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One positive lesson from Tuesday night is that assisted suicide should be struck from the progressive agenda. While voters re-elected Barack Obama, added two Democrat senators, elected an openly-lesbian senator in Wisconsin, supported or legalised same-sex marriage in four states, and legalised recreational cannabis in Colorado and Washington, in the playground of progressive politics, Massachusetts, they rejected physician-assisted suicide.

Question 2 on the ballot asked whether a doctor should be allowed to prescribe a lethal drug to end the life of a terminally ill person. This is already legal in Oregon and Washington on the West Coast. If assisted suicide had gained a beachhead on the East Coast, it would have been taken up quickly throughout New England.

But voters rejected it by 51 percent to 49 percent.

The narrow margin does not convey the success of the No campaign. As late as mid-September, a Suffolk University poll found that 64 percent of voters favoured legalising assisted suicide. The cause seemed lost.

What turned voters around? Four factors seem to have been at work.

First, disability activists were strongly opposed. They feared that legalised assisted suicide would put pressure on them to take an early exit. A powerful article in the Boston Phoenix pointed out that people who live with permanent disabilities weren’t in favour of it:

“why would a person with a disability ask for a suicide pill? My ex [boyfriend] never would. Disabled from birth, Mike has been fighting for his rights since he was in grade school. He’s a badass with 60 tattoos, and he’s not ready to die any time soon.

“But for the late-disabled, it’s different. People diagnosed with a progressive disease — MS, ALS, and other such dire acronyms — still carry the same prejudices they’ve held all their able-bodied lives. Often, they don’t know anyone living a full, enjoyable life with disabilities, don’t know such lives are possible. So if a doctor offers them an exit, they’re all too likely to take it.”

“We changed the nature of the campaign,” said John Kelly, director of Second Thoughts, a disability activist group. “This is the first assisted suicide campaign in which the disability rights perspective has reached so many people.” Their vigorous arguments persuaded voters that physical incapacity or incontinence do not rob people of their dignity.

Second, opponents of assisted suicide could not be tarred as theocrats seeking to impose their values on a post-Christian electorate. The Catholic Church strongly opposed Question 2, but stayed in the background. Second Thoughts, for instance, also backed Question 3 – about whether to legalise the use of marijuana for medical purposes. It passed.

Third, the medical establishment was strongly opposed – as it is nearly everywhere. Who knows better the hazards of allowing the healing profession to end lives?

Two of the leading supporters were Marcia Angell, a former editor of the New England Journal of Medicine, and Dan Brock, a professor of medical ethics, both of Harvard Medical School.

However, the official position of the Massachusetts Medical Society, the publisher of the NEJM, was strongly opposed. It contended that the proposed safeguards against abuse were inadequate and that predicting whether a patient will die within six months is difficult. It cited Lynda M. Young, a past president: “Allowing physicians to participate in assisted suicide would cause more harm than good. Physician assisted suicide is fundamentally incompatible with the physician’s role as healer.”

Finally, in the final weeks of the campaign, prominent progressives were emphatic in their opposition. In a New York Times op-ed, Dr Ezekiel J. Emanuel, an architect of the Obama Administration’s healthcare policy, described the “four myths” of assisted suicide: that it is all about controlling pain, that it is driven by advanced technology, that it will improve quality of life and that it guarantees an easy exit.

He described assisted suicide as fundamentally skewed against the poor:

“Whom does legalizing assisted suicide really benefit? Well-off, well-educated people, typically suffering from cancer, who are used to controlling everything in their lives — the top 0.2 percent. And who are the people most likely to be abused if assisted suicide is legalized? The poor, poorly educated, dying patients who pose a burden to their relatives.”

E.J. Dionne, a liberal stalwart who writes for the Washington Post, asked how assisted suicide “would interact with the need to curb costs in our medical system”.

In Massachusetts the Kennedy family is more revered than the Windsor family is in the UK. The late Senator Ted Kennedy was a liberal icon. So the stern opposition of his widow probably swayed many voters. Dismissing the slogan of “dying with dignity”, Victoria Reggie Kennedy wrote in a local newspaper: “for every complex problem, there’s a simple easy answer. And it’s wrong.”

“Question 2 is supposed to apply to those with a life expectancy of six months or less. But even doctors admit that’s unknowable. When my husband was first diagnosed with cancer, he was told that he had only two to four months to live, that he’d never go back to the U.S. Senate, that he should get his affairs in order, kiss his wife, love his family and get ready to die. But that prognosis was wrong. Teddy lived 15 more productive months.”

Supporters of assisted suicide will not give up. But the three most powerful arguments in their arsenal are autonomy, compassion and the belief that it is trendy and progressive. The experience in Massachusetts shows that none of these are true.

[8 Nov 12, Michael Cook,,]