Suicide Prevention for All
- lifemattersjournal
- Mar 17, 2020
- 5 min read
Updated: Feb 2, 2021
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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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