JAMA Right-to-Die Piece Was a
By N. Gregory Hamilton, M.D.
August 26, 2001
A Journal of the American Medical Association article promoting
death for "uselessness" (Shah, 2000, p.1897) was simply not
true. Dr. Michael Swenson put it succinctly: "the events described
in his story never happened" (Swenson, 2001). Swenson supervised
Dr. Shetal Shah, author of the deceptive medical journal article,
in his work as a visiting medical student in Gambell, Alaska.
The supervisor and the medical journal editor did the right
thing. They corrected the record. They told the truth. Shah,
persisted in his self-justification, claiming that what he
presented as fact could have happened.
True to the tradition of a long line of liars in
movement, Shetal Shah, M.D., presented as fact his
fantasy about what death could be like in the arctic.
He spun a yarn that a Siberian Yupik elder presented
at a remote village clinic with the chief complaint
of "uselessness." Shah then proceeded with a rambling,
romanticized saga of events that never happened.
the end of the story, the elder, rather predictably,
stepped out onto the frozen Arctic Ocean and walked
to his death.
In presenting this story, Shah imposed a harsh,
utilitarian ethic on
the Yupik culture, which has no such ethic. He claimed, "When
a man feels his ability to help the tribe has expired,
he ... bids farewell to his family and walks over
the frozen Arctic Ocean, never to return" (Shah,
2000, p. 1897). He described a culture "that feels
a man is only as valuable as the wisdom he imparts"
(p.1898). As Dr. Swenson, who actually knows something
about the people with whom he works, pointed out,
Shah's claim "perpetrates a falsehood that has never
been true among the Inuit of Alaska" (Swenson, 2001,
p. 919). As in all Inuit cultures, elders among the
Siberian Yupik are held in "very high esteem,"
because they are "intrinsically valued," "just because
they are the
In his zeal, Shah imposed the utilitarian values
of the modern
bioethics movement (Smith, 2001) upon this fictional
character from a different culture. Shah claimed
the non-existent tradition of self-extinction is
based "solely on utility" (p. 1897). The problem
is that there is no such tradition, as Swenson could
have taught him. The falsehood that the Inuit ever
had such a tradition
is apparently based on a western misunderstanding
arising from a form of nineteenth century social
Darwinism. By perpetrating a new version of this
myth, this time in the name of twenty-first century
utilitarianism, Shah devalues not only the Inuit
culture, but all individuals who may be vulnerable
and dependent (Hamilton, N.G. et al., 1998). He apparently
did so in an attempt to extend a "right to die" to
anyone who feels demeaned by their
culture, as well as to "chronic, progressively
ill, or the elderly ICU
patient with a poor prognosis" (Shah, 2000, p. 1897).
These later patients Shah himself demeaned by claiming
they have illnesses we doctors "would rather not
live with" (Shah, p. 1897). Shah's solution appears
to be a duty to die.
Shah's is merely one in a long line of right-to-die
deceptions. Patti Rosen, for example, claimed in
a television commercial key to passing the Oregon
assisted-suicide law that her daughter took her assisted-suicide
pills and slipped "peacefully away." Only when it
was too late was the truth finally revealed to the
public. Rita Marker of the International Anti-Euthanasia
Task Force had tried to make these facts known earlier.
The pills initiated a dying
process so gruesome that "a family member nearly
put a pillow over her daughter's head" to smother
her (O'Keefe, 1997). "In the end, Rosen, a registered
nurse, said she 'hit a vein,' suggesting she had
to use an injection to end her daughter's life." Only
after a decade long killing spree was it finally
revealed that 75% of Kevorkian's victims were not
even terminally ill (Roscoe, 2000). More subtly deceptive
is the Oregon Health Division (OHD)
practice of using as their sole source of data the
stories of the
assisted-suicide doctors themselves (see PCC News,
Spring 2001). OHD treats those complicit in the suicides
as if they could be counted on to tell the truth,
the whole truth, and nothing but the truth. OHD persists
in overlooking serious, unreported problems with
assisted suicide in Oregon. There have been documented
depressed individuals (Hamilton & Hamilton, 1998)
pressured by family members receiving lethal overdoses,
shopping, and grotesque failed assisted-suicide attempts
not reported by the suicide doctors or OHD (Hamilton,
The JAMA editor acknowledged that a hoax had been
perpetrated. Now, it's time to recognize a larger
pattern of deception: the claim of a "right to die" is
based on demeaning and dehumanizing fantasies of
a few individuals who consider some other people's
Shah, S. (2000). Five miles from tomorrow. Journal
of the American Medical Association 284:1897-1898.
Swenson, M.D. (2001). A story about suicide in the
arctic. Journal of the American Medical Association
Hamilton, C. (2000). The Oregon report: What's hiding
numbers? PCC News 3:2-4.
Hamilton, N.G. et al. (1998). The doctor-patient
assisted suicide: a contribution from dynamic psychiatry.
American Journal of Forensic Psychiatry 19:59-75.
Hamilton, N.G. and Hamilton, C.A.(1999). Therapeutic
assisted suicide request. Bulletin of the Menninger
O'Keefe, M. (1997). Husband's revelation illuminates
side. Oregonian, June 29, 1997.
Roscoe, L.A., Dragovic, L.J., and Cohen, D. (2000).
Dr. Jack Kevorkian and cases of euthanasia in Oakland
County, Michigan, 1990-1998. New England Journal
of Medicine 343:1735-1736.
Smith, W. (2001). Culture of Death: The Assault on
Medical Ethics in America. San Francisco: Encounter