Artykuły w czasopismach na temat „American Bar Association. Section of Taxation”

In 2005, the American Bar Association Section of Dispute Resolution published a two‐volume book authored by John W. Cooley which addressed creativity in negotiations and mediators. This comprehensive treatment consisted of exploration of the theory and science of creativity and a compilation of articles and narratives by mediators on the tools they used to bring about resolution of litigation and other complex disputes. The difference between convergent versus divergent thinking is explained in the context of creativity with the chart at right comparing the two models. See Cooley's Section 1.3.3.2.

The recent three-hour program on “Professional Responsibility and the Religious Traditions” at the annual meeting of the American Association of Law Schools (“AALS”), sponsored by the Section on Professional Responsibility and co-sponsored by the Section on Law and Religion, represents a milepost in the history of the religious lawyering movement and offers a valuable opportunity to reflect on that history. In 1998, only eight years ago, one of us defined the religious lawyering movement as “an emerging force” in legal ethics. In that short time, the movement has expanded dramatically and has received greater attention within the academy and the bar. It has developed the first institutional vehicles for disseminating and promoting conversations about religious lawyering, both among lawyers of the same faith and among lawyers of different faith traditions. Now the religious lawyering movement is increasingly confronting more complex and more difficult religious, legal and ethical issues; and is extending the religious lawyering conversation internationally.

This article is the result of a panel discussion between representatives from Argentina, Brazil, Colombia, and Mexico, at the New York State Bar Association (NYSBA)'s International Section 2011 Seasonal Meeting. The panel was given a case study and asked to analyse the general tax issues arising from a highway infrastructure project entered into by a fictitious US company ('Highways, Inc.') in one of the involved Latin American jurisdictions (Argentina, Brazil, Colombia, or Mexico). Under the hypothesis, Highways, Inc. was to choose the appropriate investment vehicle (special purpose vehicle (SPV)), corporate structure, and capital structure. The SPV's tax obligations and tax incentives in the investment country were also analysed by the panel. The objective was to come up with potential barriers and incentives to invest in the four envisaged investment jurisdictions.

Antitrust enforcement is entering a period of transition in the United States. The election of Barack Obama as President and his executive branch, regulatory, and judicial appointments will have important consequences for antitrust law and enforcement, although most observers believe that these changes will be relatively modest both substantively and in comparison to the matters of banking reform and economic stimulus. As part of that process of change, there has been no shortage of advice offered to first the Transition Team and now the Administration about how to handle competition policy going forward. Two of the more substantial efforts in this regard have come from well-established antitrust groups with very different perspectives and memberships. Both the Antitrust Section of the American Bar Association and the American Antitrust Institute have offered sophisticated lengthy public advice to the new Administration on how best to proceed in the competition law field. The reports are very different in nature and reflect the different nature of the institutions that prepared them. This essay takes a brief look at the transition reports offered by each organization and the vision they would offer for the new Administration.

As part of a multistate research program on use of high-performance concrete (HPC) in highway bridges, a bridge originally designed as a three-span adjacent box girder bridge was converted to a single-span bridge by using 70-MPa HPC and 15-mm strands. As part of the research, a test beam was constructed and tested. Instruments placed in the beam before casting were used to measure transfer length, which was found to be approximately 1.22 m, larger than the 50-bar diameters usually used in the American Association of State Highway and Transportation Officials (AASHTO) Standard Specifications but consistent with recent studies. After the beam concrete reached the required compressive strength, it was tested to destruction. The beam was able to resist the required AASHTO ultimate moment without failure. It was found that the AASHTO cracking load was conservative for this beam, mostly because the measured modulus of rupture greatly exceeded the value assumed in the AASHTO specifications. The behavior of the beam was successfully predicted using a section analysis.

Abstract The purpose of regulating any profession is to assure competent practitioners, particularly where its absence can cause irreparable harm. Regulatory “licensing” ideally achieves such assurance, while at the same time avoiding unnecessary supply constriction. The latter can mean much higher prices and an inadequate number of practitioners. Regrettably, the universal delegation to attorneys of the power to regulate themselves has led to a lose/lose system lacking protection from incompetent practice while also diminishing needed supply. The problem is manifest in four regulatory flaws: First, state bars—in combination with the American Bar Association—require four years of largely irrelevant higher education for law school entry. Most of this coursework commonly has nothing to do with law. Second, and related, these seven-years of mandatory higher education (that only the United States requires for attorney licensure) impose extraordinary costs. Those costs now reach from $190,000 to $380,000 in tuition and room and board per student—driven by shocking tuition levels lacking competitive check. Third, attorney training focuses almost entirely on a few traditional subjects, with little attention paid to the development of useful skills in most of the 24 disparate areas of actual practice (e.g., administrative, bankruptcy, corporate, criminal, family, taxation, et al.). And schools often pay scant attention to legislation, administrative proceedings, or the distinct areas of law that will be relevant to a student’s future practice. Fourth, state bars rely on supply-constricting bar examinations of questionable connection to competence assurance. In the largest state of California, the bar examination fails about 2/3 of its examinees. This system has fostered an opportunistic cottage industry of increasingly expensive preparatory courses that further raise the cost of becoming an attorney—even after 7 years of higher education. Meanwhile, the bars regulating attorneys in the respective states: a) Do not treat negligent acts as a normal basis for discipline (outside of extreme incapacity); b) Do not require malpractice insurance—effectively denying consumer remedies for negligence; c) Do not allow clients injured by malpractice to recover from “client security funds”; d) Do not require post-licensure “legal education” in the area of an attorney’s practice; e) Do not test attorneys in the area of practice relied upon by consumers—ever; and f) Respond to cost-effective, technology-centric solutions to legal problems not by regulation to assure consumer benefit, but by attempts to categorically foreclose them in favor of total reliance on often unavailable/expensive counsel. No area of state regulation has more openly violated federal antitrust law than has the legal profession. The United States Supreme Court held in 2015 that any state body controlled by “active market participants” in a profession regulated is not a sovereign entity for antitrust purposes without “active state supervision.” Yet four years later, attorneys continue to regulate themselves without such supervision, overlooking the threat of criminal felony and civil treble damage liability.

More than sixty years have elapsed since Justice Holmes first enunciated in Lucas v. Earl the principle that income from personal services "must be taxed to him who earns it" and that assignments of such income "however skilfully devised" will not be respected for tax purposes. The Supreme Court has described this principle-now known as the assignment of income doctrine-as the "first principle of income taxation." Yet despite its venerable lineage and importance, the doctrine remains today beset by confusion and uncertainty. This was vividly demonstrated in Schneer v. Commissioner where the Tax Court agonized over the application of the doctrine to a simple, indeed pedestrian, set of facts. The twenty-page majority opinion brought forth a concurrence, based on an entirely different theory, and two vigorous dissents, one of which attacked the court's decision as "unprincipled." The decision has given rise to considerable comment, some of it heated. One commentator described the decision as not only wrong but "exquisitely wrong, so misguided at every turn, that it becomes a wayward sort of achievement," while another described the first commentator's analysis as "wrong, although not exquisitely wrong."' All commentators, however, have recognized the case's significance. The Tax Lawyer, the official publication of the American Bar Association Section of Taxation, designated the case as one of the important tax decisions of 1992, while a publication of the Section on Taxation of the Association of American Law Schools recommended its use in the classroom as the "practically perfect case" for teaching the assignment of income doctrine. The Schneer case therefore presents an opportune occasion to reexamine the assignment of income doctrine as applied to personal service income.

As chair of the Committee on Tax Structure and Simplification of the Section of Taxation of the American Bar Association, I invited Professors Fleming and Yin to lead a discussion with members of the Committee on the effects of various proposed consumed income tax models. Splendid scholars as they are, each converted his informal remarks into a published article.Meanwhile, the airwaves have been surfeited with talk shows, interviews, and panel discussions dealing ad nauseam with flat, and flatter, taxes, a consumed income tax, a national sales tax, and various proposals for taxation of business income. The general obfuscation of important and critical issues often seems intentionally deliberate, and in any case, however presented, does little to inform the public. Of all the issues we have on our national platter-abortion, gun control, educational policy, crime in the streets-taxation is the most emotionally supercharged because it affects us all. We all pay taxes, direct and indirect; taxes pervade and permeate our lives. Why can we not have clear and direct demonstrations of what various proposals would accomplish? Some years ago, Louis Eisenstein wrote that the problem is not that the American people do not understand the tax system; rather, the problem is that they may come to understand it too well.

This paper was originally written for the Second Invitational Conference on Professionalism in Tax Practice, which was scheduled to be held in Washington in January 1996 under the sponsorship of the American Bar Association Section of Taxation, the American College of Tax Counsel, the American Institute of Certified Public Accountants, the National Association of Enrolled Agents, the National Association of Tax Practitioners, the National Society of Public Accountants, and the Tax Executives Institute. The Conference was postponed because of the Blizzard of 1996.Copyright © 1996 by Michael B. Lang.Our income tax system requires that taxpayers report their income annually and assess the correct amount of tax on this income. This selfassessment system, however, depends on taxpayers ferreting out the provisions of the tax law that apply to them and properly applying those provisions to their factual situations. The immensity and complexity of the tax law and the difficulty of applying even apparently clear legal provisions to complex sets of facts (the most difficult lesson in law school for the typical law student) make this process impossible for many taxpayers. As a result, they turn to tax professionals for assistance in preparing tax returns.These professionals generally fall into one or more of four groups: (1) lawyers licensed to practice law in at least one state or the District of Columbia (licensed lawyers); (2) certified public accountants (CPAs); (3) those admitted to practice before the IRS under the provisions of Circular 230; and (4) "income tax return preparers," as defined in section 7701 (a)(36 (return preparers). Professionals in each category are subject to their own set of practice standards. Many professionals in the tax field are members of more than one group and thus subject to multiple sets of standards. For example, licensed lawyers or CPAs may be subject to their respective state regulatory authorities, Circular 230 (because they are admitted to practice before the IRS), and the statutory provisions affecting return preparers.Once the taxpayer seeks the help of a professional, several difficulties inevitably mar the return preparation process. First, although the professional should be more skilled at finding the tax law relevant to the taxpayer's situation, the professional's knowledge of the facts underlying the taxpayer's tax situation depends entirely on the information known to and conveyed by the taxpayer. The way in which the professional inquires about the facts may influence how the facts are reported by the taxpayer. Hence, the taxpayer's response is a function of the professional's inquiry. Furthermore, the taxpayer may deliberately slant the facts in the hope of reducing her tax, or simply fail to report all of the relevant facts because of misunderstanding, misperception, forgetfulness, or the like. These considerations raise the prospect that a return prepared by even the most assiduous professional may be less accurate than what a well-informed, well-intentioned taxpayer might have prepared independently.

