On Morning Joe a few minutes ago, Pat Buchanan described the fear behind the death panel debate as the fear that old people without anyone around who loves them will be steered in their final years toward elective euthanasia. Surely the steering power of a government authorized to command and control the health care economy would be profound indeed. But the root issue behind the death panel debate is not federal power — it’s human dignity.
The archetypal or stereotypical conservative would say that even an old, isolated person has a reason to reject suicide that reaches to the foundations of what makes us human and what gives humans dignity. The archetypal or stereotypical progressive would say that conservatives need to abandon their romantic and/or religious fantasies that a dying person finds more dignity in enduring great suffering until their body fails than in choosing to die beforehand. Liberals, who, technically speaking, are stuck or torn between conservatism and progressivism, would be torn on this issue too. Liberalism — the political philosophy and worldview, not the ideological position — struggles to square or reconcile two competing visions of human dignity.
It’s tempting to say the first or conservative vision defines dignity in terms of the human race or species, and that the second/progressive vision does so in individualistic terms. On the question of suicide, that may seem true; but on health care more broadly, it’s obviously false. Progressives, not conservatives, are the ones most apt to think that the power of social science to help us all comes from its ability to generate valid predictions based on large-n data inputs — data in which each individual is reduced to their minimal statistical significance, and made mutually interchangeable accordingly. It turns out that conservatives and progressives also harbor an internal tension between thinking of dignity as existing in virtue of our shared human being and dignity as existing in virtue of our individual human being. It’s almost as if that tension reflects something fundamental about being human — both as a member of the human species and as a unique individual person.
But that tension today is colored deeply by our disgusted, despairing sense of nihilism over individual suffering. It’s increasingly difficult for us to conceive of the decision to soldier through a terminal illness as dignified. The problem is exacerbated by the costs of such care. If the stoic sufferer has loved ones, he or she is insensitive to what he or she is “putting them through;” if not, the stoic sufferer is wasting their — if not other people’s — money. For what? Paradoxically, perhaps, even our individualistic attitude toward the worthlessness of suffering lowers our estimation of individualistic pride.
By now it might be clear that I’ve been sliding back and forth between the assumption that enduring a terminal illness will be a natural or hands-off process versus one full of medication, treatment, and care. Possibly the final question about dignity that bears on our health care debate pertains less to choosing suicide than accepting death. But even this question is conditioned by the reality that choosing between acceptance and choice is made more human by doing so with one’s family. Unfortunately, ‘more human’ might not mean more painless or even more uplifting. Struggling with mortality can often be harder and messier with family than in isolation.
So perhaps the root moral issue behind the death panel debate actually just throws us back onto the question of whether we should choose to permit the government to influence this, one of our most difficult decisions, at one of our most vulnerable or susceptible moments. Because it appears the government at that moment would tend strongly to have greater confidence, and less at stake, than any of us.
August 25th, 2009 | 11:03 am
“So perhaps the root moral issue behind the death panel debate actually just throws us back onto the question of whether we should choose to permit the government to influence this, one of our most difficult decisions, at one of our most vulnerable or susceptible moments.”
Well, that’s the issue. Why would any American familiar with the republican virtues ever allow gov’t to intrude into health care, or any other extra-Constitutional activity for that matter? America is about to find out why democracy destroys nations.
August 25th, 2009 | 10:15 pm
“It’s tempting to say the first or conservative vision defines dignity in terms of the human race or species, and that the second/progressive vision does so in individualistic terms. On the question of suicide, that may seem true; but on health care more broadly, it’s obviously false.”
I’m having trouble understanding why it’s tempting to say the conservative vision defines dignity in terms of the human race, or why on the question of suicide such an assertion would seem true. I’m more inclined to agree with the the idea that “it’s obviously false,” and I’m unclear where suicide provides a potential counter-example. Don’t conservatives place more emphasis on individual dignity in insisting that a dying person should not succumb to the temptation of suicide, but rather hold their life as sacred until they naturally draw their last breath (a belief that comes from their “romantic and/or religious fantasies”)? I’m having difficulty seeing how you conclude that a conservative might define dignity in terms of the species in this case. Thanks for any clarification on this otherwise thought-provoking post.
August 26th, 2009 | 12:01 am
Thanks, Zach. You’re right about the significance of the soul to the conservative vision, but human dignity isn’t exactly the same as the individual soul, even if we all have our own souls. I mean to point up the way in which conservatives are inclined to consider dignity to reside in or emanate from what’s best in us all as human beings, as a reaction against the longing to consider dignity from the perspective of what’s best “for me.” Much of the common conservative vision of dignity comes from a vision of human flourishing which looks at humanity from a holistic point of view — the Good for Man. But as I suggested, this basically classical inheritance comes under pressure from the post-Reformation inheritance of Christian individualism.
August 26th, 2009 | 6:17 pm
As a preliminary point, I reject the notion that the above post has absolutely anything to do with any health care proposal in Congress. The proposal stated that physicians would be reimbursed for end-of-life discussions. The physicians, who get paid for services, have no incentive to use the discussions to encourage plug-pulling.
More generally, this post makes a classic incorrect political assumption: because I am for something, the people on the opposite end of the political spectrum are against it. Broadly speaking, progressives/liberals are not enthusiastic supporters of putting oneself out of misery. Assisted suicide isn’t a plank of the Democratic party and I would imagine where you stand on the issue has a lot more to do with personal experiences with dying loved ones than whether you voted for Obama or McCain.
Therein lies the problem: it assumes that if the pro-life Right stands unequivocally against suicide, (which, once again isn’t even at issue in the healthcare debate) the left must be for it. The specter of scary statistical analysis is raised. Nihilism is invoked. Liberals believe in nothing, not even people.
I’m reminded of those lists of “Top Conservative Movies” one sees now and again. A movie is reviewed and the “conservative values” are highlighted: the protagonist is brave. He doesn’t need government to defeat the aliens. Someone decided not to get an abortion (as if abortion were de rigeur for every pregnant progressive).
Bravery is something conservatives value. Liberals, human beings who share a nation (and sometimes a household) with conservatives, agree. Of course, a conservative may see a tale of bravery in the face of long odds and take from that the notion that suffering is ennobling and spine-strengthening and that government should not try to alleviate it through social programs and the like. Conservatives may see the same movie, appreciate the bravery but take away a message that, for example, the film has exposed a great injustice against the protagonist calls out for a larger solution because perhaps this suffering, while noble, can be avoided. One movie, one positive character trait, two different political solutions.
Treating people who have a different political philosophy as literal opposites provides no insights. It’s only useful for demonization and demagoguery, which may be the point of this post.
September 2nd, 2009 | 8:42 pm
his post makes a classic incorrect political assumption: because I am for something, the people on the opposite end of the political spectrum are against it. Broadly speaking, progressives/liberals are not enthusiastic supporters of putting oneself out of misery. Assisted suicide isn’t a plank of the Democratic party and I would imagine where you stand on the issue has a lot more to do with personal experiences with dying loved ones than whether you voted for Obama or McCain.
September 3rd, 2009 | 11:24 am
[...] panels would be enormously efficient and useful by taking the messy, painful, difficult — and most of all human! – process of dying and placing it in the hands of an impartial and disinterested group of [...]
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