Physician Assisted Suicide as a Civil Right

Section 1553 of the Patient Protection and Affordable Care Act (a.k.a., ObamaCare), titled "Prohibition Against Discrimination On Assisted Suicide," appears to side with opponents of physician assisted suicide, protecting them from "discrimination."   At the same time it reframes the debate as one of civil rights, and brings assisted suicide more into the mainstream.

The section's title is itself misleading; a more accurate title would be "Prohibition Against Discrimination for Refusing Assisted Suicide":

The Federal Government ...[et. al] may not subject an individual or institutional health care entity to discrimination on the basis that the entity does not provide any health care item or service furnished for the purpose of causing, or for the purpose of assisting in causing, the death of any individual, such as by assisted suicide, euthanasia, or mercy killing. [my italics]

Opponents of euthanasia, I suppose, should rejoice.   But, one has to ask, why write such a law? 

I asked Rita Marker at the International Task Force (see her recent AT article here) for her interpretation of section 1553.  She described it as a "bizarre conscience clause" for those who refuse to participate in assisted suicide.

The conscience clause has been evoked for doctors who refuse to do abortions because of their religious convictions.  Most recently the issue surfaced in the Senate race between Scott Brown and Martha Coakley, when Coakley said that devout Catholics who refused to dispense morning after pills "shouldn't work in the emergency room."  Last year, soon after taking office, President Obama promised to eliminate the "Provider Refusal Rule," the conscience clause implemented by President Bush, but to date Obama seems to be more occupied with vast restructurings of the American economy.

The difference here is that abortion is legal in all fifty states.  The abortion conscience clause is a necessary response to an understandable debate about whether health care providers can refuse to perform a legal procedure.  Assisted suicide however is legal only in Washington, Oregon and sort of legal in Montana.  Doctors opposed to assisted suicide have no such need for protection, with the exception of the states mentioned above.  Similarly, in the 45 states that outlaw same-sex marriage, clergy do not need protection from lawsuits for refusing to marry same-sex couples.

Protecting physicians who object to assisted suicide therefore has the effect of making them the exception to a view that some believe will inevitably become the law of the land.  The legislation might have been written, for example, to assert that the Federal Government will prosecute a Jack Kevorkian who violates the laws against euthanasia.  The existence of the statute acts in a backhanded way to legitimize assisted suicide in the court of public opinion of the other 47 states.
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