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Eva Feder Kittay’s essay, “Getting from Here to There: Claiming Justice for the Severely Cognitively Disabled,” magnifies the principle of social justice.

Kittay, a SUNY-Stonybrook philosophy professor, asks if her daughter has legitimate claims to both protection and resources. With cerebral palsy and severe cognitive disability, Sesha will always be dependent on others. As Kittay frames it, if Sesha were not extended these claims, neither would those two and younger, those with dementia, nor those in vegetative states.

Some believe that Sesha has no legitimate claims, because she lacks the capacities for the moral status of personhood. These include the abilities to create a life narrative, to anticipate death, and to appreciate pleasures.

However, I agree with Kittay, who defines our personhood by the capacity to be in relationship with others. Caring justice begins with an acknowledgment of our dependency. Before we die, we will all face dependency- whether temporary or permanent. Our well-being is not inversely related to our need for care or to care. We need each other. Interdependence trumps independence in a society in equilibrium.

Professor Eva Feder Kittay

Kittay’s case is a caution to lawmakers debating the legalization of assisted suicide. John Rawls’ “veil of ignorance” theory orients us to the reality of not knowing what the future holds. When we debate public policy, we must consider our unknown future. Are we setting policy while healthy, assuming we will be forever? Or, do we consider that we may be one of the vulnerable, needing an ethic of care to guide those determining our treatment?

Justice demands respect for each member of our moral community, whether strong or vulnerable. Societies go awry under competing pressures and with persuasive leaders. In the mid 1900s, the U.S. was the first country to implement a eugenics program with forced sterilization of the intellectually disabled, the mentally ill, those with epilepsy, the blind, the deaf and those with physical deformities. Thirty-two states had such programs, and the last compulsory sterilization took place in 1983. In fact, American policy inspired Nazi practice.

When societies measure moral worth based upon a malfunctioning part obliterating the whole, they slip into morally impoverished states. They move in the direction of a philosophy of eugenics. We are not at that point.

However, the challenges our country may face due to scarce financial resources and burgeoning health system demands could impact the vulnerable. Lawmakers could debate the worthiness of vulnerable people, along with their rights to protections and entitlements.Are we setting policy while healthy, assuming we will be forever? Or, do we consider that we may be one of the vulnerable, needing an ethic of care to guide those determining our treatment?

Assisted suicide activist Barbara Coombs Lee, Compassion and Choices president, once explained her position as it relates to those with dementia and cognitive disabilities as, “it is an issue for another day but is no less compelling.” Unabashedly and in public view, her explanation exemplified the proverbial “slippery slope.”

The gallop of assisted suicide legislation should serve as a call to action for an interdependent society- one in which we are uncompromising in our respect for others. Does suicide reflect that respect?

If legislators support policies in which physicians can provide lethal drugs to those likely to die within six months (now proposed in Oregon as within one year), what keeps them from expanding those laws- legalizing lethal drugs to those burdening others? This is not surreal when lawmakers look to balance budgets and make difficult choices. Re-read the casualness of Lee’s remarks. The U.S. is not as pure as the driven snow. Check our past history.

As Kittay wrote, “We are all some mother’s child.” In a society championing social justice, lawmakers must demand options that provide true compassion and choices for everyone.

Why does conversation in state capitols concern how physicians can assist patients in killing themselves? When others reflect on this 50 years from now, will they be as astonished as we were when judging our 20th century eugenics program? These laws come with frightening consequences once this horse is out of the barn. Our nation can do better.

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