Mercy Killing

Mercy killing, while regarded by some as an act of compassion, is seen by others as an act of despair or desperation and an inability to ask for help.

  • Media coverage is usually more sympathetic to the perpetrator than the victim.
  • Murder and suicide among the elderly are usually without the wife's knowledge or consent.
  • Disabled children's rights are eroded when a parent-killer is treated leniently.
  • When adult children kill a parent it is often because they are the ones who can't bear to deal with it anymore.
  • Carers may be in danger of killing a loved one because they have a problem coping or relinquishing control.
Mercy killing is a term that has long been used to justify euthanasia, when the perpetrator is considered to have acted out to free another from suffering. There is conflict over whether those accused are mercy killers, deserving of compassion from the Courts or whether they are murders who should be prosecuted and convicted.

Many ethicists would justify such actions since the ultimate motive was a good one but others say that the while the ultimate motivation may have been to stop the suffering of the other person, no-one has the right to kill to achieve that end.

Mercy killers and their victims usually fall into one of the following categories:
  • Killing terminally/chronically ill, disabled or elderly spouse
  • Parents killing disabled child
  • Children killing elderly, sick or disabled parent
  • Nurses killing a patient
  • Doctors killing elderly, sick or disabled patient
  • A lover (or friend) killing a terminally ill or disabled 'other'
Disability rights activists object  to the typical media coverage of such cases. US organisation Not Dead Yet, responding to the coverage of a 74 year-old woman who was shot in her hospital bed by her husband issued a press release:
Not Dead Yet and other national disability rights groups have been watching with growing anger and horror as the murders of disabled people of all ages have occurred with what seems like ever-increasing frequency. The news coverage of these tragedies is also a cause for deep concern. Accused murderers of disabled people are often portrayed by reporters as loving, caring individuals acting out of compassion. The Chicago media coverage of the Harrison murder is no exception to this trend.

Specifically, the coverage in the Daily Southtown and the Chicago Sun-Times has been disturbing to read. From the very first story in the Southtown, the speculations of unnamed police officers, neighbors, and a member of the clergy were quoted -- all suggesting that Shirley Harrison was "suffering" and that her murder could be described as a "mercy killing." The Sun-Times published quotes from unnamed police sources that suggest reporters may have actually suggested that police label this murder a "mercy killing." The Sun-Times recently published a series of articles on elder abuse and should know that it's unwise to rush to label murders of old, ill or disabled women as "mercy killings."

In fact, according to the prosecutors, Shirley Harrison did not ask to die. She did not complain of suffering or pain. Her condition was expected to improve.

Domestic violence is all too common in our culture. If the victim of that kind of violence happens to be old, ill or disabled, that's no reason to assume the violence was an act of mercy. Shirley Harrison's last moments were spent looking at a gun pointed at her by a person she thought she could trust. It's hard to imagine a more horrible way to die. The murders of old, ill and disabled people need to be treated in the same way as any other murders -- labeling these murders as understandable or excusable can encourage such killings -- and deprive all other potential victims of the equal protection of the law and, perhaps their lives. 1


The geriatric Romeo and Juliet scenario
Professor Donna Cohen, who is based in Florida and has led many of the world's homicide-suicide studies, says the geriatric Romeo and Juliet scenario is the most poignant and palatable explanation for grieving survivors, and for a society that routinely devalues disabled people and the elderly ? except that it's hardly ever true.

"These are not acts of love. They are not compassionate homicides. They are acts of desperation and depression, other forms of psychopathology, or domestic violence."

Dr Cohen's research indicates that older men ? who almost always initiate the acts ? routinely proceed without their wife's knowledge or consent. She says true pacts occur in perhaps one half of 1 per cent of elder homicide-suicides.

"Kindly elderly husbands are now one of the world's fastest growing groups of killers" she says. 2

Pointing out that most men are task-orientated, Cohen suggests that they come to the decision to kill their wives because they can't face the fact that they are unable to care for them. These men are reluctant to have the wife put into a rest home, and in fact imminent hospitalisation of a spouse, a sense that they are losing control of the situation, may be a factor in the homicide-suicide decision. 

"There is little awareness that those in 24 hour caring roles could have mental health conditions that may lead to homicide-suicide. If a young and fit couple say to one another, kill me if I become sick or disabled, this can become a license to kill in later life ? and an argument for social and legal sympathy that has proved quite successful in New Zealand."

