As a scholar in the field of disability studies, it seems obvious to me such structural oppression precludes a public capacity to regulate assisted suicide. Neither the government, the medical profession, or the social justice community have the capacity to detect, respond to or stop the injustices that inevitably occur in offering suicide to people who are experiencing some form of disability.
Laws cannot remediate systemic conditions that disadvantage certain identity groups. Hence, most disability rights activists share the proponents position that what they call “aid in dying” is a social justice issue, but we believe that as proponents of what is actually assisted suicide, they are on the wrong side of it.
Patient/Doctor Miscommunication, The Mask, and Lowing Standards of the Psychiatric Profession
Unlike most states where assisted suicide legislation has been proposed, Massachusetts requires people seeking assisted suicide to see some sort of counselor before obtaining the means to end their life. This is not due to the proponents’ earnest desire to prevent abuse, but because MA groups like MPOWER, Second Thoughts, and others have demanded that people with psychiatric illnesses have at least this slim, tenuous chance of having their condition recognized in the course of applying for
In order to illustrate: There is no way to enforce the “safeguards” written into the Oregon law, hence, the latter are profoundly permeable and subject to manipulation. for instance, if someone’s doctor detects depression and refuses to write a lethal prescription, Compassion and Choices (Hereafter C&C) will refer them to someone who will. For instance, shortly after the Oregon passed its “Death with Dignity Act,” C&C facilitated the suicide of a woman named Helen whose doctor had attempted to refer her for psychiatric care. According the Michigan Law Review:
“The medical director of Compassion in Dying said…Helen was ‘frustrated and crying because she was feeling powerless. He said she had been doing aerobic exercises up until two weeks before she contacted him but told him she could not do them anymore.'”
In short, C&C’s medical director put himself in the role of a psychiatrist; on a functional level, he lowered basic standards for the provision of psychiatric care to depressed patients. According to C&C’s logic, a terminally ill person who wants to die is rational because they have become disabled, and their right to die is absolute.
Moreover, Oregon’s statistics are reported by doctors who participate in assisted suicide; the latter have a clear interest in concealing any misbehavior. Most people are reluctant to admit that they broke the law; much less that they facilitated the death of an unwilling person.
Suicide Contagion/No Family Notification:
Suicidal people in Oregon have used right-to-die literature and devices to bring about their deaths. In 2011, Nick Klonoski, A twenty-eight year old Oregon resident purchased an “exit bag” from a right to die activist who was selling them online and used it to commit suicide.
Although C&C often frames the right to die in terms of individual and familial autonomy, none of the existing or proposed laws require individuals to notify their families. Hence, such laws offer no protection against the psychological effects of “common” suicide and will inevtiabley subject grieving families to a horrible form of social invalidation: “Gee, we’re sorry that this law facilitated your family member’s suicide; but other people want the right to die.”
The Right to Die Movement Does not Believe in Restricting that Right to Those who Are Dying
Unfortunately, many people use the term “slippery slope” to refer to what might happen if assisted suicide were legalized. It’s much more appropriate to think of assisted suicide in terms of systemic inequality that fall outside the letter of any law. For instance, Canadian Supreme court recently legalized assisted suicide for anyone with an “irremedial medical condition;” including every member of the disabled community, whether our disabilities be cognitive, physical, or psychological. Compassion and Choices released a press statement in support of that decision.their expression of support for this ruling contained no such caveat.
Moreover, during a 2014 visit to Connecticut, Barbara Coombs Lee said that assisted suicide for people with dementia was “a question for another day, but no less compelling.” During a 2015 interview with the Christian Century, Coombs Lee asserted, “it isn’t just about pain, everyone has their own definition of suffering.”
Media reporting on this issue also has the capacity to manipulate public opinion in favor of expansion.For instance, the last few months have included national coverage of the following stories: Washington Post:“Should People with Acute Mental Suffering Have a Right to Die?”
