‘Gender Hybrid’ Children?

There is an old joke: What do you call the medical student who finished last in his class? Answer: “Doctor.”

The increasing legalization of assisted suicide has accorded that joke a disturbing pertinence. A doctor who prescribes poison need not be an excellent medical practitioner. He or she need not specialize in treating patients who present with particular life-threatening conditions, and indeed, can prescribe even if never treating the patient’s underlying condition at all.

For example, Jack Kevorkian was a pathologist who never treated a living patient after medical school. But if assisted suicide had been legal in his time, he would have been qualified to lethally prescribe. Along similar lines, before assisted suicide was legalized, the California death doctor Lonny Shavelson was a part-time ER doc who mostly pursued a career as a photojournalist and author.

Predictions by specialists of death within six months are often uncertain. Imagine the potential for abuse or mistakes from a non-specialist or a generalist. Add in a potential profit motive, and the danger becomes acute.

I bring this up because of a discouraging story profiling a New Jersey death doctor named Robin Plumer who runs an assisted suicide service. From “This N.J. Doctor Will Help You Die — for a Hefty Price,” on NJ.com:

But dignified death doesn’t come cheap. Dr. Robin Plumer, the specialist who oversaw her [a recently diagnosed ALS patient’s assisted suicide] case, charges as much as $8,000.

In the seven years since MAID was legalized in New Jersey, an invisible industry has emerged, a seven-month NJ.com investigation has found. The controversial practice has become a niche specialty, often operating in the shadows. Fewer than a dozen doctors and only a handful of pharmacies statewide are willing to assist terminal patients in dying.

So in 2020, Plumer launched the state’s first medical practice solely devoted to MAID. In so doing, she created a specialty market for assisted death in New Jersey — one that includes concierge service and hefty prices.

Assisting suicide is not a board-certified medical specialty. It might be more accurate to say that facilitating death is Plumer’s primary focus. Indeed, she is a mass legal suicide assister, responsible for about half of New Jersey’s MAIDed toll:

She’s since overseen about half the state’s 409 physician-assisted cases from 2019 through 2024.

“You can tell I devote a lot of time and energy to working with patients,” Plumer said. “And just like any other specialist, you know, we want to be reimbursed for our time.”

But critics contend Plumer, 68, has all but commodified death. She is packaging it like a travel agent, they say, preying on the terror of the terminally ill and the desperation of their families in a fragile time.

If Plumer assisted 200 suicides at, say, an average cost of $5,000 apiece, that’s a million bucks!

Plumer admits my thesis that assisting suicides doesn’t require providing many actual professional services:

The actual doctoring part of assisted death is rather modest. A medical professional like Plumer is not required on the date of death. In fact, patients must self-administer the MAID cocktail because euthanasia — when a doctor administers the lethal drugs — is illegal in the U.S.

Instead, the real value Plumer offers is the presence and gravitas she brings, she says. She’s part confidant and part facilitator.

Reading this story reminds me of the Canadian doctor who has killed more than 400 people — which she told a reporter was the most fulfilling work she has ever done. Ugh.

And that highlights an important point. Whether legal or not, assisting suicides is the antithesis of what medicine is supposed to be about, i.e., promoting healing, facilitating wellness, providing palliation, and maximizing quality of life — which is precisely why so many treating clinicians refuse to participate in hastening their patients’ deaths.

The story also tells us something about how assisted suicide legalization has changed the mores of contemporary society. Plumer is fervently supported by her dead customers’ friends and family members. Many even attended their loved ones’ deaths that she facilitated. Such normalizing of suicide will have profound ramifications beyond the early demise of terminally ill people.