Sunday, September 21, 2008

KNOW THINE OPPONENT

On the political right there’s a popular saying that "A conserva- tive is just a liberal who’s been mugged," and in some cases it’s probably true. Also true is that Death With Dignity (DWD) advo- cates, whatever their prior view of the subject, have often had exposure to tending a loved one through a lingering and intrac- tably pain-ridden departure from life.

DWD’s staunchest opponents, for the most part, are those lucky enough not to have witnessed such a thing and who don’t them- selves suffer from ALS, bone cancer or similar conditions likely to leave them in an uncomfortable, hopeless and helpless state for a prolonged period. In a culture so assiduously death-denying as ours, few, especially from the younger, healthier cohorts, give any thought to what could befall them as their lives end. It’s just not the sort of thing you want to dwell on. Besides, the kinds of truly bad deaths I refer to are a small minority among the many thousands of deaths that occur on any given day.

At the opposite end of the spectrum, deaths which might be cal- led good—i.e. peaceful, relatively expeditious and with family and friends having a chance to say goodbye—are rare as well. The great majority of deaths are merely deaths, no better or worse than the norm. Ah, you say, "’Twas ever such." But actually, it wasn’t. Modern medicine not only works cures and promotes recoveries that previous generations couldn’t have imagined, it can and does greatly extend the lives of hopeless cases where quality of life isn’t meaningfully taken into account. And one of those cases might be you.

Yet who’s to decide if or when enough is enough? That, pure and simple, is the crux of the DWD issue. My answer is the ill person him- or herself; never the government, never insurance compan- ies or healthcare providers, and never family members unless expressly designated by the ill person to make that decision. I see it as one of the absolute rights of person-hood, which medical practitioners should be as bound to follow as they are other direct instructions from a mentally competent patient.

DWD opponents, meanwhile, believe the decision is solely God’s, or in the case of nonbelievers, that it’s best left to chance. After all, miraculous recoveries have been known to occur. Nor do I doubt the sincerity of people holding that view. I accept that many of them fully intend to, and do, endure as a matter of faith or principle, whatever suffering may come their way. It’s a brave choice, and not easy to carry out, though it barely qualifies as choice, since the alternative possibilities—jumping off the hos- pital roof if you’re ambulatory or securing assistance if you’re not—are either heavily stigmatized or legally foreclosed.

Another popular saying, "God never gives you more than you can stand," sums up that view. My problem is in finding that view, when it is forced on others as a matter of law, to be immoral, and on the very basis it stakes for itself—the sanctity of human life. If there is sanctity to human life, and I believe there is, then respec- ting the wishes of the person whose life is involved follows from that sanctity.

Placing a higher value on human life in the abstract than one does on individual instances of it seems a very odd business. More- over, the notion that God never gives you more than you can stand is palpably untrue. What is death but God’s having finally given a particular human entity more than it can stand?

In addition, DWD opponents argue that the imperfections of hu- man nature mean no safeguards can ever be devised that will prevent government agencies, insurance companies, healthcare providers and unauthorized family members from seizing the opportunity and putting terminally ill and mentally or physically handicapped people to death. However, the Oregon record over ten years of DWD shows no such occurrences nor have any, to my knowledge, been documented in other countries with DWD laws. In fact, opponents who make this slippery-slope argument often contradict themselves by supporting the death penalty, despite its enabling statutes having been devised by imperfect human beings and despite its proven risks of executing innocent persons.

So what we have in regard to DWD is essentially a religious dis- pute, although anti side has so far been more successful in legislating and enforcing its view through government inter- vention. The same, of course, can be said of the pro side on legalized abortion, though I support that, because it expands individual autonomy in deciding whether or not to have a child without compelling any particular decision. Nonetheless, it’s a tougher call. While a fetus gestated less than 100 days can’t exist in any real way separate from the mother, it is still a human entity. Even so, within that timeframe I’m willing to weigh the mother’s autonomy, privacy and dignity as superior to the fetus’s not- withstanding that the fetus itself isn’t requesting abortion or giving informed consent.

While the two issues are frequently equated, DWD is altogether different. The human entity making the request and giving con- sent is the human entity whose life is offered up. What is free will, be it derived from God or not, if it doesn’t include the moral right to end one’s life or order it ended? But that’s not how things are in the US of A, or not yet.

Still, I understand why many people regard DWD as immoral and respect them for that. It’s a principled view. But like me, they’ve chosen to live in, and support with their patriotism, a country that has a bedrock constitutional prohibition against established religion. Where we part ways is that they want our government to behave as though it does have such a religion and I don’t. Under our system, blanket limits on individual choice in an area as fundamental as determining the circumstances of one’s last days aren’t properly a government matter.

But trying to put yourself in the other guy’s shoes usually helps in any disagreement. Let’s hope everybody now knows everybody else a little better.

1 comment:

Last one standing said...

Governor Gardner from Washington wrote about this today on the Huffington Post