Thursday, October 15, 2009

Smith Uses Personal Narrative to Criticize Use of Personal Narrative.

"Abandoning the Most Vulnerable" is the title of a new article by Wesley J. Smith in The Weekly Standard, published on the 12th. In it Smith does more of what he does best: extrapolate an extreme example as fully representative of what is to come. But in this article, he also gets stuck inside his own logic.

He takes the case of Myrna Lebov, apparently killed by her husband, George Delury, in New York in 1995 and throws it up as an example of what will happen in Britain now that prosecutorial laws for those who assist suicide have been revised in the wake of the Debbie Purdy case. (Purdy, a multiple sclerosis patient, wanted to ensure that her husband, Omar, would not be prosecuted for helping her to travel to Switzerland for aid in dying once he returned to Britain, where aid in dying is illegal. She won her court case.)

But Smith trips himself up in the argument. Using the Lebov/Delury story - Delury was found to now have assisted his wife according to her will but in exasperation at the grueling work as caregiver - as an example of what will happen now that British laws have been adjusted - a bitter husband killing a suffering patient because of the trauma of care taking (the traumatization of Delury is something Smith chooses to brush over). Smith writes:

What do these guidelines teach us about assisted suicide? First, "death with dignity" is not just about terminal illness: It is about fear of disability and debilitation. A husband assisting the suicide of his wife, who wanted to die because their son became a quadriplegic, would be prosecuted under the guidelines, but he wouldn't face charges for assisting the suicide of the son.

Second, the guidelines prove that assisted suicide is not a medical act. Nothing in them requires a physician's review or participation.

Third, the court ruling and guidelines illustrate how the rule of law is crumbling. What matters most today is not principle, but emotion-driven personal narrative.

But arguing against use of personal narrative, and using a personal narrative to do so, is a little unconvincing. In the bait and switch, Smith fails to account for the failure of medical or social services to address the trauma of care taking Delury suffered. And he fails to note that Delury was indeed prosecuted for his role in his wife's death.

By legalizing Death with Dignity in the US, oversight and regulation will be brought to end of life care. By making Death with Dignity a "medical act," doctors and other staff members will be able to intercept and treat suffering patients and counsel burdened and traumatized caretakers. It is more regulation, discussion, and transparency that is needed in end of life care, not more opacity. By reforming health care to cover even the neediest of patients and by practically and maturely addressing end of life situations, greater regulation will prevent situations like that of Lebov and Delury.

In Britain, revising the laws on assisted suicide - though the revisions are imperfect - applies stricter oversight and prosecutorial reach on those who assist their loved ones in ending their lives. Malicious actions are not common. Preventing them is, however, important. So is respecting the wishes of suffering patients at the end of life and honoring the role that care takers play in ushering their loved ones to a humane end. I regret that Smith is unable to see the necessity of personal narrative in this debate.

For an ethicist, Smith seems to have sadly lost sight of argument logic as well.

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