As is well known, on May 10, 2013, at a session of the American Bar Association Tax Section meeting in Washington, DC, Lois Lerner, at the time the director of the Exempt Organization Division of the Internal Revenue Service, apologized for IRS mishandling of applications by Tea Party groups for exemption as social welfare groups under § 501(c)(4) of the Code. A few days later, the Department of the Treasury Inspector General released a report (TIGTA Report) concluding that the “IRS used inappropriate criteria that identified for review Tea Party and other organizations applying for tax-exempt status based upon their names or policy positions instead of indications of potential political campaign intervention

I presented an outline of this paper to a meeting of the Tax Structure and Simplification Committee of the Tax Section of the American Bar Association in August, 1993, and a draft of the paper to a University of Virginia law school workshop.Copyright © 1995 by George K. Yin. All rights reserved.This article concerns a tax policy issue of keen current interest: the possible replacement of the income tax with a broad-based tax on consumption. The leadership of the new 104th Congress has promised early scrutiny of consumption tax proposals.The weak link of most consumption tax plans relates to how they would distribute the tax burden across income classes. Critics charge that consumption taxes are regressive or at least not as progressive as the existing income tax. Many theorists believe, however, that one form of broad-based consumption tax, a cash-flow or consumed income tax, is immune to such criticism because it is an individualized consumption tax and could be implemented in a manner very similar to the income tax. Supporters of the cash-flow tax assert that it is flexible enough to attain any desired degree of progressivity.In this article, I examine that proposition. Focusing on the impact of the cash-flow tax on low-income taxpayers, I conclude that it would be surprisingly difficult to fashion a cash-flow tax as redistributive at the lower end of the income scale as the current income tax system while still preserving the asserted advantages of the cash-flow tax. Although it may still be advisable to move towards a cash-flow tax system, it is important for policymakers to recognize the inherent limitations of such a system for achieving progressivity at the lower end of the income spectrum.

Photo by Sharon McCutcheon on Unsplash ABSTRACT COVID-19 highlighted a disproportionate impact upon marginalized communities that needs to be addressed. Specifically, a focus on equity rather than equality would better address and prevent the disparities seen in COVID-19. A distributive justice framework can provide this great benefit but will succeed only if the medical community engages in outreach, anti-racism measures, and listens to communities in need. INTRODUCTION COVID-19 disproportionately impacted communities of color and lower socioeconomic status, sparking political discussion about existing inequities in the US.[1] Some states amended their guidelines for allocating resources, including vaccines, to provide care for marginalized communities experiencing these inequities, but there has been no clear consensus on which guidelines states should amend or how they should be ethically grounded. In part, this is because traditional justice theories do not acknowledge the deep-seated institutional and interpersonal discrimination embedded in our medical system. Therefore, a revamped distributive justice approach that accounts for these shortcomings is needed to guide healthcare decision-making now and into the post-COVID era. BACKGROUND Three terms – health disparity, health inequities, and health equity – help frame the issue. A health disparity is defined as any difference between populations in terms of disease incidence or adverse health events, such as morbidity or mortality. In contrast, health inequities are health disparities due to avoidable systematic structures rooted in racial, social, and economic injustice.[2] For example, current data demonstrate that Black, Latino, Indigenous Americans, and those living in poverty suffer higher morbidity and mortality rates from COVID-19.[3] Finally, health equity is the opportunity for anyone to attain his or her full health potential without interference from systematic structures and factors that generate health inequities, including race, socioeconomic status, gender, ethnicity, religion, sexual orientation, or geography.[4] ANALYSIS Health inequities for people of color with COVID-19 have led to critiques of states that do not account for race in their resource allocation guidelines.[5] For example, the Massachusetts Department of Public Health revised its COVID-19 guidelines regarding resource allocation to patients with the best chance of short-term survival.[6] Critics have argued that this change addresses neither preexisting structural inequities nor provider bias that may have led to comorbidities and increased vulnerability to COVID-19. By failing to address race specifically, they argue the policy will perpetuate poorer outcomes in already marginalized groups. As the inequities in COVID-19 outcomes continue to be uncovered and the data continue to prove that marginalized communities suffered disproportionately, we, as healthcare providers, must reconsider our role in addressing the injustices. Our actions must be ethically grounded in the concept of justice. l. Primary Theories of Justice The principle of justice in medical ethics relates to how we ought to treat people and allocate resources. Multiple theories have emerged to explain how justice should be implemented, with three of the most prominent being egalitarianism, utilitarianism, and distributive. This paper argues that distributive justice is the best framework for remedying past actions and enacting systemic changes that may persistently prevent injustices. An egalitarian approach to justice states all individuals are equal and, therefore, should have identical access to resources. In the allocation of resources, an egalitarian approach would support a strict distribution of equal value regardless of one’s attributes or characteristics. Putting this theory into practice would place a premium on guidelines based upon first-come, first-served basis or random selection.[7] However, the egalitarian approach taken in the UK continues to worsen health inequities due to institutional and structural discrimination.[8] A utilitarian approach to justice emphasizes maximizing overall benefits and achieving the greatest good for the greatest number of people. When resources are limited, the utilitarian principle historically guides decision-making. In contrast to the egalitarian focus on equal distribution, utilitarianism focuses on managing distributions to maximize numerical outcomes. During the COVID-19 pandemic, guidelines for allocating resources had utilitarian goals like saving the most lives, which may prioritize the youthful and those deemed productive in society, followed by the elderly and the very ill. It is important to reconsider using utilitarian approaches as the default in the post-COVID healthcare community. These approaches fail to address past inequity, sacrificing the marginalized in their emphasis on the greatest amount of good rather than the type of good. Finally, a distributive approach to justice mandates resources should be allocated in a manner that does not infringe individual liberties to those with the greatest need. Proposed by John Rawls in a Theory of Justice, this approach requires accounting for societal inequality, a factor absent from egalitarianism and utilitarianism.[9] Naomi Zack elaborates how distributive justice can be applied to healthcare, outlining why racism is a social determinant of health that must be acknowledged and addressed.[10] Until there are parallel health opportunities and better alignment of outcomes among different social and racial groups, the underlying systemic social and economic variables that are driving the disparities must be fixed. As a society and as healthcare providers, we should be striving to address the factors that perpetuate health inequities. While genetics and other variables influence health, the data show proportionately more exposure, more cases, and more deaths in the Black American and Hispanic populations. Preexisting conditions and general health disparities are signs of health inequity that increased vulnerability. Distributive justice as a theoretical and applied framework can be applied to preventable conditions that increase vulnerability and can justify systemic changes to prevent further bias in the medical community. During a pandemic, egalitarian and utilitarian approaches to justice are prioritized by policymakers and health systems. Yet, as COVID-19 has demonstrated, they further perpetuate the death and morbidity of populations that face discrimination. These outcomes are due to policies and guidelines that overall benefit white communities over communities of color. Historically, US policy that looks to distribute resources equally (focusing on equal access instead of outcomes), in a color-blind manner, has further perpetuated poor outcomes for marginalized communities.[11] ll. Historical and Ongoing Disparities Across socio-demographic groups, the medical system exacerbates historical and current inequities. Members of marginalized races,[12] women,[13] LGBTQ people,[14] and poor people[15] experience trauma caused by discrimination, marginalization, and failure to access high-quality public and private goods. Through the unequal treatment of marginalized communities, these historic traumas continue. In the US, people of color do not receive equal and fair medical treatment. A meta-analysis found that Hispanics and Black Americans were significantly undertreated for pain compared to their white counterparts over the last 20 years.[16] This is partly due to provider bias. Through interviewing medical trainees, a study by the National Academy of Science found that half of medical students and residents harbored racist beliefs such as “Black people’s nerve endings are less sensitive than white people’s” or “Black people’s skin is thicker than white people’s skin.”[17] More than 3,000 Indigenous American women were coerced, threatened, and deliberately misinformed to ensure cooperation in forced sterilization.[18] Hispanic people have less support in seeking medical care, in receiving culturally appropriate care, and they suffer from the medical community’s lack of resources to address language barriers.[19] In the US, patients of different sexes do not receive the same quality of healthcare. Despite having greater health needs, middle-aged and older women are more likely to have fewer hospital stays and fewer physician visits compared to men of similar demographics and health risk profiles.[20] In the field of critical care, women are less likely to be admitted to the ICU, less likely to receive interventions such as mechanical ventilation, and more likely to die compared to their male ICU counterparts.[21] In the US, patients of different socioeconomic statuses do not receive the same quality of healthcare. Low-income patients are more likely to have higher rates of infant mortality, chronic disease, and a shorter life span.[22] This is partly due to the insurance-based discrimination in the medical community.[23] One in three deaths of those experiencing homelessness could have been prevented by timely and effective medical care. An individual experiencing homelessness has a life expectancy that is decades shorter than that of the average American.