"Describing every case as a mercy killing masks the health factors and also trivializes the risk to sick and disabled New Zealanders who have no opportunity to change their minds about comments they may have made when they were young and healthy." 3

Parents who kill their children
Parents, often out of despair, desperation or simply burnout as caregivers, having killed their disabled or terminally ill child, are usually portrayed sympathetically by the media and often are not convicted, or receive minimal sentences. 

In New Zealand in May 2004, a Nelson man was found with the dead body of his five-month old daughter who had been diagnosed, on the day of her death, as having a rare brain disorder - lissencephaly.

During the trial the father admitted holding his hand over his daughter's face until she stopped breathing. It seemed a clear case, yet it took an eight-woman, four-man jury only 47 minutes to find the baby's father not guilty of murder or manslaughter.

Disability and child advocacy groups expressed alarm at the verdict, feeling it could erode the rights of severely disabled children and pave the way for them to be killed indiscriminately. 4

Dr Dick Sobsey, Ed D., of the University of Alberta, Canada, in an article Altruistic Filicide: Bioethics or Criminology? considers the difference between those who kill a disabled child out of 'compassion' and those who kill a non-disabled child for the same reason:
Resnick's (1969) classic American study of parents who killed their children found that about 50% rationalized their actions as altruistic. A more recent Canadian Study of 10 fathers who killed their children also classed 50% as altruistic filicides (Marleau, Poulin, Webanck, Roy, & Laporte, 1999). 

Not surprisingly, a majority of parents who commit other forms of child abuse also rationalize their behavior as justified (Dietrich, Berkowitz, Kadushin, & McGloin, 1990), often as beneficial to the child. 

While only a few parents who kill their children rationalize their behavior on the basis of disease or disability, others kill their children because they want to spare them from poverty, family breakup, discrimination, exploitation, or a wide variety of other real and imagined social ills. 

In most cases, the rationales are distorted and irrational. In some case cases, the parents have clear psychopathology but sincerely believe their rationalizations which are often influenced by societal attitudes and beliefs. 5


Killing a parent
A study in the Journal of the American Medical Association points to the fact that the family of a dying or severely disabled person often find it very distressing to watch their loved one. According to the study:

"Surprisingly the drugs were given nearly as often "for the comfort" of the patient's family as they were give to reduce the suffering of the patient themselves... [Additionally] in four out of every five cases, nurses who had discretion in administering drugs said that they were treating the patients for the comfort of their loved ones." 6

People who are gravely ill are very vulnerable emotionally. 'Suicidal thoughts' and requests for euthanasia or assisted suicide may be unconsciously reinforced by family members who are distressed by the condition and perceived 'suffering' of a loved one. 7

In New Zealand we had the prominent case of Lesley Martin, a former intensive nurse who attempted to kill her mother, then wrote a book justifying her action. The book, To Die Like a Dog led to her arrest and eventual conviction. She said her mother had told her she didn't want to die "inch by inch" and she had promised her mother not to let that happen.

Martin's lawyer based his evidence on the fact that Martin was stressed and tired and should never have been responsible for the care of her own mother. Better palliative care for her mother was an option for Joy Martin in the last days of her life but Lesley had declined the offer.

Part of her defense rested on the fact that she in writing the book, although she thought she was writing things as they happened, she may in fact have been suffering from 'cognitive dissonance', or memory distortion. 

At the trial Professor Roderick MacLeod of the University of Otago Medical School and a specialist in care of the terminally ill stated that it was quite normal for dying people to feel "scared and frightened. And when they ask me to kill them, which they do, I talk about that with them and basically the vast majority of them are saying they don't want to live like this, which is entirely different from saying they want to be dead."

Martin was sentenced to 15 months in prison and served half the sentence. 8

Angels of mercy/ angels of death
The Hospice Patients Alliance (HPA) is concerned that some physicians, nurses and even family members are administering overly high dosages of narcotics, sedatives or antidepressants when the patient has no need for them, as a form of euthanasia or mercy killing. They say:

"Lynching" ("hanging" for those who don't know their history) the elderly and disabled would be a shocking thing to do. But merely "euthanizing" the elderly or disabled, at least to some, doesn't seem to sound so bad." 9 

Australia's Dr Philip Nitschke, stated that, "assisting suicide can attract a life sentence in jail" so, he says, "the best advice is to do it and say you didn't." Any "angels of mercy" taking heed of Dr Nitschke can, if accused of killing a patient simply say, "it was out of mercy;" that they killed the patient or "I wanted to relieve the patient's suffering." 10

In 2001 a Swiss nurse, having previously confessed to the ''mercy'' killings of nine elderly women, admitted responsibility for 18 deaths of old people in nursing homes and hospitals. The man Swiss media dubbed the "Angel of Death'' told investigators he had put his victims - mostly old women -- out of their misery by injecting them with drug overdoses or smothering them with plastic bags and towels.

