Hospice Patients Alliance: Patient Advocates

The Call and the Counterfeit

Getting It Right (Contra Smith and Byock)
Part Two

by Ron Panzer

April 4, 2015
updated April 9, 2015

Woe to them that call evil good, and good evil;
that put darkness for light, and light for darkness;
that put bitter for sweet, and sweet for bitter! — Isaiah 5:20

The Call

Those who hear the call feel the dear Lord's touch. Like an intoxicating jasmine-scented breeze, nothing in this world can compare with such a gift from God! Florence Nightingale — Mother Teresa of Calcutta — Cicely Saunders — they all heard the call.1 Each one searched to find its meaning until the mission became clear.

No obstacle can stop such a soul once they have been given such a mission, and the example they gave to us is like a lamp in the darkness and chaos of the world man creates for himself. For decades, they each sacrificed so much in order to serve their Lord.

Nightingale nurses, Missionaries of Charity, and pro-life hospice nurses and physicians are honored to follow in their footsteps in some small way. Each of them revolutionized the care of those in need and inspired many thousands of others. We can only hope to be and do a little bit in this world that would contribute to continuing their true mission, and in some small way please the dear Lord Jesus who called them and each of us to a purer way of serving through sacrificial love.

Recalling Jesus's words (Matthew 5:7), Queen Victoria honored Florence and gave her a brooch upon which was inscribed the words, "Blessed are the merciful!" for in her, she saw a woman whose will to show the most tender kindness and care for the ailing was made strong. She and the entire world witnessed a woman whose devotion to merciful service was pure, a woman who exposed and challenged the evil, cruel, but widely accepted neglect of patients in her time and overcame these evils through perseverance and love. There is not one modern civilian or military hospital in the world that does not strive to follow the principles and quality improvement measures introduced to modern healthcare by Nightingale!

Florence Nightingale, Mother Teresa, and Dr. Cicely Saunders cared for and poured their lives into service for those ailing and dying before them, giving everything they had to those so much in need. All three demonstrated a wholistic approach to care that addressed the needs of the total person and followed the example and teaching of the dear Lord Jesus.

Those who received such expert and loving care, trusted them completely, because they knew that the hands that cared for them and the heart that moved those hands had been given to God alone. A palpable dedication and warmth poured out of their hearts that comforted patients' souls, giving them peace and hope in this world and in the next.

Not once did either of them ever suggest to a patient that he or she hasten death in any way! Though some may wish to avoid the suffering they experience or envision by taking their lives, we can do much to relieve that suffering, to love that individual, and allow an authentic inner healing to take place.

It was for good reason that Florence Nightingale was called the Lady with the lamp! If we are to care for those who are nearing death, we can do nothing better or purer than to follow such shining examples in our work!

Reverence for God and reverence for the very being of those we serve can only be a blessing to them and will always help us to discern the right way forward in the often confusing and challenging times that are to come.

Clearly recognizing and retaining the purity of the mission we serve will help us to see through the many deceptive voices leading us to go astray and to accept without qualification such a strikingly different way — a much-acclaimed, seductive, even impressive but dark secular path.

Byock's "Splendid"2  Counterfeit

In pursuing this topic, I would again wish to make it clear that there is much about Dr. Byock and Wesley Smith to be admired. I have learned from reading Wesley's articles and it is certain Dr. Byock has taken excellent care of many patients. Yet, when I read Wesley's statements that characterize as false the brave testimony of so many nurses, doctors, patients and family members who report the truth about what is occurring in the end-of-life care settings, I cannot remain silent.

I realize that some are angry that I have questioned Ira Byock and Wesley Smith. I cannot do otherwise if I am to remain faithful to the mission I serve. Read on and you will understand why I do so.

In his book, Culture of Death, in the very few pages that even mention hospice, wrongdoing of any sort or imposed deaths occurring in that setting is not mentioned, yet this book was written in 2000 and news about such deaths was already widespread for anyone who cared to pay attention. Wesley is, without a doubt, paying attention to the news and reports and certainly must be aware of them, but chooses to not only not share this with his readers, but chooses to mischaracterize American hospice today as if it were the hospice of forty years ago when Dr. Saunders' mission was prominent and practiced widely.

When Smith gives Byock the highest praise, I have to respond. He has praised him for many years, yet Ira Byock, MD has individually done more harm than almost all other hospice and palliative care physicians in the country. He, along with a few other culture of death activists have completed the tainting of the industry throughout the nation.

How did he do it? In part, Byock merged the euthanasia movement with the hospice industry through the creation of Partnership for Caring. He also helped to set the tone for hospice and palliative care practice at the newly formed American Academy of Hospice and Palliative Medicine. You should know that if you understand Ira Byock, you will understand what happened to the industry!

My hope in writing is that the reader may discover the truth and understand how the tainting of the industry was accomplished.

Wesley has repeatedly implied that when terminal sedation is used in hospice, it is used properly and is not widely being used to end the lives of vulnerable patients. When referring to this type of sedation, Smith prefers to use the term "palliative sedation." He says that it is only used to relieve symptoms and that with terminal sedation in hospice, the patients die of their terminal illness alone.

In other articles, he has differentiated between those who use terminal sedation appropriately and those who intend to end life; he condemns those who use it to end life. The problem is that Wesley implies that any wrongdoing is occurring in American hospitals or elsewhere, but never in hospice. The impression Wesley gives his readers is truly not believable in 2015, ten years after Terri Schiavo was executed in a hospice!

I hope that he takes the time to research and re-evaluate his position and what he is telling the public. Wesley tells his readers to disbelieve the reports coming in about problems in hospice, yet we hear from so many families who are suffering in anguish due to a hidden epidemic of medical killing right under the nose of so many, even Mr. Smith.

Just today I received a call from a nurse in the Southeastern United States whose brother, age 67, was deprived of fluids against his will even though he was completely competent to make his own decisions, was overdosed with morphine, and died within two days of entering hospice. He had no pain issues, was begging for water, and was refusing the morphine. This is part of American hospice today!

Yesterday, I received a call from a journalist in California whose elderly father was put in hospice. Her father was conscious, did have a terminal condition but was nowhere near dying in any sense of the word. He had a mild problem with short-term memory, but otherwise could carry on intelligent, detailed conversations and relate to everyone around him. He was placed without cause on Seroquel, then Haldol, Ativan and morphine and died shortly after that. The daughter is devastated and told me that "they robbed us of the precious time we would have had together!"

I cannot understand how it is even possible for Wesley Smith not to know about such cases. They are so common and every patient advocacy organization in the country has heard about them! When it comes to abortion or assisted-suicide, Wesley is right there at the front exposing the evils and helping the people to realize the worth of human lives. When it comes to healthcare professionals who might be forced to take part in these, he regularly bemoans the possible or actual violation of medical professionals' conscience rights.3 Yet, again, he never mentions that any such problems could arise in end-of-life care settings and then affect the conscience rights of healthcare professionals there!

Apparently, according to Wesley, hospice agencies, administrators, managers, medical directors, and so many others can do no major wrong. What other conclusion can one draw from his numerous statements that extol the good of hospice, never mention any serious harm to patients at all, and when he reports problems involving unethical behavior such as terminal sedation applied inappropriately, he tells us it happens in hospitals, not in hospices! This is exactly backwards, since the imposition of death through terminal sedation has historically occurred mostly in hospices, and has now spread to hospitals and other healthcare facilities, mostly through the establishment of palliative care divisions within their halls or through the subcontracting of services to hospice agencies that are allowed to practice there.

As one of the main speakers at Patients Rights Council ("PRC") — formerly called the International Task Force on Euthanasia and Assisted Suicide — Wesley is extremely well-informed about the history of the assisted-suicide and euthanasia movements, including Dr. Byock's involvement with the euthanasia organization, Choice in Dying and Partnership for Caring. Wesley knows much about the laws, proposed laws, case law, the permutations and implications of the various laws in several nations, yet how is it that he says nothing at all about the covert euthanasia movement in hospice settings? From what Mr. Smith writes and says, there is no covert euthanasia movement involving these end-of-life care settings.

If Wesley is right, then where did it go? Where did all those euthanasia supporters from the Euthanasia Society of America go in the 1990s and thereafter? The activists like the former Hemlock Society and the current "Compassion" & Choices who openly support legalization of assisted-suicide — the same thing as euthanasia for purposes of advancing their cause — are a different crowd and this is well-known and documented.

Compassion & Choices' leader, Barbara Coombs Lee was an executive with an HMO/managed care corporation when she wrote Oregon's assisted-suicide law. So much for the "altruistic" motivations behind the legalization of assisted-suicide! With similar concerns about minimizing healthcare costs for those who are "better off dead," the covert euthanasia movement took over much of the hospice industry, Mr. Smith!

Some of the more revealing calls and emails we receive are from hospice nurses working in the field all around the country. These nurses report the problems they encounter with hospice agency administrators and nursing directors that are either in the business only for the money, or hospice agency administrators who are culture of death types that do not respect the sanctity of life. What happens in those hospices violates everything these nurses stand for.

We have heard from some of these nurses who talk about having worked at a good hospice that adhered to the standards of care and the original mission of hospice. They then explain how they either moved, or the hospice closed, and they went to work for another hospice that was run completely differently, and they were absolutely horrified at what was going on there. Not all hospices are the same! Smith should realize this.

Yet, his own website at PRC lists the development of what has become the covert wing of the movement, beginning with the living will as an incremental step toward euthanasia, through organizations that promote other methods of limiting patient care, and then the planned eventual legalization of euthanasia. This has been the strategy ever since the euthanasia movement's leaders realized the American public was not ready yet for legalization of euthanasia and gave up directly lobbying for legalization. It was at that point that they decided to work on a step-by-step basis.

Smith knows all about the plans that the euthanasia activists have had for decades and decades! This wing has brought us the living will, advanced directives, do not resuscitate orders, polst forms and undeclared, i.e., stealth euthanasia. On the PRC website, it shows the development of the Euthanasia Society of America into Byock's Partnership for Caring organization. However, when referencing Partnership for Caring, for years it has not even mentioned Ira Byock. The PRC website mainly mentions his former partner there, Karen Orloff Kaplan. Why hasn't Byock been shown to be the partner in the euthanasia movement's efforts?4

I can understand that since Byock and Smith's opposition to assisted-suicide coincide, it may be that Smith sees Byock as an ally in that fight, but ignoring the historical record that details what Byock has been up to, and knowingly refusing to share it with the public is not fair to the public. It gives them a terribly false understanding of this man and the work he has done. It is simply not possible that Smith does not know Byock's historical association with the Euthanasia Society of America, i.e., "Choice in Dying" and its successor organizations!

The main type of mention of Byock that I found on the Patients Rights Council site is to link to many articles that quote Byock's arguments in opposition to legalized assisted-suicide. Almost all of the covert euthanasia supporters like Byock take this stance: publicly oppose assisted-suicide but practice stealth euthanasia when they wish in a hospice or palliative care setting! Are we to simply accept that everything Byock does and has to say is right because he opposes assisted-suicide, or because he's so articulate and expert in end-of-life care otherwise?

I have listened to the distraught nurses and doctors who have lost their jobs because they protested what was going on in hospice and palliative care settings. Some have even had their licenses targeted for not going along with the death agenda that is policy where they worked! Can Wesley Smith be completely unaware that because of many hospice administrators' hostility to the pro-life position, many pro-life nurses have been involuntarily forced to leave the field they love, or are retiring?

The pro-life nurse, physician, pharmacist or other professional is a very real target in secular humanist health care settings and not just with regard to abortion procedures or dispensing of abortifacients, as Smith might lead one to believe. Anyone who speaks out against what is occurring in many hospices is labeled a troublemaker, is harassed, retaliated against and eventually made so unwelcome that they leave on their own or are fired outright.

Please wake up, Mr. Smith! We who are in the trenches of healthcare settings need the help and don't need to be told that what has happened to us didn't happen! I know from experience that when you've been a whistleblower, or advocated for a patient defending him or her from harmful actions or policies set by superiors, you are very vulnerable. I've felt the full force of hospice administrators and know that as an employee, the so-called "protections" of the law are often quite meaningless. They harass you anyway! I've been there!

What do you really know as an employee about being a whistleblower in hospice, hospital, or other healthcare settings? It is one thing to sit behind the safety of a desk and write, and quite another thing to stand up against corrupt administrators who implement criminal practices at their agency! It is also quite another thing to day after day listen to the anguished cries of distraught families all over the country. Their voices cry out not only for justice, but for people like Wesley Smith to speak and share the accurate truth and not "whitewash" the reality.

When the lawless attain power in a nation or hospice, or any business or agency, they do not tolerate disobedience and especially do not tolerate those who challenge them and expose their evil. In other words, they believe they can do what they wish to do, while the law is for others to follow.

Like snakes, they become enraged and plot to destroy these who have made themselves into "enemies" by simply speaking truth, seeking to protect human rights, freedoms, patients, or to stop criminal activity. When the lawless attain power, their "enemies lists" grow and grow as time passes. Secular humanism and communism have much in common. When individuals of either bent attain authority to act, they do not tolerate dissension at all.

As Richard Wurmbrand has explained to us in his book, Tortured for Christ,5 such lawless ones insist that everyone under their command or authority make a public showing of "approving" their evil, and depending on the power attained, those who refuse to do so are either imprisoned, tortured, harassed, fired, or even killed (Daniel 3).

Such employees take a big risk and sacrifice much in order to speak up for what is right and to protect their patients! Many employers will violate the laws against retaliation since they know that nothing major will happen to them even if they're found out. They fire or severely harass the employees who they don't want around! Meanwhile, the employee and his family suffer the loss of an income, experience a sudden financial crisis, and must struggle to survive. Many never re-enter the field they love, because they will again be targeted as retribution for having spoken the truth! They often suffer financially for the rest of their lives!

If the employee brings a lawsuit to protest such treatment, the corporation has attorneys on retainer who can easily fight the claim year after year. The employee has limited funds and cannot focus all his attention on such a legal action when he or she's going under financially and cannot continue to fight for long.

I should say that family members whose loved ones were killed in a hospice setting are outraged by what Wesley Smith continues to write since, as an authority, he is telling them that they don't know what they saw and have suffered!

