Background
Over the summer, the District of Columbia Council voted 11-2 in favor of the legalization of physician-assisted suicide. The contents of the law can be summarized as follows:
“Patients must be older than 18 with less than six months to live to be eligible. They must make two requests at least 15 days apart for life-ending medications and ingest the drugs themselves. Two witnesses must attest that the patients are making the decision voluntarily.”
However, the District of Columbia is a federal district under the exclusive jurisdiction of Congress, clearly stated in the Constitution. After the bill was passed by the D.C. Council, the U.S. House of Representatives voted to advance a measure that would repeal the “Death with Dignity” Act.
According to the most recent Gallup poll conducted repeatedly between 1990 and 2015, approximately 68 percent of the American public favors physician-assisted suicide. Prior to 2013, there was an equal split between Americans on physician-assisted suicide. A divergence in the opinion of Americans began definitively around 2013 and has progressively widened.
A caveat that Gallup included in their research was rephrasing their question to address different ways the issue is often phrased in the media. Instead of just asking respondents, “When a person has a disease that cannot be cured and is living in severe pain, do you think doctors should or should not be allowed by law to assist the patient to end the patient’s life by some painless means if the patient and his or her family request it?” the question was restated as such: “When a person has a disease that cannot be cured and is living in severe pain, do you think doctors should or should not be allowed by law to assist the patient to commit suicide if the patient requests it?” The phraseology of the questions, one that references “a painless relief of suffering” and then the other that references “suicide” had no statistically significant effect on how those surveyed felt about the issue. The overwhelming majority of those who are in favor of a “painless relief of suffering” also feel the same way about “suicide.”
The Rhetoric of the Right to Die Movement
I hypothesize that the mechanical factor that caused the majority of the public to view physician-assisted suicide in a favorable did not lie in the connotational difference between “the painless relief of suffering” and “suicide,” but in the movement’s definition of physician-assisted suicide as a “right.” Calling a piece of prospective legislation a “right” inherently places that legislation above and beyond the status of a normal piece of legislation. In America and the modern Western world, defined rights are revered as “God given.” When the population comes to the point when a given course of action or service from the government is deemed worthy of the definition of a “right,” nuanced conversation about whether that “right” is legitimate or not decreases sharply.
To draw a parallel to the salient and ongoing healthcare debate, once healthcare was framed by both political elites and interest groups as a “right,” it became unpopular and divisive to suggest that healthcare was not indeed a human right. It is close to impossible to rid Americans of so-called “defined rights,” because the removal of rights equates to tyranny.
It is also worth noting the titles of a few activist organizations and why those titles, ads and rhetoric may lead the public to be persuaded that physician assisted suicide, and not natural death, is the more humane course of action. In the early 1970’s, an organization called “Compassion in Dying” was formed. This organization promoted what they thought were positive implications of physician-assisted suicide legislation. According to Jonathan Haidt, one of the leading scholars in the field of moral psychology, compassion and all associated words attunes to the Care/Harm level of the human psyche. This level of Moral Foundations Theory states that in most normal circumstances, we humans do not wish to see anyone suffer. There is a more recent activist organization, entitled “Death with Dignity.” This name implies that those who do not support physician-assisted suicide do not support the dignity and rights of the dying. It’s an effective rhetorical strategy utilized by just about every activist organization, regardless of political affiliation.
In Practice
Rhetorical analysis aside, in practice euthanasia thrusts moral issues upon American society. According to ABC News, some insurance companies are opting to only cover the cost of physician-assisted suicide, rather than, for instance, Barbara Wagner’s chemotherapy treatment.
“The 64-year-old Oregon woman, whose lung cancer had been in remission, learned the disease had returned and would likely kill her. Her last hope was a $4,000-a-month drug that her doctor prescribed for her, but the insurance company refused to pay.What the Oregon Health Plan did agree to cover, however, were drugs for a physician- assisted death. Those drugs would cost about $50.”
