociology, Galton wrote that selecting and cultivating the finer traits in dogs can be equally applied to humans. Qualities are generally either desirable (such as health, energy, ability, and manliness) or undesirable (sickness, frivolity, foolishness). Society should conserve the former and reduce the latter through selective breeding, Galton wrote.

“What nature does blindly, slowly, and ruthlessly, man may do providently, quickly, and kindly,” he wrote.

But even as Galton ejected soul and spirit, stripping humans down to our material parts, he argued that eugenics must be “introduced into the national conscience, like a new religion.”

Demonstrators in 1985 hold signs on the steps of the Supreme Court backing Oregon’s physician-assisted-suicide law. Jay Maillin/Bloomberg via Getty Images

A New Faith for a New Day

In 1929, a former Baptist pastor did just that.

Charles Francis Potter grew up in the late 1800s in Marlboro, Mass., the son of a shoe factory worker. Influenced by his family’s Baptist faith, Potter began preaching as a teenager and was ordained at 17.

By 1914, he had abandoned Biblical orthodoxy and become a Unitarian pastor, according to the Unitarian Universalist History and Heritage Society.

In a series of public debates with Baptist Pastor John Roach Straton of Calvary Baptist Church in Manhattan, Potter questioned the veracity of the virgin birth, the deity of Jesus, and the Bible’s creation narrative.

That caught the attention of Clarence Darrow, who represented John Scopes, a public school teacher. In 1925, Scopes went on trial for violating a Tennessee law that prohibited the teaching of evolutionary theory in public schools. Potter served as Darrow’s Biblical adviser.

Eventually, even the Unitarian idea of God became untenable for Potter, and he founded a quasi-religious group called the First Humanist Society of New York.

He called it “a new faith for a new day.”

Humanism’s appeal was already growing in the U.S., drawing adherents mostly from the halls of academia and society elites. By 1941 humanism’s cultural creep had spread across the nation, giving birth to the American Humanist Association.

Eschewing the existence of the supernatural, the AHA affirms humanity’s “ability and responsibility to lead ethical lives of personal fulfillment that aspire to the greater good.”

At its core, humanism is also about personal autonomy—in life and in death. Harvard University’s humanist chaplain Greg Epstein once summed up the ethos this way: “In short, humanism is being good without God.”

Guided by those principles, Potter founded another, not-so-unrelated group in 1938—the Euthanasia Society of America, or ESA. Turning the 2,500-year-old Hippocratic Oath on its head, the ESA advocated ending human suffering by ending human life.

Weeding the Human Garden

ESA had only been in business for two years when Potter delivered a prescient speech, according to Ian Dowbiggin, a history professor at the University of Prince Edward Island, Canada. Dowbiggin, who writes on the history of medicine, quoted Potter’s address in the Journal of Policy History in 2002: “Euthanasia, or merciful release from suffering, is rapidly emerging from the stage when it was considered merely the obsession of a few left-wing social reformers to the period when it is being recognized as an important social measure in the same class with birth control and eugenics.”

In fact, eugenics ideology permeated the ESA board of directors. Among them, Planned Parenthood founder Margaret Sanger.

She declared her low regard for some humans in a 1957 interview with reporter Mike Wallace. He asked her if she believed in a God who punishes or rewards people after death. Did she believe in sin?

“Well, I think that the greatest sin is bringing children into the world that have disease from their parents, that have no chance in the world to be a human being, practically. Delinquents, prisoners, all sorts of things just marked when they’re born. To me that is the greatest sin that people can commit.”

And Potter had another famous female contemporary: Helen Keller, who was blind and deaf—and pro-euthanasia. A bout with scarlet fever as an infant left Keller in a dark and silent world. As a child, she became incorrigible. But after teacher Anne Sullivan taught Keller to use sign language, the child’s whole world opened up. Keller graduated from college in 1904 and became an outspoken advocate for women’s suffrage, the poor, and the disabled.

But her advocacy for the disabled only went so far.

In 1915, a baby named John Bollinger was born. The child had no external right ear and his right shoulder was attached directly to the right side of his head, which itself was abnormally large. Also, his colon was malformed. Surgery could have remedied the more life-threatening problems. But the mother’s doctor, a eugenicist named Harry Haiselden, refused to treat the baby and told his parents their son would be better off dead. The boy died from lack of treatment five days later.

Haiselden defended his actions in a Chicago Tribune account. “I would not kill the infant. I would not administer poison or take its life by any active surgical means. I shall merely stand by passively and let it die. I will let nature complete its bungled job.”

Keller was among those who defended Haiselden. In a letter to The New Republic, she called Baby Bollinger’s life “not worthwhile.” Allowing him to die was the “weeding of the human garden.”

