Last Sunday’s New York Times Magazine had an article by Peter Singer entitled “Why We Must Ration Health Care.”  If you don’t know Peter Singer, it’s not his fault.  He is a professor of bioethics at Princeton University who has a hearty appetite for controversy and philosophical engagement.  He is a noted animal rights proponent and, seemingly by design, a villain to the disabilities community.

My first thought upon seeing the article was to recall the passing, on June 4, 2008, of Harriet McBryde Johnson.  Harriet, who died at the age of 50, was an incredible disability and civil rights attorney.  She also wrote articles for the New York Times Magazine where she engaged Singer in ongoing debate on issues of life and death for individuals with disabilities.

In a February 2003 article, Unspeakable Conversations, she addressed Singer’s statement that: "It does not seem quite wise to increase any further draining of limited resources by increasing the number of children with disabilities."   Harriet, who had spinal muscular atrophy, brought the discussion down from the philosophical plane to the personal.  Singer, she pointed out, was saying that Harriet’s parents should have had the option of killing the baby she once was in order to “avoid the suffering that comes with lives like mine and satisfy the reasonable preferences of parents for a different kind of child."

But getting back to this Sunday’s article, I think it’s clear that Peter misses Harriet.  You see, after he describes something called a “quality-adjusted life-year” (QALY) which compares the cost-effectiveness of various medical procedures as part of a process of deciding which medical treatments will be paid for with public money, he says: “Some will object that this discriminates against people with disabilities.”  Could that be Harriet?

He explains that if people feel that they would rather live one year as able-bodied than two years as quadriplegic, then a medical procedure that extends the life of a quad should only have half the value as one that extends the life of an able-bodied person.  Singer agues that even though a quad would not want to give up a year of life, she would want to be “cured,” thereby acknowledging that her life is not as valuable as one that is able-bodied.  He concludes:  “Disability advocates, it seems, are forced to choose between insisting that extending their lives is as important as extending the lives of people without disabilities, and seeking public support for research into a cure for their conditions.”

But alas, Harriet is not here to set Singer right.  She can no longer point out that disabilities and medical conditions are different things.  (The Oregon Health Plan recognized that almost twenty years ago.  Get with it, Peter!)  As a civil rights attorney, Harriet can no longer remind Singer that the law protects minorities from the tyranny of the majority: what “people” may think about the value of minorities does not permit them to devalue their lives.

And I think Harriet knew something about American values: that this is a land where people can strive to improve their condition without penalty.  In 2006, Harriet spoke at the United States Holocaust Memorial Museum.  Her topic was "Deadly Medicine," a disability rights perspective on the Nazi Euthanasia program to exterminate people with disabilities. She reminded us that among the first groups that Hitler slated for elimination were people with disabilities.  Between 1939 and 1941, over 200,000 people with physical and intellectual disabilities were sent to death.

If the American public were polled and a majority said that life as a quadriplegic is not worth living, would Singer be satisfied if the government provided them with no medical treatment?  In that case, would a quad choose the Nazi method over prolonged suffering from untreated medical conditions?  Questions that Harriet McBryde Johnson would relish asking.