Assisted suicide has been on my mind ever since Washington DC took steps to legalize the act in 2016. The fact that it wasn’t on my radar before is a luxury of my health. For Americans with disabilities, it is a constant threat to their dignity. Starting about 20 years ago, disability groups began speaking out and forming official positions against assisted suicide. Many accused those with disabilities of “meddling” and trying to “take away” the rights of those with disability. Advocates of Physician Assisted Suicide say being able to have a doctor give lethal prescriptions is a right all people with a terminal condition should have. People with disabilities have a completely different point of view.
At the Life/Peace/Justice Conference, Diane Coleman, JD, gave a presentation via Skype called “A Disability Rights and Social Justice Perspective Against Assisted Suicide”. Coleman is the president and CEO of Not Dead Yet, a group formed by people with disabilities to stop assisted suicide. Coleman started her talk with a brief history of the organization and the movement she fights for. The Jack Kevorkian murders in the 1990s were a huge wake-up call for the disabilities rights movement — ⅔ of those whom Kevorkian performed “mercy killings” on had non-terminal disabilities.
Coleman then gave some case studies about people who were pressured to commit suicide because of their disabilities. Coleman shared the story of Terrie, who was in a car crash at age 19. The doctors would ask her mother if she was ready to pull the plug, telling her that her daughter would never be able to have a career or a social life, amongst other things. When her mother refused, the doctors would then work on Terrie. They tempted her with morphine so she would not feel the pain of being taken off a ventilator. Terrie refused, and went on to have a job and be a mother.
One might still question what this has to do with disabilities. Most of the reasons people request assisted suicide, Coleman explained, are related to their state of disability. These reasons include: loss of autonomy (91.4% of those who requested assisted suicide in Oregon felt this way); and the decreasing ability to participate in activities that make life enjoyable (89.7% felt this way).
Coleman addressed the dangers of assisted suicide, public policy, and the US healthcare system. It has been predicted that assisted suicide will gain popularity as the health system turns to it as an economic opportunity. In Oregon, two physicians recommended chemotherapy for a woman with lung cancer to extend her life and a man with prostate cancer to relieve his pain. The Oregon Health Plan sent both letters saying that their plans would not cover chemotherapy. Among the “treatments” the insurance would cover: suicide. Another case like this in California occurred in 2016, shortly after assisted suicide was legalized there.
Coleman, and other disability advocates, hold the same large concern that PAS would lead to the abuse of elders and disabled persons. Under laws in Oregon and Washington, a friend or relative, including an heir, can encourage an elder to make a request for assisted suicide, pick up the prescription, and administer the drug with or without consent. No objective witness is required at the death, so there is no way of knowing whether abuse has occurred. With one in ten elders abused in the United States, it would be surprising if assisted suicide was not used at some point, or often, without an elder’s consent. Coleman expressed her disdain for Compassion and Choices, a major force behind assisted suicide. Compassion and Choices, formerly known as the Hemlock Society, aids in most of the assisted suicide deaths in Oregon. They will refer an ill person to another doctor if their doctor will not assist them in dying, a process known as “doctor shopping”. In fact, the median duration of the physician-patient relationship for patients requesting assisted suicide in Oregon is 13 weeks. In 2008, Compassion and Choices referred 88% of these patients.
Coleman explained how many people who are pro-assisted suicide will justify their position with various “safeguards”. A major problem with the “safeguards” is that people are often misdiagnosed. “Terminal” predictions are often unreliable. Some bills included “terminal” as people with conditions that are only terminal if left untreated, such as diabetes. In addition, very few people are psychologically evaluated before being given a lethal prescription. In Oregon, only 5.1% of people who request assisted suicide have been referred for psychological evaluations. Doctors are also permitted to fulfill a request for lethal medication rather than treat diagnosed depression. In this way, a double standard is created in the field of mental health care for those with and without physical impairments. In one salient case, a man named Michael Freeland who had a 43-year history of severe depression, suicide attempts, and paranoia, obtained a lethal prescription. He ended up not taking the prescription, and eventually received high-quality medical and social services that lead to no longer having a desire to end his own life via assisted suicide.
Coleman then gave the solution for the end of assisted suicide: social justice. Equal rights means equal suicide prevention. There needs to be an emphasis on palliative care and the treatment of chronic pain. What people with disabilities really need is to be listened to and having solutions found to what is bothering them. We then need to address the problem with (re)humanizing solutions to help the person live the highest quality of life possible.
"They give us so-called 'choice,' but we want social justice." - Diane Coleman