Program #0395 for Monday, October 15, 2012: Carter Snead on physician-assisted suicide

October 15, 2012

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Carter Snead on physician-assisted suicide

Carter Snead on physician-assisted suicide

Summary of today’s show: Carter Snead, a law professor at University of Notre Dame, joins Scot Landry to talk about the moral principles embodied in the passage of laws and why the arguments put forth by the proponents of Question Two to legalize physician-assisted suicide would provide no barrier to even more extreme forms of euthanasia, voluntary or involuntary, and would place the most vulnerable groups among us at risk.

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Today’s host(s): Scot Landry

Today’s guest(s): Carter Snead, Caroline Cassidy, Bridget Rose

Links from today’s show:

Today’s topics:

1st segment: Today’s show is coming live from Montrose School in Medfield, Mass. The school is hosting sessions on assisted suicide for the young women at the school by Carter Snead, a professor at University of Notre Dame. Scot said we’re talking about assisted suicide still because polls show 50% of Mass. voters still don’t know about this issue.

Scot said the Committee Against Physician Assisted Suicide is starting to air a new radio ad on Massachusetts radio stations. They aired the new ad. It talks about the six-month prognosis, the ingestion of 100 capsules is not in a medical setting and without any supervision, that the doctor doesn’t have to be present, and that family doesn’t have to be notified. The close of this is that proponents say it’s all about control, but because of lack of effective safeguards, this is a law that is out of control.

Scot said television advertising will start soon, probably later this week.

Carter Snead is director of the Center for Ethics and Culture and a professor of law. He specializes in the relationship between bioethics and the law. Scot said Carter has also spoken at St. Sebastian School and will speak tomorrow at the Boston Leadership Forum breakfast at 7:30am at the Union Club. He will speak tonight at the Montrose School at 7pm.

Scot noted that Carter isn’t from Massachusetts but he wanted to help us on this issue. He said the stakes don’t get higher than assisted suicide and those outside of Massachusetts who care about the well-being of the most vulnerable populations want to help. We have seen in other places how these types of laws put them at risk. He noted that New York state took up this issue and agreed that the state shouldn’t legalize it, even though some agreed with the concept, because it placed the vulnerable at too much risk.

Scot said many folks don’t know that this sort of legislation has come up in 25 states and in all but two states it’s been turned away. Carter said overwhelmingly in the US is that assisted suicide is frowned upon, criminalized, disavowed by the medical profession. There is an active and well-funded movement to legalize assisted suicide and then later euthanasia. Even those who are not Catholic or committed to the same Catholic moral principles can agree that the framework of this proposal is very bad. There is little evidence from Oregon’s legalization because there is no real reporting. In the Netherlands, what started as assisted suicide has led to voluntary and involuntary euthanasia.

Scot asked if that progression is something likely to happen here if it passes in Massachusetts and whether the extra autonomy is worth that price. Proponents know euthanasia wouldn’t pass on its own. Carter agreed that it’s an incremental strategy to go from assisted suicide for a limited population to eventually involuntary euthanasia. That’s because that there’s no meaningful principle to say yes to assisted suicide and no to involuntary euthanasia.

Scot said the primary argument from proponents is that dignity involved me having the right at the end of my life to control when I die. People have a right to self-determination in matters of their existence. Scot said we have to respond that suicide affects all of us. Carter said “dignity” in this context means autonomy. He said dignity is a kind of intrinsic, inalienable value recognized in every human being. They’re using dignity to refer only to their individual lives. As Americans we care about liberty.

The argument for autonomy shows it doesn’t do what it’s proponents say it does. We don’t live as disembodied wills. We live situated in families and communities with chosen and unchosen relationships. We’re all interconnected and there is a principle of solidarity when it comes to our actions. Suicide impacts survivors and the community they live in. Scot said it particularly affects the people who say they wish they would have known in order to help. Carter said the Question doesn’t required any kind of mental health evaluation when we know that the vast majority of people who think of suicide are mentally ill.

People are going to make this decision without autonomy. Suicidal desires are often alleviated with effective pain management. Given any real choice, suicide is a phony autonomy.

Scot said anybody who’s lost someone they care about knows the impact affects everyone you know. He added that what’s even worse is that they will assist someone in taking their own life without informing family members.

If we say it’s all about autonomy, then a lot of other things can appeal to the same autonomy argument. Carter said if we allow this as autonomy, how can we criminalize voluntary euthanasia? How can we stop suicide pacts? How can we limit this only to people who are terminally ill? How can we claim emotional suffering isn’t worse than physical suffering? How can we say cold, rational judgment isn’t better than the judgment of someone who is pain and near death? In the Netherlands right now, they are considering a proposal to allow non-terminal suicide for people who have decided they are done with life.