[24] lll. Action Needed: Policy Reform While steps need to be taken to provide equitable care in the current pandemic, including the allocation of vaccines, they may not address the historical failures of health policy, hospital policy, and clinical care to eliminate bias and ensure equal treatment of patients. According to an applied distributive justice framework, inequities must be corrected. Rather than focusing primarily on fair resource allocation, medicine must be actively anti-racist, anti-sexist, anti-transphobic, and anti-discriminatory. Evidence has shown that the health inequities caused by COVID-19 are smaller in regions that have addressed racial wealth gaps through forms of reparations.[25] Distributive justice calls for making up for the past using tools of allocation as well as tools to remedy persistent problems. For example, Brigham and Women’s Hospital in Boston, MA, began “Healing ARC,” a pilot initiative that involves acknowledgement, redress, and closure on an institutional level.[26] Acknowledgement entails informing patients about disparities at the hospital, claiming responsibility, and incorporating community ideas for redress. Redress involves a preferential admission option for Black and Hispanic patients to specialty services, especially cardiovascular services, rather than general medicine. Closure requires that community and patient stakeholders work together to ensure that a new system is in place that will continue to prioritize equity. Of note, redress could take the form of cash transfers, discounted or free care, taxes on nonprofit hospitals that exclude patients of color,[27] or race-explicit protocol changes (such as those being instituted by Brigham and Women’s Hospital that admit patients historically denied access to certain forms of medical care). In New York, for instance, the New York State Bar Association drafted the COVID-19 resolutions to ensure that emergency regulations and guidelines do not discriminate against communities of color, and even mandate that diverse patient populations be included in clinical trials.[28] Also, physicians must listen to individuals from marginalized communities to identify needs and ensure that community members take part in decision-making. The solution is not to simply build new health centers in communities of color, as this may lead to tiers of care. Rather, local communities should have a chance to impact existing hospital policy and should also use their political participation to further their healthcare interests. Distributive justice does not seek to disenfranchise groups that hold power in the system. It aims to transform the system so that those in power do not continue to obtain unfair benefits at the expense of others. The framework accounts for unjust historical oppression and current injustices in our system to provide equitable outcomes to all who access the system. In this vein, we can begin to address the flagrant disparities between communities that have always – and continue to – exist in healthcare today.[29] CONCLUSION As equality focuses on access, it currently fails to do justice. Instead of outcomes, it is time to focus on equity. A focus on equity rather than equality would better address and prevent the disparities seen in COVID-19. A distributive justice framework can gain traction in clinical decision-making guidelines and system-level reallocation of resources but will succeed only if the medical community engages in outreach, anti-racism measures, and listens to communities in need. There should be an emphasis on implementing a distributive justice framework that treats all patients equitably, accounts for historical harm, and focuses on transparency in allocation and public health decision-making. [1] APM Research Lab Staff. 2020. “The Color of Coronavirus: COVID-19 Deaths by Race and Ethnicity in the U.S.” APM Research Lab. https://www.apmresearchlab.org/covid/deaths-by-race. [2] Bharmal, N., K. P. Derose, M. Felician, and M. M. Weden. 2015. “Understanding the Upstream Social Determinants of Health.” California: RAND Corporation 1-18. https://www.rand.org/pubs/working_papers/WR1096.html. [3] Yancy, C. W. 2020. “COVID-19 and African Americans.” JAMA. 323 (19): 1891-2. https://doi.org/10.1001/jama.2020.6548; Centers for Disease Control and Prevention. 2020. “COVID-19 in Racial and Ethnic Health Disparities.” Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/index.html. [4] Braveman, P., E. Arkin, T. Orleans, D. Proctor, and A. Plough. 2017. “What is Health Equity?” Robert Wood Johnson Foundation. https://www.rwjf.org/en/library/research/2017/05/what-is-health-equity-.html. [5] Bedinger, M. 2020 Apr 22. “After Uproar, Mass. Revises Guidelines on Who Gets an ICU Bed or Ventilator Amid COVID-19 Surge.” Wbur. https://www.wbur.org/commonhealth/2020/04/20/mass-guidelines-ventilator-covid-coronavirus; Wigglesworth, A. 2020 May 11. “Institutional Racism, Inequity Fuel High Minority Death Toll from Coronavirus, L.A. Officials Say.” Los Angeles Times. https://www.latimes.com/california/story/2020-05-11/institutional-racism-inequity-high-minority-death-toll-coronavirus. [6] Executive Office of Health and Human Services Department of Public Health. 2020 Oct 20. “Crises Standards of Care Planning and Guidance for the COVID-19 Pandemic.” Commonwealth of Massachusetts. https://www.mass.gov/doc/crisis-standards-of-care-planning-guidance-for-the-covid-19-pandemic. [7] Emanuel, E. J., G. Persad, R. Upshur, et al. 2020. “Fair Allocation of Scarce Medical Resources in the Time of Covid-19. New England Journal of Medicine 382: 2049-55. https://doi.org/10.1056/NEJMsb2005114. [8] Salway, S., G. Mir, D. Turner, G. T. Ellison, L. Carter, and K. Gerrish. 2016. “Obstacles to "Race Equality" in the English National Health Service: Insights from the Healthcare Commissioning Arena.” Social Science and Medicine 152: 102-110. https://doi.org/10.1016/j.socscimed.2016.01.031. [9] Rawls, J. A Theory of Justice (Revised Edition) (Cambridge, MA: Belknap Press of Harvard University Press, 1999). [10] Zack, N. Applicative Justice: A Pragmatic Empirical Approach to Racial Injustice (New York: The Rowman & Littlefield Publishing Group, 2016). [11] Charatz-Litt, C. 1992. “A Chronicle of Racism: The Effects of the White Medical Community on Black Health.” Journal of the National Medical Association 84 (8): 717-25. http://hdl.handle.net/10822/857182. [12] Washington, H. A. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present (New York: Doubleday, 2006). [13] d'Oliveira, A. F., S. G. Diniz, and L. B. Schraiber. 2002. “Violence Against Women in Health-care Institutions: An Emerging Problem.” Lancet. 359 (9318): 1681-5. https://doi.org/10.1016/S0140-6736(02)08592-6. [14] Hafeez, H., M. Zeshan, M. A. Tahir, N. Jahan, and S. Naveed. 2017. “Health Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Youth: A Literature Review. Cureus 9 (4): e1184. https://doi.org/10.7759/cureus.1184; Drescher, J., A. Schwartz, F. Casoy, et al. 2016. “The Growing Regulation of Conversion Therapy.” Journal of Medical Regulation 102 (2): 7-12. https://doi.org/10.30770/2572-1852-102.2.7; Stroumsa, D. 2014. “The State of Transgender Health Care: Policy, Law, and Medical Frameworks.” American Journal of Public Health. 104 (3): e31-8. https://doi.org/10.2105/AJPH.2013.301789. [15] Stepanikova, I., and G. R. Oates. 2017. “Perceived Discrimination and Privilege in Health Care: The Role of Socioeconomic Status and Race.” American Journal of Preventative Medicine. 52 (1s1): S86-s94. https://doi.org/10.1016/j.amepre.2016.09.024; Swartz, K. “Health Care for the Poor: For Whom, What Care, and Whose Responsibility?” In Cancian, M., and S. Danziger (Eds.). Changing Poverty, Changing Policies (New York: Russell Sage Foundation Press, 2009), 69-74. [16] Meghani, S. H., E. Byun, and R. M. Gallagher. 2012. “Time to Take Stock: A Meta-analysis and Systematic Review of Analgesic Treatment Disparities for Pain in the United States.” Pain Medicine 13 (2): 150-74. https://doi.org/10.1111/j.1526-4637.2011.01310.x; Williams, D. R., and T. D. Rucker. 2000. “Understanding and Addressing Racial Disparities in Health Care.” Health Care Financing Review 21 (4): 75-90. https://scholar.harvard.edu/davidrwilliams/dwilliam/publications/understanding-and-addressing-racial-disparities-health. [17] Hoffman, K. M., S. Trawalter, J. R. Axt, and M. N. Oliver. 2016. “Racial Bias in Pain assessment and treatment recommendations, and false beliefs about biological Differences Between Blacks and Whites.” PNAS 113 (16): 4296-4301. https://doi.org/10.1073/pnas.1516047113. [18] Pacheco, C. M., S. M. Daley, T. Brown, M. Filipp, K. A. Greiner, and C. M. Daley. 2013. “Moving Forward: Breaking the Cycle of Mistrust Between American Indians and Researchers.” American Journal of Public Health. 103 (12): 2152-9. https://doi.org/10.2105/AJPH.2013.301480. [19] Velasco-Mondragon, E., A. Jimenez, A. G. Palladino-Davis, D. Davis, and J. A. Escamilla-Cejudo. 2016. “Hispanic Health in the USA: A Scoping Review of the Literature.” Public Health Reviews 37:31. https://doi.org/10.1186/s40985-016-0043-2. [20] Cameron, K. A., J. Song, L. M. Manheim, and D. D. Dunlop. 2010. “Gender Disparities in Health and Healthcare Use Among Older Adults.” Journal of Women’s Health (Larchmt) 19 (9): 1643-50. https://doi.org/10.1089/jwh.2009.1701. [21] Bierman, A. S. 2007. “Sex Matters: Gender Disparities in Quality and Outcomes of Care. Canadian Medical Association Journal 177 (12): 1520-1. https://doi.org/10.1503/cmaj.071541; Fowler, R. A., S. Sabur, P. Li, et al. 2007. “Sex-and Age-based Differences in the Delivery and Outcomes of Critical Care. Canadian Medical Association Journal 177 (12): 1513-9. https://doi.org/10.1503/cmaj.071112. [22] McLaughlin, D. K., and C. S. Stokes. 2002. “Income Inequality and Mortality in US Counties: Does Minority Racial Concentration Matter?” American Journal of Public Health 92 (1): 99-104. https://doi.org/.10.2105/ajph.92.1.99; Shea, S., J. Lima, A. Diez-Roux, N. W. Jorgensen, and R. L. McClelland. 2016. “Socioeconomic Status and Poor Health Outcome at 10 years of Follow-up in the Multi-ethnic Study of Atherosclerosis.” PLoS One 11 (11): e0165651. https://doi.org/10.1371/journal.pone.0165651. [23] Han, X., K. T. Call, J. K. Pintor, G. Alarcon-Espinoza, and A. B. Simon. 2015. “Reports of Insurance-based Discrimination in Health care and its Association with Access to Care.” American Journal of Public Health 105 Suppl 3 (Suppl 3): S517-25. https://doi.org/10.2105/AJPH.2015.302668. [24] Aldridge, R. W., D. Menezes, D. Lewer, et al. 2019. “Causes of Death Among Homeless People: A Population-based Cross-sectional Study of Linked Hospitalization and Mortality Data in England.” Wellcome Open Research 4:49. https://doi.org/10.12688/wellcomeopenres.15151.1. [25] Richardson, E. T., M. M. Malik, W. A. Darity Jr., et al. 2021. “Reparations for Black American Descendants of Persons Enslaved in the U.S. and their Potential Impact on SARS-CoV-2 Transmission.” Social Science and Medicine 276: 113741. https://doi.org/10.1016/j.socscimed.2021.113741. [26] Wispelwey, B., and M. Morse. 2021. “An Antiracist Agenda for Medicine.” Boston Review. http://bostonreview.net/science-nature-race/bram-wispelwey-michelle-morse-antiracist-agenda-medicine. [27] Johnson, S. F., A. Ojo, and H. J. Warraich. 2021. “Academic Health Centers’ Antiracism Strategies Must Extend to their Business Practices.” Annals of Internal Medicine 174 (2): 254-5. https://doi.org/10.7326/M20-6203; Golub, M., N. Calman, C. Ruddock, et al. 2011. “A Community Mobilizes to End Medical Apartheid.” Progress in Community Health Partnerships: Research, Education, and Action 5 (3): 317-25. https://doi.org/10.1353/cpr.2011.0041. [28] New York State Bar Association. 2020. “New York State Bar Association House of Delegates: Revised COVID-19 Resolutions.” https://nysba.org/app/uploads/2020/10/Final-Health-Law-Section-COVID-19-Resolutions_10-8-20-1-1.pdf. [29] Egede, L. E. 2006. “Race, Ethnicity, Culture, and Disparities in Health Care.” Journal of General Internal Medicine 21 (6): 667-669. https://doi.org/10.1111%2Fj.1525-1497.2006.0512.x

