Active and passive euthanasia in capitalist health care

Yoshie Furuhashi furuhashi.1 at
Fri Dec 8 00:00:47 MST 2000

Lou Paulsen wrote:

>This is a really tough issue, and I am in a good position to see both sides.
>As I work in healthcare, I have an opportunity to follow their
>'establishment press' some.  The trend is really frightening to me.  Of
>course it is all a matter of "following the money."  Under the old
>"fee-for-service" plans, the financial incentive on the part of the
>providers and suppliers was to provide as much healthcare as possible.  No,
>don't let the patient die, use as many costly drugs and procedures as
>possible, keep the patient alive as long as possible, and charge it all to
>the patient's insurer.

Thanks for a very fine post.  It seems to me that "the right to die"
will be a bigger problem in the USA than in Holland.  In nations
where the right to universal health care is well established,
codification of "the right to die" is likely to cause fewer problems
than here.

Then again, social democracy -- even at its best -- is no guarantee
for disabled people's rights.  Take, for example, Sweden:

*****   Eugenic sterilisation: Europe's shame

Eugenic ideas were promoted across much of Europe during the 1920s
and 1930s, with forcible sterilisation of the 'unfit' a constant
demand of the eugenicists.  Charles Webster reports on a troubled
period in our history

During the summer of 1997, the name of Maria Nordin, a dignified
72-year-old former hospital worker from North Norrland in Sweden,
shot to media prominence throughout northern Europe, and her case was
even briefly noted in the British press.

Maria Nordin came from a poor family.  She was short-sighted and slow
at school, taken into an institution in a distant town and eventually
released in her teens, but only after being sterilised.  It was
called voluntary sterilisation, but in effect it was compulsory.
Understandably, this humiliating experience left a deep mark on her;
with the help of some Swedish journalists, she has at last persuaded
the authorities to take notice of her grievance.

Investigators quickly discovered that Maria Nordin's case was by no
means unique.  She was one of some 60,000 people subjected to
sterilisation in Sweden between 1935 and 1976.  Most were women, and
the majority were labelled as mentally defective, although most
probably had only minor physical or social disabilities.  This
finding has come as a severe embarrassment to the Swedes, and
especially the Social Democrats under whom sterilisation was
introduced and then greatly extended.  The government has apologised,
accepted that this 'treatment' constituted abuse, and it is likely
that substantial compensation will be paid to survivors.  The
existence of eugenic sterilisation has severely shaken Swedish public
opinion and it blemished the reputation of the internationally
renowned Swedish welfare state....

<>   *****

Social democracy and the welfare state may depend upon the idea that
since the state provides care, it is also entitled to decide who
deserves to live or die.  The organicist metaphor of a "body politic"
of which individuals are disposable "members" is dangerous as well.

>I guess this is sort of an extended personal meditation on the question of
>"choice".  I am always distrustful of the word, because capitalism is
>founded on the religion of "free choice", but these choices are always made
>within a completely constricting framework which gives you a very bad set of
>choices.  What is this "freedom"?  What causes people to make the "free
>choices" that they do?   Yes, it is better to have choice than to have no
>choice; better "bourgeois" individual choice than "feudal" inflexibility.
>But how much of a choice are we really getting?   And who is really doing
>the choosing?  We have to keep our critical perspective.

Well stated.


More information about the Marxism mailing list