2nd segment: Scot said the second big argument by the proponents is “Who am I to impose my values on others” and citing separation of church and state. Carter said the response to the idea that the state has to be morally neutral misunderstands what the law is. Law is the imposition of values by definition. Law decides what is legal and illegal. It does impose on people. Every law is grounded in some normative framework and oriented toward a particular good to be pursued or some harm to be avoided. Even the speed limit balances many goods and many harms and evaluating the fit of the means of the law and the final end.

The notion that the basic good of human life and state’s obligation to protect it—a fundamental reason for government—is unsurprising. And if we say that religious traditions’ value of human life is a violation of separation of church and state, then we have to undo all our homicide laws and more.

If something is legalized, what other risks come along with that? Can they be regulated in a way that doesn’t endanger other people? Assisted suicide doesn’t work within that framework. If I’m a statesman I see there’s no breaks within this system. All of the aforementioned problems cited—including lack of legal definition of ingestion—lead to the inevitable lack of protection for the vulnerable.

Scot said Carter said earlier today that sometimes the law shapes our values, instead of vice versa. Cardinal Sean has said that if the law sanctions suicide for one group of people, then how can the state’s efforts to minimize suicide across all age demographics, particularly the young, fail to shape some people to think that suicide is the solution for their suffering.

Carter said law does shape people’s behavior. The government endorsement or tolerance has deep symbolic significance for citizens. There are a whole array of examples from the Netherlands to illustrate this point. It’s impossible to hold the line when the government says it’s okay to kill yourself for whatever reason. The costs are just too grave to allow such a law. How many cases of involuntary euthanasia are worth the autonomous suicide of a few?

Scot said in the Netherlands some people who are very sick and near the end of life fear going to the doctor because they’re afraid of being euthanized. So they’re not getting the healthcare they need. Why would we make that possible here? Carter asked how the proponents could oppose what’s happening in the Netherlands within the framework of their own arguments? There’s no grounds for refusing those conditions.

Think about health insurance. There are cases from Oregon of people receiving notification from the insurance carriers telling them that the companies will pay for the assisted suicide and not for expensive treatments. How many instances of coercion that lead to a person’s death is too many to justify this system of assisted suicide?

Scot quoted Carter as saying that in principle societies make laws against self-annihilation. Carter said suicide has always been a crime in the law historically and was eventually de-criminalized. At the same, assisted suicide’s criminalization was expanded. And the law allows someone considering suicide to be detained. Assisted suicide is condemned in the law in all states but three: Oregon, Washington, and Montana. The Montana Supreme Court declared it is not illegal, but no legal either. What’s proposed here is quite radical.

A systemwide availability of facilitated killing promotes an inegalitarian ethos against those living in diminished states. The state also has an interest in preserving the medical profession’s integrity and legitimacy.

3rd segment: Scot welcomed two seniors at Montrose School, Bridget Rose and Caroline Cassidy. Bridget is president of the pro-life club at the school. Scot asked her for her reactions to what Carter talked about today.

Bridget said many high school students don’t know what this question is about. They will talk about autonomy, dignity and the arguments against assisted suicide. They’re energized to inform others.

Scot asked Caroline what she heard today that would shock her. She said she was taken aback by the possibilities. Quality of life replaces life itself as an argument.

Caroline is voting for the first time in November. Scot asked her about voting on an issue that is literally about life and death. She said it’s an amazing responsibility as a young person with strong beliefs. We have a responsibility to take up the value of our lives.

Scot cited the arguments that values should not be imposed on others. He asked Bridget how she would respond to that. She said they discussed in her classes why can’t one person decide for themselves. She said they’ve now learned that it affects everyone and as members of communities our decisions and actions affect everyone.

Scot asked Caroline what she thinks about the possibility that assisted suicide will make young people think suicide is more viable. She said there have been more stories lately in the news about kids contemplating suicide in their difficult lives.

Scot noted that disability groups particularly are opposed to this question because of the pressures they fear will be brought against them.

Scot said a lot of the advertising on this issue will be focused on older voters, but young people put a lot of weight in the tolerance and autonomy arguments. Carter said there’s superficial appeal to the idea, but students are smart enough that when they think about the interconnectedness of all people and the implications of these arguments, then it doesn’t carry the weight that proponents hope it does.

The people most at risk through a system of legalized suicide are the weakest, the poorest, the marginalized.

Carter said he hopes the voters will consider the consequences for all those who will be threatened in dramatic ways, as shown in the Netherlands. He said he was encouraged and buoyed by what he saw in the young men and women at St. Sebastian’s and Montrose School and how they are being formed.

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