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The Right To Die: Should Government Intervene? The Right To Die: Should Government Intervene? My Position is No In the recent years discussions about the right to die, the fervor of the national debate over assisted suicide and euthanasia has not decreased. Instead, it has been recast in legal, individualistic terms, in a manner disturbingly reminiscent of government stubborn social battles over abortion. No longer at the forefront of the discussion is the question when, if ever, it is morally right for dying or seriously ill individuals intentionally to take their own lives. Instead, the issue occupying center stage is whether they should have a legal right to do so, and if necessary to enlist the aid of a physician willing to prescribe the lethal dose.
This paper discusses these very controversial issues. What should be the appropriate stance of the criminal and civil law toward various types of physician-assisted suicide and euthanasia? This question is extremely complex. At the heart of the matter, of course, are the moral questions alluded to in our opening paragraph. However, the resolution of the moral issue in and of itself does not dictate sound law. In some cases, a society might rightly choose not to punish acts it believes to be seriously immoral.
Conversely, a society might decide to enact a blanket prohibition against certain types of behavior, despite the fact that they might be morally permissible in certain cases. Key factors in the decision about criminalization include whether the behavior in question directly harms only the individual performing it or others as well, how widely supported the moral judgment about that behavior is, whether the prohibition will be an effective deterrent, the level of resources required to enforce it, and the probability that it can be enforced equitably. Another crucial consideration is the undeniable pedagogical function of the law: how will enacting or repealing the relevant criminal prohibition, when combined with other aspects of our legal system, shape our understanding of a virtuous life and a good community? (1) These are not questions that can be answered in the abstract, but only with reference to the dynamics of life within a particular society at a particular point in its history. The fundamental question is what legal framework will enhance the common good, and how the particular prohibition at stake coheres with that framework.
In the U. S. this question at times becomes entangled in matters of American constitutional law. (2) When the courts articulate a new constitutional right, they effectively prevent the elected representatives of the people from implementing any legal framework the courts judge to be inconsistent with that right. The government shares a very confident attitude toward the potential for abuse entailed by legalization of assisted suicide and euthanasia. Several critical problems associated with legalizing, and therefore legitimizing, assisted suicide and euthanasia are discussed below. Doctors as Killers.
Physician-assisted suicide and voluntary euthanasia are not "private choices. " They are choices that require the involvement of some of the most powerful figures in American society: members of the medical profession. Doctors who agree to participate in one or more instances of voluntary euthanasia or assisted suicide will not stop practicing medicine after so doing. They will go on to care for other persons who need their help, with their professional sensibilities now shaped by this new experience. (3) Furthermore, there is reason to question whether the availability of assisted death will give physicians, as well as members of the broader medical community, an excuse for not remedying profound inadequacies in the way the U. S. health-care system currently manages end-of-life issues. Managed Care.
The problems associated with giving physician the power to kill are even more acute when we take into account the "managed care" revolution currently underway in the American health-care financing and delivery system. (4) Government appear nearly oblivious to this fact. Two aspects of this revolution are particularly likely to exacerbate the dangers associated with legalizing assisted suicide. (5) First, under managed care, most providers have a financial incentive to limit the treatment provided to their patients. Studies have shown that most health-care costs can be traced to expenses incurred in the last months of life. Employers and insurance companies could achieve great financial savings by encouraging patients to choose assisted suicide at the "appropriate" time.
The Plight of the Vulnerable. The New York Task Force on Life and the Law, whose membership encompassed a wide range of views on the ethical issues, unanimously concluded that assisted suicide and euthanasia would be "profoundly dangerous" for "those whose autonomy and well-being are already compromised by poverty, lack of access to good medical care, or membership in a stigmatized social group. " (6) Government does no better in its treatment of dangers to vulnerable populations. Compassion contends the real problem is that the poor and the handicapped will be denied the right to kill themselves. (7) In addition to the poor, the elderly, the mentally impaired, and women (8) all face special risks in a regime of legalized aid-in-dying. Both practical and theoretical forces converge to magnify these risks. As a practical matter, American society is simply not committed to providing members of these groups with the social support and resources that they need. Our most recent attempt to provide universal health care was a dismal failure.
