There’s a good little piece here by Daniel Fleming, who reminds us of the larger economic context in which debates about physician assisted suicide and euthanasia are taking place; and, should the legislation be passed, of the context in which the legislation will be enacted. Here’s a taster:

Where we make social interventions in our context, we should also remember that it will inevitably become someone’s business to deliver on them. Correlatively, in answer to the first question, we should consider what the impact of private, for-profit, companies which specialise in the provision of euthanasia might be. Such companies would have as their primary purpose profit or return to share-holders. They would, assumedly, be required to increase business in order to produce better annual results. What would their marketing strategies look like? Who would their target market be?

One can quickly imagine a strategic planning meeting whereby the market of those who are dying or those who are close to someone who is dying become the aim of the product, perhaps also particularly those who would not be able to afford other forms of end of life care, or those who are suffering from some form of depression. The current proposed legislation [in Victoria and New South Wales] rests on the possibility of someone making a free and fully informed decision, but freedom and coercion have a tenuous relationship when it comes to marketing strategies – especially those directed at vulnerable groups, and that is something we should consider in this case.

To put it crudely, if we agree to this legislation we should be willing to accept active and aggressive marketing strategies from companies who enact it …

Such companies do not currently exist, but for-profit health insurance companies do, and so we should also consider what the proposed legislation might look like from the perspective of an insurance company which is trying to improve its bottom line. Could it be that insurance companies would direct patients toward the cheaper option instead of agreeing to a larger payout for more expensive care?

In the United States, for example, a physician recently claimed that “insurance companies in states where assisted suicide is legal have refused to cover expensive, life-saving treatments for his patients but have offered to help them end their lives instead.” As anyone who has sat in a budget meeting will know, the logic applied here by the insurance companies is perfectly compatible with the value-set imposed by capitalism.

These are uncomfortable considerations, and they take the debate outside of its typical contours which consider the suffering of an individual and sometimes their family, and whether or not it is right for that person to end their own life with medical assistance. That debate still needs to be had. However we land there, it is crucial to remember that the debate takes place in an ideological context, and if or when the legislation is enacted it will be done in a way that takes it beyond the intent of those proposing it, and into the realm of the value set of capitalism. Any legislation or major social interventions has social consequences beyond its original purpose.

You can read the full article here.