How the Culture of Death was Brought to America Through Palliative Medicine

Elizabeth Wickham
Executive Director, LifeTree, Inc.
Copyright, 2011
Reproduced with Permission

Most of us were dismayed at the death imposed on Terri Schiavo by dehydration and starvation over six years ago. We remember the false claims that her death was a natural death. We did not embrace the arguments of those who framed the crime as a "family matter."

Terri's death was just one step in a well-orchestrated plan to fundamentally change the national healthcare infrastructure which has been under way for several decades. Its goal is to legalize euthanasia by the backdoor and change America's attitude about the hastening of death.

The campaign to change the philosophy of care is directed by several non-profits, bioethics think tanks and health care organizations and is funded by Robert Wood Johnson Foundation, George Soros's Project on Death in America and several other private foundations. It began to take hold in the '80s and '90s and accelerated in the 2000's.

LifeTree has developed a timeline of the strategies, funding sources and tools with links to important primary sources.1 The movement is referred to as the "third path" because of its similarities to the "Third Way" political movement in England in the 1930s.

As with the abortion movement, this stealth euthanasia movement is based on a false philosophy of choice and is riddled with lies and confusion.

How to accomplish their goals? On the demand side, the public needed to be "reeducated". On the supply side their strategy was to educate doctors, nurses, chaplains, social workers and other health care professionals and to research and measure "quality." Another prong of their strategy was to change laws and policy guidelines at the state and federal levels. Influence on public policy at the state level was exerted by the end-of-life coalitions or community-state partnerships under the direction of the Center for Practical Bioethics (formerly Midwest Bioethics Center).2

The year 1997 was pivotal. The Supreme Court held that mentally competent terminally ill people do not have a constitutional right to physician-assisted suicide, but states can make their own laws regarding its legality.

At the time the pro-life movement claimed victory. But, the decision distinguished between physician-assisted suicide (by administration of barbiturates) and other types of death hastening (by withdrawal of life-sustaining treatments or aggressive pain treatment that results in death).

That same year the Assisted Suicide Funding Restriction Act of 1997 to bar taxpayer dollars from financing physician assisted suicide explicitly exempted from its restriction on federal funding these same acts which hasten death.3

The events in 1997 solidified the emergence of two distinct wings within the right-to-die movement.4

The more nuanced wing has been able to build on the Court's distinction and argue that certain forms of hastened death are a moral alternative to physician-assisted suicide. Nearly a majority of states have passed laws to criminalize assisted suicide but with language that makes exceptions for withholding/withdrawing of life-prolonging treatment and pain management that hastens death "as long as the intent is not to hasten death."

When Soros and RWJF announced an end to their funding of Last Acts Partnership in late 2003, some pro-life groups claimed partial victory. However, the right-to-die movement simply melded into mainstream medicine through the new subspecialty of medicine calling itself palliative care.

Palliative care is a "process" of care which uses an interdisciplinary team (palliative care physician, nurses chaplains, social workers and other professionals) to facilitate decision-making for the patient.5 The palliative care model is comfort-focused, as compared to disease-focused. The population considered appropriate for palliative care is expanding from patients who are dying to patients with chronic conditions, life-limiting injuries from accidents, and those who are seriously ill.

The "third path" movement is now working through palliative care and hospice groups, particularly the 5-member umbrella group Hospice and Palliative Care Coalition -- the National Hospice and Palliative Care Organization (NHPCO), the American Academy of Hospice and Palliative Medicine (AAHPM), the Hospice and Palliative Nurses Association (HPNA), the National Palliative Care Research Center (NPRC) and the Center to Advance Palliative Care (CAPC). Funding from RWJ Foundation and Soros continues.

In order to lead and mobilize social change they produced a consensus statement called the National Consensus Project for Quality Palliative Care (NCP) in 2004 (later revised in 2009).6 These guidelines have been formally approved and endorsed by many of the major health care organizations.7

The NCP developed into the National Quality Forum (NQF), the nation's public-private entity for determining the quality of health care. NQF identified palliative and hospice services as a national priority for government funding in 2006 and developed a framework for measuring and reporting best practices in palliative care.8 Palliative care is now a legitimate field of medicine and eligible for support in the eyes of public policy makers.

For those keeping track, the growth of palliative medicine has been phenomenal. Hospitals continue to implement palliative care programs at a rapid pace. The Center to Advance Palliative Care Press Release on July 14, 2011 reported that the number of U.S. hospitals with a palliative care team has increased for the tenth consecutive year or by 138.3 % from 2000-2009. Over thirty percent of all U. S. hospitals have palliative care programs.

The Center to Advance Palliative Care keeps a state-by-state report card on access to palliative care. The last report was released in 2008 but will be updated in early October, 2011.9

Fortunately, their efforts have met some barriers from a society that is not accepting of their definition of "improved quality". However, most people are simply unaware that these fundamental changes in medicine did not occur by accident and are unaware of the extent of the problem. More education is needed. We recommend the resources available at our website


1 See [Back]

2 Midwest Bioethics Center organized end-of-life coalitions or community-state partnerships in over twenty states using existing ethics networks to fundamentally change health policy in five broad areas including advance care planning, pain and symptom management, educational requirements, quality of care and finance/reimbursements. See "State Initiatives in End-of-Life Care, Focus: Community-State Partnerships, Championing End-of-Life Care Policy Change", Issue 19, June 2003 published by Midwest Bioethics Center in cooperation with Last Acts. [Back]

3 See "Legislative Update: Assisted Suicide Funding Restriction Act of 1997" by Perry G. Fine, MD in the Pain and Public Policy Section (David E. Joranson and Michael Ashburn editors) of American Pain Society Bulletin, March/April, 1998, Volume 8, Number 2. Perry Fine writes that the act explicitly states that certain activities are exempt from its restriction of federal funding including 1) the withholding or withdrawing of medical treatment of medical care including nutrition and hydration and 2) any treatment used to alleviate pain, even if this treatment increases the risk of death, as long as increasing such risk is not the purpose for which the treatment is prescribed. [Back]

4 The militant wing advocate for physician assisted suicide and includes the Hemlock Society, Death with Dignity and Compassion and Choices. The more nuanced wing has direct connections to the Euthanasia Society of America but gave itself more beneficent-sounding names over the years including Society for the Right to Die, Concern for Dying, Choice in Dying, Partnership for Caring and Last Acts Partnership. In recent years this wing has been converging. [Back]

5 In a recent interview Dr. Diane Meier who is director of the Center for Palliative care summariized: "It (palliative care) is very patient- and family-centered, beginning with who this patient is, who this family is, what the disease is, what stage the disease is in, what are the treatment options, how does that fit within the patient's specific goals and hopes and fears, and through that very deliberate and patient process working out a case plan that is realistic and meaningful. (emphasis added)" Taken from "Training Doctors, Combating Myths", Health Progress, Jan/Feb 2011. [Back]

6 See [Back]

7 See Dr. Diane Meier of the Center to Advance Palliative Care presentations: "Hospice and Palliative Care: The Quality Imperative", April 26, 2006, "Palliative Care Comes of Age", Orlando, Florida, June 21, 2007 and "What's Next", Orlando, Florida, June 23, 2007. [Back]

8 National Quality Forum. A National Framework and Preferred Practices for Palliative and Hospice Care; December 2006. Available at [Back]

9 See [Back]