What’s the calling card value of the National Rifle Assn. and other conservative organizations? Skepticism of government infringing on the autonomy and freedom of individuals, of course. But in yet another example of America’s incoherent politics, assisted suicide has been legalized in liberal California by appealing to precisely these conservative values.
Perhaps it’s not surprising that the best arguments against assisted suicide — especially advanced by such liberal icons as E.J. Dionne and Victoria Kennedy — are progressive. Liberals are generally happy for government to restrict individual freedoms to prevent violence and killing. They are also generally skeptical of the idea that choice leads to genuine freedom, especially for those without power on the margins of our culture.
Indeed, liberal states such as Massachusetts, Connecticut, New Jersey and, until this week, California had all recently rejected such legislation. Britain’s attempt to pass an assisted-suicide bill also went down to overwhelming defeat.
To get a victory in California, its supporters were forced to bypass the regular legislative process (which defeated the bill) and instead consider the bill in a healthcare special session, and under unusual rules. This context is as telling as it is disturbing.
Gov. Jerry Brown, despite being disappointed with its irregular passage, cited the pain and suffering of the dying as the reason he signed the bill. But it turns out these aren’t the reasons most people in the U.S. request assisted suicide. Indeed, with palliative sedation, doctors can keep patients unconscious so they don’t feel pain. According to Oregon’s public health department, the top reasons given for assisted suicide in the state are loss of autonomy (91.5%), decreased ability to engage in enjoyable activities (88.7%), loss of dignity (79.3%), loss of control of body (50.1%) and becoming a burden on others (40%).
We’ve created a culture that worships freedom, autonomy and productivity, and pushes those who don’t fit that picture to the margins. Is it any wonder that poll data show that the poor and blacks and Latinos, along with virtually every disability rights group, are skeptical of assisted suicide?
Can a state really call itself progressive if, instead of working to change a culture where those without autonomy and control are considered a burden, it decides to make it easier for such people to kill themselves?
And there is evidence that the supposed safeguards in the law will not be enough to prevent the problem of the slippery slope. In the Netherlands and Belgium, the “right to die” just keeps broadening. An ever-increasing number of those exercising that right are requesting and receiving death because of depression, not pain or terminal illness. One Belgian legal expert has warned that the right to die is “going to become a kind of obligation.” Once the euthanasia crack opened, he said, it has just kept getting wider.
Supporters of assisted suicide in the U.S. argue that slippery slope concerns are overblown, but even in Oregon the facts tell a different story. Physicians for Compassionate Care has shown that some patients with severe depression have been approved for assisted suicide in Oregon. California has earmarked no money to train healthcare providers, evaluate problematic cases or prosecute negligent physicians. It is therefore likely to end up in the same place as Oregon, a state with safeguards in theory but where, according to a 2008 law review article, in practice, those safeguards can be circumvented.
Liberals also know that the logic of autonomy and individual choice are difficult to contain. California’s legislation, like Oregon’s, insists one must be within six months of death. But why should that be? Doesn’t the logic of autonomy and individual choice push beyond six months?
In point of fact, one Oregon legislator has attempted to expand the assisted-suicide threshold from six to 12 months but failed, due in part to strong opposition from groups in favor of assisted suicide overall. The president of Death with Dignity in Portland, for instance, said that such an expansion would send the wrong message to lawmakers in other states. “You just run the risk of the slippery slope argument big-time,” he said.
So at least one reason the six-month threshold has remained in place in Oregon is that pro-assisted suicide forces have reigned in what could be the natural progression of the legislation until it passes in other states. But this won’t last forever. The social forces that produced the disasters in the Netherlands and Belgium will eventually be unleashed on Oregon and California.
It was somehow fitting that, at about the same time Brown was signing assisted suicide into law, a study published in the Southern Medical Journal showed a correlation between legalizing assisted suicide and an increase in total suicides rather than a decrease, as some proponents had predicted. Other states thinking of starting down this fateful path (New York is likely the next battleground) should resist the temptation to react with well-meaning but uninformed, knee-jerk compassion.
If they take the time to study the issue, they will find that legalizing assisted suicide is a defeat for progressive principles. A lesson that Californians will learn as well. Sooner or later.
Charles C. Camosy is an associate professor at Fordham University specializing in bioethics. His most recent book is “Beyond the Abortion Wars.” Twitter: @nohiddenmagenta