Even those who have never been to medical school know that all physicians are taught “first do no harm.” It’s not a part of the Hippocratic Oath, as some believe, but it is certainly a part of every medical student’s training.

Assisted suicide is a direct betrayal of this training. While some would rationalize that helping those who are suffering die is compassionate, I would say it’s really playing God. Only God can grant life and only God should determine when life ends. Anyone with Judeo-Christian values would agree. The late great Washington Post columnist, Charles Krauthammer wrote in 1997, “When you see someone on a high ledge ready to jump, you are enjoined by every norm in our society to tackle him and pull him back from the abyss.”

Nicholas Tomaino, writing in The Wall Street Journal, tells us suicide is neither noble nor natural. That principle became less clear with the advent of physician-assisted suicide. Krauthammer was writing about Vacco v. Quill, in which the Supreme Court would hold unanimously that the Constitution doesn’t create a right to that procedure. “We are being asked to become a society where, when the tormented soul on the ledge asks for our help in granting him relief, we oblige him with a push,” Krauthammer wrote, reflecting on the oral arguments.

Laurence Tribe, who argued the case for the plaintiffs, suggested the slope wouldn’t be so slippery. The procedure would be granted to the patient with end-stage heart failure, not the man on the ledge. At the same time, Mr. Tribe posited that people at the “threshold at the end of life” enjoy the liberty to decide how they die. Krauthammer spotted the argument’s hole. Why couldn’t the chronically ill “who face a lifetime of agony,” or the “healthy but bereft,” avail themselves of the same right?

Assisted suicide came to the U.S. in the 1990s through the efforts of Dr. Jack Kevorkian, a misguided physician from Michigan who assisted over 40 people in dying by suicide. His first public assisted suicide was in 1990 of Janet Adkins, a 54 -year-old woman diagnosed with early-onset Alzheimer’s disease in 1989. (Today there are new medications to slow and even reverse the effects of this devastating disease.) In 1998, Kevorkian videotaped himself giving a man a lethal injection, with the patient’s consent, and aired the tape on 60 Minutes. This was significantly different from previous cases, where it was always the patients themselves who reportedly completed the suicide process. He was found guilty of second-degree murder and served eight years of a 10–25 year sentence. He was released in 2007, and died on June 3, 2011.

 Since then, ten states and the District of Columbia have legalized physician-assisted suicide and others are considering it. (All of these jurisdictions are blue states.) Americans who are skeptical of Dr. Krauthammer’s warning might consider the experience of our neighbors to the north.

Mr. Tomaino writes that Canada has undergone a crash course in what the country calls “medical assistance in dying,” or MAID. The experiment began in 2015, when the Canadian Supreme Court ruled in Carter v. Canada that “laws prohibiting physician-assisted dying interfere with the liberty and security” of people with “grievous and irremediable” medical conditions. Parliament codified the decision the following year.

Lawmakers thought they were imposing limits. “We do not wish to promote premature death as a solution to all medical suffering,” then-Justice Minister Jody Wilson-Raybould said. The plaintiff’s lead lawyer in Carter argued that “in almost every case,” doctors will want to “help their patients live, not die.” “We know physicians will be reluctant gatekeepers.”

Yet Krauthammer was right. The Superior Court of Quebec soon ruled that MAID was unconstitutional because it required that an applicant’s death from “a grievous and irremediable medical condition” be “reasonably foreseeable.” Parliament amended its “discriminatory” regime in 2021, opening wider the door to facilitated death. The new law dropped safeguards, such as the minimum 10-day assessment period between request and provision. It also proposed mental illness as an eligible condition, the implementation of which the government has delayed until 2027. The message for everyone else remains the same: If you want to die, you needn’t wait.

(Note: To learn the consequences of this policy, read my next post – Part II.)

Recently, I opposed former President Trump’s new IVF proposal to have the government subsidize or pay for In-vitro Fertilization (IVF). (Trump’s IVF Entitlement) While I’m not backing down from what I wrote, here is an opposing point of view.

Ira Stoll, writing in The Wall Street Journal, says current government policy is tilted against having children.  Federal law requires most health insurers to cover contraception at no cost to the patient. That includes birth-control pills, long-acting methods such as intrauterine devices, and often even surgical permanent sterilization methods like tubal ligation. He says Trump’s idea would restore the federal government’s neutrality on the decision to start a family.

Right now, the government, and many private insurers, will pay for medical procedures to prevent pregnancy. But they often won’t pay for IVF, the “test-tube baby” technology that’s existed for nearly 50 years and often is necessary to enable childbirth. This double standard is a recipe for population decline. It’s a policy prescription for, in JD Vance’s memorable phrase, a nation of “childless cat ladies.”\

Stoll points out we’re heading in the wrong direction when it comes to our fertility rate as a nation. In April, the National Center for Health Statistics announced that the fertility rate in the U.S. hit a record low. The current level of roughly 1.6 births per woman is below the replacement rate needed to maintain the population, absent immigration. What does this mean to us as a nation?