Photo ID 129550055 © Katarzyna Bialasiewicz | Dreamstime.com ABSTRACT It has been 26 years since medical aid in dying (“MAiD”) was first legalized in Oregon, and today, about 20 percent of people in the US live in jurisdictions that permit MAiD. The New York State legislature is currently considering a bill that would permit Medical Aid in Dying for terminally ill patients in certain defined circumstances. Those states now benefit from decades of experience, evidence, and reporting from MAiD jurisdictions. This demonstrates that legislation can simultaneously grant terminally ill citizens the civil right to access MAiD while also aggressively protecting all patients from coercion, manipulation, and harm. Given the copious evidence gathered in the past decades, concerns about abuse can no longer be credited as grounds for opposing the passage of legislation that is demonstrably both effective and safe. INTRODUCTION It has been 26 years since medical aid in dying (“MAiD”) was first legalized in Oregon,[1] and today, about 20 percent of people in the US live in jurisdictions that permit MAiD.[2] Other jurisdictions, including New York, are actively considering adopting MAiD laws. Those states now benefit from decades of experience, evidence, and reporting from MAiD jurisdictions, demonstrating that legislation can permit MAiD while also aggressively protecting all patients from coercion, manipulation, and harm. The data should allay the concerns of those who oppose MAiD due to the risk of abuse, coercion, and a hypothetical slippery slope. We, as a society, as clinicians, and as ethicists, must remain vigilant and prevent abuse of MAiD, given the potential risks in the community and in congregate care settings and the risk of patient exploitation by family members. However, given the copious evidence, concerns about abuse do not justify opposition to legislation that is effective and safe. I. New York’s MAiD Bill The New York State legislature is currently considering a bill that would permit MAiD for terminally ill patients in defined circumstances.[3] The bill applies only to adults with a terminal illness or condition that is “incurable and irreversible” and “will, within reasonable medical judgment, produce death within six months.” The bill contains numerous protective requirements: MAiD requests can only be made by the patient themself; requests cannot be made by healthcare agents, surrogates, or anyone else; MAiD requests must be made both orally and in writing to the patient’s attending physician; No person is eligible for MAiD solely because of age or disability; The patient’s attending physician must determine the patient has a qualifying terminal illness, has decision-making capacity, and has made a voluntary, informed decision to request MAiD, in the absence of coercion; These determinations must be confirmed by a second consulting physician in writing; If the attending physician has any concern that the patient may not have decision-making capacity, the patient must be referred to a mental health professional; The attending physician has additional duties to the patient, including ensuring the decision is informed, by discussing the patient’s condition and prognosis; discussing the MAiD process, and treatment alternatives like palliative and hospice care; offering referrals to other appropriate treatment, like palliative and hospice care; and educating the patient that their request can be rescinded at any time and offering them an opportunity to do so; The written request must be witnessed by at least two adults who cannot be (i) related to the patient, (ii) entitled to any portion of the patient’s estate, (iii) employed by a healthcare facility where the patient is receiving treatment or residing, (iv) or the attending physician, consulting physician, or mental health professional determining decision-making capacity; and MAiD medication must be self-administered by the patient, and it must be voluntarily ingested.[4] ARGUMENTS FOR AND AGAINST MAiD II. No Evidence of Abuse of Existing MAiD Laws MAiD supporters and critics alike have a concern about the abuse of MAiD. For this reason, MAiD laws throughout the US incorporate strict eligibility criteria and protective procedural requirements. For instance, patients are eligible only if they are terminally ill with six months or less to live, more than one physician must be involved, and requests must be witnessed (by individuals unrelated to the patient who will not profit from the patient’s estate). MAiD requests have been closely examined in the 27 years since Oregon became the first state to legalize the practice. The results show that these compassionate and protective measures have worked. There have been no documented or substantiated incidents of MAiD abuse since Oregon became the first to implement a MAiD law in 1997.[5] In 2019, the executive director of Disability Rights Oregon (DRO), an organization mandated by federal law to investigate complaints of abuse or neglect of people with disabilities, reported that DRO has never received a complaint that a person with disabilities was coerced into obtaining a prescription for MAiD drugs.[6] A recent study of aggregated data from all nine of the US jurisdictions with publicly available MAiD records from 1998 to 2002 found that 95.6 percent of those who died by MAiD were non-Hispanic white individuals, and 53.1 percent were male.[7] 72.2 percent of these individuals had at least some college education, 74 percent had a cancer diagnosis, and the median age of MAiD death was 74 years old. Only 11 percent of patients were uninsured. MAiD users tend to be white, older, educated, diagnosed with cancer, and insured. Fears that MAiD would overwhelmingly be used by (or on) the poor, the uninsured, the uneducated, or racial and ethnic minorities have not materialized. This data has actually raised a converse concern: that MAiD may, inequitably, not be readily available to less privileged populations or those with a diagnosis other than cancer.[8] Opponents of MAiD may argue that the recent relaxation of certain legal restrictions in some jurisdictions is evidence that the slippery slope to unrestricted euthanasia has begun. This is a mischaracterization. Certain restrictions have been adjusted. For instance, Oregon and Vermont removed the residency restriction that previously excluded non-residents from eligibility.[9] Both states changed the residency requirement due to lawsuits challenging the constitutionality of requiring residence.[10] New Jersey’s law will likely change soon, as well.[11] Initial MAiD laws were drafted to be highly restrictive out of concern about unintended and unforeseeable consequences. Given the gravity of the subject, decades ago, it was better to err on the side of caution, even if that meant excluding from eligibility people who ought to, ethically or legally, be included. Now, with nearly 30 years of experience and data, we can better determine which requirements are necessary to appropriately protect patients, clinicians, and society. Restrictions proven to be unnecessary can now be modified. The core purposes of MAiD laws and the rights and protections they provide are not changing. Rather, a few aspects of the regulations are being adjusted so they are not more restrictive than necessary to achieve their purpose. The ever-growing body of evidence that MAiD laws can adequately protect against abuse and the mythic slippery slope has assured many that their fears will not materialize.[12] For example, NYU bioethicist Arthur Caplan was once a vigorous opponent of MAiD. He worried that MAiD laws would lead to the abuse of the poor, uninsured, and disabled in service of cost-saving or the convenience of others. [13] But, after closely following the empirical evidence from MAiD early-adopters, Oregon and Washington, Caplan changed his mind. In 2018, he argued in favor of the NY MAiD bill before the New York State Assembly Standing Committee on Health.[14] Discussing his review of evidence from these states, Caplan stated: I found no cause for my concerns, none with respect to the slippery slope. There isn’t solid evidence of coercion or duplicity being exercised with respect to people who choose assistance in dying in either state. The police, government officials, families of those who have chosen to use the legislation and the general citizenry find no causes or basis for changing the laws due to abuse or misapplication . . . These slippery slope arguments are just not true . . . there is no current factual support for this slippery slope argument that vulnerable individuals are at risk for being coerced into using the law.[15] Decades of evidence has shown that legislation can simultaneously grant terminally ill patients access to MAiD while also protecting against coercion and abuse. In the face of this evidence, continuing to deny access to MAiD because of hypothetical abuse is unjust and unethical. III. Views of Opponents are Neither Grounded in Fact nor Consistent with Current End-of-Life Practices a. Risk of coercion One common argument heard today from some disability advocates who oppose MAiD goes something like this: Everybody who would qualify for and use MAiD is (or will become) a disabled person, so MAiD only kills people with disabilities. The most common reasons people choose to end their lives via MAiD are disability issues, like loss of autonomy, less ability to engage in activities, and loss of dignity. They argue that, instead of making it easier for disabled people to die, we should make sure that proper services and support exist so that disabled people do not choose to die. Such disability-rights-based arguments tend to assert that to avoid abuse, we must prohibit MAiD altogether. They argue that legalizing MAiD will inexorably lead to abuse and coercion, and disabled people will be pressured into suicide. Some even argue that MAiD laws are the first step to euthanasia, noting the path in other jurisdictions.[16] As an initial matter, people with disabilities deserve adequate support and services, and these are not always available to them. People with disabilities have faced tremendous discrimination in the healthcare system and have been historically prevented from accessing proper care and asserting their autonomy. Ensuring that all can access adequate end-of-life care, like palliative or hospice care, is an ongoing battle that ought not be abandoned. But fighting for adequate end-of-life care and legalizing MAiD are not mutually exclusive. In Oregon, 90 percent of those who access MAiD are enrolled in hospice and states with MAiD laws tend to have better access to palliative care than states without.[17] MAiD proponents seek only to add another choice for the dying, not to diminish any other options. This is reflected in the text of New York’s pending bill, which explicitly requires patient education and referrals to appropriate end-of-life services, like palliative care and hospice.[18] No one has openly argued that society should hold terminally ill patients hostage in order to obtain broader support and funding for palliative care, but that is the practical effect. Beyond the need for supportive services and proper access to the full range of end-of-life care options, the disability argument fails. First, the assertion that MAiD laws will be abused and disabled people will be coerced into suicide is not grounded in fact. To the contrary, real-life evidence gathered in over two decades of legal MAiD has shown no documented or substantiated incidents of abuse, as discussed above.