“It is the possibilities of happiness, intelligence and power that give life its sanctity,” Keller wrote, “and they are absent in the case of a poor, misshapen, paralyzed, unthinking creature.”

Responsible Death

Public eugenics campaigns fell into disfavor after World War II. But low regard for “defective” humans had already infected the culture—and, following in Potter’s footsteps, people who once held Biblical orthodoxy in high regard showed increasingly low regard for their fellow humans.

Remember, Potter appointed Margaret Sanger to the board of the Euthanasia Society of America. In the late 1960s, the Rev. Henry Pitney Van Dusen echoed Potter’s observation that Planned Parenthood and the euthanasia movement were opposite points along the same spectrum.

“Popular attention centers on the Planned Parenthood movement at the other end of life,” said Van Dusen, who led the progressive Union Theological Seminary for 18 years. Euthanasia, he added, “is concerned with the responsible termination of life. The more we can relate these two movements practically the better, because they are both concerned with the responsible care of human life, one at its beginning and the other at its end.”

The pastor practiced what he preached. In 1975, Van Dusen completed a suicide pact with his wife, Elizabeth. Neither was dying, but their health was declining. “Who wants to die in a nursing home?” they asked in a suicide note. Their deaths made national headlines.

That same year Karen Ann Quinlan celebrated a friend’s birthday, oblivious that her name would soon make headlines and advance the right-to-die movement.

Julia and Joseph Quinlan look through a scrapbook about their daughter, Karen Ann. Bettmann/Getty Images

Tragic Trio

Quinlan was 21 years old and at her friend’s birthday party when she fell into a coma after reportedly ingesting alcohol and diet pills. Doctors said she was in a persistent vegetative state—a kind of waking coma—and would never recover. Her parents, Joseph and Julia Quinlan, asked doctors to remove her respirator, arguing their daughter would not want to live that way. Her doctors refused. The Quinlans appealed to a judge and lost. But the New Jersey Supreme Court agreed to hear their case and in 1976 ruled in the Quinlans’ favor.

The landmark decision established in New Jersey the right to refuse medical treatment—or the “right to die.” It also allowed for surrogates to make that decision for an incapacitated person.

Attorney James Bopp said the court’s decision set a terrible precedent. At the time he was president of the National Legal Center for the Medically Dependent and Disabled.

“Our argument was that her quality of life should not be judged in order to determine what medical treatment should be provided,” Bopp said. His organization filed an amicus brief in the case. “That was discrimination based on disability and … she had an equally valuable life and was entitled to full protection of the law.”

Following the court ruling, Quinlan’s doctors removed her respirator. But she continued breathing on her own for almost 10 years and received food and hydration through a feeding tube. Her parents did not request its removal.

“They weren’t ready to do that,” Bopp said.

Quinlan’s was the first of a tragic trio of very public cases that took the right-to-die debate from fringe groups to state capitals to the U.S. Supreme Court.

Nancy Cruzan two years before her accident. Keith Philpott/Getty Images

The second was Nancy Cruzan, a 25-year-old Missouri woman. In 1983, a traffic accident left Cruzan in a persistent vegetative state. Like Quinlan, she received food and hydration through a feeding tube. Cruzan’s parents, Lester and Joyce, said she would not want to live that way, and, in 1989, took their case all the way to the U.S. Supreme Court.

The high court held that the Due Process Clause supports a person’s right to refuse medical treatment, even if doing so leads to his or her death. But it also upheld Missouri’s law that, in order for a surrogate to make that decision for an incompetent person, they must present “clear and convincing evidence” that the incompetent person wanted to withdraw life-sustaining care.

The Cruzans returned to lower courts with additional testimony from Nancy’s friends, who said she told them she would not want to live as she was. The parents prevailed. Doctors removed Cruzan’s feeding tube on Dec. 14, 1990. She died 12 days later.

Terri Schiavo smiles at her mother, Mary Schindler. Matt May/Getty Images

That same year, Terri Schiavo, a 26-year-old Florida woman, suffered an unknown injury that left her in a persistent vegetative state. The Quinlan and Cruzan precedents laid the foundation for the life-or-death battle over Schiavo’s life 15 years later.

Her husband Michael Schiavo insisted his wife would want the feeding tube removed. He hired right-to-die activist and attorney George Felos to represent him—not his wife—in court.

Terri Schiavo’s parents, Mary and Bob Schindler, fought back. And by 2005 Terri was the focal point of an international debate over the right to die—or live—and who got to make that decision when the patient couldn’t speak for herself.

By the time the battle began playing out in court, medical ethicist Wesley Smith concluded pro-life advocates had little legal ground to stand on.

“Terri’s case was going back to ground that was clearly surrendered,” he said.

