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Douthat Gambles on Physician-Assisted Suicides and Loses

September 7, 2009

090416[1]In today’s column, Ross Douthat makes a surprising — I am tempted to say daring — rhetorical move for a conservative. Typically, conservatives like to portray health care reform as a threat to individual liberty: by arguing, for example, that reform will result in the rationing of care or in government bureaucrats stepping between you and your doctor. For Douthat, the goal of “perfect autonomy, perfect control, and absolute freedom of choice” is, by contrast, what lies behind the idea that of health care as a human right.

If it is a rhetorical gamble on Douthat’s part to link choice to reform, Douthat stands to help his side win its argument that reform would result in state-sponsored decisions to end lives. While no New York Times columnist could get away with repeating Sarah Palin’s lie about death panels, Douthat argues that the mentality behind health care reform also undergirds support for physician-assisted suicides:

Our move toward physician-assisted suicide springs from the same quest for mastery over mortality that leads us to spend nearly twice as much on health care as any other developed nation. And our instincts run so strongly toward unlimited spending that it’s much easier to imagine the government going bankrupt paying for extreme life-saving procedures than it is to imagine a suddenly cost-conscious bureaucracy pressuring doctors to administer lethal overdoses.

It sounds paradoxical to link the desire for unlimited medical treatment to the desire for physician-assisted suicide. But the idea that there’s a right to the most expensive health care while you want to be alive isn’t all that different, in a sense, from the idea that there’s a right to swiftly die once life doesn’t seem worth living.

In each case, the goal is perfect autonomy, perfect control, and absolute freedom of choice. And in each case, the alternative approach — one that emphasizes the limits of human agency, and the importance of humility in the face of death’s mysteries — doesn’t mesh with our national DNA.

Douthat has at least the virtue of intellectual honesty, yet his disregard for basic facts easily rivals that of Michael Steele. First, while it is true that the US spends twice as much on health care as any other developed nation, it is also true that we are the only developed country not to guarantee health care to all of its citizens. Why? For precisely the reason Douthat condemns reform: because of our obsession with “perfectly autonomy, perfect control, and absolute freedom of choice,” which conservatives have repeatedly insisted can only be delivered by the free market. Once the government steps in, they argue, you get rationing, government interference with medical procedures, and all the rest.

Douthat likewise misrepresents the liberal position, as though the goal of reform can somehow be linked to “the desire for unlimited medical treatment.” What liberals are talking about is expanding access to basic health insurance to people who couldn’t otherwise afford it: not in the name of liberty, but in the name of human rights. Liberals have also looked into evaluating the effectiveness of treatments covered under Medicare, a proposal that Michael Steele strongly denounced in a recent Washington Post op-ed (which I have also blogged about). There is, thus, no link between “the desire for unlimited medical treatment” and “the desire for physician-assisted suicide,” since liberals have not really been talking about the former. (Michael Steele has!)

Now, it is true that some liberals favor physician-assisted suicide on the same grounds that many conservatives oppose health care reform: to borrow Douthat’s phrase, out of a desire for “perfect autonomy, perfect control, and absolute freedom of choice.” Shame on both sides, I say.

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