[19] The slippery slope has simply not materialized. Advocates for people with disabilities who are opposed to MAiD have not clearly articulated exactly who is vulnerable to being coerced into obtaining a MAiD prescription or even how such coercion could logistically occur. Most people with disabilities are not vulnerable to MAiD abuse, as they do not have a qualifying terminal illness or lack decisional capacity due to a developmental disability and are therefore not eligible. MAiD opponents appear to be claiming that all those who qualify for MAiD are vulnerable and seek protection from MAiD laws. But this would include many of the people that, over the past decades, have aggressively and publicly advocated for access to MAiD – terminally ill people, like Brittany Maynard,[20] many of whom lobbied hard for the passage of MAiD laws while knowing that they themselves would die before the laws passed. Opponents of MAiD from a segment of the disability rights community are telling individuals who they claim, without permission, as members of the MAiD opposition community, that they must all endure unimaginable suffering without a MAiD option because they must be protected from theoretical coercive harm. People with disabilities should be allowed to make their own choices. No one, not even the most well-meaning advocate, should be allowed to obstruct a patient’s end-of-life choices – those choices belong to the patient alone. b. Argument That the Demand for MAID is a Result of Poor Disability Services Second, the argument that terminally ill patients would decline MAiD if only they had better disability services or support is disingenuous to the extent that it ignores the fact that people choosing MAiD are actively dying. No provision of supportive services can change this. And it is perfectly reasonable for someone who knows that they will die in less than six months to want some control over the manner of their death and to avoid the deterioration, indignity, and suffering that could come with it. The argument construes a MAiD death as a choice to die rather than live with a disability. But individuals choosing MAiD are not choosing death – death is coming and coming quickly. MAiD simply offers some control over this reality, giving patients an option that is safe, certain, and painless. Certainly, supportive hospice services should be available for these individuals. But there is no evidence demonstrating that any amount of service would eliminate the need and desire for the MAiD option. c. Inconsistent Positions on MAID and Other Ending Life Care Options: Palliative Sedation and VSED MAiD opponents who are concerned about abuse and coercion often hold inconsistent views on other currently available ending life care options.[21] For example, some argue that palliative sedation[22] renders MAiD unnecessary and does not present the same ethical problems.[23] However, whereas MAiD can only be chosen by the patient themself (and the patient must have decision-making capacity), the same is not true for palliative sedation. Palliative sedation, a valuable modality of end-of-life care, does not have to be initiated by the patient. If the patient is deemed not to have decision-making capacity to make that decision, their healthcare proxy can decide to initiate the process and continue it until the patient dies. Individuals other than patients often choose to begin palliative sedation and continue it to its inevitable conclusion. And because palliative sedation does not require enabling legislation, none of the protective safeguards incorporated in MAiD legislation are available to protect those who receive palliative sedation. Some may try to differentiate between palliative sedation and MAiD by saying that once started, palliative sedation can always be discontinued – it need not end in the patient’s death. This is true, but the very process of palliative sedation will inevitably make the patient insensible or unconscious or otherwise unable to exercise a choice to stop sedation. With MAiD, the patient must self-administer and ingest the medication on their own, with death following quickly. The patient can choose to forgo MAID up until the very moment of self-administration. Considering MAiD’s procedural safeguards, including that only the patient may choose and administer MAiD, MAiD patients are offered more protection from potential abuse than patients who receive palliative sedation. While some have vocally opposed MAiD for decades, there has not been similar opposition to the option of voluntarily stopping eating and drinking (VSED). With VSED, adults with decision-making capacity make a voluntary decision to refuse nutrition and hydration to die more quickly. People choosing VSED are, essentially, making the same choice that people choosing MAiD do. But VSED is a less predictable process that takes much longer to complete. Unfortunately, the process also carries a risk of unpleasant side-effects, though proper care can help mitigate them. Additionally, the practice of VSED is not constrained by statutorily defined protective measures, as is the case with MAiD – one does not even need to have a terminal illness to choose VSED.[24] It is logically inconsistent for those who oppose MAiD because of the perceived potential of abuse to hold different views about VSED.[25] If malevolent actors can unethically pressure or coerce patients into MAiD, they can also coerce them to stop eating and drinking. As with palliative sedation, it could be argued that an important difference is that VSED can be stopped, unlike MAiD. This argument fails clinically and ethically. As with palliative sedation, the VSED process eventually results in the patient losing consciousness and decision-making capacity. The patient generally becomes unarousable for a period that could last for days or even weeks. For this reason, it is crucial for VSED patients to express their choice in writing (or preferably in video recording)[26] to ensure that they will not be given nutrition or hydration when they are no longer able to enforce their refusal (or if they begin asking for nutrition or hydration). Therefore, there is a period in which the patient cannot decide to end the process, just as with palliative sedation. To the extent that someone is so concerned with potential abuse of MAiD that they seek to ban it but have not expressed similar concerns with VSED, these positions are inconsistent. At a NYS Bar Association-sponsored conference on MAiD in 2019, David Hoffman asked a MAiD opponent whether, “as someone who is looking out for the interests of a segment of the disability population,” she supports palliative sedation and VSED.”[27] Kathryn Carroll, who represented the Center for Disability Rights (“CDR”), confirmed that CDR did not oppose palliative sedation and did not offer a position on VSED. She noted the subtle difference in intention: I don’t believe the Center for Disability Rights has taken issue with palliative sedation. And my understanding is that there is a key difference between palliative sedation and assisted suicide, particularly in that palliative sedation, the point is not to bring about the death of the person, but to relieve the pain that they are experiencing. And so the death is more of a side effect rather than the intended outcome.[28] During the questioning, she provided no explanation as to why the potential for abuse would be different among palliative sedation, VSED, and MAiD.[29] The other MAiD opponent on the panel, Dennis Vacco, of Vacco v. Quill[30] fame, interjected but could not explain any ethically significant difference between VSED and MAiD. Instead, he focused solely on palliative sedation, stating that the relevant difference is that palliative sedation can be stopped: . . . treating the pain including what you referred to as terminal sedation, is not moral and legally and ethnically the same as physician-assisted suicide . . . The fact of the matter is – the difference is you can terminate that treatment, and it’s the permanent aspect of physician-assisted suicide that goes back to what I said 20 minutes ago. You can’t put the bright line anyplace else other than where it is.[31] But, as discussed above, that difference is of little import, given that palliative sedation results in patients without the ability or capacity to make the choice to stop treatment. Vacco then reverted to his concerns about the potential for coercion and the elusive slippery slope, referencing his primary argument that the only way to ensure there is no abuse of a MAiD law is not to have one at all: The bright line that is created by the law in the state of New York, which makes physician-assisted suicide a manslaughter in the second-degree, or assisting suicide by anybody, manslaughter in the second degree . . . is unfortunately the only place that line can be. That line should not move further toward accommodation. And we see here in the context of . . . all of the so-called protections in the statute. With every protection that is not prohibition, with every protection, you raise the possibility of abuse. You raise the possibility with every protection.[32] Neither Vacco nor Carroll addressed the fact that many common practices today can be the result of coerced decisions. These practices have none of the safeguards contained in MAiD legislation. As another panelist, David Leven, stated: consider that people who want to have life-sustaining treatment withdrawn, whether it’s a ventilator or feeding tube, they can also be coerced by family members. That can happen even more often, of course, because that process takes place more and more often, and there are none of the safeguards that we’re talking about here . . . there are risks involved in any process which might result in a hastened death. But there seems to be very little risk involved with medical aid in dying based on the experience in 40 years and the nine states which now permit medical aid in dying.[33] There is an inescapable inconsistency within the disability argument: one cannot logically be so concerned about the abuse of legalized access to MAiD to justify opposing all MAiD legislation while simultaneously supporting options like palliative sedation or VSED as abuse-free alternatives. d. Argument Against Speaking for a Community with Diverse Views Finally, while some disability advocates opposing MAiD will claim terminally ill patients as part of their community, they have no right or authorization to speak for the extremely heterogeneous group of terminally ill patients or the disability community[34] as a whole. The disability community is not homogenous; while some members oppose MAiD, others support it.[35] Recent polling indicates that MAiD may have broad support across the disability community.