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« Protest by suicide | Main | Lost and the shortcomings of criticism »

Thursday, November 9, 2006

Protecting the fragile self

In a series of inter-related posts on medical ethics, Eugene Volokh has written a thought-provoking essay, or actually an essay excerpt, arguing that the denial of experimental drug therapies to dying patients is unconstitutional.

In a way this is an intuitive argument. Many AIDS patients of the 1980s and '90s, and cancer patients across the decades, have found themselves in pitched battles with the Food and Drug Administration over the availability of cutting-edge drugs still awaiting approval by the (in)famously careful agency. And it is hard indeed to side with the government in these cases. Why not let the fatally ill decide what risks to take, even if death could thereby be hastened?

Volokh's tack is an interesting one. He grounds his claims in the right to self-defense, which is difficult to actually point to in the Constitution but has been held up in crucial court cases of the last century:

This is not a general autonomy argument, premised on the theory that all people should be free to ingest whatever they choose into their body. Rather, it’s an argument specifically focused on the right to self-defense, a right supported both by the Court’s caselaw (Roe and Casey) and by the longstanding acceptance of the right to lethal self-defense.

I thought the Roe decision was founded on what the Supreme Court called the right to privacy (a strange way to look at it, I've always thought), but perhaps they referred to a right to self-defense in the context of cases where the woman's health is at risk? I know that in a famous paper on abortion, the philosopher Judith Jarvis Thompson posed abortion rights as a byproduct of a right to a kind of self-protection. Her thought experiment was to imagine that you wake up one day and find that you have been hooked up to another being, like a Siamese twin, who depends on your body for survival. Are you therefore bound to provide that help, for nine months, at increasing discomfort and risk? She thought not, even if health were not an issue.

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