Posts Tagged health care law
Recently one of my daughters has become very enamored of a particular story in one of her books. She asks me to read it several times in a row, several times a day, ad nauseam, to the point where I just want to throw the book out the window. But I’m glad she asks me to read it so often, because on one of these endless repetitions I saw something in this little bedtime story that made me think of the times in which we live.
The story is called “The Bell of Justice,” based on a poem by Henry Wadsworth Longfellow. It tells the tale of a village in whose square “old King John” ordered a great bell erected. Any townsperson who was wronged in any way could ring the bell to ask that justice be done, and the judge would see to it.
But, the story goes on, after many years the people of the town stopped caring about the Bell of Justice. The bell went so unused that it pull-rope rotted away. The town’s judge, who remembered and valued the bell, told a citizen to tie a forest vine to the stub that remained of the bell’s rope so that, when need arose, the bell could still be rung, even though no one had touched it or thought about it for years.
Meanwhile, the town’s knight, who was now old and gray, had stopped caring for his favorite horse, who had accompanied the knight on his adventures but was now also old. The knight saw no need to feed or care for this horse, since he no longer used the animal on a regular basis. Only on holidays or when he had occasion to go into town did the knight see a reason to feed and care for his horse.
So the horse went in search of food elsewhere and ended up wandering into the center of the town. When the horse saw the vine hanging from the Bell of Justice, he made for it right away, and as he pulled on the vine trying to detach it from the bell’s rope, the bell began to ring.
The townspeople, unused to hearing the bell, ran to the square to see what was causing it to ring. The judge, of course, also came. All were treated to the sight of a thin, sickly horse munching on the vine that had become the bell’s pull-rope.
The judge, recognizing the horse, immediately ordered that the knight care for the animal’s old age, since the horse had served him so faithfully many years ago. After this, the townspeople always remembered the Bell of Justice.
Seems like a fun little bedtime story, one that has a “surprise factor” of a horse having no idea what he’s really doing by pulling on that vine, seeking justice for himself while being unaware of the real implications of his actions. But there’s more to it.
In 2008, 64 year-old Barbara Wagner, a woman living in Oregon (the state to which Brittany Maynard moved in order to be able to legally end her life due to a diagnosis of brain cancer) experienced a recurrence of cancer, and was told that certain medications would ease her pain and help her to live with a decent quality of life until death came to her on its own. But when she tried to fill the prescription for these palliative medications, she was told that her insurance company would not cover their cost.
The company would, however, cover physician-assisted suicide.
Mrs. Wagner didn’t take that option. She died about a year later, in 2009.
A similar case arose in 2008 with an Oregonian and cancer victim named Randy Stroup. In his case, the Oregon state health plan did end up paying for his palliative care.
While the increasing acceptance of physician-assisted suicide – I refuse to call it “euthanasia,” a word that means “good death” – may appear to be a sign of increasing tolerance, compassion, and worship of choice, it is a sign of the increasing devaluing of human life. It tells us that human life has value only as far as it is serviceable.
Overnight, we as a society have accepted blindly the concept that human beings possess a utilitarian dignity – a dignity that comes not from a person’s nature as a human being, but from their usefulness, their ability to produce. Barbara Wagner, an aging, dying, retired school-bus driver, had according to this view nothing more to contribute. She was no longer needed. Why shell out cash to prolong the life of a person who can no longer produce? Barbara Wagner’s life was accordingly reduced to its value in money and efficiency.
Barbara Wagner’s plain, wrinkled face and age-weighted body escaped the notice of most. More recently, Brittany Maynard, twenty-nine, married, and stunning, captured the attention and compassion of the world when she teamed with Compassion and Choices (formerly The Hemlock Society) to advocate for the legalization of physician-assisted suicide in every state. Maynard was diagnosed with a hideous, aggressive brain cancer that would have eventually subjected her to excruciating physical agony and robbed her of her personality, her sanity, and her very life. She determined to end her life before those symptoms began to arise, and to become the spokesperson for the social and legal normalization of physician-assisted suicide.
There is no question that Maynard’s position was a bleak one. I’m just sad that she thought suicide was her only option.
We have arrived at a point, as a society, where we cannot see any value in suffering. We have lost the ability to see that age, illness, and horrible circumstances can indeed possess purpose.