[36] e. MAiD Opponents Hold the Rights of the Terminally Ill Subordinate to Their Personal Morality and Unsubstantiated Theoretical Concerns The argument that does not get much attention, the one that is the simplest and perhaps even the most compelling, is that all killing is wrong, and the government ought not to be in the business of enabling it. That is certainly a compelling religious and moral argument against individuals engaging in any form of acts that result in ending a human life. But such an ethical or theological position does not dictate that individuals who hold different views on personal morality should be precluded by the state from accessing the most safe, certain, and painless means of addressing an invariably terminal illness. Arguments like the one described above by Vacco (that the only way to completely avoid potential MAiD abuse is to prohibit MAiD) are essentially claiming that the safest thing to do is to subordinate the suffering of the terminally ill to avoid the more subtle task of balancing the interests of two different groups of New York state citizens. But surely, that is the role of the legislature every day. And we should expect no less from the legislature on this issue. The best way to ensure no one dies in car accidents is to prohibit driving. But instead of doing so, we implement safety regulations (like speed limits) to balance the right to travel with the right of everyone else not to be killed in the process. Evidence demonstrates that MAiD legislation can also strike a balance between the rights of the terminally ill and the need to prevent harm. It is not justifiable to support a blanket prohibition of MAiD. CONCLUSION Opponents of MAiD have had decades to cite problematic case studies or formulate a compelling moral argument against it that is grounded in data rather than an assertion of their personal morality. Plainly, no one on either side of the MAiD legislative discussion wants to see anyone subjected to involuntary euthanasia or coerced into MAiD as a better alternative to palliative care when such a plan of care is a viable alternative to “ending life care.” However, enough time has passed, and the risk of coercion has been given sufficient study and debate that we can now conclude, as a society, that the rights of the terminally ill and the rights of persons committed to living their best and longest life with a disability are wholly compatible. It is time for the legislature to strike the appropriate balance and give the terminally ill a well-regulated, responsible pathway to obtaining medication that can relieve their suffering in a manner that is safe, certain, and painless. - [1] Oregon’s Death with Dignity Act, Oregon Health Authority, https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/index.aspx [2] Elissa Kozlov et al., Aggregating 23 Years of Data on Medical Aid in Dying in the United States, 70 Journal of the American Geriatrics Society 3040 (2022). https://doi.org/10.1111/jgs.17925 [3] Medical Aid in Dying Act, A.995-A, N.Y. St. Assemb. (2023), available at https://legislation.nysenate.gov/pdf/bills/2023/A995A; see also, Medical Aid in Dying Act, S.2445-A, N.Y. St. Senate (2023), available at https://legislation.nysenate.gov/pdf/bills/2023/S2445A. [4] Id. [5] Ronald A. Lindsay, Oregon’s Experience: Evaluating the Record, 9 The American Journal of Bioethics 19 (2009), https://doi.org/10.1080/15265160802654137; Christopher A. Riddle, Medical Aid in Dying: The Case of Disability, in New Directions in the Ethics of Assisted Suicide and Euthanasia 234 (Michael Cholbi & Jukka Varelius eds., 2nd ed. 2023), https://doi.org/10.1007/978-3-031-25315-7; Health Law Section: Duties, Rights & the Law at the End of Life (2019), NY ST. BAR ASSOC. (Nov. 8, 2019), https://nysba.org/products/health-law-section-duties-rights-the-law-at-the-end-of-life-2019/; Medical Aid in Dying: Hearing on A.2383-A Before the New York State Assembly Standing Committee on Health (2018) (testimony of Arthur Caplan), transcript available at https://nystateassembly.granicus.com/DocumentViewer.php?file=nystateassembly_bc5bd4afc9fd8b9021781bc9e35e15ae.pdf&view=1; Fact: Medical Aid in Dying Laws Work to Protect Patients. (n.d.). Compassion & Choices. Retrieved September 5, 2023, from https://compassionandchoices.org/resource/fact-medical-aid-in-dying-laws-work-to-protect-patients; Frequently Asked Questions. (2021, December 7). Death With Dignity. https://deathwithdignity.org/resources/faqs/. [6] Bob Joondeph, Letter from Disability Rights Oregon (DRO), Compassion & Choices (Feb. 14, 2019), https://www.compassionandchoices.org/docs/default-source/default-document-library/disability-rights-oregon-dwd-letter-2-14-19.pdf. [7] Elissa Kozlov et al., Aggregating 23 Years of Data on Medical Aid in Dying in the United States, 70 Journal of the American Geriatrics Society 3040 (2022). https://doi.org/10.1111/jgs.17925 [8] Id. [9] Medical Aid in Dying: Act 39: Patient Choice and Control at the End of Life, Vermont Ethics Network, https://vtethicsnetwork.org/palliative-and-end-of-life-care/medical-aid-in-dying-act-39 (last visited Sept. 21, 2023). [10] Gideonse v. Brown, No. 3:21-cv-01568-AC (D. Or.); Bluestein v. Scott, No. 2:22-cv-00160 (D. Vt.). [11] Govatos v. Murphy, No. 2:23-cv-12601(D.N.J.). [12] Medical associations, historically opponents of MAiD, have begun adopting neutral positions, reflecting changing attitudes of the medical community. E.g., California Medical Association removes opposition to physician aid in dying bill, California Medical Association (May 20, 2015), https://www.cmadocs.org/newsroom/news/view/ArticleId/27210/California-Medical-Association-removes-opposition-to-physician-aid-in-dying-bill; Board directs CMS to develop and distribute “End-of-Life Act” education to members, Colorado Medical Society (November 22, 2016), https://www.cms.org/articles/board-directs-cms-to-develop-and-distribute-end-of-life-act-education-to-me; Vermont Medical Society Policy on End-of-life-Care, Vermont Medical Society (2017), https://vtmd.org/client_media/files/vms_resolutions/2017End-of-Life-Care.pdf (last accessed Sept. 21, 2023); but see Physician-Assisted Suicide, AMA Code of Ethics, https://code-medical-ethics.ama-assn.org/ethics-opinions/physician-assisted-suicide. (5.7 provides opinion opposing MAiD; opinion 1.1.7 provides opinion on conscientious objection.); The American Medical Association could vote to change its stance on medical aid in dying, Death with Dignity (Nov. 10, 2023), https://deathwithdignity.org/news/2023/11/ama-could-vote-to-change-stance-on-maid/ (Update notes that the AMA did not change its stance from opposed to neutral at its November 2023 interim meeting in Baltimore, but referred the resolutions for further study). [13] Medical Aid in Dying: Hearing on A.2383-A Before the New York State Assembly Standing Committee on Health (2018) (testimony of Arthur Caplan), transcript available at https://nystateassembly.granicus.com/DocumentViewer.php?file=nystateassembly_bc5bd4afc9fd8b9021781bc9e35e15ae.pdf&view=1. [14] Id. [15] Id. [16] Id. (noting the laws in Netherlands, Belgium and Canada.); see also National Council on Disability, The danger of assisted suicide laws: Part of the Bioethics and Disability series (2019). https://ncd.gov/sites/default/files/NCD_Assisted_Suicide_Report_508.pdf. [17] Sean Riley & Ben Sarbey, The unexamined benefits of the expansive legalization of medical assistance-in-dying, 19 J. Bioethical Inquiry 4, 663 (2022) (citing Oregon Health Authority Center for Health Statistics, Oregon Death with Dignity Act: 2018 Data Summary (2019), https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year21.pdf and R. Sean Morrison, et al., America’s care of serious illness: A state-by-state report card on access to palliative care in our nation’s hospitals, 14 J. Palliat. Med. 10, 1094–1096 (2011)). [18] Medical Aid in Dying Act, A.995-A, N.Y. St. Assembly. (2023), available at https://legislation.nysenate.gov/pdf/bills/2023/A995A [19] See also, Ben Colburn, Disability‐based Arguments against Assisted Dying Laws, 36 Bioethics 680 (2022) (cataloging research in multiple countries and concluding that “there is no evidence that assisted dying laws have a disproportionate effect on people with disabilities”). https://doi.org/10.1111/bioe.13036 [20] Eyder Peralta, As Planned, Right-To-Die Advocate Brittany Maynard Ends Her Life, NPR (Apr. 3, 2014), https://www.npr.org/sections/thetwo-way/2014/11/03/361094919/as-planned-right-to-die-advocate-brittany-maynard-ends-her-life (Activist Brittany Maynard moved to Oregon after she was diagnosed with a malignant brain tumor, because her home state did not permit MAiD at the time). [21] Ending life care is defined as the final stage of the end-of-life care continuum, where the patient chooses to end their life as a means to end their suffering or unacceptable quality of life. [22] Palliative sedation is defined as “the use of medications to induce decreased or absent awareness in order to relieve otherwise intractable suffering at the end of life,” and it carries a risk of hastening death. Molly L. Olsen, Keith M. Swetz & Paul S. Mueller, Ethical Decision Making With End-of-Life Care: Palliative Sedation and Withholding or Withdrawing Life-Sustaining Treatments, 85 Mayo Clin Proc 949 (2010). https://doi.org/10.4065/mcp.2010.0201 [23] E.g. Disability Rights Toolkit for Advocacy Against Legalization of Assisted Suicide, Not Dead Yet, https://notdeadyet.org/disability-rights-toolkit-for-advocacy-against-legalization-of-assisted-suicide (last visited Dec. 8, 2023) (describing palliative sedation as “a legal solution to any remaining painful and uncomfortable deaths; one that does not raise the very serious hazards of legalizing assisted suicide”); Testimony of CDR’s Kathryn Carroll, Esq. Opposing NY Assisted Suicide Bill A2383A, Not Dead Yet (Apr. 23, 2018), https://notdeadyet.org/testimony-of-cdrs-kathryn-carroll-esq-opposing-ny-assisted-suicide-bill-a2383a. [24] Voluntarily Stopping Eating and Drinking: A Compassionate, Widely-Available Option for Hastening Death, (Timothy E. Quill et al. eds., 2021). https://doi.org/10.1093/med/9780190080730.001.0001 [25] This is not to say that MAiD and VSED are ethically identical. Different writers have articulated various reasons why MAiD and VSED are meaningfully different and meaningfully similar. Here we distinguish the potential for abuse, as this is the argument that persists among MAiD opponents, For a broader discussion on the ethics of VSED and how it compares to MAiD, see Voluntarily Stopping Eating and Drinking: A Compassionate, Widely-Available Option for Hastening Death, (Timothy E. Quill et al. eds., 2021). https://doi.org/10.1093/med/9780190080730.001.0001 [26] Id.; see also David N. Hoffman and Judy Schwarz, Can Patients Choose to Stop Eating–Even If They Have Dementia–and Can Health Care Facilities Get Paid for Taking Care of Them? Ethics and Reimbursement at the End of Life (Am. Health L. Ass’n Conf. on Long Term Care and the Law 2020). [27] Health Law Section: Duties, Rights & the Law at the End of Life (2019), NY St. Bar Assoc. (Nov. 8, 2019), https://nysba.org/products/health-law-section-duties-rights-the-law-at-the-end-of-life-2019/. [28] Id. [29] CDR still does not appear to have articulated a position on VSED. CDR is a major and vocal opponent of MAiD legislation in NY with considerable resources (they state their projected 2010 budget was approximately $29,000,000). About Us, Center for Disability Rights, https://cdrnys.org/about/. [30] Vacco v. Quill, 521 U.S. 793 (1997) (holding that there is no equal protection violation when N.Y. law criminalized assisted-suicide but permitted removal of life-support systems). [31] Health Law Section: Duties, Rights & the Law at the End of Life (2019), supra note 5. [32] Id. [33] Id. [34] Ben Colburn, Disability‐based Arguments against Assisted Dying Laws, 36 Bioethics 680 (2022) (providing evidence that “that people with disabilities, and disability rights organizations, have diverse views on the question of whether assisted dying should be legal”). https://doi.org/10.1111/bioe.13036 [35] Us for Autonomy, https://www.usforautonomy.org (last visited Sep 10, 2023); see also, Kathryn L. Tucker, Building Bridges Between the Civil Rights Movements of People with Disabilities and Those with Terminal Illness, 78 U. of Pitt. L. Rev. 329 (2017) (collecting and describing amici participation by disability advocates supporting end-of-life liberty). https://doi.org/10.5195/lawreview.2017.473 [36] E.g., USA/National Public Opinion Survey, Susquehanna Polling & Research, Inc. (Feb. 2023),https://d31hzlhk6di2h5.cloudfront.net/20230307/2e/9e/21/14/d37db7887f3f349202ae6f31/Raben_Crosstabulation_Report_2023.FINAL%20(1).pdf ).