They've already heard from the "hospice can do no wrongers" from the hospice that killed their loved one: "You are exaggerating!" "You don't understand hospice!" "It was just the natural dying process!" "Poor thing, you're having a difficult time grieving!" "Let our grief counselor help you!"

Just imagine how it feels for the families of victims when those staff who ended their loved ones' life suggest that they counsel these family members who have lost their loved ones to medical murder! Outrageous and intolerable! Think about victims of war whose family members have been killed and then someone (like Smith) telling them, "It didn't happen!" That's how it feels to hear him tell everyone, "Don't believe the stories" that some hospice staff are killing their patients.

The devastation families experience is very real, and they are not ignorant of what good end-of-life care involves! Some of these family members are physicians, registered nurses, pharmacists, medical social workers, psychologists, and other professionally trained healthcare workers whose loved ones were killed. Just today, I received yet another letter from an outraged adult daughter who wrote so clearly:

Forced death by dehydration is barbaric and cruel! Any doctor who dehydrates a patients violates the Hippocratic Oath. How can any doctor ignore family member's demands to stop the drugging and dehydration? Hospice is America's Hospice Holocaust.

Perhaps only with the power of the pen, Americans will realize the evil that exists in America's healthcare and voice outrage and force changes to end death by forced excessive drugging and dehydration. I never knew this evil existed until my dad was taken to Hospice from my home while I was at work. 31 days later he was murdered at _________ Hospice.

My demands for the doctor to send my Dad home were ignored. My demands for the doctor and nurses to stop drugging my Dad with drugs that he didn't need and never wished to use were ignored. My demands for the doctor and nurse to stop dehydrating my Dad were ignored. Murder is murder no matter where it is committed. My Dad was murdered! There is no doubt that God will judge the doctors and nurses who commit murder in the guise of healthcare or hospice care.

This is a mild letter compared to some we receive, and of course, not every hospice agency or staff is doing these things, but many are. When it happens, the devastation it brings to the family and to the patient are unspeakably wrong. With these and too many other voices of anguish ever in my mind and my heart, I must continue and provide the evidence that proves Ira Byock is not merely a "splendid physician" as Smith writes, but also one of the main forces behind the proliferation of stealth euthanasia in the country.

Even if we must stand alone, and many like Smith join in and deny that hospice professionals have done any serious wrong, we must continue to speak the truth that we know for certain is the truth!

Oh yes, I can see how Ira Byock's writings can mesmerize you and make you into a "true believer" so that you think he's one of the most wonderful end-of-life care professionals out there. He clearly does provide some of the finest end-of-life care possible for many of his patients, but there is more to the story. I can understand that if you know him personally or have heard him talk you might be convinced and find yourself agreeing very enthusiastically with much of what he says, but that doesn't change the facts.

Byock presents the attractive "face" of this evil. He speaks exquisitely of many good things, even love, but is it possible for man to truly love if he does not know humility before God? Byock says, "The healthiest response to death is to love, honor, and celebrate life. To life!" Who can disagree with such words? You have to really pay attention to the details and understand what he means when he uses his words.

Byock does not realize that it is God who has given the spark of life to each of us. It is that glorious spark of life that we see in each other, that we love, and that reflects His glory alone!

The Spirit of God has made me,
And the breath of the Almighty gives me life. - Job 33:4

Byock recognizes that it is wrong to kill his patients, so he always says that he never does so, but elsewhere in his writings and statements he admits that he performs what Cicely Saunders called slow euthanasia! He not only lies to the public, but he lies to himself. What kind of love is it that would hasten a patient's death when God has forbidden it? But he thinks this concern is of no import when it's done his special way. Yet, I would not wish you to take my word for any of this; find out for yourself what the truth is!

We can be sure that the culture of death rarely if ever announces itself, and those who are part of it do not think of themselves that way at all! In our time, the culture of death hides behind the polished veneer of professionalism, wonderfully-built facilities, and smiling faces — even the label "pro-life." They are respected, often intelligent, yet they don't see the world as a person of faith might and don't make the same decisions when it comes to life.

When it comes to hastening death, they re-define what it means to be alive and what it means to kill so that they can kill. If you suggest that many in hospice or palliative care settings are medically-killing patients, they become enraged and offended, and then protest that they never do such things. Meanwhile, Smith endorses these lies as truth and condemns as lies the truthful reports of victims! I wish it were not so! Others all around may praise those who hasten death while pretending to provide "care," but that doesn't mean we must believe them without cause.

Let's understand that Byock knows very well what the debate is about and what the issues are. He states very clearly6 that

"the toxicity of the assisted suicide debate has spilled over and threatens to poison important public discussion about how we can most wisely use finite resources to provide the best care for the greatest number of people. "Rationing health care" is the now familiar, albeit incendiary, shorthand that the "Pro-life" activists have successfully assigned to this vital subject. Through the filter of the culture war, opposing camps are characterized as secular humanists who want to limit lifesaving treatments to people who are no longer productive versus God-fearing religious conservatives who believe every life has value and only God can make decisions about life and death. As in all wars, the opponents see things very differently and don't like one another. They are much more likely to aim invectives than to actually speak with one another. This is no way for our caring society to deal with a very real problem that we already have. [Byock's own emphasis here]

Of course, Byock distances himself from those "terrible" secular humanists, but elsewhere tells us that's exactly what he is! Byock goes on to explain that he comes from a cultural, but not religious, Jewish background and understands that

.... "the primal social contract is not a contract; it is a covenant. Human beings belong to one another before we are born and long after we die. In a morally healthy society, people are born into the welcoming arms of the human community and die from the reluctant arms of community. Within this covenantal experience, the well-being of others affects my own quality of life .... Our challenge as a moral people is to use those resources wisely, justly, and humanely.

....I am ardently Pro-life, but it has nothing to do with "Pro-life" politics.... The Pro-life agenda we advance is apolitical. We strive to save and preserve people's lives and care for people who go on to die .... The Jewishness of my upbringing revered life more than any notion of God.

Byock, as you can see, is quite eloquent, well-read and articulate, but also completely contemptuous toward God. Since Byock supposedly believes "human beings belong to one another before we are born," why does he enthusiastically support the medical killing of these unborn and the Planned Parenthood facilities that have murdered millions?

If he really believed that human beings belong to one another before we are born, if he truly was "pro-life," he would tell people that the yet to be born are truly human, confirming what science has long established. He would tell the people that these most innocent of all humans deserve our love and protection!

He gives the public a nice "sound bite," but Byock clearly does not believe what he says to the public! He has deceived himself for so long that he may not fully perceive the glaring contradiction between his words and his support for medical killing of those not yet born. And what does Byock mean by a "moral" people? It's not what many people think of when they use the term!

He's very slick! He says that he cares for people's lives and for people who "go on to die," but does not at that point explain how some of his patients "go on to die!" Definitions matter and he doesn't use these words the same way as most people of faith do.

In addition, if respect for human life and human willfulness in defiance of God's will is to be elevated above God, as Byock does, then that is not the actual pro-life position that I and many others embrace. A truly pro-life mission arises first from the acknowledgement of God, with reverence for Him, and then human life is seen in its proper context: created by God, blessed by God, and to be honored because of God. We see God's breath of life within those we serve! Byock is repulsed by that pro-life mission!

He goes on to speak about the importance of caring and how all human beings deserve proper care in so many ways, which anyone would agree with. He does share the insight that many healthcare professionals experience a sense of the sacred when a person is born and when they die. I and many others agree!

While he says that the sacred is "experienced — physically and emotionally — as complete rightness in the moment," he refuses to admit that God exists and concludes that the experience of the sacred one might encounter in life has nothing to do God. Byock might as well go on to admit that, as a secular humanist physician, he would only accept explanations of human experience that have a physiological psychological basis. It appears that for Byock, "love" becomes nothing more than a matter of neurotransmitters like adrenaline, dopamine and serotonin, and the experience of "the sacred" is something similar — something that is part of the human experience, perhaps "wonderful" and to be encouraged as he understands these things, but not sacred in any sense that one of faith (or God) would understand the word!

Byock assuredly completely discounts the significance of God telling Moses to remove his sandals because the ground has been made holy or sacred by God's presence there (Exodus 3:5). When Byock experiences, or hears about anyone experiencing "the sacred," he never takes the next step to say, "My God!" "My Lord!" and then reverently bow before Him. How tragic! But of course, Byock wouldn't consider any of this tragic. He doesn't believe in it.

I encourage anyone who wishes to understand more about the culture of death to read Byock's books and articles. Read his words for yourself. You will very likely find yourself agreeing with him on many things and wonder how he could be part of the culture of death at all. If you finally perceive his re-definitions of terms that sound so right, and how he practices, you'll see how his part of the culture of death could be perceived as a very splendid thing to some who are completely infatuated with him.

Byock hides his past associations with the euthanasia society and pretends it doesn't exist. He uses almost the exact language Cicely Saunders and others who are pro-life would, but there are key differences which we will get to, aside from the fact that Saunders was a devoted pro-life Christian who was following a calling, and Byock is anything but that.

When Wesley Smith labels Dr. Saunders' mission as "secular," he quotes a biographer of Saunders who did characterize her mission in this way, and Wesley accepts and endorses this view of her mission. However, what is meant in the biographer's context is that Dr. Saunders did not preach to her patients or clothe the mission in a formally religiously affiliated manner. Yet, when Smith characterizes Dr. Saunders' mission as "secular," he gives the impression that her mission was the same as the secular hospice currently dominating the hospice industry in America.

Smith implies that Dr. Ira Byock is actually continuing in her footsteps and is faithfully serving her mission in his secular practice. That Dr. Saunders chose not to declare a formal religious affiliation for her work is not the same thing as Byock choosing to embrace a strident, secular humanist worldview and practice with utilitarian, secular bioethics as one's guide.

For a moment, consider that those who embrace a culture of death worldview are influencing the direction of our entire nation. We might ask ourselves the question, "If you wished to completely subvert an entire nation built upon a Judeo-Christian worldview and fundamentally move it toward a culture of death by removing all remnants of its former foundation, how would you go about doing it?"

You, and leaders who have come before you, would say the things people wished to hear so you might attain power. You would continue to appear to be affirming traditional values so long as needed, while doing things that not only contradict those values but undermine and re-form every fundamental branch of society. You would hide the ruthless, cold heart within and display the loving facade that your supporters adore.

Over time, you would re-make each of those branches of society in a different image, and appoint those who reject the traditional worldview to influential positions, judgeships and highest-level administrators of the law, so they and you might carry out and continue the transformation. You would sabotage the adherence to traditional law while making new laws that favored the changes sought.

It may be that one day the people will awaken and see that an almost universally unrecognized and silent coup d'état has already occurred.

When observing such a leader's actions, many, even "great political analysts" who did not understand him at all, might accuse him of being weak, naive, incompetent, crazy, or even ignorant. However, when his actions were viewed with such a transformation in mind, everything he did would be seen to be consistent with the sole goal of fundamentally and irreversibly changing the nation as he originally set out to do. When the scales fall away from our eyes, we may see that the actions that would be done by an enemy are being done by an enemy within.

You say that such a thing could never happen? In the face of a manufactured crisis — the arson burning of the German legislative building, the Reichstag, and the assigning of blame for it to the communists by Hitler's Nazi supporters, along with other strong-arm tactics and political maneuverings — Adolf Hitler was appointed to power by those who were democratically-elected, and then later "democratically" (but not without coercion) given even further powers. Even if many at the time and later did consider him weak, naive, incompetent, crazy or ignorant, he was able to do unspeakable evil!

Yes, there were many who recognized what he was and what he wanted to do, but just the same, there were many who were enthralled with him and facilitated his ascent to tyrannical power. Just imagine yourself in the Germany of the 1930s watching all the changes coming your way and being unable to do anything about it. Hitler was a National Socialist, not a Marxist socialist. He was a statist and enemy to the democratically-run German nation of his time, yet managed a coup d'état without military conquest.

The same has happened here though the final stages are only now coming into view and the full ramifications of this change are yet to be realized. The philosophy behind this statist push is not "German nationalism" or "Aryan supremacy" but something that some see now and will be more clearly seen by most in the very near future. When a "justice department" no longer applies the force of the law to all equally, allows the targeting of groups that are pro-life, conservative and Christian, and also selects which laws to select and which ones to ignore, then we must open our eyes to see that the protection of the law no longer extends equally to all citizens.

When the saintly, pro-life Little Sisters of the Poor are opposed by this statist regime with an anti-life Justice Department,7 you can know with certainty that the federal government is no longer on the side of protecting human decency, life, fundamental morality, or basic Constitutional rule. We can know that cronyism, nepotism and many other corrupt practices are to be expected. Discrimination against those of faith is increasing in frequency within many Western nations including the U.S.

Whether you believe these things or not, whether you laugh and think these statements are complete nonsense, matters not. Those who agree with Wesley Smith's "progressive" hospice cheerleading — that virtually nothing terribly wrong is occurring and that no deaths are being imposed in hospice settings — may ridicule reports that reflect the truth. The realities in our nation and within our healthcare system remain. Those who have experienced these things directly know the truth and suffer the daily anguish that colors their lives, contrary to any propaganda shared through the media, the government, or through some "progressive" - conservative blogs.

When it comes to our nation, the most pressing question is whether our nation that was built upon Judeo-Christian values and law, and established a unique Constitutional rule, can ever be reclaimed and restored. In the past, our nation and its leaders have honored the Christian worldview and have simultaneously especially sought to protect each individual's right to believe as he or she wished, because it was a voluntary, willing faith that was sought, not something to be imposed upon any individual.

What do we see now? We can see someone who rejects the sanctify of life, who makes all citizens fund medical killing of the unborn with their taxes, who rejects the sanctity of the covenant of marriage between a man and a woman and rejects the Judeo-Christian biblical stand, and who is a statist, running our country. To understate the problem: socialistic statism is antithetical to American Constitutional rule and to basic freedom.

You may ask why I might wish to mention any of these things in an article about end-of-life care. Ask yourself, "What kind of healthcare will there be when an anti-life, anti-Christian, secular federal government controls all of it?" "Will pro-life values guide the decision-making?" Or, "Will secular humanist, utilitarian values guide the decision-making?" Where do you think our country is headed under its current leadership (of either political party)? The mission of life is neither Left nor Right and belongs to no political party, yet the established power in both is opposing that mission!

