Suicide Prevention for All

by Stephanie Hauer

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The loss of human life in any circumstance is tragic. While many acts of violence are imposed outwardly, suicide is a uniquely poignant and painful form of violence that faces inward. As a society, we are quick to mourn those lost to suicide and to call for its prevention when it affects someone we know from the media or our own lives. Social media platforms have added

ways to detect and report signs of suicidal thoughts demonstrated by its users so that

intervention can be prompt and successful. The phone numbers for suicide hotlines are

frequently circulated. More and more resources are being made available to those who are

contemplating suicide so that they can receive the help they so desperately need.

So why does that fervor for prevention disappear when someone is not able-bodied?

The movement to legalize assisted suicide flies in the face of the suicide prevention measures

that are gaining traction in other settings. All people are deserving of suicide prevention care,

regardless of their health, age, ability, level of independence, or any other factors. Human life is

always worth protecting, but assisted suicide undermines that truth.

Assisted suicide is particularly scrutinized by disability activists. Much of the justification

behind assisted suicide has ableist elements and therefore harms the entire disabled

community. Not Dead Yet is a grassroots disability rights that opposes assisted suicide and

euthanasia. They succinctly explain the dangers of including assisted suicide as a medical

treatment option for people who are seriously ill or disabled.

First and foremost, assisted suicide perpetuates misconceptions about having disabilities. Most

people who advocate for the legalization of assisted suicide emphasize unbearable pain as the

main reason for its use. However, according to Oregon’s Death with Dignity Act Annual Reports,

lethal prescriptions were issued for very different reasons: 91% for loss of autonomy, 89% for

decreased ability to engage in activities, 81% for loss of dignity, 50% for loss of control of bodily

functions, and 40% for feelings of being a burden. That list describes some of the challenges

that people with disabilities face on a regular basis. If they are valid reasons to offer lethal

prescriptions to patients, then the implication is that all people with disabilities do not have lives

worth living because they face those same challenges.

We live in a society that celebrates and regularly expects physical ability. The structures around

us are designed for a specific skill set, and people with disabilities frequently find those

structures difficult to navigate. Our designs, from the entrances of buildings to the layout of

bathrooms to the construction of most clothing, are not inclusive to everyone. As such, it is

unsurprising that when someone who was previously able-bodied finds themselves in a situation

where they are not free to navigate the world in their independent and comfortable way, they

view this as a loss of dignity. When patients are offered assisted suicide because of challenges

such as the loss of control of bodily functions, it indicates that anyone with incontinence,

spasms, or other losses of bodily function is considered to similarly lack dignity.

Not all patients are offered legally assisted suicide. As Not Dead Yet states, “some people get

suicide prevention while others get suicide assistance, and the difference between the two

groups is the health status of the individual, leading to a two-tiered system that results in death

to the socially devalued group. This is blatant discrimination.”

The second danger inherent to assisted suicide is the role of doctors as gatekeepers. While

anyone could request assisted suicide, not everyone will receive it. That decision is made by

physicians, requiring them to predict if a patient will die within six months, and whether the

request for death is made with a rational and clear mind or from a position of impaired

judgement. Such evaluations are difficult to make and often inaccurate. As such, those who do

not fit the criteria for assisted suicide are still sometimes permitted to proceed with their request

for death, because the evaluation system makes mistakes.

Doctors consistently underestimate the quality of life of people with disabilities compared to their

patients’ self-assessments. This is yet another manifestation of the misconceptions about

disability and the false idea that dignity is only found in independence and physical ability.

Instances of abuse of patients or elders are common and often unnoticed; the patient may be

coerced or threatened into requesting assisted suicide even if they themselves do not want it. A

physician who has no knowledge of such abuse cannot factor it into their decisions, may give a

lethal prescription to someone who actually wants to live.

The third problem with assisted suicide is that it presents an “easy way out” with an

unacceptable cost. Much of this is “ease” is within a financial context. Killing a patient is a one-

time expense, whereas continued care is an ongoing cost. Many of the conditions that activate

consideration of assisted suicide can be mitigated through better palliative care. It is also

common for patients to develop depression that can be treated. Both of these avenues come at

an additional financial cost.

Assisted suicide allows physicians, health care providers, and the legal system to put their own

interests before the interests of the patient. Health care providers, who are under constant

pressure to reduce their costs, can cut funding to programs that provide even basic care such

as help getting out of bed, using the toilet, and bathing, because an “alternative” is offered.

Under futility policies and statutes, physicians and health care providers have the right to

override a patient’s requests for life-sustaining treatment. When the patient inevitably dies from

this absence of care, the cause of death is listed as their medical conditions, so no investigation

is necessary and no meaningful data can be collected to provide statistics on these kinds of

deaths. Finally, the legal standards can be written to grant immunity to physicians in all

circumstances because they only have to act on “good faith,” which is the lowest culpability

standard possible (even below “negligence.”) This allows the legal system to practically ignore

physician assisted suicide cases.

In 2016, Canada passed a bill known as the Medical Assistance in Dying Act. This bill allows for

assisted suicide under the care of a nurse practitioner or doctor. It requires that the patient seeking euthanasia fit the following criteria in order to be given the lethal prescription: eligible for

federally funded medical care, eighteen years old or older, mentally competent, diagnosed with

a “grievous and irremediable medical condition,” making a voluntary request for death, and

having informed consent to all treatment options available, including euthanasia. While the

technicalities of these criteria are intended to help reserve the process for only those who

“need” it, they fall short of addressing the concerns identified by Not Dead Yet and other groups

who advocate against assisted suicide.

Suicide is not a solution. Allowing assisted suicide into our society is unjust and discriminatory.

It enables those in power to put their own self-interest above the good of their patients. It

perpetuates the misconceptions that people with disabilities lack dignity and do not lead

valuable lives. And most of all, it comes at the intolerable cost of human lives. While assisted

suicide and euthanasia are often portrayed as compassionate acts, the truth is clear. Killing a

person, especially someone who is in need, is always wrong.

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This article originally appeared in Volume 7 Issue 4 of Life Matters Journal.

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