Since the dawn of the anti-choice movement more than 40 years ago, its leaders have linked abortion, euthanasia, and infanticide. As Human Life International (HLI) and other anti-choice groups see it, abortion leads to euthanasia
as day leads to night. Furthermore, they see infanticide as a form of euthanasia, and have called it the bridge between the two.
Meanwhile, LifeNews.com, a go-to information source for many antis, recently tapped an emotional nerve among opponents of reproductive rights by invoking the notion of non-voluntary euthanasia, wherein doctors have the power to decide who lives, who dies, and when. “Euthanasia is no longer voluntary in the Netherlands, one of the first countries to embrace it,” the site reports. “Today, they have what’s called kryptonasia, where doctors make the decision of when a patient’s life should be taken, without input from the family.”
Lest LifeNews.com readers think this merely an example of European permissiveness or unbridled liberalism, the website’s editors quickly made the story relevant to readers in the United States, charging that the imposition of the Affordable Care Act (ACA) has brought “death panels” to U.S. soil. Reportorial emotions run high as LifeNews.com and the National Review, among other media outlets, conjure the Godlike powers of the ACA’s Independent Payment Advisory Board (IPAB), an oversight panel that the antis consider an Obama-crafted vehicle for life-and-death decision making.
It’s not the first time the right wing has imagined this lurking menace.
In its initial incarnation, the ACA included funding so doctors could be paid for providing end-of-life counseling to Medicare beneficiaries, Karen Davenport, director of health policy at the National Women’s Law Center, told RH Reality Check. The goal was to ascertain people’s end-of-life preferences before those decisions needed to be made. For example, might they opt for palliative care over medical intervention if they become terminally ill? Have they considered signing a Do Not Resuscitate Order to prevent being hooked up to machines and force fed? Conversely, do they want doctors to do everything possible to keep them alive?
Davenport notes that the end-of-life counseling provision never made it into the final version of the ACA, in large part because Republican lawmakers erroneously labeled the proposed discussion a “death panel” and railed that it was a bold-faced attempt to push grandparents and people with disabilities into a cost-saving, humanly orchestrated demise. But its defeat did not signal the end of “death panel” malarkey, and conservatives have continued to shout the phrase wherever and whenever possible. “The idea of having a board that decides if people will get services or not fits into a pervasive right-wing narrative,” Davenport said. “It’s great rhetoric. Presenting an imminent threat to people who already distrust Obama and the government revs up supporters.”
Who cares if the allegations are true?
Indeed, when Congress created the IPAB, the right quickly moved in to attack this new, presumably assailable target as a threat to medical autonomy. That it has absolutely nothing to do with medical decision making was irrelevant. So what is the board’s function, you ask?
“The board is a backstop to make sure that Medicare, a really important source of health care for elders and the disabled, realizes cost savings,” said Davenport. “The law explicitly prohibits rationing care or doing anything to propose changes to the program. Among other things, it can’t impose higher cost-sharing for recipients or raise premiums.”
Once it is convened, the non-partisan board will be composed of 15 congressionally vetted people, all recommended by party leaders. As of today, no one has been nominated to serve. Still, once appointments are made, their job will be to make recommendations to the House, Senate, and president. Congress will then vote these recommendations up or down. “Their exclusive focus will be on the fees that are paid to providers with an eye toward controlling Medicare reimbursement rates to physicians,” Davenport said.
This reality, of course, has done nothing to assuage the antis. The specter of euthanasia—and physician-assisted suicide—continues to loom large, claim HLI and other anti-choice groups. In fact, as increasing numbers of lawmakers and the general public express their support for allowing the terminally ill to end their lives on their own terms, their panic is escalating. In addition, their fear-mongering about the United States’ moral decline is ramping up. To make its point, the right routinely trucks out the death-with-dignity legislation that is gathering steam throughout the world. Closer to home, they raised a ruckus over Vermont’s decision in May to become the fourth U.S. state to allow physicians to provide medication to dying patients so they can end their lives. The Center for Bioethics and Culture Network expresses the views of most death-with-dignity opponents when it argues that “a society that permits or legalizes euthanasia and assisted suicide for the few, embarks on a path leading inexorably to permissive mercy killing of the many.”
This stance leaves supporters shaking their heads and asking why.
“If someone wants to commit suicide, it’s most often an impulsive act that comes from mental illness,” Barbara Coombs Lee, president of Compassion & Choices, a Washington, D.C.-based advocacy group that champions expanded options for terminally-ill people, told RH Reality Check. “Assisting them is illegal. This is very different from aid in dying, which is a rational decision that comes at the end of life. We are talking about offering people who are dying a peaceful exit at a time of their own choosing. It’s very different from assisting in a suicide or coaxing depressed people to jump from ledges.”
It comes down to choices, Coombs Lee says, and who has them and who doesn’t. Furthermore, she calls conservative grumblings about “death panels” and death-with-dignity legislation “a bunch of heat and political posturing.” What’s more, she said, “the extremism that drives these scare tactics does not represent mainstream America. People are overwhelmingly in favor of having end-of-life options.”
Not surprisingly, they are similarly in favor of the ACA and reproductive justice.