Introduction Crime fiction is one of the world’s most popular genres. Indeed, it has been estimated that as many as one in every three new novels, published in English, is classified within the crime fiction category (Knight xi). These new entrants to the market are forced to jostle for space on bookstore and library shelves with reprints of classic crime novels; such works placed in, often fierce, competition against their contemporaries as well as many of their predecessors. Raymond Chandler, in his well-known essay The Simple Art of Murder, noted Ernest Hemingway’s observation that “the good writer competes only with the dead. The good detective story writer […] competes not only with all the unburied dead but with all the hosts of the living as well” (3). In fact, there are so many examples of crime fiction works that, as early as the 1920s, one of the original ‘Queens of Crime’, Dorothy L. Sayers, complained: It is impossible to keep track of all the detective-stories produced to-day [sic]. Book upon book, magazine upon magazine pour out from the Press, crammed with murders, thefts, arsons, frauds, conspiracies, problems, puzzles, mysteries, thrills, maniacs, crooks, poisoners, forgers, garrotters, police, spies, secret-service men, detectives, until it seems that half the world must be engaged in setting riddles for the other half to solve (95). Twenty years after Sayers wrote on the matter of the vast quantities of crime fiction available, W.H. Auden wrote one of the more famous essays on the genre: The Guilty Vicarage: Notes on the Detective Story, by an Addict. Auden is, perhaps, better known as a poet but his connection to the crime fiction genre is undisputed. As well as his poetic works that reference crime fiction and commentaries on crime fiction, one of Auden’s fellow poets, Cecil Day-Lewis, wrote a series of crime fiction novels under the pseudonym Nicholas Blake: the central protagonist of these novels, Nigel Strangeways, was modelled upon Auden (Scaggs 27). Interestingly, some writers whose names are now synonymous with the genre, such as Edgar Allan Poe and Raymond Chandler, established the link between poetry and crime fiction many years before the publication of The Guilty Vicarage. Edmund Wilson suggested that “reading detective stories is simply a kind of vice that, for silliness and minor harmfulness, ranks somewhere between crossword puzzles and smoking” (395). In the first line of The Guilty Vicarage, Auden supports Wilson’s claim and confesses that: “For me, as for many others, the reading of detective stories is an addiction like tobacco or alcohol” (406). This indicates that the genre is at best a trivial pursuit, at worst a pursuit that is bad for your health and is, increasingly, socially unacceptable, while Auden’s ideas around taste—high and low—are made clear when he declares that “detective stories have nothing to do with works of art” (406). The debates that surround genre and taste are many and varied. The mid-1920s was a point in time which had witnessed crime fiction writers produce some of the finest examples of fiction to ever be published and when readers and publishers were watching, with anticipation, as a new generation of crime fiction writers were readying themselves to enter what would become known as the genre’s Golden Age. At this time, R. Austin Freeman wrote that: By the critic and the professedly literary person the detective story is apt to be dismissed contemptuously as outside the pale of literature, to be conceived of as a type of work produced by half-educated and wholly incompetent writers for consumption by office boys, factory girls, and other persons devoid of culture and literary taste (7). This article responds to Auden’s essay and explores how crime fiction appeals to many different tastes: tastes that are acquired, change over time, are embraced, or kept as guilty secrets. In addition, this article will challenge Auden’s very narrow definition of crime fiction and suggest how Auden’s religious imagery, deployed to explain why many people choose to read crime fiction, can be incorporated into a broader popular discourse on punishment. This latter argument demonstrates that a taste for crime fiction and a taste for justice are inextricably intertwined. Crime Fiction: A Type For Every Taste Cathy Cole has observed that “crime novels are housed in their own section in many bookshops, separated from literary novels much as you’d keep a child with measles away from the rest of the class” (116). Times have changed. So too, have our tastes. Crime fiction, once sequestered in corners, now demands vast tracts of prime real estate in bookstores allowing readers to “make their way to the appropriate shelves, and begin to browse […] sorting through a wide variety of very different types of novels” (Malmgren 115). This is a result of the sheer size of the genre, noted above, as well as the genre’s expanding scope. Indeed, those who worked to re-invent crime fiction in the 1800s could not have envisaged the “taxonomic exuberance” (Derrida 206) of the writers who have defined crime fiction sub-genres, as well as how readers would respond by not only wanting to read crime fiction but also wanting to read many different types of crime fiction tailored to their particular tastes. To understand the demand for this diversity, it is important to reflect upon some of the appeal factors of crime fiction for readers. Many rules have been promulgated for the writers of crime fiction to follow. Ronald Knox produced a set of 10 rules in 1928. These included Rule 3 “Not more than one secret room or passage is allowable”, and Rule 10 “Twin brothers, and doubles generally, must not appear unless we have been duly prepared for them” (194–6). In the same year, S.S. Van Dine produced another list of 20 rules, which included Rule 3 “There must be no love interest: The business in hand is to bring a criminal to the bar of justice, not to bring a lovelorn couple to the hymeneal altar”, and Rule 7 “There simply must be a corpse in a detective novel, and the deader the corpse the better” (189–93). Some of these directives have been deliberately ignored or have become out-of-date over time while others continue to be followed in contemporary crime writing practice. In sharp contrast, there are no rules for reading this genre. Individuals are, generally, free to choose what, where, when, why, and how they read crime fiction. There are, however, different appeal factors for readers. The most common of these appeal factors, often described as doorways, are story, setting, character, and language. As the following passage explains: The story doorway beckons those who enjoy reading to find out what happens next. The setting doorway opens widest for readers who enjoy being immersed in an evocation of place or time. The doorway of character is for readers who enjoy looking at the world through others’ eyes. Readers who most appreciate skilful writing enter through the doorway of language (Wyatt online). These doorways draw readers to the crime fiction genre. There are stories that allow us to easily predict what will come next or make us hold our breath until the very last page, the books that we will cheerfully lend to a family member or a friend and those that we keep close to hand to re-read again and again. There are settings as diverse as country manors, exotic locations, and familiar city streets, places we have been and others that we might want to explore. There are characters such as the accidental sleuth, the hardboiled detective, and the refined police officer, amongst many others, the men and women—complete with idiosyncrasies and flaws—who we have grown to admire and trust. There is also the language that all writers, regardless of genre, depend upon to tell their tales. In crime fiction, even the most basic task of describing where the murder victim was found can range from words that convey the genteel—“The room of the tragedy” (Christie 62)—to the absurd: “There it was, jammed between a pallet load of best export boneless beef and half a tonne of spring lamb” (Maloney 1). These appeal factors indicate why readers might choose crime fiction over another genre, or choose one type of crime fiction over another. Yet such factors fail to explain what crime fiction is or adequately answer why the genre is devoured in such vast quantities. Firstly, crime fiction stories are those in which there is the committing of a crime, or at least the suspicion of a crime (Cole), and the story that unfolds revolves around the efforts of an amateur or professional detective to solve that crime (Scaggs). Secondly, crime fiction offers the reassurance of resolution, a guarantee that from “previous experience and from certain cultural conventions associated with this genre that ultimately the mystery will be fully explained” (Zunshine 122). For Auden, the definition of the crime novel was quite specific, and he argued that referring to the genre by “the vulgar definition, ‘a Whodunit’ is correct” (407). Auden went on to offer a basic formula stating that: “a murder occurs; many are suspected; all but one suspect, who is the murderer, are eliminated; the murderer is arrested or dies” (407). The idea of a formula is certainly a useful one, particularly when production demands—in terms of both quality and quantity—are so high, because the formula facilitates creators in the “rapid and efficient production of new works” (Cawelti 9). For contemporary crime fiction readers, the doorways to reading, discussed briefly above, have been cast wide open. Stories relying upon the basic crime fiction formula as a foundation can be gothic tales, clue puzzles, forensic procedurals, spy thrillers, hardboiled narratives, or violent crime narratives, amongst many others. The settings can be quiet villages or busy metropolises, landscapes that readers actually inhabit or that provide a form of affordable tourism. These stories can be set in the past, the here and now, or the future. Characters can range from Edgar Allan Poe’s C. Auguste Dupin to Dashiell Hammett’s Sam Spade, from Agatha Christie’s Miss Jane Marple to Kerry Greenwood’s Honourable Phryne Fisher. Similarly, language can come in numerous styles from the direct (even rough) words of Carter Brown to the literary prose of Peter Temple. Anything is possible, meaning everything is available to readers. For Auden—although he required a crime to be committed and expected that crime to be resolved—these doorways were only slightly ajar. For him, the story had to be a Whodunit; the setting had to be rural England, though a college setting was also considered suitable; the characters had to be “eccentric (aesthetically interesting individuals) and good (instinctively ethical)” and there needed to be a “completely satisfactory detective” (Sherlock Holmes, Inspector French, and Father Brown were identified as “satisfactory”); and the language descriptive and detailed (406, 409, 408). To illustrate this point, Auden’s concept of crime fiction has been plotted on a taxonomy, below, that traces the genre’s main developments over a period of three centuries. As can be seen, much of what is, today, taken for granted as being classified as crime fiction is completely excluded from Auden’s ideal. Figure 1: Taxonomy of Crime Fiction (Adapted from Franks, Murder 136) Crime Fiction: A Personal Journey I discovered crime fiction the summer before I started high school when I saw the film version of The Big Sleep starring Humphrey Bogart and Lauren Bacall. A few days after I had seen the film I started reading the Raymond Chandler novel of the same title, featuring his famous detective Philip Marlowe, and was transfixed by the second paragraph: The main hallway of the Sternwood place was two stories high. Over the entrance doors, which would have let in a troop of Indian elephants, there was a broad stained-glass panel showing a knight in dark armour rescuing a lady who was tied to a tree and didn’t have any clothes on but some very long and convenient hair. The knight had pushed the visor of his helmet back to be sociable, and he was fiddling with the knots on the ropes that tied the lady to the tree and not getting anywhere. I stood there and thought that if I lived in the house, I would sooner or later have to climb up there and help him. He didn’t seem to be really trying (9). John Scaggs has written that this passage indicates Marlowe is an idealised figure, a knight of romance rewritten onto the mean streets of mid-20th century Los Angeles (62); a relocation Susan Roland calls a “secular form of the divinely sanctioned knight errant on a quest for metaphysical justice” (139): my kind of guy. Like many young people I looked for adventure and escape in books, a search that was realised with Raymond Chandler and his contemporaries. On the escapism scale, these men with their stories of tough-talking detectives taking on murderers and other criminals, law enforcement officers, and the occasional femme fatale, were certainly a sharp upgrade from C.S. Lewis and the Chronicles of Narnia. After reading the works written by the pioneers of the hardboiled and roman noir traditions, I looked to other American authors such