Death wars: as euthanasia advocates press their case, the moral health of the country is at stake.

THE struggle over legalizing euthanasia is not just another public-policy debate. As in the national convulsion over slavery in the last century, noth- ing less is at stake than our view of human life -- from which spring our defining values, our ethics, and indeed, the very nature of the society we will create for our descendants.

There are grounds for alarm in the extent to which advocates of euthanasia and assisted suicide -- the death culture -- have succeeded in the last ten years in undermining the traditional Western ethic that views all people as having been born with equal moral worth. As a result of the death culture's efforts, the "inalienable" right to life, identified by Thomas Jefferson in the Declaration of Independence, has less resonance among many than a so-called right to die.

Most of the damage has been done through the courts. In 1995, two lawsuits were filed in New York and Washington State by a handful of terminally ill people and doctors claiming that state laws that made assisting in suicide a criminal offense were unconstitutional. Not too many years ago these cases would have been laughed out of court. But never underestimate the power of activist judges. When these cases came to trial in 1996, the Ninth and Second United States Circuit Courts of Appeal found, for differing and conflicting reasons, that there is a legally enforceable right to commit suicide lurking somewhere in the Constitution -- which forced the issue to be taken up by the Supreme Court of the United States.

These courts acted in direct contrast to the Michigan Supreme Court, which in 1994 had ruled in one of the Kevorkian cases that there is nothing to be found in the U.S. Constitution that creates a right to be killed by a doctor. At that time, Kevorkian sought review by the U.S. Supreme Court but was rejected out of hand. When the Supreme Court did agree to hear the federal cases, but then, at the oral argument, most of the justices appeared hostile to mandating a constitutional right to die, legal observers concluded that there would be no Roe v. Wade for euthanasia.

But that is less comforting than it might sound. Winning in the Supreme Court as it is now constituted was always a long shot for proponents of euthanasia. But winning wasn't necessarily the point. Rather, the goal was to elevate the euthanasia cause from the tabloid headlines reporting Kevorkian's exploits to the legitimacy of having the highest court in the land respectfully deliberate over the radical notion that suicide is a legally enforceable right. Whatever the Court decides (and its decision could be issued by the time this article is read), the tactic has worked. Euthanasia proponents reaped a harvest of favorable press reports, editorial endorsements, and television exposure.

The death culture received another judicial boost in Florida earlier this year when a judge granted an AIDS patient's request to have his suicide facilitated by a doctor. Never mind that the patient did not bring the lawsuit spontaneously. The suit was sponsored by the Hemlock Society of Florida and the ACLU, which had advertised to find an appropriate plaintiff and then audi- tioned potential litigants to determine their ability to testify compellingly, as if the case were a Broadway play. And never mind that the doctor in ques- tion is not the plaintiff's personal physician. In a truly disturbing decision using 1984-style Newspeak, the judge ruled that killing is a form of "medical treatment" protected by Florida's right to privacy. This decision, too, has been appealed, in this case to the Florida Supreme Court, which could issue its own decision any day now.

These and other court cases, such as the Kevorkian acquittals, have suf- ficiently legitimized assisted suicide among much of the public as to set the stage for an historic political battle. Look for pro-euthanasia legislation to be repeatedly introduced throughout the country. Early efforts are almost sure to lose. But if the death warriors are anything it is tenacious. They follow the guerrilla-warfare model: Be defeated today, come back tomorrow; be defeated tomorrow, come back next week, next month, next year. As in Vietnam, you can lose most of the battles but ultimately win the war by outlasting the adversary.

The pattern has already been established. In 1988, euthanasia advocates promoted a ballot initiative in California that would have permitted doctors to administer lethal injections. They failed utterly, being unable even to obtain enough signatures to qualify for the ballot. In 1991, they were back, this time in Washington State, where they succeeded in getting a euthanasia initiative on the ballot, only to see it lose in the election. The next year, the action returned to California, where an initiative was placed on the bal- lot but, as in Washington, lost in the election. Then, in 1994, it was on to Oregon and Measure 16, a trimmed-down ballot proposal that did not legalize lethal injections but permitted doctors to knowingly write prescriptions for use in suicide. This time the death culture won, with 51 per cent of the vote.