When it comes to end-of-life care, those who support a socialized healthcare system, who actively reject the culture of life — Dr. Byock and his key fellow activists — have guided this industry to a very dark position. When it comes to this niche of healthcare, we must ask ourselves a similar question, "Can we restore a culture of life so that healthcare again becomes a safe haven where all patients can trust that their caregivers will care for them and not kill them at some point?"

Before we answer that question, we must understand what has occurred in healthcare, just as we must understand what has happened to our nation. We must ask and then find the answer to this question: "If one wished to subvert the end-of-life care mission that Cicely Saunders brought to the world without anyone noticing, how would you do it?" They'd do it in exactly the same way that a nation's moral fabric and system of laws and their nature have been overturned and then changed!

You'd choose to outwardly appear to be doing the same things Dr. Saunders did, say most of the same things she said — as Byock does so well — but then introduce incremental changes through private organizations, supposedly "well-meaning" nonprofit "charitable organizations,"8 and governmental agencies. You'd bring legal actions to obtain court rulings that favored the changes sought and you'd manipulate governmental bureaucracies so they would firmly establish the complete change of direction for the mission.

You would re-define terms and teach a different approach so that traditional standards and restraints were replaced without the public's awareness and were violated without being recognized as violations!

You would "talk the talk," but be willing to walk a path Dr.Saunders never walked! You might have "all the expertise in the world" concerning the management of the many end-stage diseases that are confronted in end-of-life care. You might speak with the eloquence of angels! People might find you truly inspirational! You might be masterful in how you applied medical intervention to relieve suffering at the end of life, but you would base all decision-making upon secular bioethics9 with the inevitable, consequent willingness to choose to end the lives of some patients at a certain point, by one means or another.

When Byock began his practice as a new physician working in family practice and end-of-life care, secular bioethics was the thrilling "new wave" that hit the industry hard. He had no resistance to adopting these new formulations of purportedly ethical principles since they were consistent with the progressive worldview he already had. Later as a hospice leader and emergency physician in Montana, he continued the work of inserting secular values into the work of end-of-life care. Today, when he suggests we use scarce healthcare resources "wisely," "justly," and "humanely," he doesn't use the words the same way most people do! He tells us he is a secular humanist and he uses these words with secular bioethical meanings!

These new basic principles that guided the supposedly "ethical" performance of research and healthcare were jumbled together by the "Belmont Commission" established earlier by Congress and then codified into federal law in 1979. The principles became mandatory policy for all federal employees, federally-funded research at the universities and all public health departments. It also found its way into all the courts and the legal system, the medical and nursing schools, and the rest of society. These principles were also independently adopted in other nations as well so we can now understand what has happened to Western civilization.

The Judeo-Christian based sense of morality has been removed as a basis for decision-making, and the Hippocratic Oath10 for physicians is no longer required. A new mindset that reflected the defiant willfulness of the 1960s "Me Generation" has been clothed in "lofty" language and applied to matters of life and death. The adoption of the secular principles by the federal government did away with the principles upon which our nation was founded! President George Washington foresaw just such a terrible turn of events when he spoke to the nation at his Farewell Address and said:

Of all the dispositions and habits which lead to political prosperity, religion and morality are indispensable supports. In vain would that man claim the tribute of patriotism who should labor to subvert these great pillars of human happiness, these firmest props of the duties of men and citizens.

The mere politician, equally with the pious man, ought to respect and to cherish them. A volume could not trace all their connections with private and public felicity. Let it simply be asked where is the security for property, for reputation, for life, if the sense of religious obligation desert the oaths, which are the instruments of investigation in courts of justice?

And let us with caution indulge the supposition that morality can be maintained without religion.11

Supposing "that morality can be maintained without religion" is exactly what was done by the Congress's adoption of the principles in the Belmont Report. The federal government's adoption of the secular bioethical "principles" was the equivalent of an ethical atomic bomb that obliterated everything that formed the foundation for a culture of life in healthcare settings. It was, in essence, the rewriting by man of the Ten Commandments. God knew, of course, but who among us really noticed?

When it comes to healthcare, figuratively speaking, no matter how wonderful the "soup" that the cook, i.e., physician, prepares, when you add just a little poison to the mix, the entire pot is spoiled! If one type of "spice" (secular bioethical principle) doesn't work to justify ending the patient's life, then the physician just chooses another "spice" (secular bioethical principle) till he gets the desired result: death.

After the adoption of the Belmont principles, how would you spread this revolution in ethics to all physicians? You would train the trainers to follow your lead and teach healthcare workers to practice with a completely different spirit. Not only would you present the mission differently, but you would omit the most important aspects of the mission: reverence for God and reverence for the lives He gives to us so that we may learn to serve as He would have us serve.

Byock is the man who chose to work with others and do exactly these things to end-of-life practice so that the mission Cicely Saunders brought would be subverted for his own aims. Although he observed end-of-life practice both in America and in England, because he brought to the patient care setting a diametrically different worldview, he experienced the delivery of end-of-life care from his own perspective. Byock clearly never understood or shared Saunders' mission, even though he's been working in the field ever since to promote his secular re-invention of the mission.

Saunders was the one that fought and overcame the medical establishment's backwardness — just as Florence Nightingale had done with regard to hospital care settings — but her focus was life-affirming end-of-life care. She initiated research and implemented the latest and most effective medical means of relieving pain, while paying attention to the whole person and the complete environment, as Florence Nightingale had taught. Saunders extended the work of Nightingale into the end-of-life care niche of healthcare and addressed the "total pain" the patient may be experiencing.

Remember, even though she later became a medical social worker and then physician, Dr. Cicely Saunders had first been trained as a Nightingale nurse! She thought as a Christian pro-life nurse whose focus therefore was on affirming the sanctity of life and serving the dear Lord in allowing patients to live fully until the time that they would die naturally. This is a focus and mission that Byock never embraced! While she worked with and was surrounded by a largely secular society, Dr. Saunders' mission was "secular" only in its outward appearance!"

Byock and others like him have illicitly ridden the waves of enthusiasm generated by Dr. Saunders' work, aped the language and practices she developed and have been received ever since by the public as if they were her own. The public, just like Wesley Smith, could not have been more mistaken! Most of the public would be unable to discern the difference between Saunders and Byock, and many even applaud Byock for introducing his secular version of end-of-life care. Why would Wesley Smith applaud Byock's example and role in end-of-life care?

Byock has demonstrated that similar to many physicians who practice in harmony with Saunders' mission, he not only has acquired from them a wealth of knowledge, but is also motivated by the wish to do the very best for his patients according to what he believes is right He sets himself out as an authority to tell the world how to "die well" and how to change healthcare so that it provides the "best care possible."

Yet, having had decades to find his place in the world, to determine where he stands on the issues relevant to patient care — to discern and contemplate Saunders' pro-life mission, or the mission of life — he informs us that he absolutely does not share Saunders' love for God or believe in Him at all, doesn't hear the same call, and does not possess reverence for life as she did. He clearly shows us that he doesn't share her mission!

Byock tells us he's a secular humanist. Secular humanists have a very different idea of what is right compared to someone who has reverence for human life and for God! Secular humanists seek to achieve "human happiness and social justice" as they define it and through the means they favor, usually government-imposed action, not through faith-based charities — without any reliance on God, any religious organization, church or temple. Secular humanists actively seek to rid themselves and society of:

the political control of [what they consider] repressive regimes; the ecclesiastical control of organized religion; even the social controls of societal and family expectations, conventional morality, and the tyranny of the village....

Secular humanism ... [is] a comprehensive nonreligious life stance that incorporates a naturalistic philosophy, a cosmic outlook rooted in science, and a consequentialist ethical system.12

When they say "science," they mean science that denies any reality but that which can be studied by physical scientific means, i.e., scientism. When they adopt a "consequentialist ethical system," they mean that the consequences alone are what's important. They say that if the results achieved by an action are "good," then the act taken to achieve the goal is good or "justified."

Many secular humanists believe that the ends do justify the means, but they hide this from the public and pretend they care about the means! They often try to find a way to rationalize what they do so they may appear "ethical" to the general public. With this secular view of all things, Byock has forged ahead with great determination to shape the end-of-life care industry according to his mission.

He has his own agenda and is a compelling and convincing communicator. He's been very successful in achieving these goals, and is especially well-received by progressive, Left-leaning, secular audiences, though he has fooled many pro-life crowds. When explaining how he hopes to finalize the changes he desires, Byock regularly recalls the German sociologist Max Weber. Ione Whitlock explains:

When Byock delivered a provocative keynote address to a conference of over 275 end-of-life health professionals, researchers, policymakers, and community activists, he described the "levers" that could be used to change the US death-denying culture. Bureaucracy would be their ally. Byock noted that "... Max Weber said that social movements that become successful become routinized by the agency of bureaucracy. Therefore, ironically, bureaucracy is the means and the mark of our success to this point." 13

Byock and others like him have successfully lobbied those in the health insurance industry and those shaping the federal government for decades so that the secular version of end-of-life care is the standard. Over the past few decades as secular hospice has spread around the country, most small, pro-life Jewish or Christian hospices have been either forced out of business through unfair business practices, swallowed up by larger non-profit hospice corporations, or simply been marginalized through extreme competitive and cutthroat marketing by the larger non-profit and for profit hospice chains. How many hospice agencies today would affirm the Hospice Life Pledge14 written by several pro-life leaders and hospice professionals about ten years ago?

The involvement of socialist-leaning physicians like Byock (and others just like him) in shaping government imposed healthcare reform and end-of-life care is entrenching the culture of death into the very fabric of our nation's healthcare system! Virtually all families will be confronted at some point by Byock's version of hospice and palliative care; in some cases they will be quite satisfied, but in other cases they will be horrified, as confirmed by the constant stream of reports received by patient advocacy organizations all across the country.

What Byock means by the U.S. "death-denying culture" might be debated but generally, his implication is that too many Americans with a "poor quality of life" are having their lives "wrongly" prolonged through life-saving interventions when it would be more appropriate to let these patients die. While it was the 20th century physicians themselves that removed dying from the family home where most of us would prefer to die, well-intentioned physicians were sincerely seeking to save lives in the acute care hospitals through the use of modern medical technology, surgery and medicine.

I would agree that in some ways they went too far so that death and birth have been "medicalized." What should be the natural process of birth and death was hidden from the family view. The hospice setting provided by Christian nuns in England where Saunders first experienced better ways of serving terminally-ill patients provided another model that encouraged family contact and affirmed the lives of the patients so that the family relationships were strengthened. Saunders continued and developed this type of care while eventually seeing to it that such care was also provided in the patient's own home.

Those who have faith do not deny death and do recognize its natural place in the spectrum of the human life cycle, but we do insist that basic care such as food and water and other simple treatments be continued so long as they are helpful. We believe that a life well-lived and affirmed leads to a so-called death with dignity, because dignity is something living patients possess. The dead do not care about such things.

Those who embrace the prevailing culture of death are increasingly calling for the removal of food and water and other basic forms of care when patients' lives are judged to have what they call a "poor quality of life." Ironically, although Byock's books and articles emphasize the close, personal attention he as a physician provides his patients, predictably, the bureaucratic change establishing government-run universal healthcare that he has sought for decades is drastically reducing the opportunities for such physician-patient interaction. These and other changes deny many physicians the ability to control their patients' care, because bureaucrats are now setting lower reimbursement rates for certain procedures and segments of the population and therefore shape the provision of, or failure to provide, care.

When, due to intentionally lowered reimbursement rates, the provision of care to certain categories of patients becomes an actual drain on the financial well-being of hospitals and physician practices, as it already has done, that care is no longer offered and increasing numbers of elderly, disabled, and chronically-ill patients are manipulated into secular-styled hospices around the country.15 In addition, many rural and even some regional hospitals have already been, or will be, forced to close their doors completely! Byock regularly touts the economic benefits of shunting patients into hospice, and now, secular hospice and palliative care is being merged into the continuum of healthcare from the beginning of life to the end.

One might wonder why Byock has been so successful when his mission is so starkly different from Dr. Saunders'. Byock has adopted much of the same body of knowledge and applied it in his end-of-life care. He knows how to tell stories and connect with his readers, patients and audiences. He is charming, witty, intelligent, persuasive, and caring in his own way (up to a point).

When you read Byock's description of his elderly father's last days living with pancreatic cancer, it's impossible not to experience a great sense of admiration for both father and son and to feel your heart strings pulled.16 By sharing moving accounts of several other patients in his books, he introduces what he calls "best practices" in hospice and palliative care. Much of what he shares is actually good advice. However, if you didn't know much about the reality of hospices past and present, as well as the intricacies of what goes into professional pro-life hospice care, you might be fooled into thinking that if all hospice staff practiced the way Dr. Byock describes, they could do little wrong.

Byock is so well-received more importantly because he is one of them, a "progressive," secular humanist espousing the popular worldview adopted by establishment political leaders on both the Left and Right. He has positioned himself as the reasonable voice and he sounds pro-life when he opposes euthanasia and assisted-suicide and states:

I believe that deliberately ending the lives of ill people represents a socially erosive response to basic human needs. If we can stay civil and (even relatively) calm, we can debate physician-assisted suicide while also substantially improving end-of-life care.17

The progressive crowd recognizes him as progressive. The pro-life crowd has no idea what he really is! That's why Smith's wholehearted endorsement of Ira Byock is so misleading and damaging to those in the pro-life community who trust his judgment!

Byock is absolutely not pro-life at all!