Stoll tells us the costs of low birthrates—empty cities and school buildings, an insufficient working-age population to support retiring baby boomers, a military that isn’t meeting its recruitment targets—far outweigh the costs of adding IVF to insurance coverage. Fourteen states and the District of Columbia already have fertility insurance laws that cover IVF, according to Resolve, a patient advocacy organization. Internationally, covering IVF hasn’t hindered Israel’s impressive economic performance as a “startup nation.”

He advocates a more sensible accounting of Mr. Trump’s proposal would include not only the costs of the medical procedure but the benefits to society of more souls, a concept conveyed in the biblical injunction to be fruitful and multiply. Found in Genesis 1:28 and again in Genesis 9:1, it is the first commandment in the Bible and one of the few that predates the Sinai covenant.

Stoll says, “The roughly $15,000 price of an IVF procedure is nothing compared with the priceless potential of an individual human being. That new person might start a company, cure a disease, inspire students or improve the world in any number of other ways. Almost certainly, that person will pay over a lifetime far more in taxes than the cost of the IVF procedure.”

It is the high cost of IVF procedures that makes this government entitlement hard to swallow. The cost of preventive measures such as contraception pills, IUDs, and even tubal ligation are much lower and therefore more easily justified. I would argue all of these healthcare costs should be subject to insurance premiums that justify the expense. I don’t think the government should be more willing to pay for these treatments to prevent pregnancy any more than those to enhance pregnancy.

I am certainly in favor of healthcare procedures that encourage life as much as those that prevent it. But let’s get back to insurance coverage, whether private or federally funded, that covers the healthcare needs of individuals, not a one-size-fits-all approach such as we’ve been burdened with since the passage of The Affordable Care Act known as ObamaCare. Then we won’t have men with healthcare insurance that covers mammograms or women with coverage for prostate exams – or fertility treatments they may never use.

In-vitro fertilization (IVF) has become the latest political football. Democrats want to paint Republicans as opposed to this infertility procedure as part of their campaign for “women’s reproductive rights.” Now, former President Donald Trump is pushing back by saying he not only approves of IVF, but he wants the federal government, or your insurance company, to pay for it. In this atmosphere of hot political rhetoric, cooler heads must prevail.

The Wall Street Journal editorial board is generally conservative, but they oppose Trump’s proposal. Here’s what they say, “Donald Trump this week proposed subsidizing in-vitro fertilization treatments for all Americans, and the politics aren’t hard to discern. Mr. Trump is trying to blunt a GOP liability with women voters, particularly on abortion. But a new federal fertility entitlement is a fiscal and cultural thicket Republicans don’t want to enter.”

Most Americans know someone who has struggled to conceive children, and couples often turn to IVF procedures that cost tens of thousands of dollars from egg retrievals to embryo transfers. Insurers don’t always cover IVF, though companies appear to be expanding fertility benefits as more Americans form families at later ages. In 2022 some 43% of large employers covered IVF, up from 27% in 2020, according to one survey.

WSJ editors say, “The irony is that Mr. Trump is mimicking Barack Obama and his Affordable Care Act, which demanded that insurers offer the federal government’s preferred benefits regardless of expense. The cost of fertility procedures for some will be buried across higher premiums for everyone else. If Mr. Trump forces Affordable Care Act plans to cover IVF, he will encourage more Americans to move to taxpayer subsidized plans from small business offerings that often can’t afford to cover IVF.”

The editors are correct in saying this mimics the worst aspects of ObamaCare, the Affordable Care Act. Obama promised, “We’ll lower premiums by up to $2,500 for a typical family per year. . . . We’ll do it by the end of my first term.” (6/5/08). But premiums actually more than doubled. The main reason for the increase was the ACA mandated certain healthcare coverage in all policies – even prostate exams for women and mammograms for men. By mandating coverage not everyone needed, the price went up for everyone! The same thing would happen if Trump mandated IVF coverage for everyone.

WSJ goes on to explain the cost could run into the tens of billions annually, not least if Medicaid had to cover IVF, which it inevitably will if ObamaCare plans do. The government would dictate how many attempts are covered when an IVF cycle fails, and micromanage the quality of clinics. If you think IVF is expensive now, wait until it’s “free.”

It’s easy to understand why Trump is making this proposal this late in the election campaign. With Kamala Harris promising to continue the Biden Administration policies of college debt forgiveness, and pushing her own ideas of free healthcare for illegal immigrants, and even housing subsidies up to $25,000 for illegals, Trump feels like he’s in a bidding war for the American voter. Harris even promises a $6,000 tax credit for newborns!

But someone has to pay for all this government largess. We’re $35 trillion in debt now and that “someone” is the American taxpayer. If we don’t reign in the spending, the loser will be the defense budget and that’s just not acceptable in a world on the brink of WWIII.

IVF can be a wonderful solution to infertility problems, but let’s let couples make their own decision to attach such coverage to their health insurance. Trump’s proposal will only raise the cost of healthcare for everyone, including seniors like me who have no need for IVF.