A Difficulty of a Serious Nature
When the founders of the U.S. Constitution in 1787 considered whether America should let the people elect their president through a popular vote, James Madison said that “Negroes” in the South presented a “difficulty … of a serious nature.” http://www.pbs.org/newshour/updates/electoral-college-slavery-constitution/
When James Madison was writing about the ‘difficulty of a serious nature’, he was referring to the 3/5 compromise which mandated slaves be considered less than fully human for the sake of the electoral process. It seemed a logical stroke of genius for the economic and political stability of our nation.
Before the ink was dry on the signing of the Constitution, it had already spilt and indelibly stained the fabric of the nation. That stain continues to tarnish every decision made when it comes to treating others amongst us as fully human.
People like me of African descent in these United States of America as well as anyone who does not look distinctly European continue to face systematic institutional discrimination. We have always been an ethnic group, a people of color or race of mankind that is either tolerated or accommodated out of convenience. We have been categorized and catalogued based upon the percentage of African blood that flows through our veins reflected in the texture of our hair and the hue of our skin. Because of this we have always been a difficulty of a serious nature in our nation.
From the cradle to the grave we are still deemed a difficulty of a serious nature in this country. We continue to face discrimination in housing, education, justice and very important from my point of view healthcare. As I trained in medicine and surgery I witnessed and participated in the sanctioned use of our black patient and clientele as objects differing only from the cadavers in core body temperature. There were designated hospitals and sections of hospital reserved for doctors in training. There were hospital services and teams solely reserved for people who happen to be of darker skin tone. These discriminatory practices are less overt these days but remain reflected in the life expectancies and quality of care of people like me.
This is an issue from cradle to grave. If our healthcare system and providers could not be trusted and cannot be trusted to exhibit professional integrity and not discriminate when life chances are good, why should we believe it will happen when life teeters on the edge.
Physician-assisted suicide is seen by many as a compassionate response to relieve pain and suffering. I have yet to meet or care to meet a colleague who takes pleasure in seeing someone suffer. We were trained to relieve emotional, physical, psychological and even spiritual pain. Not all of us practice our profession on the front line, face-to-face with families and friends of someone who is suffering. However, I am cautious of being swayed by the wave of emotions that would drown out my professional decision-making.
To actively participate in the death of someone in front of me is a difficulty of a serious nature. Convenient compassion would certainly justify doing so. But I know that this compromise can often be made for the economic and even familial politic. I understand how good intentions signed in black ink for the sake of the individual and family will stain forever relationship between physician and patient. One never knows who conspires with whom to end life.
Suffice it to say that I do not trust in the healthcare system and its providers to make nondiscriminatory choices when dealing with a difficulty of a serious nature. This is especially true if one’s practice is made up solely of helping people die. I can imagine that one would need to be certified in killing. Proper protocols and ethics would be established. But if the practitioner were not paid adequately those boundaries can always be pushed and violated.
Pain and suffering are difficulties of a serious nature. When people of color have historically been denied and continue to be denied adequate healthcare, why should we entrust those same institutions and systems to rule and decide in our best interest? Of course, being of darker skin hue is a permanent, life long, pre-existing condition which all the actuarial tables note. The banks, the justice system, the education system all take note of this pre-existing condition. Should I trust my doctors to determine when I should die?
Physician-assistant suicide represents to me yet another way to rid ourselves of someone no longer holds value. These are 3/5 persons. Putting them out of their misery, taking away their breath allows us to breathe easier. We call it compassion. I call it convenient compassion. My fear is that once we embrace this way of ending life for the isolated few, we will find it necessary to redefine suffering. We will once again have designated hospitals with designated services for designated people. We can harvest their organs at the same time the rifle through their belongings.
I see this as a boon for insurance companies which would rather that I die from my pre-existing condition than use up the benefits that would go to their profits. Families likewise cannot be trusted to rule dispassionately when there are potential financial benefits. Convenient compassion allows the governments to balance their budgets on Medicaid and Medicare and it takes non-compliant, disruptive and complicated patients off of my office schedule. It is convenient for all of these entities and disguised as compassion. It serves the decision makers who can easily coerce even those who are conscious that it is within their best interest. After all, if I am near to death, I can easily be convinced that I should sacrifice my last hours, days, weeks or months for the sake of people who really love me and just want me out of my misery and out of their way.
This is a difficulty of a serious nature. When seen through the eyes of someone who has experienced and even participated in treating people as less than equal, I see where this will ultimately end. I will actively pursue defeating any agenda that seeks to address a difficulty of a serious nature by dehumanizing and killing the person in front of me no matter who advances this convenient compassion. I urge you to do likewise.