as Edgar Allan Poe who, in the mid-1800s, became the father of the modern detective story, and Thorne Smith who, in the 1920s and 1930s, produced magical realist tales with characters who often chose to dabble on the wrong side of the law. This led me to the works of British crime writers including Arthur Conan Doyle, Agatha Christie, and Dorothy L. Sayers. My personal library then became dominated by Australian writers of crime fiction, from the stories of bushrangers and convicts of the Colonial era to contemporary tales of police and private investigators. There have been various attempts to “improve” or “refine” my tastes: to convince me that serious literature is real reading and frivolous fiction is merely a distraction. Certainly, the reading of those novels, often described as classics, provide perfect combinations of beauty and brilliance. Their narratives, however, do not often result in satisfactory endings. This routinely frustrates me because, while I understand the philosophical frameworks that many writers operate within, I believe the characters of such works are too often treated unfairly in the final pages. For example, at the end of Ernest Hemingway’s A Farewell to Arms, Frederick Henry “left the hospital and walked back to the hotel in the rain” after his son is stillborn and “Mrs Henry” becomes “very ill” and dies (292–93). Another example can be found on the last page of George Orwell’s Nineteen Eighty-Four when Winston Smith “gazed up at the enormous face” and he realised that he “loved Big Brother” (311). Endings such as these provide a space for reflection about the world around us but rarely spark an immediate response of how great that world is to live in (Franks Motive). The subject matter of crime fiction does not easily facilitate fairy-tale finishes, yet, people continue to read the genre because, generally, the concluding chapter will show that justice, of some form, will be done. Punishment will be meted out to the ‘bad characters’ that have broken society’s moral or legal laws; the ‘good characters’ may experience hardships and may suffer but they will, generally, prevail. Crime Fiction: A Taste For Justice Superimposed upon Auden’s parameters around crime fiction, are his ideas of the law in the real world and how such laws are interwoven with the Christian-based system of ethics. This can be seen in Auden’s listing of three classes of crime: “(a) offenses against God and one’s neighbor or neighbors; (b) offenses against God and society; (c) offenses against God” (407). Murder, in Auden’s opinion, is a class (b) offense: for the crime fiction novel, the society reflected within the story should be one in “a state of grace, i.e., a society where there is no need of the law, no contradiction between the aesthetic individual and the ethical universal, and where murder, therefore, is the unheard-of act which precipitates a crisis” (408). Additionally, in the crime novel “as in its mirror image, the Quest for the Grail, maps (the ritual of space) and timetables (the ritual of time) are desirable. Nature should reflect its human inhabitants, i.e., it should be the Great Good Place; for the more Eden-like it is, the greater the contradiction of murder” (408). Thus, as Charles J. Rzepka notes, “according to W.H. Auden, the ‘classical’ English detective story typically re-enacts rites of scapegoating and expulsion that affirm the innocence of a community of good people supposedly ignorant of evil” (12). This premise—of good versus evil—supports Auden’s claim that the punishment of wrongdoers, particularly those who claim the “right to be omnipotent” and commit murder (409), should be swift and final: As to the murderer’s end, of the three alternatives—execution, suicide, and madness—the first is preferable; for if he commits suicide he refuses to repent, and if he goes mad he cannot repent, but if he does not repent society cannot forgive. Execution, on the other hand, is the act of atonement by which the murderer is forgiven by society (409). The unilateral endorsement of state-sanctioned murder is problematic, however, because—of the main justifications for punishment: retribution; deterrence; incapacitation; and rehabilitation (Carter Snead 1245)—punishment, in this context, focuses exclusively upon retribution and deterrence, incapacitation is achieved by default, but the idea of rehabilitation is completely ignored. This, in turn, ignores how the reading of crime fiction can be incorporated into a broader popular discourse on punishment and how a taste for crime fiction and a taste for justice are inextricably intertwined. One of the ways to explore the connection between crime fiction and justice is through the lens of Emile Durkheim’s thesis on the conscience collective which proposes punishment is a process allowing for the demonstration of group norms and the strengthening of moral boundaries. David Garland, in summarising this thesis, states: So although the modern state has a near monopoly of penal violence and controls the administration of penalties, a much wider population feels itself to be involved in the process of punishment, and supplies the context of social support and valorization within which state punishment takes place (32). It is claimed here that this “much wider population” connecting with the task of punishment can be taken further. Crime fiction, above all other forms of literary production, which, for those who do not directly contribute to the maintenance of their respective legal systems, facilitates a feeling of active participation in the penalising of a variety of perpetrators: from the issuing of fines to incarceration (Franks Punishment). Crime fiction readers are therefore, temporarily at least, direct contributors to a more stable society: one that is clearly based upon right and wrong and reliant upon the conscience collective to maintain and reaffirm order. In this context, the reader is no longer alone, with only their crime fiction novel for company, but has become an active member of “a moral framework which binds individuals to each other and to its conventions and institutions” (Garland 51). This allows crime fiction, once viewed as a “vice” (Wilson 395) or an “addiction” (Auden 406), to be seen as playing a crucial role in the preservation of social mores. It has been argued “only the most literal of literary minds would dispute the claim that fictional characters help shape the way we think of ourselves, and hence help us articulate more clearly what it means to be human” (Galgut 190). Crime fiction focuses on what it means to be human, and how complex humans are, because stories of murders, and the men and women who perpetrate and solve them, comment on what drives some people to take a life and others to avenge that life which is lost and, by extension, engages with a broad community of readers around ideas of justice and punishment. It is, furthermore, argued here that the idea of the story is one of the more important doorways for crime fiction and, more specifically, the conclusions that these stories, traditionally, offer. For Auden, the ending should be one of restoration of the spirit, as he suspected that “the typical reader of detective stories is, like myself, a person who suffers from a sense of sin” (411). In this way, the “phantasy, then, which the detective story addict indulges is the phantasy of being restored to the Garden of Eden, to a state of innocence, where he may know love as love and not as the law” (412), indicating that it was not necessarily an accident that “the detective story has flourished most in predominantly Protestant countries” (408). Today, modern crime fiction is a “broad church, where talented authors raise questions and cast light on a variety of societal and other issues through the prism of an exciting, page-turning story” (Sisterson). Moreover, our tastes in crime fiction have been tempered by a growing fear of real crime, particularly murder, “a crime of unique horror” (Hitchens 200). This has seen some readers develop a taste for crime fiction that is not produced within a framework of ecclesiastical faith but is rather grounded in reliance upon those who enact punishment in both the fictional and real worlds. As P.D. James has written: [N]ot by luck or divine intervention, but by human ingenuity, human intelligence and human courage. It confirms our hope that, despite some evidence to the contrary, we live in a beneficent and moral universe in which problems can be solved by rational means and peace and order restored from communal or personal disruption and chaos (174). Dorothy L. Sayers, despite her work to legitimise crime fiction, wrote that there: “certainly does seem a possibility that the detective story will some time come to an end, simply because the public will have learnt all the tricks” (108). Of course, many readers have “learnt all the tricks”, or most of them. This does not, however, detract from the genre’s overall appeal. We have not grown bored with, or become tired of, the formula that revolves around good and evil, and justice and punishment. Quite the opposite. Our knowledge of, as well as our faith in, the genre’s “tricks” gives a level of confidence to readers who are looking for endings that punish murderers and other wrongdoers, allowing for more satisfactory conclusions than the, rather depressing, ends given to Mr. Henry and Mr. Smith by Ernest Hemingway and George Orwell noted above. Conclusion For some, the popularity of crime fiction is a curious case indeed. When Penguin and Collins published the Marsh Million—100,000 copies each of 10 Ngaio Marsh titles in 1949—the author’s relief at the success of the project was palpable when she commented that “it was pleasant to find detective fiction being discussed as a tolerable form of reading by people whose opinion one valued” (172). More recently, upon the announcement that a Miles Franklin Award would be given to Peter Temple for his crime novel Truth, John Sutherland, a former chairman of the judges for one of the world’s most famous literary awards, suggested that submitting a crime novel for the Booker Prize would be: “like putting a donkey into the Grand National”. Much like art, fashion, food, and home furnishings or any one of the innumerable fields of activity and endeavour that are subject to opinion, there will always be those within the world of fiction who claim positions as arbiters of taste. Yet reading is intensely personal. I like a strong, well-plotted story, appreciate a carefully researched setting, and can admire elegant language, but if a character is too difficult to embrace—if I find I cannot make an emotional connection, if I find myself ambivalent about their fate—then a book is discarded as not being to my taste. It is also important to recognise that some tastes are transient. Crime fiction stories that are popular today could be forgotten tomorrow. Some stories appeal to such a broad range of tastes they are immediately included in the crime fiction canon. Yet others evolve over time to accommodate widespread changes in taste (an excellent example of this can be seen in the continual re-imagining of the stories of Sherlock Holmes). Personal tastes also adapt to our experiences and our surroundings. A book that someone adores in their 20s might be dismissed in their 40s. A storyline that was meaningful when read abroad may lose some of its magic when read at home. Personal events, from a change in employment to the loss of a loved one, can also impact upon what we want to read. Similarly, world events, such as economic crises and military conflicts, can also influence our reading preferences. Auden professed an almost insatiable appetite for crime fiction, describing the reading of detective stories as an addiction, and listed a very specific set of criteria to define the Whodunit. Today, such self-imposed restrictions are rare as, while there are many rules for writing crime fiction, there are no rules for reading this (or any other) genre. People are, generally, free to choose what, where, when, why, and how they read crime fiction, and to follow the deliberate or whimsical paths that their tastes may lay down for them. Crime fiction writers, past and present, offer: an incredible array of detective stories from the locked room to the clue puzzle; settings that range from the English country estate to city skyscrapers in glamorous locations around the world; numerous characters from cerebral sleuths who can solve a crime in their living room over a nice, hot cup of tea to weapon wielding heroes who track down villains on foot in darkened alleyways; and, language that ranges from the cultured conversations from the novels of the genre’s Golden Age to the hard-hitting terminology of forensic and legal procedurals. Overlaid on these appeal factors is the capacity of crime fiction to feed a taste for justice: to engage, vicariously at least, in the establishment of a more stable society. Of course, there are those who turn to the genre for a temporary distraction, an occasional guilty pleasure. There are those who stumble across the genre by accident or deliberately seek it out. 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