Where do we draw the line? When do we cross over from saying that it’s okay for a person to end his life for physical terminal illness but not for depression? When does the creep begin from suicide for cancer to suicide for a bad marriage, or job loss, or any other emotional or mental anguish that makes life too hard to bear?
Why bother telling our young people to seek help for suicidal thoughts, tendencies, or attempts because their lives have value and meaning? Why bother telling people who suffer from anxiety and depression to seek counseling and medication? Why seek options for the homeless?
Indeed, why not terminate disabled children in the womb – or beyond?
Yes, Brittany Maynard had her entire life ahead of her – but the time would soon come when she would no longer be able to produce. Her usefulness to the society would be gone. I wonder if, deep down, that was the reason for the overwhelming acceptance of her choice: the tragic inevitability of her loss of usefulness. And so the outlook that defines human value as an ability to contribute to the GNP agrees that she should be able to end her life in order to allow the wheels of production to continue churning through the sewage of utility.
Like the horse in that simple bedtime story, the aged, the terminally ill, the disabled are being shunted away for their lack of utility. Like the knight, we have come to see no reason to care for anyone or anything that can no longer serve our needs or wants. Like the knight, who could not see the value of the horse as a creature simply because it was a creature, simply because it possessed the sacred breath of life, we have lost the ability to cherish life for its own sake. Like the knight, who remembered and appreciated the service his horse had rendered him in years past but has ceased to care for the animal because the animal can no longer provide that service, we honor the past contributions of human beings but define their dignity by those contributions, ceasing to assign that dignity when those contributions have come to an end – when a person becomes an inconvenience.
A major part of this tragedy is that those who suffer terminal illnesses themselves believe the lie that their lives’ value has ended when their suffering begins. They have come to accept that their usefulness has come to an end because of their suffering, and that the right choice is to end their lives. They have come to believe what our culture has begun to tell them – that they are mere things instruments, tools of utility.
Where is the judge in that bedtime story – the one who will make us see the value and dignity in that old, broken-down, sickly, precious life?
 In Jennifer Boudart et. al., Bedtime Stories: Lights & Music Treasury (Lincolnwood, IL: Publications International, 2009), 34-47.
 See the following: Susan Harding et. al., “Health Plan Covers Assisted Suicide but Not New Cancer Treatment.” KVAL.com (7/31/2008, updated 10/30/2013), http://www.kval.com/news/26140519.html (accessed 11/30/2014); Susan Donaldson James et. al., “Death Drugs Cause Uproar in Oregon.” ABCNews (8/6/2008), http://abcnews.go.com/Health/story?id=5517492&page=1 (accessed 11/30/2014); Dr. Mark Mostert, “Barbara Wagner Faces Official Darkness in Oregon.” Disability Matters (7/8/2008), http://disabilitymatters.blogspot.com/2008/07/barbara-wagner-faces-official-darkness.html (accessed 11/30/2014); Kenneth R. Stevens, Jr., M.D., “Oregon Rationing Cancer Treatment but Offering Assisted Suicide to Cancer Patients: Paying to Die but not to Live.” Physicians for Compassionate Care (6/6/2008), http://www.pccef.org/articles/art67.htm (accessed 11/30/2014).
 See e.g. Dan Springer, “Oregon Offers Terminal Patients Doctor-Assisted Suicide Instead of Medical Care.” FOX News (7/28/2008), http://www.foxnews.com/story/2008/07/28/oregon-offers-terminal-patients-doctor-assisted-suicide-instead-medical-care/ (accessed 11/30/2014).
Here’s the crazy thing about the Supreme Court’s decision in favor of Hobby Lobby, which ruled that corporations need not provide health insurance coverage for medical practices the corporation’s owners/officers find morally objectionable:
Hobby Lobby says: “You can’t force your beliefs on us.”
Those who disagree with the court’s decision say: “You can’t force your beliefs on us.”
So who wins?
Perhaps a fresh look at the age-old example of the “suicidal friend” will apply. Say for instance that you, the reader, are my friend. And say, just for the sake of the argument, that you tell me to go out and purchase a gun for you.
“What for?” I ask.
“So I can kill myself with it,” you hypothetically reply.