In his books, he admits that he labels patients (or anyone) who affirm a traditional view that an unborn human being deserves the full protection of the law, who support natural marriage between a man and a woman, biblical morality, faith in God or religion, as "far right wing." When addressing "progressive crowds," he proudly announces his enthusiastic support for abortion and Planned Parenthood! The same Planned Parenthood that among other things

  • lies to the public and to all expectant mothers, denying the science established for over 100 years18 that proves the embryo or fetus is undoubtedly a fully human being
  • makes money by having medical staff kill embryonic or fetal human beings
  • is an indispensable support to the human sex-trafficking industry, providing abortions for the enslaved young women and routinely fails to alert the authorities with the result that these young women (as well as girls and boys) are not saved! Sex-trafficking enterprises cannot survive without the services of Planned Parenthood (or other abortion providers)
  • rarely promotes adoption and consistently discourages this humane and moral way for a pregnant woman to allow her unborn child to live with a family that desires a child and can support the child
  • still consistent with its founder's racist views, locates 79% of their abortion facilities in walking distance (not directly in) neighborhoods that have a high concentration of African American or Hispanic American residents.19

When university medical centers, colleges, or major media outlets arrange debates between assisted-suicide supporters and those who oppose it, Byock (or someone like him) is regularly chosen as a speaker to oppose legalization and he does oppose legalization. But arranging the debate in this way sets up a false dichotomy making it appear that these are the only two existing positions! What is being done is having the overt euthanasia movement supporters debate the covert euthanasia ("slow euthanasia") supporters, like Byock or those who whole-heartedly promote secular hospice and palliative care without ever exposing the imposed deaths occurring in these secular healthcare settings. There is a third position which is the authentic pro-life position held by Dr. Saunders and those who follow her example. Representatives of these groups are not invited!

There is no real difference in many cases between assisted-suicide and direct active euthanasia if the patient is unable to take the lethal prescription on his or her own. Once a patient is terminally sedated by hospice or palliative care staff, there is no real difference between that and euthanasia, because death is being imposed by others. That it takes one second, minute, day, or a week or two (like Byock's slow euthanasia) doesn't really change what is being done to the patient.

Wesley Smith states, "Ira Byock" [is] "a friend of mine who I respect greatly as one of the country's leading hospice physicians."20 I do not fault Smith for befriending one like Byock who shares some of his "progressive" leanings. Byock is a leading hospice physician. However, I pointedly do not agree with his support for Planned Parenthood and do not welcome his influence on the hospice and palliative care industry!

Elizabeth Wickham, PhD, Exec Dir of LifeTree organization explains how Byock's "nuanced wing" of the euthanasia movement operates:21

  • Everyone should have an advance directive to protect himself from unnecessary medical treatment at the end of life.
  • Withholding/withdrawing food and water is a natural – and even pleasant – way to die, and is a perfectly ethical means of controlling the time of death.
  • "The principle of double effect" can be used to justify terminal sedation.

Timothy Quill, MD and Karen Orloff Kaplan, MPH, ScD, have both written and openly supported assisted-suicide or "assisted dying." Byock, on the other hand, is not publicly advocating the legalization of assisted-suicide, yet his influence has caused others to go far astray. Like most physicians today, he certainly approves of withholding tube feedings to cause death when a severely cognitively disabled patient's quality of life is deemed to be poor and has expressly popularized the practice of terminal sedation to assure death!22

Byock practices in a way that has formally been condemned by Dr. Cicely Saunders and hundreds of other physicians who share her mission.

The European Association for Palliative Care released a position paper addressing the misuse of terminal sedation which was specifically approved in 2003 by Dr. Saunders. It states that:

Abuse of sedation occurs when clinicians sedate patients approaching the end of life with the primary goal of hastening the patient's death. This has been called 'slow euthanasia' [Emphasis added].23

Byock has repeatedly praised the wonders of dying by withholding food and water:

"The cessation of eating and drinking is the dominant way that mammals die," said Dr. Ira Byock, director of palliative medicine at Dartmouth-Hitchcock Medical Center in New Hampshire. "It is a very gentle way that nature has provided for animals to leave this life."

Patients who are close to death don't get hungry or thirsty like healthy people, said Byock ....

"If you ask people who have stopped eating and drinking if they're hungry, they will say no," Byock said.24

Byock's spiel about the "wonders" of stopping eating and drinking and then dying, are repeated by thousands of hospice workers all over the country, even when the patient is demanding food and water and is being involuntarily killed! Byock's implementation of terminal sedation when it is not clinically indicated is a choice to end life.

Byock knowingly deceives others when he mentions what happens when a patient is actively dying,25how patients at that very end stage do not eat or drink — and then makes his students and the general public believe that the stopping of eating and drinking when the patient is not at the very end-stage and not actively dying, is the same thing. It is not the same thing at all and he knows it! In addition, there is a huge difference between those who are involuntarily terminally-sedated and those who actively wish to commit suicide in this way.

Dr. William Chavey, assistant professor of family medicine at the University of Michigan in Ann Arbor, has admitted that hospice "can be manipulated by people with other agendas. That could be family members or a nurse who believes it is compassionate to hasten the death of a terminally ill person."26 In the accounts of patient care that Byock shares, he never admits that hospice professionals might hasten death intentionally, yet he reveals that he is willing to sedate patients into death even if they have no physical pain or none of the clinically-required criteria — exactly what Saunders called "slow euthanasia."

The use of terminal sedation, under physicians like Byock, has deviated from the clinical requirement that it only be used to treat severe terminal agitation, psychosis, or intractable physical pain of various sorts, to treating many additional symptoms such as depression, feelings of meaninglessness at the end-of-life, not wishing to be a burden on family members, or not wishing to experience a loss of dignity or control by becoming dependent upon others.

Though Byock certainly does not appear to be practicing this slow euthanasia on all his patients, and makes a point that patients must agree and seek this form of hastened death willingly, thousands of other physicians and nurses in the hospice industry have taken his widely publicized and early lead as a "wink and a nod" to expand even further, to even routinely practice this slow euthanasia on their patients. Byock very clearly mentions this practice in his book, Dying Well, published almost twenty years ago!

We know that he has exerted tremendous influence through his leadership roles in the hospice industry and through his role in the training of generations of palliative care physicians. Innumerable and continuing reports about this practice — made by physicians, nurses, social workers and thousands of families who contact dozens of patient advocacy organizations around the country — confirm how widespread it is!

Though Smith is very much opposed to assisted-suicide, and the founder of secular bioethics, Arthur Caplan, is supposedly a "reluctant" supporter of assisted-suicide, the two joined together since they both are ardent supporters of today's modern, secular hospice and palliative care industry. They wrote a USA Today article27 addressing their concerns about the way the U.S. government sets up the Medicare hospice benefit. They quote Byock in support of their conclusion that patients facing a terminal illness should not have to give up curative care in order to benefit from hospice. Both support expanded utilization of hospice and palliative care by the public.

Yes, there certainly are serious problems with how the Congress set up the Medicare hospice benefit that can be summarized as a dilemma between offering patients the choice to "give up hope" and enter hospice, or the choice to continue curative care. It might actually be a good idea to allow terminally-ill patients access to curative treatments while receiving end-of-life care, but that would depend upon the character of that end-of-life care. Will it be pro-life or culture of death care?

Smith and Caplan praise the U.K.'s system where patients can enter hospice and still pursue another round of chemotherapy for cancer, for example — hoping that it might help. As if the U.K. has a better system than the U.S.'s healthcare system! We could spend hours discussing the egregious trampling of patients' rights through their infamous "National Health System" and the denial of care and especially the well-known scandal-ridden "Liverpool Care Pathway" that exactly mirrors Dr. Byock's preferred method for stealth euthanasia.28 It all sounds so great, until you understand the details!

The Liverpool Care Pathway was developed to support patients as they near death. But the reality for patients and families has been mixed.

The system, which can involve withdrawal of medication, food and fluids, was developed at the Royal Liverpool University Hospital and the city's Marie Curie Hospice in the 1990s to provide a model of best practice in the care of dying patients. [Emphasis added]29

Here we have absolute confirmation that the same type of stealth euthanasia has been practiced in hospice for decades! Smith never mentions this! Another article from the BBC has doctors in the U.K. finally admitting what families have been complaining about for years:

There are problems with a controversial regime that allows doctors to withdraw treatment in the last days of life, doctors have admitted.

Members of the British Medical Association said dying patients may have been put on the Liverpool Care Pathway when it was not appropriate because hospitals were offered financial incentives to use it.30

The article doesn't explain that in many hospitals in the U.K. as well as in the U.S. there are palliative care wings that provide the same type of care as independent hospice agencies. Also, notice that it says doctors are allowed to "withdraw treatment," but actually doctors order food and water to be withheld! Left unsaid? Obviously, the patients died untimely deaths! Also, the writer doesn't condemn the Liverpool Pathway of dehydration killing per se. They say that some were placed on this pathway to death due to consideration of hospitals' financial benefit. However, a leading physician in the U.K. states that:

  • The NHS kills off 130,000 elderly patients every year [Emphasis added],
  • doctors use 'death pathway' to euthanasia of the elderly,
  • treatment on average brings a patient to death in 33 hours,
  • around 29 per cent of patients that die in hospital are on controversial 'care pathway'31

Smith has elsewhere written to condemn the misuse of the Liverpool Care Pathway in the U.K., so it is odd that Smith chooses to praise the U.K.'s National Health Service. Are we to believe that if the "hospice reach" is expanded by allowing patients to access curative treatments while still in hospice, that these types of imposed deaths would not also occur in hospices in the United States? The evidence that they are already occurring here is overwhelming. Too many healthcare professionals and families have told us about patients that were involuntarily terminally-sedated! So much for the — in Byock's view — "ideal" scenarios he paints that, with supposed "safeguards," require the patient's permission and request for slow euthanasia.

The push that Byock and many other hospice leaders are creating to allow patients to access curative services and still be enrolled in hospice settings might be a step that would allow some to be cured and then be discharged from hospice. On the other hand, I believe the actual intent is to expand the reach of the hospice and palliative care industry to patients who are not expected to die within six months, but do access acute hospital care and therefore require extensive and costly services. This is "expanding hospice share."

Even if patients are nominally "allowed" curative procedures, by allowing the end-of-life care industry to enroll these patients, I believe many of them will actually end up dying sooner, just as is occurring in the United Kingdom. Are we really supposed to believe that the industry doesn't wish to gain market share to bolster their revenue stream, or believe that those looking to the federal budget do not wish to reduce expenditures by getting more patients into hospice and palliative care? Of course, making more money for the industry and reducing expenditures by government is the major impetus behind this push. If Smith believes this is all about the "good" of the individual patient, he is extremely naive!

Getting back to Byock, when it comes to the practice of slow euthanasia, Byock does not discuss the repercussions that affect other family members. Even if a patient requests and gives permission for slow euthanasia — which is a form of suicide when so requested — there are other family members who do not accept it, who are pierced with the evil act and are never the same again. Suicide of any sort, even Byock's "self-requested" slow euthanasia/suicide devastates many family members. I hear from these family members regularly!

I have a cousin whose daughter committed suicide several years ago and it affected the entire extended family and still does! It is a terribly evil act even if it appears as if the patient only goes to sleep. So do those famous cases we hear about regularly where someone drank alcohol and then took several medications or drugs and are found dead the next morning. These individuals also "slept" into death, and nobody pretends that it was anything but a suicide! Even when the patient suffers from a terminal illness, the untimeliness of the imposed death, the theft of life and time with others, is a loss that many do not accept at all, and must be condemned.

Individual autonomy, i.e., "permission," used by Byock to justify his act of slowly euthanizing willing patients, is the same autonomy that motivates them to commit suicide when they can. Autonomy is not the highest law in a moral world governed by divine law that tells each one of us: "You shall not murder!" ... even if it is your own life you take. Yet, individual autonomy is accorded the highest value in guiding such a decision if it justifies taking life, even one's own. Secular bioethics in theory and practice is without a doubt tilted in favor of intending death and against preserving life.

If we are to help protect the public, patient advocates and life-affirming bioethicists must be willing to ferret out the truth whatever it is and then share what is accurate about healthcare, including not only the truly wonderful, but also the unpalatable, the shocking, as well as the deceptive.

The public must be and can only be fully informed and forewarned when we make our best effort to provide all the facts. But when it comes to Byock, how can we understand such a man? Byock clearly appears to be sincere, but sincerity alone does not make a man's actions moral. He declares that he has no faith at all in the God of his people, has no regard for allowing God to choose a man's time of death, and denies that by terminally-sedating his patients, he even intends to hasten their death.

In January of this year, Byock even unequivocally stated, "In more than 35 years of practice I have never once had to kill a patient to alleviate the person's suffering."32 I guess language and definitions make all the difference, as Wesley Smith knows better than most,33 but Byock obviously does not consider death imposed through slow, stealth euthanasia to be a form of medical killing. Byock reveals his perspective on death,

Dying is the hardest, least desirable time in any of our lives. But it is possible to feel well within oneself and right with the world even as one dies. Therein lies hope for us all.34

That kind of hope leaves me completely disenchanted and empty. For those of us with faith, dying is not the hardest, least desirable time in our lives. The period in our lives when we did not know the dear Lord is the least desirable and darkest time in our lives! Byock suggests that we should find a way to feel "well within ourselves" and "right with the world." I ask, "What about getting right with and therefore feeling right with God?"

Those of us who know God within our lives have a better hope, a more trustworthy hope, and feel blessed within ourselves throughout our lives till death, even if we suffer from a terrible illness or disability, and even as we die! The inspiring Christian, Mark Pickup, who has suffered from Multiple Sclerosis for many years testifies to this better hope! He tells us that human life matters and that it should not be artificially ended!35

Byock cannot share what he admits he does not have: faith. He cannot offer God's love and forgiveness to his patients. He cannot point the way for them and share any good news that will last through eternity. Dr. Cicely Saunders certainly had more to share. She radiated the message of God's love.

Byock can lie to himself and others as long as he wishes about not killing any patients, but the truth remains about his practice of slow euthanasia. He describes it in detail in his book, Dying Well! Cicely Saunders certainly knew the difference!

Byock's Playbook for Slow Euthanasia

Byock does proudly give examples of how he interacts with his patients to implement this death protocol. I paraphrase how he describes his strategy:36 Byock to patient:

  • You must recognize that you have a terminal illness (X, Y, or Z), and therefore you are going to die soon.
  • You will undoubtedly die from either a major stroke, heart attack, pulmonary embolism, pneumonia, pulmonary edema or some other end-stage condition (fill in the blank) that is very likely to be distressful.
  • You will therefore suffer in dying that way [dying from the actual terminal illness].
  • Let me make a suggestion: Did you know that you can choose to stop eating and drinking? If you do, I can sedate you so that you remain comfortable throughout this process.
  • If you choose this method of dying, sedation into death, you will die peacefully and without pain. I promise you will not be in pain.
  • Think about it and I'll discuss this with you later.

