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Wednesday, January 18, 2006

Ersatz Autonomy

The U.S. Supreme Court, as everyone knows by now, has ruled that the federal government can't interfere with Oregon's so-called assisted-suicide law. I have mixed feelings. I'm happy the feds were told to butt out. But I don't like the Oregon law. It's an example of ersatz autonomy. It doesn't really recognize the right to take one's own life; rather, it empowers doctors to grant permission for and to facilitate a person's suicide if that person petitions his doctor and meets the highly stringent conditions set out in the law. For one thing, another doctor has to concur, and the patient has to be certified as not being mentally ill, which opens a floodgate of reasons to deny a petition. Thomas Szasz pointed out the fraud of assisted-suicide long ago. His book Fatal Freedom goes into the subject in depth. Here's a summary in one of his Freeman columns.

5 comments:

Sheldon Richman said...

Anthony, there is a vast difference between removing a prohibition and taxing the product (although I don't approve of taxes) and extending doctors' jurisdiction to cover that product. Under the laws at issue, doctors can prescribe suicide and marijuana to certain people diagnosed as terminally or otherwise severely ill. One has to be properly sick and have a doctor's authorization. That's no step toward people being free to end their own lives or to use drugs without anyone's permission. But it is a step in the bulking up of the Therapeutic State.

Sheldon Richman said...

If you needed a doctor's prescription to get a gun permit, I'd make the same objection. By the way, I don't believe gun permitting makes a libertarian point to the public. It simply tells people that government can be creative, so what are those libertarians complaining about?

Glen Whitman said...

I'd rather be able to get X with a doctor's permission than be unable to get X at all. And given that there are many doctors, I don't even have to get the permission of one specific person.

I share your desire for complete liberty, of course. I'd rather not have to get anyone's permission. But having the possibility of getting something is better than total prohibition. For that reason, medical marijuana and physician-assisted suicide both strike me as clear and obvious movements toward greater liberty.

Sheldon Richman said...

The big picture is being missed. By requiring a doctor's prescription, these laws expand the power of the Therapeutic State and its deputies. That's a step away from individual liberty, even if people can have thing in question. In terms of educating the public about the need for decriminalization, it's a bad move because it teaches people that we don't need to decrimininalize. The government has already assured that those who "need" whatever it is are getting it, right? It is also likely that nonapproved users or would-be self-killers will face intensified repression as the state tries to show that its program doesn't amount to decrimininalization.

Sheldon Richman said...

Some additional comments:

We live smack-dab in the middle of a prescription regime. It's a bad inheritance. While I don't accept marijuana by prescription, I would never say the government should prohibit drugs that today are available only by prescription. I do my best to publicize the view that the prescription system should be scrapped. But that's a reason why I don't like medical marijuana: it sounds like an endorsement of prescriptions. Further, by supporting medical marijuana, we appear to endorse a system in which the government determines what is and is not medicine, what is and is not disease, and who is and is not a patient. I can't let myself even appear to sanction such a system.

Having marijuana defined as a medical issue cannot be an advance for individual freedom.

The medical marijuana issue and the assisted-suicide issue are essentially the same: access to drugs.

If there were free access to lethal drugs, assisted-suicide would be a non-issue. As Szasz says, if a person buys a gun and shoots himself, we don't call it "gun-dealer-assisted suicide." As I like to say, if someone jumps off a building and kills himself, is it architect-assisted suicide? I don't think so.

Finally, I can't stress enough the danger that the state will be watching more closely for unapproved users and "easy" doctors. Look how pain-management doctors are persecuted--and jailed. So the level of repression for those people could surely increase--because of medical marijuana. Should libertarians be comfortable with that?