Measure 16 was soon declared unconstitutional as a violation of equal protec- tion of the law. But a few months ago, a bizarre Ninth Circuit Court of Appeals decision reversed the trial court. The Court of Appeals dodged the merits of the case, instead ruling that since the terminally ill litigant who brought the suit was not immediately threatened with harm under the law, she had no standing to challenge the statute's constitutionality. (The Court applied a classic Catch-22: Since the woman who sued is not currently suicidal, she is not endangered; ergo, she has no standing. If she were suicidal, she would have standing, but if she were suicidal, she wouldn't sue.) The Appeals Court decision means that Measure 16 will go into effect within the next few months unless the Supreme Court agrees to hear the case.

Worried that Oregon is about to become to suicide what Reno is to divorce, Measure 16's opponents have forced a rematch on the ballot this fall. They are greatly cheered by the fact that the Oregon Medical Association -- which remained neutral during the original campaign -- has turned against Measure 16. Opponents also believe they can demonstrate that Oregon voters were misled, to state it tactfully, by Measure 16 proponents' assurances that poison pills alone are sufficient to bring about "a humane and dignified death." As proof, they need only point to a recent statement by Hemlock Society co-founder and Oregon resident Derek Humphry. Before the election, Humphry was a big booster of Measure 16. Since then, however, he has written in the New York Times that Measure 16 "could be disastrous" because 25 per cent of assisted suicides fail. Oregonians, he warned, had better be prepared with plastic bags in case the pills fail to kill their loved ones, a little matter that he somehow neglected to mention during the original campaign.

The successes of Measure 16 and the court cases have already had a deleterious impact on this country's commitment to the sanctity of human life and the rule of law.

Particularly hard hit has been Kevorkian's playground, Michigan, where he has facilitated the deaths of at least 45 people since 1990. The typical victim has not been terminally ill, as many believe, but disabled and depressed. At least four, subjected to autopsy, were found to have had no identifiable illnesses at all. Yet few Michigonians seem to object to Kevorkian's involve- ment in these assisted killings. Indeed, Kevorkian is so popular in Oakland County, where he makes his home, that the county's new district attorney campaigned on a platform of refusing to enforce the state's common law that forbids assisted suicide, thus allowing Kevorkian virtual free rein.

Meanwhile, the Michigan legislature is politically paralyzed, wringing its hands over Kevorkian's death circus, yet unable to devise a statute that would prohibit deliberate killing without punishing legitimate medical treatment for pain. Disappointingly, Governor Engler, an opponent of assisted suicide, has remained relatively passive. He promises to sign any law against assisted suicide that reaches his desk, but in contrast to his activism in other political areas, such as welfare reform, he seems to be doing little to force the issue.

Yet, all is not gloom. The death culture's string of successes has finally mobilized the opposition. Outright euthanasia remains illegal in every state. And assisted suicide is banned, either by statute or through court interpreta- tion, in 47 -- 4 states (Iowa, Louisiana, Rhode Island, and Virginia) having outlawed it since the passage of Measure 16. President Clinton has signed a law prohibiting federal funds from being used for assisted suicide. Renewed efforts are under way to promote proper end-of-life care and compassionate alternatives to killing the sick, such as hospice care and effective pain con- trol. A recent poll published by Gallup found that once people learn about such positive alternatives to euthanasia, support for legalizing assisted suicide plummets. Advocates of rights for the disabled have formed Not Dead Yet; their demonstrations against euthanasia have made headlines.

How will it all turn out? The only certainty at this point is that the next several years will be filled with the clamor of intense political debate between two emotionally adamant sides. The debate won't be pretty, but it will be crucial. The future of the ethics and morality of our culture hangs in the balance.