Douthat on the Slippery Slope of Assisted Suicide

NYT wunderkind and infrequent columnist Ross Douthat has a worthwhile take on voluntary suicide as a segue to much more egregious practices. As Douthat argues

What’s at stake is the right to voluntary euthanasia, not the sort of involuntary plug-pulling that some Republicans have claimed is concealed in the finer print of the current health care reform proposals. But you don’t have to share Sarah Palin’s death panel fears to see perils lurking at the intersection of physician-assisted suicide and health care reform.

Consider the words of a prominent oncologist, bioethicist and health care wonk, critiquing assisted suicide in 1997, just before a Supreme Court ruling on the issue. “Once legalized,” this writer warned in the pages of The Atlantic, “euthanasia would become routine. Over time doctors would become comfortable giving injections to end life and Americans would become comfortable having euthanasia as an option.” From there, it would be an easy slide to euthanizing the incompetent: “Comfort would make us want to extend the option to others who, in society’s view, are suffering and leading purposeless lives.”

Comfort — and budgetary constraints. Euthanasia would be much more likely to pass from an exception to a rule, the bioethicist argued, “in the context of demographic and budgetary pressures on Social Security and Medicare as the Baby Boom generation begins to retire, around 2010.”

And of course in Canada, where the publicly funded healthcare system is already overwhelmed, this is much more likely to be true.

The real fear, of course, is that an unaccountable medical guild will increasingly make these decisions on their own. Witness events in New Orleans following Hurricane Katrina. Perhaps the most important and least understood of needed changes in health care delivery is the need to hold physicians to far more effective account, both for decisions made and resources used. Few if any politicians have the courage to take on the medical establishment. Until they do, efforts to take control of our health care system will remain largely cosmetic.