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human being become highly visible and articulate in its defense. Its mother would be wanting, not to aid in its defense, but certainly no less than its father of the men of this country who would be accused of refusing to accept their responsibility to protect the life of the unborn. There is not a person in this country who can escape his own personal responsibility in this issue by indicating that it is the responsibility of one sex or the other and that therefore I am not involved. The real issue that faces you today is the protection of all life. To be consistent and intellectually honest, we cannot address this issue on any basis other than that we are all human beings, responsible and accountable to see that every other human being is protected by the Constitution of the United States.

Thank you, and may God bless you in your deliberations.

I would like if I might at this time, Senator, to introduce Dr. Mildred Jefferson.

Senatar BAYH. Fine.

Mr. VAN DERHOEF. Dr. Jefferson is a general surgeon in Boston, Mass., and assistant clinical professor of surgery at Boston University School of Medicine.

Dr. Jefferson is chairman of the board of directors of the National Right to Life Committee. She also is vice president and a member of the board of the Massachusetts Citizens for Life, president of the Value of Life Committee of Massachusetts, and a member of the board of directors of Americans United for Life.

Dr. Jefferson graduated summa cum laude from Texas College in Tyler, Tex., received her M.S. degree from Tufts University, Medford, Mass., and her M.D. degree from Harvard Medical School. Dr. Jefferson holds an honorary L.D. degree from Regis College in western Massachusetts. Dr. Jefferson received her surgical training at Boston City Hospital at Boston University Medical Center, Childrens Hospital Medical Center, and Massachusetts General Hospital.

She is a diplomat of the American Board of Surgeons and a member of the local, State, and national medical societies.

It is with great pleasure I would introduce Dr. Mildred Jefferson, chairman of the board of the National Right to Life Committee.

Senator Bayh. Dr. Jefferson, we are privileged to have you here.

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Dr. JEFFERSON. Delighted to be here, and thank you, Mr. Chairman, for the opportunity of appearing before this committee to speak in support of the Human Life Amendment to the Constitution.

Because of my feeling that the physician has obligations of citizenship beyond providing for the health care needs, I also participate as a member of the U.S. National Commission on the Observance of World Population Year, 1974.

Although it is a privilege for me to be here, I am somewhat saddened that we must take the strong measures that we must to prevent the destruction of lives of those who cannot defend themselves. Most immediately, there are those unborn who would be considered social embarrassment or economic burdens. The jeopardy already extends to the newly born with severe mental or physical defects. The elderly are being invited to die with dignity, and those who accept the invitation may soon find themselves invited or perhaps urged to choose to die. If a society can develop tolerance for destroying lives at the beginning and the end, why not apply the methods to eliminate the deformed, defective, incapable, the incompetent, or the inconvenient anywhere along the scale? If the destruction of life is permissible for social and economic reasons, why not for political reasons!

It is reasonable to apply the extermination principle of social change to that segment of the population that cannot fight back, cannot riot in the streets and of course, cannot vote. Getting rid of babies before they can be born in their own time can be arranged so very readily with our modern medical technology. Separating the word "abortion” from the fact of what abortion does allow it to be promoted as a welcome escape from a probles without considering the threat of harm in the promise of the relief.

The acting of killing an unborn child involves complex medical, moral, and legal issues. On January 22, 1973, the majority of the Supreme Court of the United States undertook to reduce them to a simple medical problem by handing down decisions on abortion which left the abortion decision to be a private matter between a woman and a doctor, subject to the doctor's medical judgment. The Court acted in the tradition of the 19th century Court that decided to settle the problem of slavery by declaring one ensloved Dred Scott to be “property” therefore not a person and not entitled to the protection of citizenship. The 20th century Court may have intended to create social revolution with its abortion rulings. If so, the Court succeeded in turning the whoel of social progress a full turn backward.

