Friday, March 14, 2014

Huckabee: Connecting End-of-Life Issues with Abortion Reveals Republican Weakness

by Nomad

Mike Huckabee in an attempt to garner attention, has managed to connect the abortion debate and end-of-life matters. Although Huckabee appears unaware of it, that connection actually highlights the problem with the Republican stand on abortion. On top of that, both subjects are toxic to winning the 2016 election.

The other day, while making a speech at the Susan B. Anthony List, a 501 (c)4 anti-abortion organization, former governor of Arkansas Mike Huckabee attempted to play the "Scare the oldies" card. (It's been Fox News' bread and butter since its inception.)
As reported by Politico,
The former Arkansas governor and one-time presidential candidate said women typically cite hardship or inconvenience as their reason for getting an abortion — the same reasons that he said could be used to justify ending the lives of the elderly.
The same technique of scaring the senior voters was used by Sarah Palin in her death panel nonsense. Huckabee told the audience:
“If we teach the generation coming after us that it’s okay to terminate a human life because it represents a financial hardship or social disruption, what are we telling them?”
Huckabee is the kind of politician that doesn't fear to tread the paths where other GOP angels tend to slither away from.    
In this speech, Huckabee chided his compatriots for shying away from the subject of abortion which he sees as a sure-fire election-winning issue. (Somebody should have told him that according to a 2013 poll, seven in ten Americans oppose overturning Roe v. Wade)
Huckabee ironically is attempting to connect a pair of unpopular positions and is expecting some kind of political gain.

End of Life Issues
Comparing abortion to end-of life issues is an argument that could easily backfire. As usual, Huckabee's logic fails under the slightest scrutiny. Let's begin with his attempt to scare the seniors. First off, nobody wants to euthanize the elderly; that decision belongs to the individual.

Due to the advancement of medical science, people are living longer but there is a lag between life extension and quality of the life being extended. Life in a persistent vegetative state or in intolerable chronic pain without hope for recovery is a cruel condition. Very often such patients can be kept alive indefinitely in a state of total dependency on artificial means. There is zero hope for recovery.
In legal terms, the patient is considered "incompetent" meaning unable to provide consent for initiating, continuing or withdrawing treatment. (As we shall see, this is an important distinction.)

On top of that emotional distress, there is the regrettable question of financial hardship. Huckabee - with an estimated wealth of $5 million- can afford to make light of the financial hardship of others. It's not something anybody wants to speak about- and it should never be anybody's first priority- but the reality is that prolonging life where the prognosis is hopeless can place heavy burdens of families. 

As of 2007, a Harvard study shows that at least 60% of bankruptcies are related to medical bills. With the rise in medical costs, that number is undoubtedly even higher today. And those costs are also passed on to the healthcare system. 

Shamefully, Huckabee would prefer to play on guilt and the false imagery of families selfishly pulling the plug on grandma. There's selfishness and greed but it is not with the families, but with the healthcare system that benefits from prolonged care.

In fact, the truth is that few people would wish this kind of emotional and financial burden upon their own families. Leaving this world with dignity, most of us would say, is a lot better than hanging on hopelessly, leaving a family with both guilt and a hospital bill they cannot pay. 
Who wants to be remembered this way? But again the decision belongs to the individual.

The Value of the Surrogate Decision Maker
And in the final analysis, what kind of life is Huckabee  indirectly referring to? An existence of total dependency on artificial means. Most of us would question whether such dependency actually qualifies as "life" at all.  Apart from purely parasitic or symbiotic relationships, biologists usually define life as "the possession of self-sustaining biological processes."  Inherent in those words is the concept of some kind of independence- if only in a limited sense.

