Last weekend's New York Times Magazine ran a story on former Washington governor Booth Gardner, who has Parkinson Disease, and his campaign to legalize physician assisted suicide (PAS) in Washington.
What piqued my interest about the article was that it discussed opposition to PAS that has come from progressive academics rather than the evangelical Christian community. One argument is that legalization of suicide will result in disproportionate number of deaths among women, minorities, disabled, and uninsured individuals who are more likely to see themselves as a burden to family and society than white men are. PAS in essence could be discrimminatory. Moreover, this is complicated by the fact that most doctors are white men and may be more likely to see suffering individuals as a burden and - directly or not - influence a woman's decision to end her life by merely initiating a discussion about suicide. Interestingly, 75% of Kevorkian's PAS patients were women, and more often middle-aged than elderly and frequently with non-terminal, but very disabling conditions such as multiple sclerosis. In Oregon, the only state to have legalized PAS (now over 10 years!) however, the data does not reflect a gender disparity. Nor in the Netherlands apparently, the country with the most progressive laws regarding end of life termination. But not all states have the same demographics and disease burden of Oregon and are unlikely to have the same PAS laws if passed in the future. Nevertheless some points are worth bearing in mind.
In Oregon at least PAS does not empower people to take their own lives - those that have used the law are already capable of doing that on their own. The dying patient must be capable of taking the lethal dose of medication on their own - the physician cannot actively participate. My guess is that these people are also capable of sitting in a closed garge with their cars running. It is very hard for me to see how providing people who already have the ability to end their lives a means to do so with dignity, peace, and social acceptance, will somehow promote a rash of suicides. Gardner's proposal is different. He want PAS to extend not only to terminally ill individuals but to those, like himself, with non-terminal diseases. Alzheimer's would play prominently in this debate as we see more and more baby boomers reach their 70s and 80s.
First, the conventional image of the white male doctor is rapidly becoming obsolete: over 50% of medical school graduates are now female, and there is no indication that this trend will do anything but increase. Moreover, when considering the younger physician workforce, women predominate in primary care, and it is primary care docs who will most likely be providing PAS. Second, the fact that there may be gender/racial disparities in how a law or a medical practice is carried out doesn't necessarily render that law or practice immoral. Unfortunately blacks have a higher rate of amputations (when other medical and socio-economic factors are controlled) than whites, but that doesn't mean we should stop doing amputations...