Next visit, or whenever Byock determines it's the right time to use the respect he garners as a physician to give the patient permission to adopt this form of slow, stealth euthanasia:

  • Have you thought about what we discussed?
  • Are you ready now to go to sleep and end your life through terminal sedation?
  • You want to go ahead? OK, we'll begin. Again, I promise that I will not allow you to be in pain.

Notice the results: the physician (Byock) or nurse exploits their position of authority in the physician - patient relationship to first advise the patient that this type of slow euthanasia is not only permissible but moral and an encouraged intervention! What is a patient or family member to believe? "Dr. Byock says, "It's OK," so it must be right!"

When the patient agrees, the physician or nurse then administers medications that are kept up continuously, placing the patient in a permanent sleep — a medically-induced coma. Byock's friend, Timothy Quill, MD accurately explains what happens:

In this situation, the consenting patient is sedated to the point of unconsciousness in order to relieve otherwise untreatable pain and suffering and is then allowed to die of dehydration or other intervening complications ....

Unlike the use of high-dose opioids to relieve pain, with death as a possible but undesired side effect, terminal sedation inevitably causes death, which in many cases is what the patient desires. Although the overall goal of terminal sedation is to relieve otherwise uncontrollable suffering, life-prolonging therapies are withdrawn with the intent of hastening death {Emphasis added].37

Quill supports implementing this death protocol for any type of suffering, physical or otherwise, where the patient wishes to commit suicide and clearly understands that that is what is occurring. The "other intervening complications" of terminal sedation are organ and system failure that result from dehydration. In other words, the patient might die from the induced inadequate blood volume that then results in circulatory collapse, or from damage to the organs and systems resulting from the inadequate blood supply to those organs — all caused from the slow euthanasia Byock and others promote.

The patient doesn't die from the terminal illness if terminal sedation is applied to a patient who is not actively dying already! Dr. Quill makes it extremely clear that the intent is to hasten death, resulting in an imposed death, not a natural death at all, and, understanding that this is intentional ending of life, Quill supports it enthusiastically.

This is neither pure active euthanasia where you act to kill directly by administering a lethal dose, nor is it pure passive euthanasia where you only withhold something needed by the patient to live. This is one of the reasons it is confusing to many onlookers and why it is also rightly called a stealth euthanasia. To make it seem even more confusing, terminal sedation is also called palliative, permanent, or total sedation.

Byock doesn't suggest that he applies this strategy immediately or with every patient. He "magnanimously" allows the patient and family to have some time to do the traditional end-of-life work encouraged by Dr. Saunders or others and work on their "unfinished business" and have an opportunity to heal relationships. Yet, who determines when someone has completed this work, God or a mere man like Ira?

Byock's terminal sedation "playbook," which he described in detail in his book, Dying Well back in 1997, has most certainly been read by every hospice or palliative care physician in the country and has been developed and incorporated into palliative care "scripted dialogs" that are printed and available for all to use so they may influence and manipulate patients and their families.38

This is exactly the type of slow euthanasia recently passed by the lower house of the French parliament,39 and is expected to be approved and passed into law by their Senate in a few months. It's being called the "deep sleep" bill and would allow the legalization of terminal sedation into death by patient request, exactly what Byock approves and practices as he determines according to his "great wisdom." Many in France recognize that this is a form of euthanasia, but Ira seemingly doesn't understand this! Really?

Byock's strategy for ending life would never even be considered or suggested to any patient in a pro-life setting! Yet, we have repeatedly heard about the use of this form of stealth euthanasia even in nominally faith-based hospices or hospitals. That is no surprise since most hospice agencies are members of the only large industry trade organization, the National Hospice & Palliative Care Organization ("NHPCO") which has long been led by those who were past members of the Euthanasia Society of America's earlier successor organization. And yes, this is the NHPCO that is so brazen as to actually brag about currently being the Euthanasia Society's successor organization.40

Recently, many hospice agencies have actually been required to submit proof that they are a member of the NHPCO in order to become an approved hospice provider for the "Advanced Illness" programs and to be reimbursed by the government approved insurance companies! Just think about those few pro-life administrators of hospices that remain and imagine how they feel about being required to join what is the current covert form of the Euthanasia Society of America!

The NHPCO offers many opportunities for hospice and palliative care professionals to attend conferences, to network, to call for advice, to purchase training materials for the hospice administrators, nursing supervisors and their staff, and more — all of it created with the worldview that is informed by secular humanism — never reverence for life. All of these materials are designed to indoctrinate hospice leaders and staff to spread the secular way of practicing, secular bioethics, and allows for hastened deaths through slow euthanasia, though they always publicly deny this.

Hospice and palliative care administrators working in line with the NHPCO's status as the successor organization to the Euthanasia Society of America (the corporate history is clear), naturally control their employees' environment, and therefore, can choose to only employ those who support the secular humanist vision of the mission. They will train new employees to think a certain way, act a certain way, and believe a certain way, contrary to the former Judeo-Christian worldview. Employees become "true believers" in the secular mission and are often found to be extremely offended if you question what they do, just as a religious fanatic will become outraged if you insult aspects of their belief system.

In addition to controlling the environment of employees, they control the information that surrounds them at work, at conferences, and in training materials they are to study at work and at home. The most common elements of a cult are in place: control of the environment, the information, and the ideology (secular humanism). Terms are re-defined, principles of ethics are re-defined, and the mission is re-defined. Peer pressure is used to assure the adherence to the secular humanist point of view and manner of practice.

A "holier than thou" attitude is commonly demonstrated; these practitioners believe they are doing "sacred work" when they hasten death, and intolerance for any other view is evident. Any employee who questions the secular humanist worldview and affirms a sanctity of life ethic is ridiculed, harassed, and forced out so the work environment is maintained in its evil "purity." A similar intolerance by those who share such secular humanist dogmas has been demonstrated on many college campuses around the country: students who simply stand with pro-life signs have had their signs ripped from their hands and stomped upon by these "neutral," "unbiased," "impartial" zealots.

Those healthcare professionals who work in this way, with this worldview, assert that they are "objective," "fair," "impartial," ethically "neutral," and that they do not impose anything upon any others. Yet, they do not tolerate opposing views and shout down those who disagree with them. Secular humanism and its secular bioethics is not only another type of "faith" with its own dogma and ethical bias, it is intolerant in ways that the authentically faithful Jewish or Christian believers could never be.

They actually condemn the beliefs of those of faith and seek to make others celebrate and affirm their worldview, sometimes even criminalizing those who believe in a way that challenges their view. For example, a physician who refused to perform an abortion or assisted-suicide (where legal), or refused to refer to others who are willing to do so, is viewed as having acted "unethically" and is targeted.

There is a movement to deny medical conscience rights so all healthcare professionals are forced to actively participate in, or cooperate with, the culture of death. If they refuse, many argue that these medical professionals should forfeit their license to practice and with it their careers. In other words, those who disobey the supposedly "ethically neutral" dictates of this secular humanist and mostly socialist crowd are to be destroyed!

The zealots who support their asserted "right" to have medical professionals kill them (or others deemed to have a "poor quality of life"), insist that medical professionals be forced to do so. They often lie and accuse their opponents of "cruelly forcing individuals to suffer" if they oppose legalization of assisted-suicide or euthanasia.

Of course, it is absolutely right to relieve the pain of those who are approaching death (Proverbs 31:6-7)! But, it is not right to end their lives by your own hand, however slow or deceptive the means used may be! It is God who appoints our time of death, even if Byock mocks what he calls "conservative, pro-lifers" who believe this. Byock styles himself as a "progressive" pro-lifer who is more "enlightened!"

Contrary to Byock's willingness to hasten death, we have a duty to live and to allow others to live. Whether we are a caregiver or a patient, we have a purpose to fulfill until that time comes. We may not understand the purpose at all times, but He does! What use He will make of us, what He can teach us in our very last days (that Byock shortens with some patients), and how it may affect some of those who remain is for those others to experience for themselves.

The psalmist reverently speaks to the Creator, giving Him praise:

Your eyes saw my unformed substance;
in Your book were written, every one of them,
the days that were formed for me,
when as yet there was none of them. - Psalm 139:16

God does have a plan for us and none of us know what any new day may hold for us, even if we suffer from a terrible, terminal illness and are living our very last days. But Ira, like hundreds of other secular humanist physicians, cares little for the scripture or for God's will in the matter.

And the Lord commanded us to do all these statutes,
to fear the Lord our God, for our good always,
that he might preserve us alive, as it is at this day [Emphasis added].
And it shall be our righteousness, if we observe to do
all these commandments before the Lord our God,
as he hath commanded us. - Deuteronomy 6:24-25

God gave us His law through Moses, the prophets, and the dear Lord Jesus in order to assure the well-being of all people, so that we may live well until He takes us. He has told us how to live and die well, but Byock suggests that he knows better! Byock doesn't care about the divine law. For years he has been ready with the same deceptive charade responding to those who question him, saying, I don't practice euthanasia or assisted-suicide! I am against them. They are terribly wrong, he says, and facilely lists the reasons why they are wrong.

Byock never qualifies his answer to honestly and fully explain his actual position. What Ira should say is that he doesn't support active direct euthanasia or assisted-suicide, but does favor stealth or undeclared euthanasia through terminal sedation for some of his patients even when they are not actively dying and do not need sedation.

His oft-repeated line is that it is much better for patients to die in hospice and palliative care settings so they can get excellent end-of-life care — defined as a "progressive," secular humanist would define it. Once clinically-inappropriate terminal sedation that imposes death has been re-defined as not killing — and that is what he teaches others — he can deny that he has ever killed any patient. Following his lead, any end-of-life care professional can then provide it!

Without a doubt, however, those patients he sedates into death would have died later, even much later, if they had not been terminally-sedated to death by Byock and the thousands of other physicians and nurses that have followed in his footsteps. Nobody knows how much longer they may have lived!41

That his patients may have agreed to it does not make it moral, even if secular bioethicists have approved this practice based upon their interpretation of the principle, "patient autonomy" or "respect for persons." This secular principle42 is not the same thing as respect for life! Any individual like Byock who says they are "pro-life," yet is willing to hasten death through slow euthanasia based upon this secular principle, is obviously not pro-life!

It is not necessary for me or anyone to raise all the arguments that condemn what Byock has done to subvert hospice and palliative care. Dr. Saunders expressly condemned this practice. Byock himself has quite clearly expressed, even from a secular humanist point of view, some good reasons why medical killing, i.e., assisted-suicide and/or euthanasia (either direct or slow) is wrong. When addressing medical students, Byock tells them:

Alleviating suffering and eliminating the sufferer are very different acts....

Doctors need to understand these distinctions. There are no clinical or ethical restrictions to alleviating pain when someone is dying. The established ethical principle of double effect allows for an unintended harm — including a person's death — to occur while striving toward a good....

Even if society deems it legal — for purposes of criminal liability and life insurance — for dying people to commit suicide, the medical profession believes — as I do — that intentionally ending a person's life is beyond the scope of medicine....

"Whether you are in favor of legalizing physician-assisted suicide or not — and whether assisting suicide is legal where you practice or not — let's not allow our profession to become society's answer to suffering and the high costs of dying.43

Byock doesn't see that he is condemning his own practice! It is becoming increasingly clear that this profession is becoming "society's answer to suffering and the high costs of dying." Even as he warns others about euthanasia or assisted-suicide, Ira continues to eliminate some sufferers when he "alleviates their suffering!"

In addition, he mis-applies the law of double-effect44 when he fails to mention that the law of double-effect also states that a worthy and moral goal cannot be achieved through evil means! He also deceives the public when he states that the death of a patient who is terminally sedated into death is "unintended!" He certainly intends death to occur due to his interventions and not due to the patient's terminal illness, so his goal is wrong and the means he uses are wrong. He's simply not honest about what he is doing and seeks to hide behind a charade of ethical "reasoning."

Byock has no idea what could have been, or what God may have done with those patients he sedated into death, had the patient been allowed to live longer. But, he doesn't believe in those things. He is not concerned about the days not lived. Byock and those who mirror his end-of-life care practice are pretenders who have clothed themselves in the glorious Christian mission that Dr. Cicely Saunders brought us!

Following the example of Dr. Saunders only in some respects, Byock does emphasize humanizing the dying process, being with the patient, really addressing the complex needs of the patient on many levels and so much more. To the untrained ear, it sounds very right, even impressive! These are qualities that reflect what can be best about hospice and palliative care, but how long is one supposed to provide these humanizing services? Many ask, "Why not just end it all?" Dr. Saunders said that we should provide services that respect life for however long it takes! She said to her patients,

You matter because you are you, and you matter to the end of your life.
We will do all we can not only to help you die peacefully, but also to live until you die45

She never told a patient, "I will help you to die" or "I will shorten the days you have till you die," but she did tell them in so many ways, "I will help you to live well until you die! Her work was about helping people who were still here and caring for them. Death comes of its own accord.

Byock is like someone who pours black dye into the refreshing, clear waters of a beautiful swimming pool, making all the water so dark that you can't see anything inside it. Then he throws just one small shark in the water and asks you to jump in while telling you, "Trust me! Don't worry, there are no big sharks in the water! He never tells you about the "itty bitty shark" that still kills you. Of course, it is a "beneficent" shark and will only bite you for your own good, i.e., actually, the "good of society!" And maybe if you're lucky, you won't be the one bitten when several jump in for a swim.

Byock's recommendations for change in the end-of-life care industry are the same as Wesley Smith's46 and do not focus on reforming hospice agencies themselves at all. They mainly fall into the position: We need more healthcare professionals trained in hospice and palliative care so those nearing the end-of-life can avoid acute hospital care and be properly cared for. When these are provided, patients won't need or request assisted-suicide.... Well, I would agree if such care were defined and provided to patients as Dr. Saunders practiced it!

Much, but not all, of what Byock describes in his writings — taken from the work of Dr. Saunders — actually is a step forward compared to the inadequate care that existed before Saunders' work. In his 2004 book, The Four Things That Matter Most - A Book About Living,47 Byock mentions the possibility of healing relationships at the end-of-life. This is in line with and following the example and teaching of Dr. Cicely Saunders. However, he suggests that the four most important things to help heal our relationships with our loved ones before death arrives are to have the patient learn to say to others:

  • Please forgive me.
  • I forgive you.
  • Thank you.
  • I love you.

