One thing the left and right appear to agree on, but which seems sorely lacking in good supporting arguments, is that there’s something deeply wrong with people making tradeoffs between health or longevity and money. For instance, I posed a hypothetical to a smoking-ban supporter earlier this week: Suppose we had “smoking variances” that bars could purchase for their liquor licenses, maybe limited to 15 or 20 or 30 percent of the total number of liquor licenses issued—pick the number you like. That should eliminate the worry that professional bartenders “don’t really have a choice” about what kind of environment to work in, so would that be OK? The answer was that it wouldn’t, because that 15 or 20 percent would have to pay significantly higher wages to attract workers—at least, this will happen if you buy the theory that many bar workers just hate the smoke but are subjects of economic coercion under the status quo—and “nobody should have to choose” between their health and an extra buck or two an hour. “Nobody should have to” here meaning, of course, “nobody should ever be allowed to.” (This is, by the way, one of the slipperiest locutions out there today: Any time you have an option you “have to” either take it or not take it. To have more options is to be “forced” (by the law of the excluded middle) to choose between them: Logically speaking, you “must” either accept any offer or fail to accept it. So having choices becomes a species of coercion, and removing them a kind of liberation! Orwell would be proud.)
On the right, one of the big bugaboos about assisted suicide is the prospect of people allowing financial considerations to enter into decisions about the end of life. If someone’s not expected to live more than a month or two, and their care is costing thousands daily, might they decide it’s better to shuffle off earlier and leave that extra money to their kids and grandkids? Well, they surely might. But… so what? Why is this tradeoff, as opposed to any of the innumerable others we might make, intrinsically offensive?
Partly, as I suggested the other day, I think it’s our misguided tendency to regard health as a scientifically quantifiable and, therefore, somehow uniquely “objective” value. But I think it’s also partly that we end up conflating intuitions about distributive justice with the intrinsic coerciveness of the choice situation. That is, if we contemplate someone’s being prepared to seriously jeopardize their health for what seems like not much money, it throws into relief how badly off they must be, since health really is sufficiently widely and strongly valued that it makes a good comparison point. But, of course, what’s bad or unjust is their having so few resources that they regard that tradeoff as a net gain. The added option doesn’t make matters worse, it just highlights an already existing circumstance—whether “unjust” or merely unfortunate—that it might otherwise be easier to ignore.