By joining the strong team of the woman and the doctor against the unborn child, the High Court destroyed a principle of justice in our legal system which guaranteed some balance for the weak in conflict with the strong by joining with the weak against the strong. By requiring the unborn child to escape an extermination team of the mother and doctor for 6 months before having chance of protection by the State, the High Court destroyed fairness in the application of our laws. By allowing the State to protect the life that Mr. Justice Blackmun called potential in the last 3 months before birth only if it chooses, means that the Court did not guarantee protection for the life of that child at any point before birth or after if the State should choose not to protect that life. And that opens the jeopardy to us all.

The Supreme Court destroyed the foundations of democracy in the abortion decisions by creating three categories of citizenship. The doctor and pregnant woman were elevated to the rank of supercitizens with the private right to kill by contract. Man, the father of the child, was reduced to the level of subcitizen with no defined right to protect the life of his unborn child. The unborn child was declared nonperson in the eyes of the law, and therefore, noncitizen only to allow his or her life to be taken.

The highest Court of our land undermined respect for the medical profession by granting the doctor a nearly unlimited license to kill

the unborn child. The majority opinion of the Court disparaged the hippocratic oath as a guiding principle of medical conduct. Seven justices of the Court undertook to practice medicine without a license by dictating what should comprise medical judgment in the abortion decision. Without indicating when life began, the Court established a timetable for allowing willful end of that life. Most cruelly, the Court introduced the concept of viability, "potentially able to survive outside the mother's womb” as a price to pay for continued life. It places the immature, premature survivor of abortion in the circumstance of having to prove the ability to live before being given the support system that would help sustain its life. As a physician I cannot accept that because it is not a sound or reasonable test. It also disturbs me that those physicians who have been paid to see that the mother leaves the facility with empty arms have been the ones to try to establish the criteria for viability.

In the aftermath of the Supreme Court's decisions on abortion we have seen increased efforts to popularize or make acceptable the extermination procedures of the radical social medicine. The talkmaster on a late night Boston radio program feels obliged to offer abortion counseling to a 14-year-old caller who thinks she is pregnant and has not told her parents. Specialists at a famous teaching center feel obliged to report in The New England Journal of Medicine allowing 43 infants with severe deformities to die. Legislators in the States of Florida and Massachusetts, among others, introduced passive euthanasia bills which would give the permission which doctors do not really need to withhold extraordinary means of prolonging life when death appears inevitable.

Senator Bayh. Pardon me, Doctor, by what definition is that kind of statute described as a euthanasia statute ?

Dr. JEFFERSON. It is a passive euthanasia statute in the sense that it executes an instrument which allows or directs that extraordinary means be withheld. No doctor using sound medical judgment needs such direction, but with the instrument executed, there is also the provision of what happens when the person is no longer competent to act? It is very simple then to use this to ease the person along, so it becomes very simple to convert it from a passive euthanasia bill to an active one.

Senator Bays. We are playing with words, and I do not want to get into a prolonged argument on this. I think the question of abortion is a very critical matter and I think it is complicated significantly when we try to conjure up something entirely different such as euthanasia. If there had been a euthanasia statute passed or even proceeded significantly through a legislative body, I would like to know about it. But a statute described as a passive euthanasia statute is not the same thing as euthanasia by any means. I think that sort of gets us off on the wrong road, does it not? We have got enough problem here confining it to where we are.

Dr. JEFFERSON. I am stating the things that have taken place. If one reads the letter from the doctor who was a legislator in Florida who introduced the bill, who mentioned the 5 years in the building for the bill he did introduce, and why he felt that the climate was then suitable for introducing that legislation. That was written in a letter

Senator Bays. Maybe I misunderstood you. I thought you said it had passed.

Dr. JEFFERSON. No, no; introduced. The one in Florida was introduced first. The one in Massachusetts was introduced in this session of the legislature.

Senator Bayh. Is the one in Florida similar to the Florida statute when it was passed ?

Dr. JEFFERSON. It was entirely different when passed out of committee, but there were no changes in the ones that—the one in Massachusetts was introduced which essentially followed the form of the living will.

Senator Bays. In other words, if a person like the former Senator Morse, wants to turn off the kidney machine, he has a right to say turn off the kidney machine.

