I thought it would be worthwhile to try to get a discussion going on this topic. We've already had a diary on this topic, and I don't want to undercut it.
A conversation with a group of friends last night, though, made me think that there is a side of the issue that most people aren't seeing, and wouldn't necessarily even think about without prompting.
Part of the disagreement comes from the very names used for the legislation. Supporters tend to call it "death with dignity" while opponents prefer "physician assisted suicide". Obviously, each preferred name is a product of spin, but the spin reveals a central disjunction between two world views.
Before we get to that, though, a little bit about who the sides are. It's easy to picture the "pro" side: liberal people like us, people who value civil liberties and think that choosing to end one's life is a natural right for all people; people who believe they should have the right to direct the course of their medical treatment; people who have seen loved ones go through horrible, painful deaths and don't want that for themselves. I'm someone like that.
The "cons," though, are not primarily people who think the Bible's injunction "Thou shalt not kill" applies in this situation, and that humans shouldn't go messing with god's right to determine the beginning and ending of life. No, the cons are disability rights people, and unless you spend time engaging with them you might not understand just how radically different from the standard liberal perspective the disability rights perspective is.
Let's take the title of the bill. Who could object to "death with dignity"? Isn't that something we can all relate to?
Here's how. If the policy of the state of Vermont is that once you have a certain medical condition or severity of disability your only chance to have dignity is by dying, what does that say to the people all over the state living with disabilities who need assistance to get through the activities of daily living that the rest of us take for granted?
If dignity comes through dying, does that mean living with assistance is without dignity?
If we adopt this bill, will our state policy be to send a message to everyone living with a disability that it is impossible for them to live with dignity? Or a message to everyone, with or without a disability, that if you need a certain level of assistance you can no longer have, and can't expect to have, the human dignity that we are all entitled to?
Or, to put it in the stark terms that a friend uses, are we adopting the policy that tells people you can't live with dignity if you need someone to wipe your ass? Do we want to rush into that world view?
What about the alternate title of the bill, physician assisted suicide. Opponents of the bill argue that the idea that a physician would assist one to commit suicide is the very antithesis of the proper role of doctors, to help preserve life. Supporters, while rejecting this designation, argue that it is entirely proper to allow physicians to assist people in the extremities of medical conditions that people face. Again, different world views.
Finally, will death with dignity/physician assisted suicide put pressure on people to go along with it to save the physical, financial, and emotional burden on family members? I think the evidence is unclear on this, but it's a valid question to ask.
VPR has devoted an entire Vermont Edition to this debate, and the advocates make the arguments better than I could. I urge you to listen to it.
I also encourage you, though, to consider how the world would look if you were on the other side of this divide, because it's no more than a moment's inattention behind the wheel or a cerebro-vascular accident that could be waiting for you tomorrow morning that separates you from a very different existence.
It used to be called “Patient Choices at the End of Life.” And for me that’s what it’s about.
The legislation is not saying anything to anyone about how they live their life with or without assistance.
All this legislation — and if passed, by implication the state — is saying is, here’s another choice.
When your life stops being valuable to you due to the terminal conditions you’re facing — and after going through an incredibly detailed process designed to protect your choice and make sure it really is your choice, then you have another option than waiting for death.
It’s all about more choices, not less — and the point is that my idea of my life and death with dignity and your idea of yours are likely different. So why should my options be limited because you have a different idea for you?
There’s no comparative value implied here. None. You get to live with what help you choose. I get to live — or decide not to — with what help I choose. I’d like that choice for me to include the option of a slightly earlier exit when I can’t stand my disease and its end-of-life complications any more. “Dignity” for me is not about whether I “need someone to wipe [my] ass.” It’s about refusing to be a medical guinea pig when the “treatments” are not going to help me. It’s about leaving life on my terms, should I be facing death soon with a terminal disease. So little else in such a situation is under our control — a choice of whether to live to a medically delayed end, or to die at a time of our choosing with medically prescribed and effective drugs, ought to be.
I know one of the disability advocates who has spoken out against the bill — do you really mean to say, Jack, that he and others oppose the bill because of its title? Are they really so paranoid that they think this is a plot to kill them off because of their disability? Vermont is, after all, and thankfully so, not New Hampshire. And if that advocate wants to feel insulted on the basis of semantics, then how should I feel? He’s just trivialized the suffering of my parents, mentor, and inlaws, who all would have preferred to die than linger the way they were forced to, implying that they wanted to die because of needing someone to wipe their asses.
And, while you’re right about the disability advocates and the disabled population being opposed to the unfortunately named “death with dignity” bill, you’re dead wrong that opposition is not also made up of and motivated by the same people who oppose a woman’s right to choose whether to carry a fetus to term, Bible-thumpers who tend to be Republican and who somehow reconcile “getting the government out of our lives” with forcing the government’s way into our bedrooms.
Chances are I won’t even get the option of requesting the option, won’t survive the car crash, heart attack, cerebral aneurism. Chances are that very few Vermonters will. But it says something about us that we’re willing to trust people to make choices for their own lives, to decide for themselves what their “dignity” is, and when they’ve had enough medical handling waiting for the not-soon-enough end.
But good to see it aired out. I don’t like the whole goddamned idea, and, if any law is passed, it better be morally and ethically pure as possible.
As long as the ‘choices’ are made by the individuals, and individuals are protected from others (doctors, government, relations, and yes, corporations) making the choices for them, then you avoid drifting into the euthanasia threat (I believe the Nazis were into that). There will come a day though, unless this society straightens out, when perhaps ‘death with dignity’ will hang over the heads of, not only the disabled, but the elderly, the homeless, the mentally impaired, and finally all those who can’t produce in an ‘Arbeit Macht Frei’ society.
These bills should be studied very carefully for any loopholes that could be used to hand over the power of life and death to a government that seems now in the business of abolishing basic civil rights in the name of economic recovery.
Not all of us will wind up in comas, unable to speak for ourselves. There should be advocacy for LIFE also.
Death With Dignity also sounds like a new motto for the Strategic Air Command.
would not even make that choice available to all individuals with a fatal diagnosis. There are a number of wasting diseases which simply would not qualify the patient to make a choice to die in this way. If it is not possible to predict with certainty that the patient will die of his disease within a very short time (something less than a month?) that patient will not even have the choice to end his life earlier. And two independent physicians must agree with this prognosis, certify that the patient is mentally competent; and the patient himself must request the terminal medication twice verbally as well as once in a written request made a minimum of two weeks(?) earlier (again I can’t recall the exact amount of time), before he is given the medication to take himself.
The parameters for qualification are really quite narrow, in fact.
As proposed, the “death with dignity” law could not be abused for nefarious purposes.