Douthat goes another round:
Where the legalization of assisted suicide is concerned, then, the question isn’t "suicide, yes or no" — it’s more like, "what effect is this law likely to have on the way that suicidal people are treated in our society, the way they (and their doctors) think about their own suicidal impulses, and the ease with which they can end their lives?" And my argument in the column was that both the moral logic of assisted suicide and the real-world experience of its implementation suggest that such a "right" will tend to legitimate suicide not just as an escape from unbearable agony in the last hours of death, but as an escape from other forms of suffering in other stages of life as well.
A reader is in the same territory:
I think that your reader who criticized Douthat’s argument about the depressed wheelchair user greatly simplifies the issue of depression among persons with disabilities.
From a disability rights perspective, the person in the wheelchair is depressed, not because of an inherent organic condition, but rather because of the discrimination he faces as a result of his disability. In a society in which persons with disabilities and incurable illnesses are portrayed as living lives unworthy of living – and are in fact excluded from prominent aspects of our social life – it is not surprising that some of them will become depressed.
This depression will have an organic – neurological – component, sure. But it is a profoundly social matter, and alleviating it involves not only medical interventions, but also social change. It is also, for that matter, a social responsibility. Saying that there is "nothing" to be done for this person, other than helping them to end their lives, is to turn away from examining the problem at all. Worse, it is to reinforce the very discrimination that contributes to suicidal ideation among persons with incurable illnesses and disabilities to begin with. In that sense, its pretense to "mercy" can be very hypocritical.For the record, I am not dogmatically opposed to physician-assisted suicide – life-ending interventions are an inevitable aspect of end-of-life care – but there are problems with the basic provision and practice of end-of-life care, as well as our society’s treatment of the incurably ill, that we need to address first. Right now, the "right to die" is at best distracting us from these issues – and may be in fact making them worse.
In this sense, I view the situation as analogous to your assessment of the San Francisco bill to ban circumcision: I could support a right to die, but not in this form.
Noah Millman sees both sides of the debate.
The Dish 