The investigating magistrate Orvo Nieminen said in a statement, "As far as his motive goes, he is sticking to his previous comments that he acted out of sympathy, compassion, empathy and salvation of the people involved.'' 11

Doctors killing patients
In a Channel 4 TV programme filmed at a UK teaching hospital, shown on 14th February 2002, an elderly man showing signs of recovery from a stroke was selected for death, and his hydration stopped. He clung to life for ten days without fluid. Another patient was allowed to live and went home after a consultant said he felt too tired to argue with the daughter, who insisted that her father should be given food and fluid. 12 

Dr Keith Andrews wrote in the British Medical Journal "It is ironic that the only reason that tube feeding has been identified as 'treatment' is so that it can be withdrawn..." 13

Friends, lovers and spouses
Many people find being with a friend or loved one who is ill or disabled, emotionally traumatic and disturbing. The patient's mood can be affected by subtle pressures from others. Carers may be in danger of killing a loved one because they have a problem coping and this colours their reaction to the person's request. 

International euthanasia activist and co-founder of the hemlock Society, Derek Humphry assisted his first wife , Jean, in committing suicide. He was the only witness to the death and later wrote the book Jean's Way with his new wife, American Ann Wickett who helped him found the Hemlock Society.

From the book it is clear that it was Humphry who made the decision when it was time for Jean to die. Anti-euthanasia activist and author Brian Johnston points out, "Jean exhibited a classic psychological condition displayed by the gravely ill: the desire for affirmation, the self-deprecating "cry for help." Her needs were clearly of an emotional nature." 14

It became apparent, when his wife Ann developed breast cancer and did not intend to choose euthanasia, that Humphry was exceedingly uncomfortable with illness. He left Ann, made life difficult for her and maneuvered her out of Hemlock isolating her from all her friends until the only one she could turn to for assistance and understanding was her former opponent, anti-euthanasia activist Rita Marker.

She later said that her own illness and depression left her feeling very alone and caused her to have misgivings about the right-to-die movement. She now thought that not enough emphasis was given to providing a supportive environment to those with life-threatening illnesses.

"There. You got what you wanted," she wrote her ex-husband: "Ever since I was diagnosed as having cancer, you have done everything conceivable to precipitate my death...what you did, desertion and abandonment and subsequent harassment of a dying woman, is so unspeakable there are not words to describe the horror of it." 15

A postscript addressed to Marker read: "Rita, Derek...is a killer. I know. Jean actually died of suffocation. I could never say it until now, who would believe me? Do the best you can. Ann." 16

References:
  1. Not Dead Yet Press Release
  2. "Mercy killing" debate shrouds health risks for older men carers
  3. Ibid
  4. The killing of Baby C
  5. Dick Sobsey, Ed.D.,  "Altruistic Filicide: Bioethics or Criminology?" Health Ethics Today Volume 12, Number 1, Fall/November 2001
  6. K.M. Foley, "The Relationship of Pain and Symptom Management to Patient Request for Physician-Assisted Suicide," Journal of Pain and Symptom Management 6 (July 1991) 290. 
  7. Margaret Pabst-Battain, "Manipulated Suicide," Bioethics Quarterly 2 (1980), pp. 123, 134. 
  8. The Lesley Martin story
  9. Hospice Patients Org.
  10. A practical guide to suicide Sydney Morning Herald: 12/2/2002
  11. The Daily News
  12. Do No Harm Briefing
  13. Dr. Keith Andrews, "Tortuous arguments evade the issue". BMJ 25 November 1995. 
  14. Brian Johnston, Death as a Salesman: What's Wrong with Assisted Suicide Ch 1, p3.
  15. From Ann Wickett's suicide note, reprinted in People Magazine and elsewhere.
  16. Ibid