Fight For Your Right to Die

With Donald Trump’s nomination of Neil Gorsuch to fill the open seat on the Supreme Court vacated by Antonin Scalia’s death, questions of the judge’s position on a number of issues from gay rights to healthcare to abortion have been mostly left to speculation.
But one position Gorsuch has been consistently candid in addressing is his opposition to physician-assisted death and euthanasia. His vehement disapproval of the practice (legal in 6 U.S. states and the District of Columbia) manifested in the 2016 book he authored entitled The Future of Assisted Suicide and Euthanasia. In short synopsis: Gorsuch equates physician-assisted death and euthanasia with “taking of human life” and opposes it on the grounds that all human life is fundamentally valuable and it’s always wrong to intentionally kill.
This type of paternalistic imposition of religious values is oppressive of human choice and autonomy and has no place being legislated in a society that otherwise appears to value individual liberty above all else. Federal opposition to euthanasia violates the bioethical principles of respect for autonomy, justice, and beneficence—the duty to do good.
It is wrong to deny a mentally competent person the right to safely end their life should they choose to do so. By outlawing physician-assisted death, suicide often becomes physically dangerous and puts the wellbeing of others at risk, such as suicide by cop, automobile, firearm, or jumping. Not to mention, those exposed to non-physician suicides are likely to suffer significant psychological trauma as well.
When might a mentally competent person seek euthanasia? Take the case of Dax Cowart, a former Air Force pilot who was severely burned and lost sight in both his eyes following a natural gas explosion in 1973. While his father died in the blast, Cowart survived the ambulance ride to the hospital despite his attempts at refusing treatment knowing the debilitating extent of his injuries. While being held in the hospital, Cowart continued to plead with doctors to let him die even as they “forcibly” administered treatments that he likened to “being skinned alive” for ten months. This is a clear violation of the principle of beneficence, the duty to do good and perhaps the principle of nonmaleficence, the duty to do no harm.
During the course of these ten months, he repeatedly attempted to commit suicide on his own, including trying to jump out of the hospital window to end his suffering. Following his eventual release from the hospital, he chronicled his story in a video entitled “Please Let Me Die” and went on to earn a law degree, which he uses to advocate for the patient rights he was denied.
A ban on euthanasia also violates the bioethical principles of justice, the fair distribution of resources and treatment. When patients have clearly expressed preferences via advance directives that they don’t wish to be artificially sustained in life while incapacitated, providers who continue treatment despite these wishes divert precious financial and medical resources that could be used to treat those who actually do want to be treated and kept alive.
Judge Gorsuch may passionately believe that life is always worth sustaining, but for patients who are forced to maintain an existence of suffering and pain, his stonewall opposition is an obstruction to relief and a violation of autonomy, liberty, and patient rights.

– Tyler

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Outside the ballot box

When federal election results are being tallied on the evening of November 8th, the votes of nearly 6 million American citizens will be missing as a result of systematic disenfranchising laws that disqualify ex-convicts from voting. The majority of states in the U.S. enforce some penal restrictions on voting: In the most egregious cases, Florida, Iowa, and Kentucky permanently bar all people with felony convictions from voting while Alabama, Mississippi, Arizona, Nevada, Wyoming, and Tennessee permanently disenfranchise at least some ex-criminals. As you can see in this interactive state-by-state map of disenfranchising laws, the only states that do not restrict voting for ex-offenders are Vermont and Maine.

The practical implications of these laws are problematic for representative democracy, while the ethical grounds on which they stand call into question why they were imposed in the first place. The biggest and most obvious problem is that for those who have been convicted and are no longer incarcerated, being stripped of voting rights provides another barrier to reintegration and civic engagement already made difficult by challenges that exist in obtaining gainful employment, stable housing, and societal acceptance.

Proponents of disenfranchising laws argue that ex-criminals have forfeited their rights by engaging in activity that runs contrary to the goals of a lawfully-functioning society. Let’s put aside for a moment that not all those who are convicted and serve time are even guilty of the crimes for which they’ve been charged. This is a big problem, but we’ll assume that most who are sentenced are guilty and even so we can dismantle the arguments behind the practice of disenfranchising.