Public opinion supports the individual's right to self-determination, especially when it came to outside interference by the authorities. In the Terri Schiavo case, for example, almost 60% of Americans polled felt that it was right to allow the person to die with dignity. Importantly, 75% felt it wasn't Congress' business and 70% felt it was wrong for President Bush to intervene in this private matter.
That should have told Huckabee something.
*   *   *   *
In a brilliant essay  in the New York Times Magazine , Katy Butler relates how she faced this problem with her own mother and father. Butler writes:
They signed living wills and durable power of attorney documents for health care. ..Even so, I watched them lose control of their lives to a set of perverse financial incentives.. skewed to promote maximum treatment. At a point hard to precisely define, they stopped being the beneficiaries of the war on sudden death and became its victims.
The essay also notes that numbers of patients who are no longer in control of their lives continues to grow.
Thanks to advanced medical technologies, elderly people now survive repeated health crisis that once killed them, so the "oldest old" have become the nation's most rapidly growing age group.
Of course, nobody is saying that a patient suddenly loses his or her rights. Yet without some kind of recognized protocol or without allowing somebody the right to make the decision, the patient's existence becomes nothing less than a living death. Who better qualified than family, friends or some other surrogate decision maker? Not the politician raving about death panels or a physician who may have conflicting interests.

In any case, there's no doubt that as the population grows older, end-of-life issues, and the patients' rights to die with dignity, will soon emerge as a controversy.

Somehow, Huckabee is already on the wrong side.
Relationship to Abortion
At first glance, none of this seems to have much to do with abortion. But there is a connection and it is an important one.
That connection is the fact that, like the incompetent patient, the fetus cannot survive with outside support, whether that's medical equipment, devices or other technologies or the mother's body .
During its early stages, the fetus is totally dependent on the mother for life.  The fetus is only capable of only the most basic biological processes and once removed from the mother's body, non-self-sustaining. By scientific standards, then, the fetus represents a capacity for existence but is not a form of life itself. 

But there's more.
When it comes to rights of an incompetent patient, there are appropriate procedures in resolving who should make the decisions. (Admittedly it is not a perfect system. It needs a more standardized approach.)
As in the case of an incompetent or elderly patient, a court-approved surrogate decision maker is legally qualified to make the decision to continue with support or not. (There is in fact a less of  list of relationships in prioritized order.)

The decision  becomes is the responsibility of others who are legally sanctioned. Legal surrogates have the right by law to make the decision to withdraw any artificial means of sustaining life.

In the same manner, the Supreme Court in Roe vs. Wade made the decision the mother should be looked upon as the natural proxy decision maker for the fetus. Rosalind Rosenberg's essay on the Supreme Court decision reminds us, the subject of viability was very much in the minds of the Supreme Court Justices:
Although the right to an abortion was not absolute, it was offset by the existence of the fetus, for the fetus was not a person within the meaning of the Fourteenth Amendment. An abortion could not be performed without the concurrence of a responsible physician, however, and after the first trimester, abortions could be subject to state regulation aimed at protecting the life of the mother.
While the court admitted to being unable to determine the exact point where life begins, it did not believe that the state of Texas was qualified to impose its theory of life on pregnant women. The states' interest in protecting potential life did not becoming "compelling" until the point at which the fetus is capable of surviving outside the mother's body, viability.
"After that point, states could prohibit abortions, except under circumstances in which the life or health of the mother was in danger."
They ruled that life must be for the living- as science defines it. The determining factor, they ruled, is a basic degree of independent survivability - the ability to remain alive or continue to exist. Furthermore, they decided that,  if anybody has the right to make the decision, it is the person or persons most affected -under the guidance of medical authorities. 
Not politicians in state legislatures, not religious leaders or well-financed political organizations. 
*   *   *   *
When it comes to end-of-life debate, there is clearly a need for more attention on the subject. But viability is perhaps as good a place to begin as any. Even then, there are, however, still lots of questions. For example, a patient with a pacemaker, is this viability? Life-saving drugs? Apart from mere viability, there are also higher questions about the quality of life medical science offers.

In the end, the decision must be made by the patient or the proxy decision maker or the mother, with the help of qualified and compassionate care-givers.

But, unfortunately that requires a great deal of serious thought -not with Palin political hysterics or Huckabee hucksterism.