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Bioethics Forum Essay

Physician-Assisted Death and Journalism Ethics

Two years ago, I raised concerns about a front-page New York Times article describing a case of physician-assisted death in Canada. “It seems significant that the New York Times—an arbiter of culture—devoted an extraordinary amount of attention to a planned, physician-assisted death and the rituals associated with it,” I wrote in Bioethics Forum. “There is a human interest story here, but the article had scant discussion of the ethical and policy issues raised by Canada’s form of legalized medical assistance in dying.” The Times took a giant step forward in its problematic coverage of physician-assisted death by publishing, on December 8, a remarkable 45-page special report that vividly documents the physician-performed euthanasia of Marieke Vervoort—a disabled Belgian woman who was a Paralympics champion.

Most of the special report consists of gripping color photos, including a two-page photo showing Dr. Wims Distelmans administering a lethal injection to Vervoort, with family and friends present at her bedside. The few pages of text describe Vervoort’s life, her suffering from pain, and other symptoms that eventually became intolerable, and her decision to seek physician-assisted death.

Why did the New York Times decide to produce and publish this special report? Did the paper intend to promote physician-performed euthanasia in the United States and other countries around the world, expanding access to this life-ending physician practice beyond Belgium, the Netherlands, and Canada, where it is legal? While the special report noted that Dr. Distelmans is “the leading advocate for euthanasia in Belgium,” it included no discussion of ethical or policy issues concerning the controversial and contested practice of physician-assisted death. In particular, there was no discussion of whether it is ethical for a physician to intentionally end the life of a suffering patient in response to her voluntary request by means of administering a lethal injection, nor whether a legal option of physician-assisted death should be available for patients who are not terminally ill, as in the case of Marieke Vervoort. No mention was made of the alternative option legally available to suffering individuals to end their lives by voluntarily stopping eating and drinking—a practice that does not involve physicians causing death, which has received attention in medical journals and increasingly in the news media.

Whether or not this special report was intended to promote physician-assisted death, it failed as an exercise of responsible journalism. It ought to be the mission of the news media to educate the public regarding arguments for and against controversial practices, especially when a prestigious newspaper draws attention to a practice such as physician-assisted death in a special report. The New York Times may legitimately choose to advocate for a legal option of physician-assisted death; however, that belongs in an editorial accompanied by reasoned argument, which at least attempts to do justice to competing ethical and policy considerations. I contend that publishing such a visually powerful special report, structured as a human interest story and absent any attention to ethical and policy issues, violates journalistic ethics.

Franklin G. Miller, PhD, a Hastings Center Fellow, is a professor of medical ethics in medicine at Weill Cornell Medical College.


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  1. Agree. I am puzzled by the Times’s coverage of this issue which comes across as one-sided. Totally lacking in providing larger context or presenting opposing views.

    1. Concur fully. Thanks for the posting and for addressing this issue. This USA is in no way ready for euthanasia/physician assisted suicide. As the article points out there are enough alternatives available including hospice care which gives patienbts a lot of leeway in using pain medicine in a supervised and controlled healthcare setting.

  2. I’m extremely puzzled by Miller’s essay. True, the New York Times story by Andrew Keh and Lynsey Addario doesn’t contain explicit comment on the ethics of euthanasia–but it does have much detail on the quality of Marieke Vervoort’s life, the questions people close to her had about her decision-making and mental state (and, remarkably for a news story, some misgivings on the part of the reporter and photographer concerning those), and her long history of suffering and achievement. Such matters are relevant to, if not dispositive of, adjudicating the ethical issues raised by euthanasia and physician assisted suicide. Then again, even the Gray Lady of American journalism is a news organ, not a low-level bioethics journal, and even by the standards of the former the article is an extended profile and description, not a pro-con parallel arguer. News providers publish more than one kind of story; they’re even expected to do so.

    Miller characterizes the NYT story thus: “Most of the special report consists of gripping color photos …” compared to “the few pages of text …” By counting screens while ignoring captions altogether, thus counting a photo with a caption as solely image (and thereby advantaging Miller’s account of the story), I came up with 21 screens of image and 12.5 screens of text, which comes to 63% “gripping color photos.” That indeed would constitute “most.” On the other hand, there are not just a few pages of text. There are plenty of words, thousands of them, 3638 to be precise. (I cut and pasted the entire article, minus headings, captions, and the like, into an online word counting program in order to determine this. Thus I underestimated the text content of the NYT story while at the same time slightly overestimating the image content.) That would amount to 14.5 pages of text at 250 words per page, the length of many academic conference papers. Moreover, I’m a relatively quick reader, but I’m sure I spent twice as much time on the prose as I did on the photos, gripping as they are. People who read less quickly than I do might skew the time clock farther from Miller’s relative length estimate, not closer.

    I admit that some of those latter folks might give up reading in disgust–too many words!–and just look at the pictures, but then they’d still lack the benefit of a more closely argued analysis that Miller demands. Miller’s piece contains a hyperlink to the NYT piece, so readers can figure these things out for themselves–but there’s no call for him to give readers a misleading impression (“it’s an overly dramatic puff piece, a mere photo essay really”) before they go there.

    _If_ they go there. Because anyone who–disgusted, as perhaps Miller was, by the very idea of the article–never clicks the hyperlink will walk away with a rather distorted impression of the Times’s journalism, along perhaps with new or renewed prejudice about the ability of certain media sources to discuss technical and controversial subjects. This would be unfortunately ironic, because if such people had never followed Miller’s lead, they might have been better off reading the NYT article and forming their own opinion, whatever weaknesses they might find there, _without_ Miller’s guidance.

    If I were being as uncharitable to Miller as he seems to have been to Keh and Addario, not to mention their editors and publisher, that last observation might imply that Bioethics Forum should not have published Miller’s essay. Let me suggest instead that the Forum piece should have been more carefully vetted and edited, even for a longtime contributor, to avoid the impression of a Ronald Reagan-esque “there they go again” or an ax being ground. Such impressions would likewise fail to do justice to the ethical complexities of euthanasia and physician assisted suicide, not to mention disagreements about the proper role of a journalism outlet, even a fairly high quality one, in extending public understanding of these topics.

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