The next logical problem here is that no state strips voting rights for all types of illegal activity so instead we have a system in which some crimes lead to disenfranchisement while others don’t, even in instances when the alleged threat to the public good is nearly identical. Proponents would like to believe severity is commensurate with consequences, but the arbitrary nature of the justice system means that isn’t necessarily the case. For instance, a driver in Iowa cited thrice for operating a vehicle under the influence receives a felony sentence and is permanently barred from voting even after release. An equally unsafe driver who similarly violates traffic laws and is charged with reckless endangerment or excessive speeding while sober will not face the same disenfranchisement despite that their behavior is a similar threat to the safety of the public and can reasonably be assumed to result in the same outcome (property damage, injury or loss of life, etc).

This arbitrary lineation and disenfranchisement violates the bioethical principle of justice, described by Stanford Medical as the concept of fair distribution of resources (or in this case, consequences) among society. In the case of the drunk drivers versus reckless drivers, states make their best guess at what constitutes impairment, with the majority thresholds falling around a .08 blood alcohol concentration (BAC). Our understanding of neurobiology, tolerance, toxicity and metabolism, however, recognizes that this is an inexact science and a nondrinker with an even lower BAC may be significantly impaired while someone with a higher tolerance is able to maintain homeostasis and normal functioning well over the .10 mark. This is an unfortunate inexactitude but realistically necessary as a preventive mechanism for deterring drunk driving.

However, the permanent disenfranchisement that happens for one but not the other makes no sense through the lens of the justice principle. It also makes no sense from a penal perspective, because disenfranchisement is unlikely to be an effective deterrent against such crimes since the consequences are often years in the future.

There are myriad reasons why a repealing of disenfranchisement laws results in a more just, equitable, and most importantly, democratic society. Permanent barring of voting is a counterproductive and oppressive practice that discourages reintegration and erects insurmountable barriers to representation that no free citizen should be without.

– Tyler

Beefing with vegetarians

If you’re an animal-loving herbivore like me, get ready for a double take. Thomas Sittler’s Oxford Uehiro award-winning contrarian essay on vegetarianism and free-range husbandry presents a counterintuitive but nevertheless thorough argument that the natural world might not necessarily be able to provide a better quality of life for animals than those who spend their days on free-range farms. More specifically, Sittler argues that the life of a free-range farm animal prior to slaughter is likely substantially more accommodating and offers a better opportunity for animals to thrive and enjoy life than the natural environment in which animals constantly face the terrifying threat of predators, communicable diseases, natural disasters, and a world without mercy.

In the essay, he points out that we frequently intervene in the natural world to prevent suffering in ways such as rehabilitating injured animals or coordinating and facilitating mating, and that we don’t think twice about these interventions. This is true. However, when a wild animal is rehabilitated by humans or a population is engineered to avoid extinction, it is (I would argue) generally done with the implicit intent to return the animal(s) to a naturally sustainable population for the habitat or environment. When an invasive species threatens a habitat, it is not to wage an intervention against the natural world but rather to preserve the status quo that is often threatened by human transportation of said species.

If one were to argue for constant stewardship over animals as a preferable alternative to the natural world, it is unclear where this distinction would end. Farm animals? Domesticatable animals? Endangered species? Threatened species? Mammals? Animals with a  central nervous system? Animals who can demonstrate preference and suffering? It is clear that humans lack the resources and societal will to take on such a task that would be congruent with Sittler’s premise.

Of course, with the economic engine of capitalist livestock production, you could argue that farm animals might be the only candidate for such a task and that as such, we would at least be doing the greatest possible good for the greatest number. However, we must also consider that the economic pressures of capitalism trend toward a demand for efficiency, and as long as we are relying on capitalism to fund this temporary free-range sanctuary idealism, the industry faces the same threat of a factory farming-style takeover that would make consequentialist arguments against the idea say, “I told you so.”

