How do you see these issues and any other trends that are occurring as undermining human dignity?
When you say that some people have greater value than other people, when you say that some people have a greater claim on our care and our concern than other people, you are establishing an invidious system which would tolerate medical discrimination, perhaps in the form of healthcare rationing, perhaps in the form of a situation sometimes called futile care where doctors are entitled, under certain rules, for example in the law of Texas, to refuse wanted life-sustaining treatment based on the doctor’s perception of the quality of the patient’s life and the cost of care. You open the door to things such as euthanasia and assisted suicide. Creating a system where people are valued differently will lead to oppression and exploitation of those who are deemed to be those less valuable.
What have you discovered to be the most powerful arguments against those trends?
I think the value system of the West, whether one is conservative or liberal politically, really accepts the concept of universal human rights and universal human equality. I think we need to fight any form of discrimination that challenges that, whether it’s based on race, whether it’s based on sex or whether it’s based on physical capacities, physical health or disability. When we point out that by engaging in these utilitarian practices and policies that you’re creating another form of invidious discrimination … I think people respond … .
The minute it’s subjective, the minute that we decide that in order to have the highest value you have to have a predicated capacity, then who matters and who doesn’t becomes more of a matter of who has the power to decide and you move into a great potential for discrimination.
Underscoring this: physicians can increasingly “refuse wanted life-sustaining treatment based on the doctor’s perception of the quality of the patient’s life and the cost of care.” We’re debating whether we should have something like universal medical care, while at the same time evolving our ethics in a direction that allows for subjective delivery of that care.