The Problem with Assisted Suicide

The following two articles (excerpted by Inclusion Daily Express) actually appear paratactically on Inclusion Daily’s latest news feed. I shall have more to say about these pieces “on the other side” as they say on TV…

 

Not Dead Yet Challenges Bioethicist On Assisted Suicide Bill
(Not Dead Yet)
November 2, 2012

ROCHESTER, NEW YORK– [Excerpt] Art Caplan has an opinion piece that came out yesterday — and it’s linked from just about every conceivable place on NBC and MSNBC. It’s an endorsement of the proposed legalization of assisted suicide on the ballot in Massachusetts. While disappointing, it’s not that big a surprise; Caplan has been sliding toward this unqualified endorsement of legalized assisted suicide for several years.

And, while he’s ended up on the same side as disability activists in some instances, he’s never given us more than a casual mention, at least in anything I’ve read. I know he reads this blog occasionally, so he gets information on disability rights activism and advocacy from here when he does stop by.

The organizations pushing legalization of assisted suicide are sophisticated and well-funded. And, like many advocacy organizations, they are following an incrementalist strategy in terms of their policy goals. Through polling, focus groups and experience, they’ve developed a vocabulary about these topics that draws a favorable response from the public. And, for the moment, the more “respectable” groups are sticking to policy that is allegedly limited to people who are “terminally ill.”

But the signs of more expansive “advocacy” are already in evidence.

Entire article:
Bioethicist Endorses Mass. Assisted Suicide Bill in a Sloppy and Intellectually Lazy Essay 
http://tinyurl.com/ide1102125

 

Lieber: Lawsuit Affects Medicare Coverage
(Fresno Bee)
November 2, 2012

FRESNO, CALIFORNIA– [Excerpt] Should the federal government cover the costs of many kinds of treatments for patients who aren’t going to get any better?

It didn’t, for many years. But after the settlement of a landmark class-action lawsuit last week, Medicare soon will begin paying more often for physical, occupational and other therapies for large numbers of people with certain disabilities and chronic conditions like Alzheimer’s disease, multiple sclerosis and Parkinson’s disease.

The two questions patient advocates were left with were just how many people may benefit from the clarification of the regulations and how quickly.

The settlement, if approved by a federal judge, would end a lawsuit that accused Medicare of allowing the contractors who process its claims to use an “improvement standard” over the last few decades. To the Center for Medicare Advocacy and the many other organizations that joined the suit, that standard seemed to call for cutting off physical, occupational and speech therapy and some inpatient skilled nursing for many people who had reached a plateau in their treatment.

Entire article:
Lieber: Lawsuit affects health coverage
http://tinyurl.com/ide1102126

 

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I am not a bioethicist. My graduate school training (such as it was) was in literature. Worse, it was in literary writing. I can tell you where the anapests jangle or how the pathetic fallacy undermines a decent stanza but I can’t tell you with any reasonable certainty what makes a good life any good, nor can I tell you much about the nature of suffering. Poetry frames these subjects but leaves determinations to its readers, at least for the most part. This is because art is about ideas–about representations of reality–and not reality itself. There’s freedom in this: symbols are more flexible, more malleable than people. Love in a poem beats real love because its about the heroics of the heart that lives many fathoms down. But I am not a bioethicist. It is hard enough to be called a poet. And in general all rhetorical elevations are misrepresentations. 

But suppose I was a bioethicist? Presumably (because I’m calling the shots) I’d have a sprig   of irony left over from my poetry days. Let’s say so. As a result I believe I’d daily recognize three things about my occupation:

One: there are no bioethicists in nature. (Just like poets). 

Two: (To paraphrase Heidegger): the exertion of thought seems to meet its greatest  resistance in defining the thingness of a thing. (Just like poets).

Three: We should avoid attaching undue value to intermediate positions–life before birth, life after death, life that requires the insertion of machines or anything that introduces equipment into our appreciation of the human. 

Number three may be the hardest thing for bioethicists like Art Caplan to entertain. Since the industrial revolution all human life has been valued and granted utility in terms of its relation to technology. Children were valued in the first wave of industrialization because their limited stature made them more efficient working in the overcrowded mechanical looms. By the second wave of the industrial revolution higher standards of strength and endurance became valuable and children were sent to school. Any intellectual failure to understand the algebra of industrial utility and human value is to my mind a failure of ethics. 

Art Caplan believes the pending vote in Massachusetts that may authorize the introduction of physician assisted suicide in the Bay State shouldn’t concern disability rights advocates who argue that people with disabilities may subsequently be at greater risk for euthanasia. Caplan fails to recognize that the machinery of medicine carries costs that are often far greater than medicine’s rudimentary code of ethics can withstand. People with disabilities have every reason to be afraid.