In addition to reviewing material from FTR-117, the broadcast sets forth additional material from Smith’s book Forced Exit: The Slippery Slope From Assisted Suicide to Legalized Murder (hardcover edition, Times Books, copyright 1997). Particular emphasis is on Peter Singer, a bio-ethicist recently appointed to the faculty of Princeton University. A champion of the “Right to Die Movement,” Singer’s views have been compared with those of social philosophers whose work paved the way for the Third Reich’s “Aktion T‑4” euthanasia program. One of the main texts affecting the German euthanasia movement was Binding and Hoche’s On the Destruction of Life Unworthy of Life. In Forced Exit, Smith compares the text of a legal decision by Judge Stephen Reinhardt with key passages from the Binding and Hoche text, a major influence on Hitler’s social philosophy. Other highlights of the program include: an analysis of the difficulty physicians have in diagnosing and treating depression (many “candidates” for euthanasia are clinically depressed and, therefore, treatable); the difficulty physicians have in accurately diagnosing ‘persistent vegetative states” (many so-called “brain-dead” patients are misdiagnosed and, in some cases, conscious but unable to communicate); and the economic imperatives being imposed on physicians by for-profit HMOs.
Late night talk show host Jimmy Kimmel recently excoriated GOP Senator Bill Cassidy, the co-sponsor of the GOP’s latest health care bill, for lying to Kimmel back in July about Cassidy’s commitment to only back a health care bill that passes “The Kimmel Test”. The “Kimmel Test” is a term that Cassidy himself coined when he promised Kimmel that Cassidy would only support a health care bill that ensured children born with expensive medical complications — like Jimmey Kimmel’s recently born son with a congenital heart condition — would be able to get the medical treatment they need to live a full life. That includes treatment to address the immediate medical need, like multiple expensive heart surgeries, but also access to life insurance coverage without lifetime caps (caps which can easily be exceeded for people with expensive conditions). And the Kimmel Test isn’t limited to new born infants but is supposed to include everyone. In other words, Senator Cassidy promised Kimmel during that interview that he wouldn’t support a health care bill that basically says, “Ok, this person’s life it too expensive to maintain.” It’s the kind of thing that should be a no-brainer for a modern, decent society.
And, Of course, Cassidy’s new bill completely fails that test. It’s a “Let ’em die (eventually, when they run out of financial resources)!” bill.
So given the GOP’s seemingly endless attempts to “repeal and replace” Obamacare include seemingly endless attempts to significantly gut Medicaid and leave the United States without any sort of meaningful health care safety-net for the poor, elderly, and disabled, it’s worth keeping mind that these goals — goals which are guaranteed to send millions of Americans to an early grave — aren’t just morally outrageous on their own. They also end up complicating an array of other inherently difficult moral questions. Questions where the answers are predicated on the basic decency of the society asking them. In particular, the questions surrounding assisted suicide, allowing people to die compassionately and on their own terms, and how many resources should be spent to keep people alive when doing so is expensive.
On their own these are inevitably going to be difficult question, but they’re also the kinds of issues that become a lot harder to answer the more and more is seems like society doesn’t care if people die. And if there’s one overarching theme to the contemporary GOP’s agenda it’s an agenda to restructure society in such a way where people without the financial means are simply allowed to fall through the cracks and die. A society where we are not ‘all in it together’. That’s the goal and it’s the kind of goal that’s going to inevitably make issues like assisted suicide and whether or not people with expensive medical conditions should be given those resources much harder to answer. Or perhaps easier to answer since the answer will inevitably be “we don’t have the resources to care for you...good luck!”
Questions like “is health care a right?” are still open questions for American society. And one of the two major parties appears to be determined to gut Medicaid, a program designed to be a last resort for not just the poor but for a wide variety of people with lifelong expensive conditions. As such, it’s going to be tragically important to not forget that the disabled and those deemed to be physically unfit were the first victims of the Nazis (and the US has its own history in this area):
“What kind of society do we want to be? Those of us who live with disabilities are at the forefront of the larger discussion of what constitutes a valued life. What is a life worth living? Too often, the lives of those of us who live with disabilities are not valued, and feared. At the root of this fear is misunderstanding, misrepresentation, and a lack of knowledge of disability history and, thus, disabled lives.”
What kind of society do we want to be? Well, if the GOP gets its way we’re going to be a “let ’em die!” society. Which means we’re also going to the kind of society where any discussions about assisted suicide and the compassionate ending of life is going to be mired in the horrific politics of health care austerity and the GOP’s endless war on the poor, especially poor disable people or others with expensive medical services. You know, kind of like the Nazis. The GOP is just a little less explicit about it.
Adding to the sick nature of this political situation is that a lack of adequate health care coverage is exactly the kind of thing that’s going to put more and more people in the kind of medical situation where they have to consider some sort of assisted suicide because a painful, slow or quick, death will be the only other option they’re left with. The ethics of ending life is one of the most challenging topic a society can grapple with and it’s going to a lot more difficult to grapple with at the same time society is pondering whether or not we can pay to keep each other alive. But this is where we are. Lot’s of ethical grappling is in store for America.
So don’t forget as we grapple with this nightmare situation: the Nazis failed the “Kimmel test” too. And they didn’t casually fail it. They failed it out of an ideology that viewed entire categories of people as not worthy of life.