Some good advice and moving stories are shared. Many have adopted his system using these four things as a part of the secular hospice industry's own form of "spirituality" in order to counsel patients at the end-of-life. Aside from the inadequacy of such a hospice industry "spirituality" that is very much a "reality" being offered to patients, I cannot accept Byock's assertion that these are the four things that matter most.

We cannot have a truly healthy relationship with others without first establishing a healthy relationship with God. That "vertical" relationship which we experience as reverence held by an individual for God, the "I" to "Thou" relationship, with unconditional love permeating all of it, is essential to everything that follows if healthy human relationships and society are to flourish. This is why the first of the Ten Commandments starts with:

I am the LORD your God,
who brought you out of the land of Egypt,
out of the house of slavery.
You shall have no other gods before Me. - Exodus 20:1

God is making man aware of God. He reminds us how awesome He is! In other words, God is the One who matters most! Byock can't even begin to go down this road with his patients. Even if healthcare professionals do not preach about their faith, if they radiate that faith, patients understand and there is a communication and connection blessed by the Holy Spirit.

God is the One who can heal our relationships. When we choose to make Him central in our lives, not just as a concept, but as One we actually relate to with every breath we take, all the rest falls into its rightful place. We don't assign greater importance to anything or anyone.

It is the very loss of this central relationship that makes us look outward for fulfillment and causes the damaged relationships to arise in the first place. Only after this central relationship is cultivated with great care and reverence can our relationships be not only as He intended them to be, but as we would wish them to be if we are in the right frame of mind — truly rational and truly sane. This is the key to the ultimate healing of relationships on every level.

Byock can't voice anything about God, because for his entire life he has continuously expressly rejected God and chosen his defiant, "progressive," secular humanist approach to everything in life. No matter how much of a "feel good," +"I'm OK, You're OK," "Everything is wonderful if we only do this or that" advice he shares, so long as he pushes God away, he will always continue to widely miss the mark.

Decade after decade Byock has not varied from the goal he set for the industry from the very beginning when he started working with Karen Orloff Kaplan and others of the Euthanasia Society. When he was a leader of the current form of the Euthanasia Society (Partnership for Caring),48 he and Kaplan chose to make the following interesting statement regarding assisted-suicide:

Partnership for Caring will not join the debate about physician-assisted suicide and will take no position for or against its legalization because to do so would divert energy and attention from Partnership for Caring's mission to eliminate the suffering of dying Americans."49

When we try to understand what Byock and Kaplan had in mind, it would be good to ask ourselves, How exactly did these leaders of the current form of the Euthanasia Society plan on "eliminating the suffering of dying Americans?" Would it be too hard to believe that assisted-suicide, direct euthanasia, covert/slow euthanasia, or other stealth euthanasia methods might be the eventual methods they hoped to popularize? Would that be too hard to believe when we consider what the goals of the Euthanasia Society might have been at that time? Is there any reason to believe the goals have changed?

If there is any doubt in anyone's mind about what Byock, Kaplan and others were up to, in 1989, Choice in Dying, earlier called "Society for the Right to Die," convened a panel of 12 physicians who wrote an article, "The Physician's Responsibility toward Hopelessly Ill Patients,"50 supporting the legalization of assisted-suicide and euthanasia — the exact opposite of the organization's public stance in 2000! Doublespeak and conscious deception have been routine with this crowd for decades!

Interesting again to note that Ronald Cranford, MD, a neurologist and co-author of this very journal article, was one of the main physicians relied upon by euthanasia attorney George Felos and Michael Schiavo to support imposing death upon the disabled victim, Terri Schiavo.51 at the hospice run by Byock's friend and fellow Partnership for Caring board member, Mary Labyak.

We have to realize that when he and Kaplan re-named Choice in Dying as Partnership for Caring, he had already been practicing in end-of-life care for almost twenty years! He knew what he was doing then. He knew who they were and joined the current form of the Euthanasia Society of America in its efforts! If there were any twinges of conscience warning him away, he did the opposite.

Byock doesn't talk much today about his choice to align himself for many years with the Euthanasia Society. While he does not talk about his membership and leadership role in Choice in Dying, Partnership for Caring and Last Acts Partnership, his basic goal remains the same. Ione Whitlock of Belbury Review52 and Elizabeth Wickham, PhD of Lifetree.org have given us detailed charts and timelines53 showing the behind-the-scenes connections that have formed the foundation for the current culture of death. Smith knows more about this than most people in pro-life advocacy!

Who were just a few of Byock's major decades-long partners in the subverting of hospice and palliative care?

  • the late Mary Labyak, MSW, CEO of the Hospice of the Florida Suncoast (Last Acts Rallying Points center) that executed Terri Schiavo, a founding board member of his Partnership for Caring (Euth Soc of America); served several years as board member and Chair (1994) of the National Hospice & Palliative Care Organization

  • Timothy Quill, MD, palliative care physician who openly supports assisted-suicide and euthanasia;54, co-authored with Byock the article, "Responding to Intractable Terminal Suffering: The Role of Terminal Sedation and Voluntary Refusal of Food and Fluids,"55 promoting terminal sedation into death of patient who did not have terminal agitation, psychosis or intractable physical pain; wrote a medical journal article detailing how he illegally assisted a patient's suicide in New York State56

  • Karen Orloff Kaplan, MPH., ScD., Exec Dir of Choice in Dying (Euthanasia Soc of America), CEO of Partnership for Caring, Pres and CEO of Last Acts Partnership which was absorbed into the National Hospice & Palliative Care Organization as its Caring Connections Program; Byock chose Kaplan as a major partner in the work when he formed Partnership for Caring; Kaplan wrote Staying in Charge: Practical Plans for the End of Your Life where she devotes an entire chapter to assisted-suicide.

  • Donald J. Schumacher, Psy.D, Pres and CEO since 2002 of the National Hospice & Palliative Care Organization, another board member of Partnership for Caring (Euth Soc of America)

  • Myra Christopher, former director Midwest Bioethics Center/Center for Practical Bioethics [secular bioethics]

  • Diane Meier, MD, Director of the Center to Advance Palliative Care; former board member of Choice in Dying (Euth Society of America) as well as Natl Hospice & Palliative Care Organization and many others]

After the jury declined to indict Byock's friend, Timothy Quill, for the crime he admitted to doing, "assisting" a suicide, Quill told the public that,

he had learned from scores of accounts that his story was "the tip of an iceberg." Doctors, he said, have told him how they have taken similar action in secret and have been reluctant to discuss it, even privately [Emphasis added].57

There are others who are quite open and more honest than Byock about their end goals: Rodney Symes, MD, former long-term president of Dying with Dignity Victoria in Australia specifically justifies the use of terminal sedation for the purpose of ending life, based upon the secular principle of "patient autonomy" — the same principle Byock cites when he agrees with a patient to terminally-sedate him into death! Dr. Symes is just one more example among hundreds who encourage its use until direct active euthanasia is legalized.58

Dr. Symes takes the same approach as the pro-euthanasia organization Compassion & Choices in the U.S. Nancy Valko, RN, spokeswoman for the National Association of Pro-life Nurses, asked 7 years ago, "Is Palliative Sedation Becoming Another Form of Euthanasia?" She and so many others have seen that in many cases it is!59

On the other hand, Byock never mentions overdosing patients with opioids like morphine intentionally, and I can choose to take him at his word, but as the physicians mentioned by Quill admitted, there are many physicians (and nurses) who have secretly killed patients! In end-of-life care, as in many niches of healthcare, healthcare professionals deal with life and death on a daily basis. They have powerful tools -- medications and other treatment modalities -- that can heal or can harm. For that reason, there are standards of care to prevent patient harm. What happens when the original standards are re-written to allow harm or basic Judeo-Christian morality has been thrown to the wind?

In the end-of-life care setting, we work with opioids, some of the most lethal and at the same time beneficial pain-relieving medications known to man. In the early days of modern hospice, Dr. Saunders worked with diamorphine to relieve extreme pain and had great success. We know it as heroin! Heroin is derived from morphine and once absorbed into the body, it is re-formed back into morphine.60

Everybody knows that heroin can kill, but very few understand that it is morphine in the body, from the heroin taken, that kills. Used properly for pain relief with appropriate dosages calculated, both can equally be used to treat pain very well or to kill. Thousands of hospice staff have been trained to tell patients, "morphine cannot kill." That is an absolutely preposterous statement! So, nurses are encouraged to believe that this powerful medication cannot harm their patients and are trained to use it liberally, always believing in its "beneficent" effect.

The "lay of the land" in end-of-life care is becoming clearer now: Quill is willing to assist suicides even when illegal. Byock does slow euthanasia while protesting that he has never killed a single patient. After the execution of the cognitively-disabled victim of a likely choke-hold attack and violent altercation, Terri Schiavo, the National Hospice & Palliative Care Organization members later gave Mary Labyak a standing ovation when she walked into the NHPCO's conference! Some might wonder if any of these people have a conscience at all, but they do. They just don't listen to it and have chosen to accept utilitarian secular bioethics as their guide.

Smith glowingly cites this same National Hospice & Palliative Care Organization but in all his articles and books never mentions their history or their slant. He does not differentiate between the original organization and its character after the euthanasia activists took it over! Smith quotes the NHPCO in his article, "Liverpool Care Pathway: The Road to Backdoor Euthanasia. In their public position statement, they state:"61

The National Hospice and Palliative Care Organization supports the application of palliative sedation in "rare" cases for "the limited number of imminently dying patients who have pain and suffering that is (a) unresponsive to other palliative interventions less suppressive of consciousness and (b) intolerable."

Here, we see the term, "palliative sedation" used for sedation applied when the patient is actively dying and extremely distressing symptoms require the addition of sedation to relieve the patient's extreme symptoms. This "palliative sedation" is the same thing as "terminal sedation," also called total sedation or permanent sedation.

If Smith believes that palliative sedation or terminal sedation are rarely applied, or that the NHPCO hospice agency members only rarely use this protocol, he is living in a dream world! There are some NHPCO member hospice agencies where every patient is sedated deeply into death, and there are a few where it is used occasionally. Those that are closer in practice to Dame Cicely Saunders will use it rarely, but many hospices in the United States no longer follow her example.

Smith asserts that there is a very clear difference between "palliative" sedation and "terminal" sedation. Smith condemns "terminal" sedation which — as he uses the term — involves the intention to end life, but has implied in several articles that it's not really happening in palliative or hospice settings. He goes on to promote the use of "palliative" sedation as a legitimate medical intervention while calling "terminal" sedation illegitimate and says that is not even a "medical" intervention.

This is a real misunderstanding of what is going on, because terminal sedation is appropriate when the patient has the clinical criteria that require its application, i.e., actual terminal agitation, psychosis, delirium or truly intractable extreme physical pain that cannot be resolved with any other intervention. This type of sedation (whatever you call it) is kept up continuously till death only because the patient has symptoms that continue and often get even worse as time goes by.

To avoid confusion, we should also understand that palliative sedation may be used with a different sense to simply mean sedation that is not permanent at all. You might just call it sedation with the intent to relieve suffering, and it is not used only to relieve pain that is difficult to handle with pain-relieving medications! There are several reasons it might be used appropriately.

In any case, it is truly incomprehensible that on one hand, Smith gives Dr. Byock the highest praise, yet condemns the practice of the terminal sedation that Dr. Byock most definitely uses to end life when the patient has agreed to go through with it and requested it.

Hospice, or palliative care settings in hospitals, nursing homes and other facilities, is where it's almost exclusively being done! In fact, hospitals and nursing homes specifically move patients into hospice or palliative care settings so that their death rates are lowered statistically. "The patient didn't die in the acute care or nursing home setting." "We have improved the quality of care we provide! We have lowered our death rates significantly!" Yet, the patients die just the same. It's statistical hocus pocus and a shell game!

What Smith needs to realize is that these terms have been used in different ways by different practitioners at different times in history. If you read many different journal articles, the usage is clearly seen to change according to the times and the author involved.

If sedation is no longer needed, in an ethical end-of-life care setting, it is stopped, just as pain medication levels that are not needed can be reduced according to the new clinical status of the patient. However, in many cases, if sedation is needed, it is often needed throughout the time the patient is cared for in the end-of-life setting. This can be understood by realizing that the patient's symptoms arise from the underlying disease process which doesn't change. The symptoms the patient experiences are therefore often progressive changes arising from that same end-stage illness.

The only really important question is whether or not the practitioner is following the standards of care that Saunders and others like her have established so that the intervention fits the actual clinical needs of the patient! If that is the case, sedation of any sort is not going to be misused and can be very helpful for those needing it. It is the education and inner conscience of the practitioner that will determine how these medical interventions are implemented so that the healthcare professional gets it right.

We know that getting it right has to do with actually following our conscience to do the right thing in this world, to live in such a way that good is done as a result of our actions. That good is never intentionally ending the lives of our patients by any means, but too many in healthcare don't accept this most basic rule! Getting it right is something we begin to learn from the moment we are born, and hopefully from being raised by parents or from being taught by others not to harm others and not to murder.

Getting it right involves listening to the inner voice of conscience so that we choose means to our goals that are considered right within as well as considered moral by God's law.62

Getting it right has to do with humbly bowing before the dear Lord of all Creation, and having that humility before Him from the beginning of our day till we lay down to go to sleep. Getting it right requires us to acknowledge we do not have the right to determine the timing of our patients' deaths — and telling our patients that we cannot and will not kill them by any means!

Byock tells some of his patients that he can and that he will! He tells them he's just going to sedate them and keep them comfortable till they die. They both understand it's really about ending the life of the patient, though Byock will apparently deny this for the rest of his life!

Getting it right means that we continue to provide basic care including food and water in end-of-life care settings so long as these are truly helpful — so long as the patient's body can absorb and metabolize them. Getting it right has to do with reverence permeating our hearts. This reverence arises from the outpouring of grace from the dear Lord's Holy Spirit. Secular humanistic "respect for the individual patient's autonomy" is conditional. It has nothing in common with how the dear Lord wishes us to care for others.

If we don't have the complete facts and a proper understanding of the issues involved in "doing what is right," or the circumstances, our conscience is not capable of guiding us to the right. If we think (as Byock does) that dying naturally from a terminal illness (with best efforts at relieving pain) is the moral equivalent of dying from imposed terminal sedation with its consequent fatal dehydration, there is something really wrong with our reason as well as our conscience!

