The Euthanasia State

The tragedy of Terri Schiavo is almost complete. All that is lacking now is the picture of Michael Schiavo, flanked by his common-law wife and their two children, shrieking "out, out, damned spot!" as the funeral cortege slowly winds its way over the horizon after the graveside service.

The battle lines for the long haul have already been drawn. They are not medical, but political. One side calls Schiavo a "dying martyr for the republican right" whose supporters are "unleashing religious fundamentalism into the bloodstream of American politics" and hypocritically abandoning conservatism’s devotion to federalism.

On the other side, Schiavo’s defenders are a mixed bag. While some "expert" political pundits gamely defend resorting to federal power to save her, pro-lifers merely nurture the nave assumption that she deserves the same established legal protections that benefit death-row killers and family pets.

This entire episode never would have happened, had "compassion" not long ago become part of the political process. And that never would have transpired, but for the perversion of principle and the trashing of constitutional limitations for the sake of the nanny state. While the Founding Fathers could never have imagined the miracles of modern medicine, they recognized all too well the fallen nature of man. They understood the lust for power, a timeless temptation assailing politicians of every stripe at every level. But that libido dominandi cannot be sated unless the politician camouflages his ambition by appealing to the goodwill and compassion of the masses. These salutary natural inclinations have been basic ingredients of Christendom for two millennia. In this era of the deified state, they have become indispensable ingredients of politics.

When the inevitable consequences of this magical transformation come to light, we are confronted with horrors like the saga of Terri Schiavo.

Yes, leftist critics have had a field day mocking the "breach of principle" of those trying to use the federal courts to save Terri Schiavo’s life. But that is tantamount to breaking someone’s leg with a baseball bat, and then mocking him because he’s a cripple. The left’s very reason for being — and it is bipartisan — is to federalize everything, including health care, compassion, and even humanity itself. But now, when the "wrong people" lay claim to the new government powers, the Leviathan responds by demanding that "religious" opinions be kept out of politics. Whether it’s fair or not, that attitude has dire consequences.

Judges know that, if they start making rulings requiring the dying to be allowed to receive ordinary nutrients, including food and water, the hospitals and hospices will soon be overflowing with patients who will still be receiving Social Security, Medicare, and Medicaid support during their treatment.

Well, judges aren’t going to let that happen. Judges are people too. Every one of them got his job through a political process, and every one of them can lose his job through a political process.

They are quite aware of a fundamental fact of contemporary politics: state legislators and U.S. senators and representatives often mouth principled pleasantries to please the masses, but few will risk their political hide to sustain those principles. When it comes to money, however, they are very serious. They know that keeping a generation of old folks alive one, two, even three "extra" years, while continuing to give them government subsidies and Social Security payouts, would break the back of what is left of the country’s financial system.

Trillions of dollars are at stake. The initial costs of the "right to live" principle might well amount to $7.7 trillion. That figure assumes caring for 77 million baby boomers when they reach the last stages of old age, each costing $100,000 a year of government subsidies brought on by the extended care. And that cost would rise even further if the average life "artificially" extended amounts to more than one year.

To illustrate the depths of the dilemma, imagine an unlikely reversal of political roles that would pit a liberal Congress against conservative courts. Confronted with these numbers in the high trillions, legislators would realize that extending the lives of old folks by providing nutrition and hydration to "dying" patients would quickly bankrupt the country. What would those imaginary legislators do? I think they would pass state and federal laws prohibiting the provision of food and water to such patients, in the name of the patient’s right to a dignified death — as long as it comes quickly.

To continue the imaginary scenario, imagine a judiciary on the state and federal levels that suddenly "came to its senses" and ruled that thousands of people were being killed by thirst and starvation. Suppose these courts began requiring federal and state institutions to provide the ordinary means of sustenance that they are now denying to Teri Schiavo by court order.

Once the Supreme Court of the United States made that the law of the land, the total of all government spending would immediately increase by the tidy sum of at least 7.7 trillion dollars.

How long would today’s politicians let such judges "bankrupt the country" by providing nutrition to patients who "should be dead already" if only we allowed nature to take its course? Judges cannot impeach legislators, but legislators can impeach judges. End of story.

Privately, millions of families have made such choices for decades: sell the vacation home to pay for grandma’s cancer treatments; forego a hip replacement to make sure a grandson can finish college. Some families choose more medicine, some choose other options. Eventually the money runs out. In that narrow sense, defenders of Michael Schiavo are correct: These decisions are being made thousands of times every day. Millions of times every year.

That private reality has now become very public, thanks to federal control of health care. Because medicine has become nationalized, at least for the old, every decision about life and death will be a political issue.

When that prospect becomes clear, I doubt that the debate will focus on any principles at all — personal ethics, medical ethics, the right to life, the dignity of the person, the spiritual value of suffering, or even the painless "mercy" of euthanasia. No, since health care has become nationalized, the question of life and death will be nationalized too. And, since "strict separation of church and state" requires that all ethical principles be hounded from the public square, there will be only one standard left: money.

Money means votes. People on feeding tubes don’t vote. The rest of us — people who aren’t on feeding tubes — fall into two categories: either they pay taxes, or they rely on a myriad of government programs funded by taxes. As any appropriator will tell you, money is always in short supply. So neither group would welcome a new approach to health care that raised taxes by eight trillion dollars and then spent it on somebody else who is going to die anyway.

A sidebar: at that point, it will have to be illegal for anyone to pay privately for extending "meaningless" life through innovative medicine or even a simple feeding tube. Imagine a patient in one hospital room being given a privately-funded feeding tube, while the one down the hall is denied the same care by the government. The avalanche of envy and outrage would be politically unbearable. Hence, such treatment would be available only outside the country. Hillary Clinton, while pondering her own options (Switzerland? Belize?), might smile: her 1993 national health care plan was right on target; it was just before its time. The chickens will come home to roost when the baby boomers do.

Conclusion? Government-ordered euthanasia is coming, sooner than we think. All that talk about "living wills" is just camouflage. In our lifetimes, we will see the government proclaim that all "living wills" must be read in only one way: no support for the sustenance of "meaningless" life, the "meaning" to be determined by politically-appointed "independent experts," not family members.

In our lifetimes, yes. And, as a natural consequence, our lifetimes will be shorter.