Death with Dignity

When I saw the article title "Implementing a Death with Dignity Program at a Comprehensive Cancer Center" in a recent issue of a highly respected medical journal, I thought this might be a program that helped support patients and their families during the difficult times before and immediately after dying.  Perhaps the program facilitated discharge from the hospital so that patients who wished to die at home could do so.  Or maybe it provided an avenue for patients to express their preferences about end-of-life interventions like ventilators and feeding tubes, to avoid unwanted procedures and interventions, and to maximize pain and symptom control at the end of life.  The reader will perhaps forgive me my naivete; the article is actually about a physician-assisted suicide program at a large university hospital in Washington State.  So why wasn't the article titled "Implementing a Physician-Assisted Suicide Program at a Comprehensive Cancer Center?"

The answer is clear to even the casual observer.  Physician-assisted suicide is an unpalatable and controversial practice among physicians and the public alike.  As such, current conventions demand that the program's name be shrouded in euphemism.  Anyone reading the article will shortly discover the true nature of the Death with Dignity Program and the state laws, often referred to as "Death with Dignity Acts," which permit the existence of such programs and protect physicians who participate in them.  Such a death is not inherently more dignified than any other; the language of these laws and their clinical offspring does nothing but mask the program's true nature, if only for a brief moment.  This is doublespeak in its purest form: "language that deliberately disguises, distorts, or reverses the meaning of words."

In 1945, George Orwell wrote "Politics and the English Language," an essay published in the now-defunct British magazine Horizon.  The essay discusses how language shapes thoughts, politics, and culture and describes the use of "debased" language to conceal painful truths:

"In our time, political speech and writing are largely the defense of the indefensible.  Things like the continuance of British rule in India, the Russian purges and deportations, the dropping of the atom bombs on Japan, can indeed be defended, but only by arguments which are too brutal for most people to face, and which do not square with the professed aims of political parties.  Thus political language has to consist largely of euphemism, question-begging and sheer cloudy vagueness."

Although it was published in a medical journal, this article describes a political act - establishing legal protections for physicians who provide their patients with the means and guidance to commit suicide.  So it's not tremendously surprising that the name of the "Death With Dignity" program exemplifies doublespeak, since the phrase refers to a controversial political project.