Secular Right | Reality & Reason

Oct/12

20

Not So Slippery A Slope

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Locked inCould the availability of assisted suicide actually prolong life in some cases?

The Economist notes:

The prospect of the loss of autonomy, of dignity and of the ability to enjoy life are the main reasons cited by those wanting assisted suicide. Having the option of assisted suicide means that terminally ill people can wait before choosing to end their lives. That may have been what happened to Gloria Taylor, a Canadian assisted-suicide campaigner with Lou Gehrig’s disease (a degenerative illness). After winning a landmark court case four months ago that gave her a “personal exemption” to seek a doctor’s help to commit suicide at the time of her choosing, she died earlier this month—from natural causes.

Intuitively this makes sense.

And as for that slippery slope that the scaremongers are always brandishing, protections can be built in that ought to fence it off:

[F]or the limited measures introduced so far, safeguards abound and evidence of abuse is scant. Oregon’s legislation, introduced in 1998, is widely admired. Under it, an eligible applicant must be a mentally competent adult, suffering from a terminal illness and with less than six months left to live. His decision must be “informed”, meaning he must have been told about alternatives such as hospice care and pain control, and he must have asked his doctor at least three times to be allowed to die. A second doctor must review the case both for the accuracy of the prognosis and to certify that no pressure (from inheritance-hungry relatives, say) has been exerted.

That is too restrictive in some respects (it wouldn’t help those with locked-in syndrome, who can live on for decades), but the other protections make good sense.

And how steep is that slope? Not very.

Almost all existing or proposed assisted-suicide laws contain similar safeguards. Some also require the applicant to be suffering “unbearable” physical or mental pain. Only in Belgium, the Netherlands and Switzerland, where assisted suicide has been permitted since 1942, are the non-terminally ill eligible. Yet even that liberality has not stoked the numbers. The annual total of assisted deaths among Swiss residents is still around 300, or 0.5% of all deaths. Dignitas, the only organisation in the world willing to help foreigners die, had 160 clients in 2011. In Oregon assisted suicides represent 0.2% of all deaths. In Belgium, where voluntary euthanasia is also legal, assisted dying accounts for less than 1% of the total. Even in the Netherlands, which takes a notably relaxed approach to both forms, it represents less than 3%.

10 comments

  • Kevin Lawrence · October 20, 2012 at 3:50 pm

    Andrew, I wonder how you decide which posts to cross post at the corner. I suspect your readers and colleagues at NR need more persuading on this topic than your readers here.

  • Author comment by Steve Cardon · October 20, 2012 at 6:20 pm

    Mr. Lawrence – you are correct to some extent, although it is not a completely converted choir posting comments here as I have found. That said, thank you Andrew for a brilliantly conceived and rendered further take on this issue. The point that you make here is so valid and dead-on real, that I am pissed at myself for not making it first.

    Mr. Stuffaford obviously doesn’t need ME to answer for him, but I might point out that there is certainly value in clarifying, and working out better presentations of positions amongst like-minded individuals. Others may have explored an issue from slightly different intellectual vantage points than ones own… or simply be more adept at identifying and eliminating the irrelevant parts of a larger arguement with which they otherwise agree with.

  • Author comment by Andrew Stuttaford · October 20, 2012 at 10:48 pm

    Kevin, there is no firm rule—other than the fact that I am keen that the two sets of postings should not overlap overmuch.

    On this site, I tend to concentrate primarily on “religious” (very broadly defined) issues. On the Corner I discuss “everything else”, although I occasionally post something more typically “SR” there in response to what one or other of the Cornerites has posted.

    There are also two other things: Firstly, I do a fairly high proportion of my blogging at the weekend—a time when the Corner is usually reasonably quiet—and I don’t want to clog the place up with a succession of Stuttaford posts (no such shame here!). Secondly, I have a day job unrelated to journalism, which makes it difficult for me fully to participate during the week in proper debate over there, and some of the “SR” topics could certainly trigger that….

    FWIW I also tweet (sporadically). And that can be about anything…

  • Kevin Lawrence · October 21, 2012 at 2:09 am

    Andrew, the reason I ask is that you make a lot of sense where you post here. You also make a lot of sense when you post at the corner. Heather and the Derb too. But you all have a tendency to say things that your audience is likely to agree with.

    When I go visit the Corner and – you, Heather and the Derb *aside – it’s like I’ve come to crazy town. The crazy religious stuff that you highlight here is dialed up to 11 at The Corner. It sometimes seems like, when you and Heather champion reason over superstition here at secular right, you are preaching to the choir. The people who would gain the most from hearing your secular wisdom are your colleagues over at the corner.

    * I exaggerate a little. Rich and Ramesh are often excellent.

  • Mark in Spokane · October 21, 2012 at 5:27 am

    Is this slippery enough? http://www.kval.com/news/26140519.html.

  • Author comment by Steve Cardon · October 21, 2012 at 11:41 am

    Mark in Spokane – What exactly is the point you are making?

    Many Health care plans will not pay for a whole range of EXPERIMENTAL treatments with very limited efficacy. If you read the following article you will perhaps understand why.

    https://blogs.law.harvard.edu/billofhealth/2012/10/19/fda-reprimands-genentech-for-drastically-overstating-the-efficacy-of-tarceva/

    Here is a segment from the article(a link to the actual warning letter can be found further into the article as well):

    “A warning letter was issued to Genentech, the producer of the drug, for vastly overstating
    Tarceva’s possible benefits. The recent untitled letter accused Genentech’s promotional materials of misleadingly indicating that Tarceva in combination with gemcitabine extended overall survival by 3.7 months in comparison with gemcitabine alone, when the actual increase in survival was only about 12 days. The FDA characterized the discrepancy as ‘drastically overstat[ing] the efficacy of Tarceva.’”