Because the blind have led the blind, hospice and end-of-life care practice has fallen into the abyss of imposing deaths through too many means. Contrary to Smith, the industry has already slipped down the slope! Byock and his friends have through decades of effort "pushed it off the cliff!" When the blind lead the blind, neither leader nor the led realize the true extent of the harm that they have done (Luke 23:24)! Hundreds of staff are neither properly informed nor clear sighted.

Aside from being properly informed, philosophers speak of the need to have a properly formed conscience, a process that usually starts from early childhood and never really ends, as all of us are meant to grow throughout our lives, even up to the very moment of death. A properly formed conscience helps us to choose acts that reflect God's will and His divine law!

A properly formed conscience recognizes when grave wrong is being contemplated. That properly formed and informed conscience is that "something inside us," a practical application of our intellect, that is strongly aroused to prevent one from actually going ahead with such an action. As the habit of acting morally is strengthened, immoral acts such as medically killing our patients are perceived as repulsive and evil.

However, a childhood and education that combine to instill secular humanist ways of viewing the world, distort the conscience and misinform it so that evil is thought to be good, and good is thought to be evil! Byock was raised and educated in this way. This is how he can believe he is doing good when he ends the lives of some patients through slow euthanasia. The prophet Isaiah said, "Woe to them that call evil good, and good evil ...." (Isaiah 5:20). Modern man's nature has not changed at all since that time so long ago.

To avoid doing evil acts, not only do we need to be properly educated and informed, and to have a properly formed conscience, we need to have our "wits" about us to be able to hear this inner guiding voice of conscience, so anything that dulls our ability to think clearly, like drugs, alcohol, or any other addicting agents, or distractions through which we "lose ourselves," are to be avoided by those who wish to live an ethical life that affirms the divine law. Such a clear headed approach is essential to anyone who serves in a healthcare setting!

Our reason and our faith work together to prevent us from doing that wrong. Absorbing the lessons of scripture is a way to nourish not only our mind, but our conscience and our spiritual heart. Studying the authentic teachings of someone like Cicely Saunders would go a long way to restore a proper understanding of end-of-life care as well as what is permissible and what is not.

Without right reason and the education that arises from a culture of life, we might believe that if we simply "feel" it's ok to do something, that it actually is acceptable. In our narcissistic age, we become our own lawgivers and our own idol, placing ourselves in God's place! To prevent end-of-life caregivers from following a faulty path, Saunders spent decades writing on hundreds of topics.

Unfortunately, with our narcissistic focus on self, we forget the message she shared for so long. We forget the example the dear Lord Jesus brought to us: sacrificial love, embracing suffering that cannot be avoided while relieving the suffering of others as best we can, and knowing that life has a greater and sacred purpose blessed by God. With our focus on self, we want to endlessly increase the years of our lives and its pleasures while eliminating any suffering, and when we see that these can no longer be accomplished, we seek to end it all on our terms through euthanasia, assisted-suicide, or the various forms of stealth euthanasia.

Patients in hospice who warm to Byock's seductive offer to be sedated into death are never following the Way Jesus showed, are violating the divine law given through Moses, and even in their dying moment are rebelling against God. Patients need not endure avoidable pain; we who work in healthcare and palliative care have expert interventions to relieve that pain, and Byock repeatedly affirms that this is the case. When pain is not properly managed, it may be due to the lack of expertise of the physician or staff, or there is a lack of willingness to pay for an intervention that would actually relieve that pain.

To kill ourselves by our own hand, or the hand we call to do it, is a sin, even though this is a concept that all secular humanists reject and don't even begin to relate to.

Without faith in the God who has created all of us, it is impossible for one to be humble enough to hear good advice from those who have our best interests at heart and then come to the right conclusion about how to treat patients at the end-of-life or at any stage of life.

The faith that inspired Abraham, Isaac, and Jacob — the faith that was communicated to us later by the dear Lord Jesus — calls for us to strive to practice virtuous behavior that is a true blessing to others as well as ourselves, allowing us to become and be what He would have us be — helping us to follow His example and call to serve rightly.

Mother Teresa of Calcutta didn't have to preach to those she cared for. She demonstrated and lived Christ's love in action — mercy — communicating His universal love to all, even the homeless and penniless, those with leprosy, AIDS, other terrible diseases, and those nearing death. Cicely Saunders also took in the same. Saunders mission was to demonstrate Christ's love to everyone she cared for!

Mercy in action, prudence, justice, fortitude, purity, and temperance are virtues that help us to live lives that are truly better lives, that are in line with God's will and not just human will. Caregivers and healthcare professionals would do well to aspire to embrace these ways of interacting with others. Years ago, nurses and physicians were taught about these things, but that was then. Byock never mentions these. He doesn't know what they are. The secular humanism he embraced and has spread in end-of-life care settings now rules most of the industry. A concept like purity will only evoke a bewildered look or open derision!

If we choose to live and act in line with these virtues, submitting ourselves to His will, it is then that we will find true happiness, which is ultimately found in our reverential relationship with the dear Lord (Proverbs 9-10). With that relationship as our foundation, our eyes are opened and we see the world in a very different light. We see our patients and patient care in a different light! We reason from truth to truth, not deception to deception.

Nazis used logic to achieve many of their goals, however evil they were. They thought they were acting rationally and virtuously. If we think there was something wrong with what the Nazis thought and did, then there must have been something wrong with their predominantly secular and materialistic worldview. They thought it was fine to kill the chronically-ill, disabled, terminally-ill, and cognitively disabled, in addition to the well-known ethnically-motivated genocides they perpetrated.

Our secular humanist physicians, attorneys and deep thinkers condemn the Nazis only because of the genocide they committed, but follow in their footsteps when it comes to the perfecting of ways to kill the vulnerable that they consider "lives unworthy of life."63

Today's secular humanists believe it is right to end the lives (one way or another) of those same types of patients who use up what they believe to be scarce medical resources and whose quality of life is determined to be unacceptable. Yes, it makes sense at some point for patients to stop cycling in and out of the acute care hospital if it really doesn't help the patient, and then be cared for in a loving, life-affirming hospice or palliative care environment. Yet, that is not the same as choosing to hasten death in secular hospices like the one run by Byock's late friend, Mary Labyak or ending the lives of patients like Terri Schiavo, wherever they are, simply because they are cognitively disabled.

There is a consistent message throughout the Old and New Testaments that implores us to not be led astray by those who would deceive us. We are to allow God's laws to be written upon our hearts and to treasure them with everything we are (Psalm 119:24-28)! We must remember that the dear Lord Jesus said, "Go, and sin no more! (John 5:14; 8:11)" He forgave and chose not to condemn the individual, but did condemn the sin, thereby confirming that some acts truly are intrinsically wrong.

It is not necessary for Byock or any other to consciously seek to deceive others for them to lead others astray. They may in fact, like Byock, be gravely mistaken about the mission! However, there are others who willfully deceive the public (John 9). There are wolves in sheep's clothing who seek to kill the sheep (Matthew 10:16).

A shepherd will leave his flock to go after a lost sheep, but when he sees someone leading away the entire flock of sheep, he will run after them and defend them with all his might, even risking his life to save them (John 10)! Byock and his co-conspirators have been so convinced they are right, and have no doubts about it. They planned how to accomplish all of this and have led almost all of end-of-life care astray. Now, they're aiming at the entire healthcare industry! Smith would have all the sheep enter the wolves' dens without giving any words of caution! We who know the realities cannot allow that to happen.

I realize that many are unaware of all of these things and admire the "progressive" Ira Byock who supports medical killing of embryonic and fetal human beings but opposes assisted-suicide. I also realize there are many who admire Wesley Smith who supports the hospice industry without qualification, including the covert euthanasia activist Ira Byock while opposing both abortion and assisted-suicide. However, I and others who know the truth about hospice and palliative care must not remain silent when the public is being misled by both of them, in different ways, no matter how praiseworthy much of what each of them have accomplished may be.

Elizabeth Wickham, PhD, Ione Whitlock, and others have explained what, how, and why Ira Byock and his buddies have done what they have done to the end-of-life care industry and healthcare in general. Smith not only fails to explain how the covert euthanasia movement intentionally and successfully infiltrated much of hospice and palliative care, he denies it exists within the industry.

I encourage anyone to actually read through the many references given here, and Byock's own books, and then see what is accurate or not! There is a call and there is a counterfeit. Byock supports quick medical killing for those yet to be born and slow medical killing for those who agree to be terminally-sedated into death. This is the type of "pro-life" position he takes.

If the culture of life is not restored, Byock's opposition to legalization of assisted-suicide, along with the opposition of all the pro-life groups and individuals, will be fruitless! When the people are thoroughly indoctrinated into a secular humanistic worldview, they will think nothing of taking their own life for various reasons, killing their unborn child, killing the elderly, the severely disabled, as well as the chronically ill, among others. Focusing on defeating a proposed bill that would legalize assisted-suicide in any one state, while necessary, can never solve the problem.

Those euthanasia zealots who gave up the effort to legalize euthanasia in the short term realized that they had to change the thinking of the entire population, and that is what they have to a great extent accomplished. Due to their efforts, today, many support the legalization of assisted-suicide. Many others support the imposition of death upon patients within end-of-life care settings. Either way, the euthanasia movement is gaining ground among many, and is gradually achieving legalization of assisted-suicide state by state.

In a free society that values human life nobody will ask for an abortion, and there will be no abortion clinics. If the people do not desire to be medically killed, they won't support legalization of medical killing of any sort. However, what is sorely needed is the restoration of sanity to the members of our society. Until that day comes, we must share the truth and provide the information people need to understand how they are being manipulated into thinking in a way that eventually will result in harm and even an imposed death for any one of us.

It is necessary to understand the reality of hospice and palliative care — the bad as well as the assumed good — as well as healthcare in general. It is necessary to understand that most healthcare professionals have adopted a secular humanistic worldview, so they view society, healthcare, and the patients in a way very different way than how someone with faith views these. They therefore make decisions based on completely different principles and act in ways that would never be chosen by those of faith and who respect human life.

We need to understand how these secular bioethical principles completely contradict the divine law known to us as the Ten Commandments — especially, "You shall not murder!" Yet understanding their secular principles of death in itself is not enough to protect the vulnerable. We need to act, to create healthcare facilities that serve as safe havens for those in need where truly pro-life principles guide all decision-making. Any supposedly "pro-life" hospice or palliative care position that promotes slow euthanasia, as Dr. Byock has done for decades, is a counterfeit and must be exposed for what it is, and never endorsed without qualification!

Enemies of Cicely Saunders' mission either entered hospice directly or worked relentlessly to subvert the mission. Those who have contact with the staff have indoctrinated them and together they have been wreaking havoc in the lives of patients, families, and staff in many parts of the country, all while pretending to be doing the inspired work that Dr. Saunders brought to the world.

Dr. Ira Byock, MD and his friends: Mary Labyak, MSW; Karen Orloff Kaplan, MPH, ScD; and Donald Schumacher, PsyD, all former board members of Partnership for Caring (successor organization to Choice in Dying/Euthanasia Society of America) — and some other players in the covert euthanasia movement — are largely responsible for changing the way hospice and palliative care is practiced and for successfully changing how many Americans think about dying. Together with the complete and enthusiastic cooperation of the major media, they have succeeded in tainting the industry and encouraged so very many in our society to incrementally, year after year, wholeheartedly embrace the culture of death.

Just as the euthanasia advocate, "human rights" activist, and co-founder of the pro-abortion Amnesty International,64 Luis Kutner, wrote in 1969, the living will was a "due process of euthanasia"65 — an incremental step toward the legalization of euthanasia! In 1970, the Euthanasia Society of America distributed 60,000 living wills.

Choice in Dying, Partnership for Caring, Last Acts Partnership, and the "Caring Connections" program of the National Hospice & Palliative Care Organization all have continued this work as legal, corporate successors to the Euthanasia Society and understand the real intent is the facilitation of hastened death (which they approve) in one manner or another. This may occur either by the patient's own wishes to refuse treatment at the time, or through a Living Will, or eventually through the other legal documents developed: advanced directives, do not resuscitate orders, polst/physicians orders regarding limiting life-sustaining treatments.

Of course, the euthanasia activists who have worked with Byock these many years understand that all of these documents tend to deeply influence the thinking of Americans. Their hope all along has been for Americans to finally make the "jump" in thought to approve actively facilitating death in other ways: through the overt euthanasias: assisted-suicides and direct euthanasias as Byock's friend Timothy Quill advocates, through various forms of stealth euthanasia, or through the covert euthanasia preferred by Dr. Byock: slow euthanasia - the misuse of terminal sedation with the intent to impose death, expressly condemned by Dr. Saunders and many who remain faithful to the original mission.

When there is a real culture war going on, not just a figurative one, but one in which actual elderly, disabled and chronically-ill patients are targeted — when people are literally being killed in many hospice or palliative care settings, and you stand there and say, "Don't believe the horror stories!" — then I have real questions about the purpose being served in denying the truth. What is that purpose, Mr. Smith?

Smith has told us that he will be updating his book, Culture of Death, probably in late 2015. In the several examples of possible topics he plans on adding to the new edition, he again does not mention the invisible holocaust occurring in end-of-life care settings!66 I can tell you that if Mr. Smith fails to include any mention of hospice wrongdoing or Byock's role in it, I will know for sure that he is truly a cheerleader and co-conspirator for the secular humanistic hospice movement led by his friend Byock. I will know that he is choosing to mislead the public, especially the pro-life readers who compose much of his readership. Why?

As we have seen, he has chosen to withhold this information from the public for years. As recently as his March 17, 2015 article, "Belgium: 18% Doctors-Patient Kill Rate,"67 Wesley tells us that:

A study out of Flanders, published in the New England Journal of Medicine shows that 18% of patients deaths come either from lethal injection/assisted suicide or from being put into a deep coma and left to die.

