Assisted Suicide and “Reasonable Medical Judgment”
Damon Linker likes California’s assisted-suicide bill. After rejecting religiously-based arguments against suicide, he writes,
The arguments raised by disability-rights activists are more powerful, since they’re based less on appeals to absolute (and unconvincing) moral strictures than on the law’s potential to lead to bad consequences and abuse. One of those consequences is a kind of soft eugenics in which the terminally ill are subtly pressured to do the “selfless” thing of ending their lives to save their loved ones from the financial and emotional burdens of caring for them. One could also imagine a future attempt to expand the law to include not just terminally ill and suffering patients, but also people with chronic and debilitating but not fatal or excruciating illnesses. Finally, there’s the possibility of the law being changed so that it permits not just the patient but also family members or friends to request the lethal dosage. That, too, could lead to the exertion of pressure on a patient to end his or her life.
These are legitimate concerns that should be taken seriously, especially in light of a recent disturbing New Yorker article about how Belgium allows euthanasia for people suffering from depression. But the California law is written to avoid being applied in anything like the ways feared by most disability activists. So yes, let’s beware future amendments to the law that could lead to abuse. But that’s no reason to oppose its current, limited, and responsible form. (One doesn’t normally oppose a law based on the ways it might one day be changed, revised, or amended.)
I just want to make two comments about this. First, having read the text of the proposed law, I can’t see anything in it that would warrant Linker’s claim that “the California law is written to avoid being applied in anything like the ways feared by most disability activists.” It seems to me that it would be very easy for an attending physician and members of the dying person’s family to practice “a kind of soft eugenics in which the terminally ill are subtly pressured to do the ‘selfless’ thing of ending their lives to save their loved ones from the financial and emotional burdens of caring for them.” In fact, I don’t see how a law could be written to prevent that kind of pressure from being brought to bear on the dying.
Second, and in a spirit of theoretical disputation, I note Linker’s claim that “One doesn’t normally oppose a law based on the ways it might one day be changed, revised, or amended.” Doesn’t one? Shouldn’t one? It seems to me that there are cases in which it would be sensible to look at possible future extensions of a proposed law while evaluating its current form — and this could be one of them.
The law opens the choice of physician-assisted suicide to persons with a “terminal disease,” and defines “terminal disease” as “an incurable and irreversible disease that has been medically confirmed and will, within reasonable medical judgment, result in death within six months.” Surely someone will say, “Why six months? Why not a year — or more — if ‘reasonable medical judgment’ concludes that death is overwhelmingly likely?” That is, there’s an arbitrariness in the choice of six months as the (pardon the term) deadline for this choice which makes it likely that there will soon be pressure to extend it.
Moreover, there’s a great deal of wiggle room in the phrase “reasonable medical judgment.” One doctor may deem a disease fatal that another finds eminently treatable; and even when fatality is for all intents and purposes certain, people often surprise their doctors. Some cancer patients have lived far beyond the utmost time predicted for them; others die much more quickly than expected. (My father was one of the latter.)
So it seems to me that the law in its current form is already ripe for abuse; and it seems extremely likely that strong arguments will be made for extending the time frame in which suicide may be assisted — in the name of the same compassion that causes Linker to endorse the current bill. So even on non-religious grounds the proposed law seems to me far more questionable than Linker allows.