Recently, Colorado introduced a ballot initiative that would legalize assisted suicide (the ingestion of lethal drugs) and euthanasia (through intravenous drugs):
Coloradans do not currently have the liberty to pursue happiness by obtaining a medical professional’s assistance in achieving a peaceful death thru the administration of oral or intravenous drugs. (3) The people of Colorado hereby proclaim that mentally competent adult residents of Colorado are Sovereign in the matter of personal medical decisions and have the liberty at life’s end to set the time and tone of their own deaths, asking permission of no person or organization.The people of Colorado hereby further declare that any person or group assisting a Sovereign as defined in Section 3 above obtain Medical Aid In Dying is immune from prosecution upon presentation of acceptable documentation of the voluntary nature of the action..the Sovereign’s right to obtain Medical Aid In Dying is not limited to the maintenance of mental competency only, but can be durable into incompetency if desired and documented.”
The language of this ballot initiative contradicts C&C’s statements regarding euthanasia and its application to incompetent individuals. Hence, proponents are asking disability activists to embrace a naïve understanding of their agenda. They’re asking us to accept the canard that their agenda doesn’t include members of our community; in the face of evidence that doesn’t lend itself to that conclusion.
The Provisions of The Law Make it Difficult to Prosecute Those Who Commit Crimes
It is common for people who kill disabled family members to receive sympathy. For instance, In 1993, Robert Latimer murdered his daughter, Tracy, because she had Cerebral Palsy. At the time, Canada’s primary right-to-die organization said that Latimer should not be prosecuted for that crime because he had served his sentence for the twelve years that Tracy was alive. Latimer is now an outspoken right-to-die advocate. Shortly after the Canada verdict was read, news outlets asked Latimer for his opinion. “I think it was a step in the right direction,” he said. Ultimately, the disability rights community’s objections to assisted suicide don’t stem from fears of any specific act, but of the broader political zeitgeist that they represent.
Systemic Classism in the Practice of Assisted Suicide
Wagner had recently received a letter from Oregon’s Medicaid program informing her that it would not pay for chemotherapy to treat her cancer; but it would cover the cost of barbiturates used for assisted suicide. Another Oregon resident named Randy Stroup also received such a letter. The latter is an excellent example of how classicism impacts experiences of assisted suicide. A more affluent person may be able to pay for chemotherapy, but Medicaid recipients are constrained by whatever resources that the state is willing to put into their care.
Barbara Coombs Lee, the director of C&C, seems oblivious to such nuances. In her 2008 , “Sensationalizing One Sad Case Cheats the Public of a Sound Debate,” Coombes Lee described Wagner as: “A 64-year-old Springfield resident with end stage lung cancer, a life-long smoker enrolled in the Oregon Health Plan.”
Regardless of what her intentions were, Coombes-Lee evoked our culture of ableism and victim-blaming by making certain to emphasize Wagner’s age and her history of smoking. She went on to suggest that Wagner and her doctor had been foolish:
“The burning health policy question is whether we inadvertently encourage patients to act against their own self interest…and foreclose the path of acceptance that curative care has been exhausted and the time for comfort care is at hand. Such encouragement serves neither patients, families, nor the public.”
The classicism and paternalism associated with that perspective is inherent in the fact that as someone making $200,00 a year, Coombs Lee does not need Medicaid; and would never, ever be in Wagner’s position.
Indeed, Coombs Lee’s 2008 editorial contrasts sharply with a piece that she recently wrote for Time Magazine, which eschews her earlier advice not to focus on one sad case and celebrates the fact that “Britney Maynard’s Memory is Helping Us Achieve Death with Dignity.” In that column, she wrote:
Since Brittany’s death, nationwide demand for similar state laws has skyrocketed.Recent national polls show 74 percent of Americans and 54 percent of U.S. physicians want aid in dying to be an authorized medical option. They see that those who would deny patients this option are out of sync with new, and more just, expectations around end-of-life decisions.”
Given the significant class difference that existed between Maynard and Wagner, this column espouses a rather odd conception of justice that is unmindful of how privilege impacts interaction with the medical sphere. From a functional standpoint, C&C has played on the media’s tendency foreground the experiences of privileged individuals like Maynard while simultaneously eschewing public sympathy for people like Wagner.
Ultimately, the most important statement that I can make is this: It’s important to emphasize that ultimately, objections to assisted suicide do not stem from the paternalistic idea that disabled or terminally ill people are incompetent to make decisions for themselves; they stem from an awareness of; and a desire to prevent further casualties of, systemic injustice.