Wesley did not point out that this very same method, i.e., "being put into a deep coma" and being left to die, is Byock's preferred method of stealth euthanasia performed in American hospice! Wesley also chose not to share with the reader the following extremely significant statements from the study's authors:68:

Palliative care services were involved in 73.7% of cases in 2013 [and]

We found an increased demand for euthanasia in Belgium between 2007 and 2013, as well as growing willingness among physicians to meet those requests, mostly after the involvement of palliative care services. [Emphasis added]

I cannot but wonder why — why? — would Wesley Smith omit the involvement of palliative care physicians in most of the hastened deaths occurring in Flanders, Belgium? I can already "hear him" telling us that in the U.S., the doctors are "saints" compared to the "evil doctors" in Belgium, and that hospice doctors especially would never do such things here! Right!

Clearly, Byock's contribution to the American hospice and palliative care industry is not all "splendid" as Smith would have us believe. The patients and their families that we serve deserve to know the truth and to be prepared to recognize this culture of death's counterfeit "care" that awaits them. Armed with the truth, patient advocates and family members will be better prepared to protect their loved ones.

Mr. Smith, if the culture of life is founded on any one thing at all, it is founded upon Truth and truthfulness. If we are to remain faithful in performing our duties, we must share and speak nothing but the truth and especially the whole truth. We cannot and must not mislead the public, otherwise, we have not only failed them, but actually supported the misinformation that feeds the culture of death.

Howbeit when He, the Spirit of truth, is come,
He will guide you into all truth:
for He shall not speak of Himself;
but whatsoever He shall hear, that shall He speak:
and He will show you things to come. - John 16:13

The character and boundaries of the nation may change over time; the healthcare settings and ways in which such are funded or not funded may change as well, but the mission we are called to serve will remain. When their own loved ones are taken, the people will remember the sanctity of life and the God who gives it.

As we may be enabled to do in the extremely difficult times ahead, we must work individually and together to restore the culture of life 69 within our own circle and especially within the healthcare setting, whatever form it takes in the years to come.

Before we begin this work, we must first recognize and then reaffirm the battered and too often neglected authentic, and never secular, pro-life mission that Dr. Saunders, Florence Nightingale, and Mother Teresa of Calcutta planted in our world.

Note: I encourage the reader to actually read the listed references below to know absolutely for sure what the truth is so they can see through the pretense of those like Ira Byock, MD who pretend to be pro-life.


  1. Ron Panzer, Called to Serve, 2004-2010, Hospice Patients Alliance. Back

  2. Wesley J Smith, JD, "Caplan & Smith on Improving Hospice Share," Nov 13, 2014, NationalReview.com. Back

  3. Wesley J Smith, JD, "Pulling the Plug on the Conscience Clause," Dec 2009, Firstthings.com Back

  4. Staff, "Assisted Suicide & Death with Dignity: Past, Present & Future -Part I," Jan 2005, Patients Rights Council. Back

  5. Richard Wurmbrand, "Tortured for Christ," orig. 1983, Living Sacrifice Bk Co. Back

  6. Ira R Byock, MD, "Standing on Common Ground," from: The Best Care Possible: A Physician's Quest to Transform Care
            Through the End of Life, 2012, ch 10, The Penguin Group, New York, NY. Back

  7. U.S. Justice Dept, "On Emergency Application for an Injunction Pending Appellate Review or, in the alternative, Petition for Writ
            of Certiorari and Injunction Pending Resolution," Jan 2014, U.S. Dept of HHS. Back

  8. Marily Golden, et al, "A Progressive Case Against Assisted Suicide Laws," retrieved March, 2015, Disability Rights Education & Defense Fund.
            See reference to Barbara Coombs Lee, current head of Compassion & Choices who spearheaded & wrote the Oregon asstd suicide law
            and who was a former Vice-Pres of Ethix Corp, a managed healthcare organization that stood to gain by the deaths of patients (as do all
            health insurance companies and the govt when patients die sooner)
      Rita Marker, JD, Dying for the Cause - Foundation funding for the “right-to-die” movement,
            Jan/Feb 2001, Philanthropy Magazine; and see:
      Ron Panzer, Euthanasia to Hospice Timeline, Hospice Patients Alliance. Back

  9. Dianne N Irving, PhD, What is Bioethics?, June 3, 2000, LifeIssues.net. Back

10. Louis Lasagna, MD, "The Modern Medical Oath," 1964, Dr. Lasagna was Dean of Schl of Medicine at at Tufts Univ. Back

11. Pres. George Washington, "Farewell Address," Sept 1796, Philadelphia, PA. Back

12. Tom Flynn, "Secular Humanism's Unique Selling Proposition," March 2015, Secularhumanism.org. Back

13. Ione Whitlock, "The Current Health Care "Reform" Legislation: How it will make rationing and death hastening
            the law of the land," Nov 23, 2009, Lifetree.org. Back

14. Group effort of hospice professionals and pro-life leaders, "Hospice Life Pledge," 2003, Hospice Patients Alliance. Back

15. Ron Panzer, "Utilitarian Care Rationing: Health Care Reform, The Government's "Complete Lives System" and Hastened Death,"
            from Stealth Euthanasia: Health Care Tyranny in America (Hospice, Palliative Care and Health Care Reform),
            2011, p. 70, Hospice Patients Alliance. Back

16. Ira R Byock, MD, "Dying Well," ch 1, 1997, Riverhead Books, New York. Back

17. Ira R Byock, MD, "We should think twice about 'death with dignity'," Jan 30, 2015, L.A. Times. Back

18. Staff, "The Virtual Human Embryo," Digitally Reproduced Embryonic Morphology (DREM) Project, Louisiana State Univ
            and Human Developmental Anatomy Center (HDAC) based at National Museum of Health and Medicine, Wash, DC. Back

19. Susan W Enouen, P.E., "New Research Shows Planned Parenthood Targets Minority Neighborhoods," Protecting Black Life Project
            of the Life Issues Institute. Note: Those statistics that attempt to disprove the targeting of minorities by Planned Parenthood
            do so by saying the facilities are not located in the minority neighborhoods, but this leads to a false conclusion. If you look
            at the census data maps, it is clear that the sites for the abortion facilities are very consciously selected and are placed
            near to and most accessible to minority neighborhoods. Back

20. Wesley J Smith, JD, "Obamacare: 60 Minutes Propaganda Piece Paving the Way for Health Care Rationing Share,"
            Nov 24, 2009, National Review online. Back

21. Elizabeth Wickham, PhD, "Repackaging Death as Life - The Third Path to Imposed Death," Oct 2010, Lifetree.org Back

22. Burke J Balch, JD, "Euthanasia In the 25 Years Since Roe," 1998, Dept of Medical Ethics, National Right to Life Committee. Back

23. Nathan I Cherney, Lukas Radbruch, and The Board of the European Association for Palliative Care, "European Association
            for Palliative Care (EAPC) recommended framework for the use of sedation in palliative care,"
            2009 updated version, European Association for Palliative Care. Back

24. Karen Kaplan and Rosie Mestel, "Ceasing Food and Fluid Can Be Painless," March 23, 2005, LA Times. Back

25. Ron Panzer, "Signs and Symptoms of Approaching Death," Hospice Patients Alliance. Back

26. Judy Roberts, "Safe and Sound - Pro-Lifers Make a Call for Better Hospice Information," March 27, 2006, National Catholic Register. Back

27. Wesley J. Smith and Art Caplan, "Caplan & Smith on Improving Hospice Share," Nov 13, 2014, NationalReview.com Back

28. Ralph A Capone, MD, Kenneth R Stevens, Jr., MD, Julie Grimstad, LPN, Ron Panzer, BA, LPN, The Rise of Stealth Euthanasia, June, 2013,
            Ethics & Medics Journal, Volume 38, Number 6, the National Catholic Bioethics Center. Back

29. BBC Staff, "Liverpool Care Pathway: 'They told my family I was dying'," August 15, 2013, BBC News. Back

30. Nick Triggle, "Doctors admit problems with Liverpool pathway for dying," June 26, 2013, BBC News. Back

31. Steve Doughty, "Top doctor's chilling claim: The NHS kills off 130,000 elderly patients every year," June 20, 2012, The DailyMail, U.K. Back

32. Ira R Byock, MD, "We should think twice about 'death with dignity'," Jan 30, 2015, L.A. Times. Back

33. Rita L. Marker and Wesley J. Smith, "Words, Words, Words," originally appearing in the Duquesne Law Review Vol. 35, No. 1, (Fall 1996)
            pp. 81-107 under the title "The Art of Verbal Engineering. Back

34. Ira R Byock, MD, "The Best Care Possible: A Physician's Quest to Transform Care Through the End of Life," 2012, p. 81, The Penguin Group, New York, NY. Back

35. Mark Pickup, "Human Life Matters," Blog of Mark Pickup, 2015, Canada. Back

36. Ira R Byock, MD, "Dying Well," chapter one, 1997, Riverhead Books, New York. Back

37. Timothy E Quill, MD, et al., "The Rule of Double Effect — A Critique of Its Role in End-of-Life Decision Making," Dec 11, 1997,
            The New England Journal of Medicine, Vol. 337, No. 24 NEJM.org Back

38. Ione Whitlock, "Scripting the Conversation, Part 2: The provider-patient dialogue," Nov 17, 2014, Belbury Review. Back

39. Staff, "French parliament passes 'deep sleep' bill for end of life," March 17, 2015, Reuters News. Back

40. Staff, "Caring Connections Timeline," National Hospice & Palliative Care Organization. Back

41. Ron Panzer, "The Face in the Window," Nov 18, 2010, Hospice Patients Alliance. Back

42. Dianne N Irving, PhD, What is Bioethics?, June 3, 2000, LifeIssues.net. Back

43. Ira R Byock, MD, "What are Doctors For," from The Best Care Possible: A Physician's Quest to Transform Care
            Through the End of Life
, ch 6, 2012, Avery Press, The Penguin Group. Back

44. Dianne N Irving, PhD, "Abortion: Correct Application of Natural Law Theory," Feb 2000, LifeIssues.net Back

45. Staff, "Recollection: 'You matter because you are you'," Nov 6, 2006, Churchtimes.co.uk Back

46. Wesley J Smith, JD and Arthur L Caplan, PhD, "Assisted suicide compromise," Nov 13, 2014, USA Today. Back

47. Ira R Byock, MD, "The Four Things That Matter Most - A Book About Living," 2004, Atria Books, New York, NY. Back

48. Staff, "Caring Connections Timeline," National Hospice & Palliative Care Organization.
      Ron Panzer, "Euthanasia to Hospice Timeline," Hospice Patients Alliance.
      Elizabeth Wickham and Ione Whitlock, "LifeTree Organization Timeline," Lifetree.org Back

49. Staff, Position Statement on Physician-Assisted-Suicide, 2000, Partnership for Caring.
            formerly located at www.partnershipforcaring.org/Position%20Statement%20on%20Physician-Assisted%20Suicide.htm (website not online now) Back

50. Sidney H. Wanzer, MD, "The Physician's Responsibility toward Hopelessly Ill Patients,"
            March 30, 1989, N Engl J Med 1989; 320:844-849 DOI: 10.1056/NEJM198903303201306. Back

51. John Thurber, "Ronald Cranford, 65; Ethicist Testified in Terri Schiavo Case," June 03, 2006,, Los Angeles Times. Back

52. Ione Whitlock, "Five Things You Should Know About Palliative Care," May 25, 2014, BelburyReview.com Back

53. Elizabeth Wickham, PhD and Ione Whitlock, "Euthanasia Timeline," Lifetree.org Back

54. Timothy E Quill, MD, et al, "The Rule of Double Effect — A Critique of Its Role in End-of-Life Decision Making," Dec 11, 1997, The New England Journal of Medicine, Vol. 337, No. 24 NEJM.org. Back

55. Timothy E. Quill, MD, and Ira R. Byock, MD, "Responding to Intractable Terminal Suffering: The Role of Terminal Sedation and Voluntary Refusal of Food and Fluids,"
            March 2000, Annals of Internal Medicine, Vol 132, No. 5, for the American College of Physicians-American Society of Internal Medicine
            End-of-Life Care Concensus Panel. Back

56. Lawrence K. Altman, "Doctor Says He Gave Patient Drug to Help Her Commit Suicide," March 7, 1991, The New York Times. Back

57. Lawrence K Altman, "Jury Declines to Indict a Doctor Who Said He Aided in a Suicide," July 27, 1991, New York Times. Back

58. Rodney Syme, MD, "Dying Autonomy," Aug 18, 2014, Insight, Medical Journal of Australia. Back

59. Nancy Valko, RN, "Is Palliative Sedation Becoming Another Form of Euthanasia?," Date, Publisher. Back

60. Henry S. Rzepa, PhD, DSc "Opium, Morphine and Heroin," retrieved 2015. Back

61. Wesley J Smith, JD, "Liverpool Care Pathway: The Road to Backdoor Euthanasia," Dec 25, 2013, Human Life Review.
           "Palliative Sedation Not = To Terminal Sedation/Euthanasia," May 18, 2012, FirstThings. Back

62. Ron Panzer, "Temperance, Fortitude, The Brotherhood of Man, Man's Acts are His Own, The Nuremberg Code,"
            from Restoring the Culture of Life, April 14, 2013, Hospice Patients Alliance. Back

63. Chuck Colson, "Culling the Human Herd: The Environmental Solution?," Feb 5, 2009, BreakPoint. Back

64. Elizabeth Charnowski, "Amnesty International Continues Pushing Abortion Worldwide," Aug 9, 2012, LifeNews. Back

65. Luis Kutner, JD, "Due Process of Euthanasia: The Living Will, A Proposal," July 1, 1969, Indiana Law Journal, v. 44, issue 4, article 2, p. 549. Back

66. Wesley J Smith, JD, "I'm revising/updating Culture of Death," September 5, 2014, National Review online. Back

67. Wesley J. Smith, JD, "Belgium: 18% Doctors-Patient Kill Rate," March 17, 2015, National Review online. Back

68. K Chambaere, Ph.D., R Vander Stichele, M.D., Ph.D., F Mortier, Ph.D., J Cohen, Ph.Dr, "Recent Trends in Euthanasia
            and Other End-of-Life Practices in Belgium," N Engl J Med 2015; 372:1179-1181March 19, 2015DOI: 10.1056/NEJMc1414527 Back

69. Ron Panzer, "Restoring the Culture of Life (The Ethics of Life in Healthcare and Society)," 2013, Hospice Patients Alliance, Grand Rapids, Michigan. Back

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