    Even if Tarceva offered most people three additional months to live (which apparently is far from being the case), the argument is still whether the insurer should be covering the cost of this particular treatment, Not whether the same insurer should be allowed to offer a very humane “Right to Death” OPTION for the rest of us.

    Even the article you cite conludes there was no PROVEN causality whatsoever between offering the “suicide” option, and the denying of an expensive experimental drug that is still undergoing clinical trials… only implications and accusations from individuals who are apparently far from objective.

    Is your argument that the rest of us should be unable to get insurance coverage for an assisted suicide option, simply because others are struggling to come to terms with their impending deaths(don’t misunderstand, I am completely sympathetic with that struggle) I’m afraid it simply doesn’t wash.

    I can can see ZERO slope in this instance (slippery or otherwise). What I see are unsubtantiated, malicious, and potentially harmful accusations being leveled at an insurance company who, like all insurance companies, must weigh out what can or cannot be reasonably covered and still remain affordable.

    If everyone were given the option of any expensive experimental drug with very marginal (questionable) efficacy that in their desperation they were willing to try, health care would be profoundly unaffordable for most of us.

    This is an example of how opponents of a particlular issue will exploit the suffering of an individual approaching their death, to tempt others into drawing false conclusions. Christians use this tactic all the time in arguing any manner of issues, including the existence of an omnipotent, omnicient, omnipresent creator.

    If you do not understand basic Boolean Logic, or are in the habit of beginning your chains of logic based upon unproven or shakey premises, you may see any number of slippery slopes populated with woodland fairies, banshees, and an endless array of jealous gods who demand your belief and worship.

    Nevertheless… Oregon, a state who itself might almost be labeled “experimental” is to be lauded for taking a very right-minded, humane, and courageous step into the future.

  • Mark in Spokane · October 22, 2012 at 12:48 am

    My point is that this woman was pressured to take the quick way out rather than suck resources out of the system to preserve her little life. And this will be the path forward as rationing in medical care awaits us under Obamacare, just like there is rationing in the UK. http://www.redstate.com/2012/10/20/47622/

    Once death becomes an option, the State will push you toward it the minute you are worth more to it dead than alive.

  • Author comment by Steve Cardon · October 22, 2012 at 2:56 am

    Mark in Spokane – I understand you concern, I just feel you are focusing on the wrong thing. If, like many of us, you feel O’Bama care is an unsustainable disaster waiting to happen, do what i am doing and convince your like minded friends of the urgency to vote O’bama out of office.

    This is an entirely separate issue from choice of assisted suicide which is purely an “option” in either event. The attempt to correlate the two, made by opponents of assisted suicide is knowingly dishonest on their part. They are trying to pair the two together to create a false “either/or” choice. Again, they are entirely separate issues.

    You can’t get the Tarceva covered in “non-suicide assisted” states either… but that fact is conveniently omitted (the one that puts the lie to their claims). This, if nothing else, should tell you that one has nothing to do with the other.

    In Iowa perhaps there is a “do not resuscitate” option… AND they are denying coverage of Tarceva.. obviously they are “pressuring” you to request a “do not resuscitate”, OBVIOUSLY there is some sinister correlation. It is a crock. She was not sent a letter where just those two items were on the paper in large bold print

    WE WON’T PAY FOR THE TARCEVA… BUT WE WILL PAY FOR YOU TO COMMIT SUICIDE… WHADDAYA THINK ABOUT THAT… SAVE US ALL SOME EXTRA MONEY!!… HAVE A NICE DAY.

    She was sent extensive information listing all of the options and services available to her including the “option” of dying naturally, or arranging for the assisted suicide. I highly doubt the Tarceva denial was even sent in the same envelope as the one sent to inform her of the services offered under her program.

    the denial was most likely either established by phone, or mailed separately in response to a specific petition.

    I’m not sure how the woman is being “pressured” to commit suicide. Unless she herself initiates the request, then goes through a careful verification process to establish that she is rational, committed and in no way being coerced, she will default to dying naturally from the cancer.

    Whether she takes the Tarceva or not, the suicide option is still there for her to request or not request.

    If you read the article to which I provided a link, you will see that Tarceva “maybe” would give her two or three weeks additionally to live but in the end she is still faced with the choice of how she wishes to die. She is not going to be kicked out of the hospital or end of life hospice care just because she doesn’t want to commit suicide.

  • JC penny · October 23, 2012 at 12:02 am

    Call me facist…but I am 100% in favor of euthenasia and abortion. All the neat-speak about lives is well and good, but thet fact is that when a member of the collective draws on the net it’s time to go.

    Produce or perish.

  • Mark in Spokane · October 29, 2012 at 5:07 pm

    And just such an attitude quickly morphs into the idea that there is a duty to die. Oh, and here’s an actual example of that in effect, from good ol’ Blighty:

    http://www.telegraph.co.uk/health/healthnews/9639090/Cystic-Fibrosis-sufferer-denied-chance-of-life-drug-by-NHS.html

    Note that the drug the girl wants is free. The company isn’t charging her any money for it. They will give it to her FOR FREE. Not good enough for the State. The usual bureaucratic double-speak simply masks the real motive: elimination of the burdensome. No thank you.

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