Review of Howard Ball, "At Liberty to Die: The Battle for Death with Dignity in America"
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Eyewear Aviators Wayfarer Pilot Square. Underwear Boxers Briefs Undershirts Swimwear. Sponsored products for you. Paperback Language of Text: Our narrator is suitably amazed. The Struldbruggs, he thinks, have won the cosmic lottery. The traveler has no trouble imagining the life he might lead as an immortal, given the chance. First of all, Gulliver tells his audience at dinner, he would spend a couple of hundred years accumulating the largest fortune in the land.
And then, with all of that out of the way, Gulliver could lead the life of a philanthropic sage, dispensing riches and wisdom to generation after generation. But then the Lubnaggians bring him back to reality by explaining that eternal life is not the same thing as eternal youth. Their hair and teeth fall out. For the same Reason they never can amuse themselves with reading, because their Memory will not serve to carry them from the beginning of a Sentence to the end; and by this Defect they are deprived of the only entertainment whereof they might otherwise be capable.
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It is a vision of hell. Either that, or a prophecy of things to come, assuming the trends of the last few decades continue. Between and , the average life expectancy in the United States rose from 49 to 77 years; between and , it grew by 1. This is not immortality, but it beats dying before you reach The span of active life has extended as well.
The boundary markers of what counts as old age keep moving out. We live longer, but it's taking longer to die as well. Two-thirds of deaths among people over the age of 65 in the United States are caused by three chronic conditions: More horrific to imagine is the twilight state of being almost vegetative, but not quite, with some spark of consciousness flickering in and out -- a condition of Struldbruggian helplessness and decay. The reader will find not the slightest trace of Swiftian irony in it. The forces in question fall under three broad headings.
One is the religious right, which Ball sees as being led, on this issue at least, by the Roman Catholic Church. In , after Terri Shiavo had been in a persistent vegetative state for eight years, her husband sought to have her feeding tube removed, setting off numerous rounds of litigation, as well as several pieces of legislation that included bills in the US Congress.
The feeding tube was taken out and then reattached twice before being finally removed in , after which Schiavo died. The website of the University of Miami's ethics program has a detailed timeline of the Schiavo case.
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The third force Ball identifies is that proverbial pound gorilla known as the Supreme Court of the United States. Its rulings in Washington v. Glucksburg and Vacco v. Quill in denied the existence of anything like a constitutionally protected right to physician-assisted death PAD. As a member of the choir, I liked Ball's preaching, but it felt like the sermon was missing an index card or two. And so the reader has every reason to expect a sustained and careful argument for why that legal standard applies. The due-process clauses did come up when the Supreme Court heard oral arguments in , but it rejected them as inapplicable.
This would seem to be the point in the story where that central thesis would come out swinging.
The author would show, clearly and sharply, why the Court was wrong to do so. Again, it sounds very categorical when Ball cites that Pew survey from showing 84 percent agreement that individuals had a right to choose an exit strategy if medical care were not giving them a life they felt worth living. But the same survey results show that when asked whether they believed it should be legal for doctors to "assist terminally ill patients in committing suicide," only 44 percent favored it, while 48 percent were opposed.
With the matter phrased differently -- surveyors asking if it should be legal for doctors to "give terminally ill patients the means to end their lives" -- support went up to 51 percent, while 40 percent remained opposed. This reveals considerably more ambivalence than the 84 percent figure would suggest. The notion that a slippery slope will lead from death with dignity to mass programs of euthanasia clearly exasperates Ball, and he can hardly be faulted on that score.
A portion of the adult population is prepared to believe that any given social change will cause the second coming of the Third Reich, this time on American soil. Those who do not forget the History Channel are condemned to repeat fairly dumb analogies. But the slippery-slope argument will more likely be refuted in practice than through argument. As Ball notes, this came up in the Supreme Court discussions 15 years ago. And the demand is bound to grow, as more and more of us live long enough to see -- like Gulliver -- that there are worse fates than death.