Now, you believe that you are doing absolutely the right thing by killing yourself and have no moral objections to suicide. I, on the other hand, am radically opposed to suicide because of my deeply-held religious beliefs.
I don’t wish to live my life as a hypocrite, as I strive to apply my convictions to my everyday decisions, rather than constrain my moral and ethical senses to one hour in a church building every Sunday morning. So I refuse to give you the gun. Actually, I go a step further and do my best to talk you out of the whole thing.
“You can’t impose your beliefs on me!” you (hypothetically) yell in frustration.
But I can. I’m not going to give you the means to do something that I find morally objectionable – that I in fact see as a grave moral evil.
“Fine,” you say, “just tell me where I can get a gun.”
I’m not going to do that either, because then I would be complicit – responsible, though indirectly, for an action that I am convinced, in my informed, reasonable, rational conscience, is deeply wrong.
In fact, aren’t you imposing your beliefs on me by asking me to assist you in committing suicide?
What if I own a gun shop and you come in to buy a gun, and tell me you’re going to use it to shoot a restaurant full of people? Do I have the right to refuse you the gun?
“You’re a businessperson,” you tell me. “You have to sell me the gun because it’s your profession to do so. You have to separate your business from your personal beliefs.”
In essence, you are telling me to divide myself – to believe X but to act according to Y. It doesn’t take a degree in neurology to see that this is an absence of personal integrity.
I’ve noticed a paradox in the predominant thought of our present culture: On the one hand, many people view persons of faith as hypocrites. The thinking runs something like this: “You Christians” – and I don’t choose this particular faith at random, since Christians are, in my experience, the folks most often accused of hypocrisy – “are a bunch of hypocrites because you go to church on Sunday and then commit all kinds of sins on Monday.” Even worse is the accusation against Catholics: “You Catholics go to Confession on Saturday and then commit all kinds of sins during the rest of the week, because you just think you can go to Confession again the next Saturday and everything will be okay. Hypocrites!”
In the first place, one of the requirements for a Catholic to receive absolution – that is, the pronouncement of God’s forgiveness from the priest as His representative – is something called a firm purpose of amendment – the sincere intention to no longer fall into the sins you’ve just confessed. So the attitude of “I can keep committing these sins and just go to Confession all over again” is an abuse of the sacrament.
In the second place, the hypocrisy accusation itself is challenged when people of faith carry their convictions out the door of their house of worship and into the wider world. When religious people do this, they are then accused of violating the “separation of church and state.” This way of thinking runs something like this: “You religious people should leave your faith at the church door and not bring your religion into public life. Religion is a private matter.” So I’m supposed to be one person in church and another person in my workplace and voting booth.
So when people of faith fail to live consistently according to their beliefs (and they fail frequently because they are imperfect humans), they are accused of hypocrisy. When they try sincerely to live according to their faith, they are accused of violating the principle of church-state separation by living their beliefs in public.
Back to the matter of business owners refusing to provide or be complicit in providing services they find morally objectionable. I can hear the counter-argument: “You’re talking apples and oranges! Contraception and abortion are not the equivalent of suicide and mass murder!”
But according to the teaching of the Catholic Church – not to mention Orthodox Judaism, Islam, evangelical Christianity, and some expressions of Buddhism, to name a few – contraception and abortion absolutely fall within the category of murder. One involves the prevention of life, the other the active ending of a life that is already in developmental progress. In his 1995 encyclical Evangelium Vitae, Saint John Paul II called the increasing tolerance – nay, embracing and encouragement, bordering on idolatry – of abortion and artificial contraception evidence of the West’s “culture of death.” So for those who agree with Catholic doctrine (and why call yourself Catholic if you don’t?), participation in or even indirect compliance with either of these practices, particularly abortion, makes one an accessory to murder.
So when the Little Sisters of the Poor say that they can’t even so much as sign a piece of paper giving a third party permission/power to provide abortion and contraception services to those affiliated with their organization, this is what they mean.
No, I can’t force my beliefs on my suicidal friend who asks for a gun. That person has free will – as I do. Forcing my beliefs on another is not my intention. My intention is only to exercise the freedom to act according to my own convictions – not just within the walls of my house of worship, but in every area of my life.
You’d call me a hypocrite otherwise.