Terri’s feeding tube was removed March 18, 2005. She died of dehydration 14 days later.

A Little Help

When physicians in the 1970s began affirming a patient’s right to refuse treatment for terminal illnesses, they stopped short of expediting a patient’s death—especially if, like Terri Schiavo, patients could not speak for themselves

Their concerns were not unfounded, Wesley Smith told WORLD in 2021.

“You’re surrounded by forces that are really powerful, that are seeking to push the most marginal and vulnerable among us out of the lifeboat,” Smith said. “The cultural flow, if you will, of these bioethics cases are moving away from a sanctity of life, equality of life approach toward a utilitarian quality of life approach.”

As often happens with progressive causes, the right-to-die movement soon began eating its own.

In 1975, Jean Humphry was suffering from cancer. According to her husband, Derek Humphry, the couple agreed that he would lace her coffee with a lethal dose of drugs. He did, and Jean died. The next year, 1976, Humphry married Ann Wickett. Together, the newlyweds wrote a book about Jean’s death.

Then, in 1980, Humphry and Ann co-founded the Hemlock Society, a group that promotes assisted suicide, with University of Southern California professor Gerald Larue.

Larue was yet another ex-pastor who embraced humanism and styled himself a debunker of Bible stories and miracles.

In 1986, Humphry and Ann helped her parents commit suicide. They wrote a book about that too. Five years later, Humphry published Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying. By then, Ann had been diagnosed with cancer. Humphry left her. A bitter and very public divorce ensued. She took her own life on an Oregon mountainside in October 1991.

In her suicide note, Ann accused Humphry of driving her to do it. She also accused him of having suffocated his first wife, Jean.

Dr. Death

Not content with taking matters into their own hands like Humphry, or with doctors simply removing life-sustaining care, right-to-die activists began lobbying for doctors to take an active role in facilitating patient suicides.

By the early 1990s they were gaining support. Activists prevailed upon state lawmakers to legalize physician-assisted suicide, now called medical assistance in dying, or MAID. Such protocols allow doctors to prescribe lethal medication to terminally ill patients who then take them on their own.

In Michigan, retired pathologist Jack Kevorkian mocked those advances and called physician-assisted suicide “insufficient medical care.” He argued that doctors had a duty to end their patients’ suffering.

“I want this to be a medical service that’s controlled. It isn’t now. It’s all hit or miss,” Kevorkian told PBS NewsHour anchor Robert McNeil in June 1990, two days after he helped 54-year-old Janet Adkins kill herself.

Undaunted by the laws of God or man, Kevorkian had created a simple device that fed lethal doses of drugs through intravenous lines into his “patients,” as he referred to them. As Kevorkian watched, the patient pushed a button and released the lethal cocktail of thiopental and potassium chloride.

Adkins, a retired teacher and Hemlock Society member, wasn’t terminally ill. She wasn’t suffering with intolerable pain. She had early-onset Alzheimer’s and didn’t want to live with the disease.

On June 4, 1990, at a county park near Holly, Mich., Adkins lay in the back of Kevorkian’s white 1968 Volkswagen van. He hooked her up to his suicide machine and showed her the button that would start the lethal injection. Adkins pressed it. Kevorkian watched her die.

That was death with dignity?

After 10 years and about 130 deaths, Kevorkian earned two things: A 10- to 25-year sentence for second-degree murder (he served eight) and the American Humanist Association Hero Award.

Who Decides?

Kevorkian’s macabre campaign, along with a steady drumbeat of court cases and ever-nuanced medical terminology, helped to advance the right-to-die cause. But where doctors and legislators fail to protect patients, some faith-based groups and hospitals still do. In October 2019, religious leaders representing Islam, Judaism, and Protestant, Orthodox, and Catholic Christians met at the Vatican to sign a joint statement opposing physician-assisted suicide.

But right-to-die advocates aren’t sitting still for that. In a 2021 op-ed published by the Americans United for Separation of Church and State, Kim Callinan, president of Compassion & Choices (the right-to-die group with the catchy theme song) wrote, “It will take continued, persistent efforts to ensure that people are able to make their own end-of-life care decisions based on their conscience—free from interference by religiously-­affiliated healthcare entities.”

Meanwhile, U.S. right-to-die organizations, such as Death with Dignity, Final Exit Network, and the Hemlock Society of San Diego (HSSD), continue to press their suicide agenda.

The San Diego group issued a statement lauding the state’s new, reduced waiting period: In “most progressive nations of Western Europe and Canada, individuals do not need a terminal diagnosis to access medical assistance in dying. … Until California adopts this more enlightened criterion for MAID, HSSD will continue to crusade for California to become a progressive state as so many of its leaders proclaim it to be. We still have work to do.”