Congress and the states are slashing Medicare and Medicaid in order to reduce the federal deficit and cut taxes. Furthermore, the theoretical justifications used for assisted suicide locate the true value of human life in autonomy and independence; in the capacities to choose and to do. (9) Constitutional Right or Statutory Right? All of the dangers described above would loom large if physician-assisted suicide or euthanasia were legalized by state legislatures, as Oregon has now done. However, their magnitude will increase exponentially if legalization is accomplished by the creation of a new constitutional liberty interest. As the long history of state and federal attempts to regulate the practice of abortion after Roe demonstrates, any law or governmental policy that impinges upon the exercise of an individual's constitutionally protected sphere of action will almost certainly elicit legal challenges requiring judicial resolution. The judicial Process is expensive and time-consuming.
Disputed statutes or regulations are frequently subject to injunctions prohibiting their application while the courts decide whether their usefulness in curbing abuses justifies the burden they place on the exercise of the right in question. The cumbersome nature of formulating and implementing regulation touching constitutional rights has proved to be difficult and inconvenient in the case of abortion, it will likely prove disastrous with respect to assisted suicide. The health care delivery and financing system is evolving at such a rapid pace that regulations designed to curb a specified set of abuses are likely to be quickly outdated. In short, while legalization of physician-assisted suicide would be detrimental to the common good, its constitutional ization is likely to be far worse. (9) State Interests and the Common Good.
What explains the general inability of the government to take cognizance of the dangers posed by granting constitutional protection to the choice of assisted suicide? One possible an r to this question can be found in the way the opinions conceptualize the problem they believe themselves to be addressing. Over and against a competent, terminally ill individual's interest in ending her own life, the opinions set the interests asserted by the state. According to Compassion, the applicable state interests include preserving life, preventing suicide, avoiding undue pressure, avoiding traumatic effects on children, other family, and loved ones, preserving the integrity of the medical profession, and preventing adverse consequences (the "slippery slope" arguments discussed above). (10) None of these interests, asserts the court, is sufficiently served by a state policy that deliberately prohibits competent, terminally ill adults from putting an end to their pain and indignity by taking their own lives with the assistance of a physician. There are several basic problems with this way of conceptualizing the issue. The phrase "state interests" appears to pit the overweening activity of a nameless, faceless bureaucracy against the pain and suffering of specific individuals.
Describing the relevant state policy in narrow, malevolent terms, the court at times suggests that the state's goal is deliberately to force each and every terminally ill person to continue living in pain and suffering. (11) Related, the very term "state interests" occludes the fact that ultimately at stake is not an abstract political entity but a community composed of living human persons. It is more accurate to say that what the state is trying to protect is not its own interests, but the interests of members of the community who may be harmed by legalizing assisted suicide. If the goal of all lawmaking is to further the common good, then the state cannot fail to consider what legal scheme will work best for all of its citizens, not simply for the class of terminally ill citizens who wish to take their own lives. (12) This difference in emphasis dividing the opinions favoring and those opposing constitutional protection for assisted suicide starkly reveals the fundamental moral question underlying this problem of special ethics: How do we reconcile the good of the individual and the common good? The opinions supporting the "right to die" seem to embody a straightforward liberal individualism. In general, they assume that an individual's dignity is enhanced by expanding the range of choices open to her.
As their cavalier discussions of the social dangers posed by assisted suicide demonstrate, they simply presume that a legal scheme that expands individual freedom cannot in the end be harmful to the population at large. The mirror image of these assumptions can be found in the opinions opposing the development of a new "right to die. " Heavily impressed by the potential dangers of legalizing assisted suicide, they all but ignore the neuralgic pleas for help presented in the case studies of the plaintiffs. The most pressing challenge facing opponents of assisted suicide or voluntary euthanasia can be found in the faces of those who request such practices in order to put an end to their suffering. They are pointing to their own pain as a justification for carving out an exception to the general legal and moral rule against intentionally killing the innocent.
