How Ethical Systems Change: Tolerable Suffering and Assisted Dying by Sheldon Ekland-Olson Elyshia Aseltine

Author:Sheldon Ekland-Olson, Elyshia Aseltine [Sheldon Ekland-Olson, Elyshia Aseltine]
Language: eng
Format: epub
Tags: Social Science, Sociology, General, Death & Dying, Disease & Health Issues
ISBN: 9781136465376
Google: L9jFBQAAQBAJ
Publisher: Routledge
Published: 2012-03-22T04:41:25+00:00

Uncertainty, a Duty to Die, and Rationed Health Care

In 1958 27-year-old professor, Yale Kamisar, then teaching at the Minnesota Law School, wrote of his “non-religious views” and concerns for gravely ill persons. He took issue with liberalized euthanasia policies developed in a recently published and much discussed book, The Sanctity of Life and the Criminal Law, written by a jurist from the University of Cambridge (Williams 1957).

Surely, Kamisar wrote, the “freedom to choose a merciful death” was an important right. However, persons in the throes of suffering facing the possibly painful end of their lives are not well positioned to make life-ending decisions. It would be foolish to assume otherwise. Kamisar saw, with less psychological and interpersonal precision, what Elizabeth Kübler-Ross (1969), drawing from her conversations with the terminally ill, would give empirical substance to a decade later in On Death and Dying. A mountain of clinical research supported the idea that many if not most suicidal patients are depressed and ambivalent. Since persons are doing something irrevocable in a state of uncertainty, great care should be exercised.

Even assuming persons deciding to end their life were fixed in resolve and rational in thinking, Professor Kamisar foresaw problems. He wondered, was this really the kind of choice “that we want to offer a gravely ill person? Will we not sweep up in the process some who are not really tired of life, but think others are tired of them; some who do not really want to die, but who feel they should not live on, because to do so … would be a selfish or a cowardly act?” “Will not some,” Kamisar continued, “feel an obligation to have themselves ‘eliminated’ in order that funds allocated for their terminal care might be better used by their families or, financial worries aside, in order to relieve their families of the emotional strain involved?” (1958: 990). Professor Kamisar’s fears seemed to be confirmed in a speech given almost three decades later, on March 27, 1984.

Three-term Colorado governor and healthcare activist, Richard Lamm, was speaking to elderly constituents gathered on Senior Day in Denver. He was concerned over escalating costs of healthcare associated with the life-prolonging capabilities of new drugs, medical technologies and procedures. It was time, Governor Lamm suggested, to consider setting limits. “We’ve got a duty to die and get out of the way with all of our machines and artificial hearts and everything else like that and let the other society, our kids, build a reasonable life.”

The governor’s words were picked up in the press. They created an immediate stir. Reports and editorials focused on the phrase “duty to die and get out of the way.’’ Despite Governor Lamm’s immediate protests of superficial mischaracterization of what he had said, this phrase repeatedly appeared for many years in subsequent academic discussions, press accounts, and congressional hearings (“Gov. Lamm Asserts Elderly, If Very Ill, Have ‘Duty To Die’” 1984). While the crassly stated duty-to-die message may not have been Governor Lamm’s intended message, for many it was the message heard.

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