Dr. JEFFERSON. He has a right to direct, but the doctor does not need that in terms of the law or an instrument to be executed. If the physician is following the case carefully, the sound medical judgment should let him know when it is not reasonable to use the extraordinary means.

Senator Bayh. Well, suppose the patient disagrees with the doctors and says look, I'm tired of you poking me with that needle. Would you just stop it. Then do you as a physician, think a patient has a right to ask the doctor to do that or not?

Dr. JEFFERSON. The patient has every right to ask, but the doctor must act within that doctor's sound medical judgment, and that doctor still

Senator BAYH. Was that answer yes or no? Dr. JEFFERSON. I cannot answer that yes or no because the doctor still has to act within the provisions that control his action in the hospital.

Senator Bays. Let us take the kidney problem as specifically, painfully and unfortunately faced by our former colleague Wayne Morse.


Senator Bayh. Wayne Morse happened to be somebody everybody knows. Suppose Jack Jones out here that nobody ever heard of comes to you and says, "Look, I do not want to take that treatment anymore, Doctor."

Dr. JEFFERSON. I would have to turn Jack Jones over to a doctor who would allow a patient to dictate his treatment. You see, I come from a rather different medical background. I was part of the first team to work on the kidney transplantation so that I look upon kidney failure in a different way. I also handle the relationship of a patient in a different way. I have never had a patient ask to refuse treatment that was considered necessary within my medical judgment, so that if I felt, understanding and meeting the patient's sense, that he wanted to direct his treatment, I would feel obliged to find that patient another doctor.

Senator BAYH. Then the answer you would give to my question is “no," you would not continue to serve as a physician to someone who wants to stop receiving certain treatment and let nature take its


Dr. JEFFERSON. That is true, when I feel that best medical judgment indicates that there is a positive chance for the treatment. You do not just treat because you have the things there available.

Senator Bayh. All right, thank you.

As I say, I can accept the argument of euthanasia as a very good signal to us to be careful that we do not follow the tragic experience of Nazi Germany. But I must say I have much greater faith, than apparently you and some others do, in the capacity of the people of this country to root out euthanasia. I think it is possible to distinguish the difference between death with dignity and euthanasia. I have heard death with dignity described as letting someone make his or her determination as to what kind of treatment and how long it should be prolonged, as long as they are within command of their capacities.

Dr. JEFFERSON. I understand your view, but I see it obviously from a different circumstance. I know that in medicine we cannot be sure that every patient is going to get reasonable care. I know that things that are considered extraordinary today were not-or will not be considered extraordinary within 2 or 3 years. I know some things that were considered extraordinary in 1965 that are perfectly ordinary and reasonable treatment now. I am not willing at this point to allow the members of my profession to step back from doing what is reasonable and necessary because I know already there are few,

, very few, but still a few who will not know what is necessary at the time.

So that when people mention death with dignity to me, I know in the first place that dignity is a quality of the living not of dying, and when people see this, often they have not seen many people die. I have been watching people die since I was a child, when I used to visit them to see the souls leave, and there was no dignity in dying from neglect, from strangling on one's own secretions, from trying very hard to breathe, or from feeling so dry that the person is gasping. But the doctor who is following the patient well, even in the most hopeless of circumstances, can help the patient die comfortably and more easily, but still within a reasonable ethical limit, and it is just that unfortunately slogans are appealing, but people often do not look far enough behind the slogans.

Senator BAYH. I am certainly looking behind the slogans. I do not like to see anybody gasping or strangling on their own liquids either, but we are talking about a relatively few people, that ever have to face that decision. Unfortunately some of them do, and I, for one, would not want to impose some sort of a rule by constitutional amendment or statute limiting their right to control the amount of treatment received. If I were a legislator I would not want to say to those relatively few people, we are going to take your right to determine how you are going to go to your own Maker, as long as you do not take it yourself.

Dr. JEFFERSON. That is quite all right. Thank you.

Repeatedly, the High Court has refused to review the scientific evidence of the life of the unborn in cases, for example, like those from Connecticut and Rhode Island, the evidence which was so well presented to you in this hearing on May 7 by Dr. Albert William

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