Because Ms. Wagner’s circumstances made it easier for insurance companies to cover the cost of the one time only euthanasia medication, insurance companies are, in a sense, coercing patients into death who may not be able to afford to stay alive.
A more philosophical argument for those opposed to physician assisted suicide cite is its implications in the framework of natural law. Natural law assumes that the value of the life has always been of the highest order in society. Suicide is seen in a new light by the Right to Die movement as “the alleviation of suffering.” It suggests that a life that has suffering is one of lesser value because it becomes disposable. Some view the lack of screening for mental illness as further evidence of the increasing disposability of life: “Under many proposed assisted suicide bills, people would not be screened for depression when they request life-ending drugs...Studies have shown the majority of patients who request assisted suicide will withdraw that request when they are treated for depression,” according to The National Cancer Institute, supported by numerous doctors. Following this logic, the breakdown of the inherent value of life inevitably equates to the breakdown of the crux of natural law.
The Positive and Negative Legality of Right to Die
There are various legal bases the US House of Representatives used to justify overturning the Death with Dignity Act in the District of Columbia. Because differing sets of morals rarely come to terms with one another, legality and practicality tend to usurp moral arguments. As stated in the Declaration of Independence, every man is entitled to “life, liberty and the pursuit of happiness.” The pursuit of death is not explicitly stated within these confines. In Washington v. Glucksberg (1997), the US Supreme Court unanimously ruled that, "The history of the law's treatment of assisted suicide in this country has been and continues to be one of the rejection of nearly all efforts to permit it. That being the case, our decisions lead us to conclude that the asserted 'right' to assistance in committing suicide is not a fundamental liberty interest protected by the Due Process Clause.” In Vacco v. Quill (1997), the US Supreme Court again unanimously stated that physician-assisted suicide could continue to be banned by states. These Supreme Court rulings clearly and definitively state that death and the pursuit of death is neither stated nor implied in the Constitution as a “right.”
However, there are different varieties of rights as defined by philosophers of the law. The most common differential between rights is the difference between positive rights and negative rights. Essentially, a positive right is a step the government takes to be more active in the lives of its citizens, and a negative right is a step the government takes to be less active in the lives of its citizens. It is embedded in the American genome that we adhere to the “rights” of citizens, but rarely do we pause to think about the generic composition of a “right,” or the repercussions the action in dispute would cause. Adding more nuance to the conversation regarding positive rights and negative rights is an important distinction to make when defining any act as a right when not explicitly stated in the founding documents of the nation.
There are three potential ways to classify the positive or negative nature of the Physician-Assisted Suicide debate. First, those who are in favor of physician-assisted suicide who state that it is the responsibility of the government to act in a positive fashion; to enact legislation that would protect those who wish to choose when they are to die. By this logic, physician-assisted suicide is a positive right. For a different sector of those in favor of physician-assisted suicide, there is a different perspective. Many feel that this is a negative right, that it is not the business of the government whether someone makes the personal decision to live or die, and the government should not intervene. Therefore, physician assisted suicide also meets the qualifications for a negative right. On the opposite side of the aisle there is no division. For those who are against physician-assisted suicide, some feel that the government should act in a positive fashion, and enact legislation that protects the sanctity of life itself. There is no logical argument behind an Against Physician Assisted Suicide Position/Negative Right combination. In order to prevent, from their perspective the wrongful death of someone who requested to be killed, there must be a law in place, a positive measure that has been previously taken or taken with greater strength in the future, to protect the sanctity of life.
Conclusion
The opinion of the public was swayed on the “Right to Die” issue when the “right” to die was defined as a right. However, just because the popular opinion of the day favors calling “the right to die” a right does not make it so. Which type of right is “The Right to Die?” We are lucky to live in a country designed by people who saw the genius in the slow-moving bureaucratic system we have today. Before “rights” are determined by the masses with the shift in the popular breeze, it is important to return to our foundation.