Tuesday, September 08, 2009

The "Lucid" Slippery Slope

Amazing. After dredging up a 12-year-old essay and citing Rahm Emanuel's brother's overblown concerns about voluntary euthanasia becoming commonplace, Ross Douthat expresses,
Yet the conservatives pillorying him, unjustly, as a “deadly doctor” could just as easily be quoting him. Twelve years later, Emanuel’s Atlantic essay remains a lucid case for the existence of a slippery slope, especially under government-managed health care, to some sort of death-by-bureaucrat.
Earth to Douthat: the "slippery slope" is a logically fallacious form of argument. A "lucid" slippery slope argument, it would seem, would be one that's transparently illogical, yet Douthat approaches it as if it's sound logic.

Douthat proposes that in the United States,
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.
So then, why bring up the euthanasia "slippery slope" in the first place? To placate the Republican Party? To avoid acknowledging that "death panel" fear mongering is premised on lies? Out of fear of directly calling "shenanigans" on the Sarah Palin wing of his party? To wrap the "death panel" lies in an essay by the brother of a Democratic politician, to illogically suggest that Democrats see the lies as having merit?
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.
It sounds paradoxical because it is paradoxical. People who fear death so much that they'll exploit every medical procedure and technology until "the bitter end" aren't apt to suddenly change their minds and embrace euthanasia. People typically choose one track or the other, not both.

It's also easy for the young to suggest that support for the right to die is selfish, somehow borne of a selfish unwillingness to embrace "death's mysteries" (even though it's a headlong rush into those very mysteries). It's fair to ask: What's Douthat's alternative? Embrace the suffering, learn from it for as long as it endures, then die? What's the lesson in that: The standard cop-out, "God works in mysterious ways"?

Douthat complains that assisted suicide
encourages relatives to see a loved one’s slow death as a problem to be solved, rather than a trial to be accepted.
So, basically, Douthat sees death, no matter how prolonged and painful, as a "trial to be accepted" unless a doctor can frustrate God's will by extending your life in which case it's a trial to be delayed. If your brain shuts down before your body, or you are so wracked in pain that you're unable to process the world through the haze of your pain medications, well, that's fine because there's a lesson in there somewhere for your family to learn. If you have no family, well, maybe it's a lesson for the nursing home staff?

What about "active" euthanasia versus "passive" euthanasia? How does Douthat respond to an individual's choice to decline life-extending treatment? A family's choice on behalf of a terminally ill loved one? A doctor's choice to allow that, even though life could be extended, perhaps for years, simply by inserting a feeding tube? What if the family is, as Douthat might put it, humble in the face of death's mysteries, and sees God as mandating that they accept that trial with a critically ill infant or child, even though the child could live for many years, perhaps even live a normal lifespan, if the family authorized a surgical intervention? Would Douthat still dictate that they follow his religious beliefs, and not their own?

Douthat's essays suggest childhood attendance of Sunday School, with no subsequent reflection on the deeper social and ethical issues behind that grade school level preaching. Just as it's not sufficient to scream "slippery slope" at everything you find objectionable, fretting that society might become comfortable with something that makes you (or your Priest or Sunday School teacher) uncomfortable is not a sufficient basis for an argument for or against anything. But it's not just Douthat's ethical argument that is hollow - what he presents as fact is just plain false:
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.
If that were the case, we should be spending to achieve the best outcomes, not spending wastefully while on the whole obtaining inferior outcomes. We do spend a lot on end of life care, but we deny sufficient medical care to tens of millions of people who could live longer, more fruitful lives if given the benefit of that care. And Douthat aligns himself with the political party that wants to maintain that status quo. (Go figure.)

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