What can those opposed to the recognition of such an exception say to them? (13) The responses that come immediately to mind are not entirely satisfactory. First, we could say that both the rule itself and permissible exceptions are determined entirely with reference to the well-being of society as a whole. Thus, we could contend that physician-assisted suicide and euthanasia are not permitted because they harm the common good, not because they harm the individuals who request the procedures. Moreover, we could go so far as to acknowledge that the prohibition in question does in fact harm some patients. On this view, asking a terminally ill person to obey the law on end-of-life decision-making is analogous to asking a young man to obey his draft notice. In both cases, society is requiring an individual to suffer a real harm for the sake of other members of the community.
Consequently, we should state that government should not intervene in issue of the right to die. Endnotes: (1). M. Cathleen Kaveny, "Toward a Thomistic Perspective on Abortion and the Law in Contemporary America, " The Thomist 55 (1991) 343 - 96. (2). T. Howard Stone and William J.
Winslade, "Physician-Assisted Suicide and Euthanasia in the United States, " The Journal of Legal Medicine 16 (1995) 481 - 507. (3). On physician, virtue, and euthanasia, see Grant R. Gillett, "Learning to Do No Harm, " Journal of Medicine and Philosophy 18 (1993) 253 - 68. (4). David Orentlicher, "Paying Physicians More to Do Less: Financial Incentives to Limit Care, " University of Richmond Law Review 30 (1996) 155 - 197. (5). M. Cathleen Kaveny and John Langan, S.
J. , "The Physician's Call, " New York Times, 15 July 1996, A- 11. (6). The New York State Task Force on Life and the Law, When Death is Sought: Assisted Suicide and Euthanasia in the Medical Context [ 19941 chap. 3 (7). Compassion in Dying v. State of Washington, 79 F. 3 d 790 (9 th Cir. 1996) (8). Susan M. Wolf, "Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia, " in Feminism & Bioethics, ed.
Susan M. Wolf (New York: Oxford University, 1996) 282 - 317. (9). Lonny Shavelson, A Chosen Death: The Dying Confront Assisted Suicide (New York: Simon & Schuster, 1995) (10). American Medical Association, "Physician Assisted Suicide, Report 59 of the Board of Trustees (A- 96). (11). Compassion, 79 F. 3 d at 816. (12). Charles H.
Baron et al. , "A Model State Act to Authorize and Regulate Physician-Assisted Suicide, " Harvard Journal on Legislation 33 (1996) 1 - 34. (13). Ibid. (14). Lonny Shavelson, A Chosen Death: The Dying Confront Assisted Bibliography; Kaveny, C. "Toward a Thomistic Perspective on Abortion and the Law in Contemporary America, " The Thomist 55 (1991): 343 - 96. Stone H. , Winslade, W. "Physician-Assisted Suicide and Euthanasia in the United States, " The Journal of Legal Medicine 16 (1995): 481 - 507. Gillett, G. "Learning to Do No Harm, " Journal of Medicine and Philosophy 18 (1993): 253 - 68. Orentlicher, D. "Paying Physicians More to Do Less: Financial Incentives to Limit Care, " University of Richmond Law Review 30 (1996) 155 - 197.
Kaveny C. , Langan, J. "The Physician's Call, " New York Times, 15 July 1996, A- 11. The New York State Task Force on Life and the Law, When Death is Sought: Assisted Suicide and Euthanasia in the Medical Context, 1994 chap. 3 Compassion in Dying v. State of Washington, 79 F. 3 d 790 (9 th Cir. 1996) Wolf, S. "Gender, Feminism, and Death: Physician-Assisted Suicide and Euthanasia, " Feminism & Bioethics, ed. Susan M. Wolf (New York: Oxford University, 1996): 282 - 317.
American Medical Association, "Physician Assisted Suicide, Report 59 of the Board of Trustees (A- 96), 1996 Baron C. et al. , "A Model State Act to Authorize and Regulate Physician-Assisted Suicide, " Harvard Journal on Legislation 33 (1996) 1 - 34. Shavelson, L. A Chosen Death: The Dying Confront Assisted Suicide. New York: Simon & Schuster, 1995
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Research essay sample on Physician Assisted Suicide Terminally Ill