The paper also fails to take into account the environmental costs of raising livestock, which negatively affects both humans and ecosystems alike. According to the U.N., livestock use 30 percent of the earth’s entire land surface including 33 percent of the global arable land used to produce feed for livestock.” Free-range, pasture-fed animals would require even more land on which to feed. Sittler’s argument rests on the idea that this would be beneficent for the free-range animals and wild animals would effectively be put out of their misery, an idea for which practical implications would mean clearcutting rainforests and habitats rich in biodiversity and which likely sounds appalling to all but the most callous.  Nevertheless, the process would result in more fossil fuels being used for clearing land, more resources devoted to raising animals for human consumption, and an increase in large, methane-producing animals such as cows and pigs. Given the carbon dioxide and methane increase involved in livestock agriculture that is known to contribute to problems of global warming and pollution affect humans and nonhuman animals alike, this hardly seems like a beneficent change.

There is also, in my view, the equally pressing concern of anthropocentricism and the undeniable point that we lack the perspective to know an animal’s preference between the relatively safe but ultimately doomed state of living as a free-range commodity and the uncertain but non-engineered state of the natural world. To this concern, I would use the following (albeit anthropocentric) analogy: You are given the choice between prison and civilian freedom. With prison, you are ensured relative safety, a steady source of food and attention to health concerns as well as a prison yard with which to roam. With civilian freedom, you are ensured relatively nothing, and face the risk (with varying degrees) of untimely death nearly every day. Yet, as appeal records would indicate, most humans would still prefer civilian life, the analog to the natural world. Do animals have an awareness of the difference? Very difficult to say, but anecdotal accounts like those of Inky might indicate they do.

I do commend Sittler (an Oxford undergraduate) for his articulate and challenging position paper, and I have to smile about all the feathers it will ruffle. But for the time being, I remain unconvinced of the moral superiority of an omnivorous diet given the reality of capitalistic forces and the environmental impact of animal agriculture that would adversely affect the planet as a whole.

-Tyler

Zika fever pitch

With the Associated Press now reporting some 200 cases of Zika nationwide, concern about the spread and implications of the mosquito-borne virus has reached a new pinnacle this week. Adding to that, new reports on the severity of symptoms in certain cases is giving weight to the idea that Zika is among the most pressing concerns in public health since the eradication of Ebola from West Africa in January.

While solutions to the growing epidemic have varied, the ever-categorical Slate has suggested wiping mosquitoes off the face of the earth is a reasonable response. To be fair, it’s not just Slate, as a number of scientists are seriously considering if and how the rest of our shared ecosystem would suffer from a lack of what the Spanish call “little flies” (mosca being the word for fly and -ito being its diminutive suffix). Mike Turner, head of the department of infection and immunobiology at Wellcome Trust, an international charitable foundation “dedicated to improving health through science” is calling for a return to the notoriously banned DDT of Silent Spring infamy to eradicate the mosquito population.

Aside from the obvious and well-documented effects of DDT on bird populations and the human health consequences of pervasive use of an endocrine disruptor, here are three other reasons I think this should be at the very bottom of a list of possible solutions to the Zika problem:

  1. Mosquitos are not the source of Zika virus. Yes, they are its primary vector but taking the extraordinary measure of eradicating mosquitoes does not mean Zika cannot continue to be spread through sexual contact or even yet through an undiscovered vector.
  2. Only a specific genus of mosquito (aedes) is even a competent and capable carrier of Zika. There are some 4000 varieties of mosquitoes. There are far more tactful approaches on the horizon that don’t require eradication.
  3. It furthers the already nearly-ubiquitous idea that speciesist, anthropocentric solutions are viable options to public health concerns. While absolutists might argue that any bioengineering of ecosystems and their inhabitants represents this idea, eradication is the most extreme, pestilent form of this kind of outbreak resolution. It is the Donald Trump of contagion response, if you will.

– Tyler