By Alex Schadenberg, Executive Director, Euthanasia Prevention Coalition
Daniel C. Schreck who is a bioethicist and a member of the National Council on Disability, an independent federal agency charged with advising the president, Congress, and other federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities, wrote a commentary that was published in the Greenwich Time on the Connecticut assisted suicide bill.
Schreck writes first about the myths:
Assisted suicide, we are told, poses no threat to people with disabilities thanks to statutory safeguards: There is no record of abuse in states where assisted suicide is legal because there is none to be found. We are told that these straightforward laws have narrow eligibility for the terminally ill and are merely codifying the personal choice to end one’s terminal suffering. These are the facts, or so we are told.
Schreck then explains the facts:
The fact is, the Oregon Health Division’s 22 years of assisted suicide reports show that people with non-terminal disabilities receive lethal prescriptions every year and that pain is not even a top-five reason. Rather, a loss of autonomy and feeling like an emotional and/or physical burden to one’s family, consistently rank among the top reasons. Accordingly, those who access lethal prescriptions include those with diabetes, rheumatoid arthritis, gastrointestinal diseases, liver disease, and Parkinson’s disease, among many other non-terminal medical conditions.
The fact is, many assisted suicide bills such as HB 6425 define “terminal” as “incurable” and “irreversible,” which greatly expands the eligible population. Would my little daughter Rose, who has Down syndrome, meet the genetic profile that some physicians would deem “incurable” and “irreversible”? As we at the National Council on Disability — an independent federal agency that advises the president and Congress — outlined in our recent report, “terminal” in assisted suicide laws doesn’t mean with treatment. Therefore, people with perfectly treatable disabilities die by assisted suicide every year.
The fact is, despite claims of enhancing autonomy, assisted suicide laws diminish its realization. Under HB 6425, the patient’s long-term doctor does not need to verify a lack of coercion, and the two witnesses required on the written request do not need to know the patient and can be an heir. Nothing in the bill can prevent an outside organization, friend, relative, or heir from “encouraging” a person to make the request, signing as a witness, picking up the prescription, and even administering the drug with or without consent. And, because no objective witness is required at death, who would even know?
The fact is, assisted suicide laws often foreclose rather than expand choice by creating perverse incentives for profit-driven health insurance providers to deny care to patients and to offer assisted suicide instead. Some of those providers are state-funded Medicaid programs, which in states that have legalized assisted suicide have denied coverage for curative treatments while paying for cheaper suicide drugs. In Oregon’s most recent annual assisted suicide report, people dying by assisted suicide who receive state-funded health care increased to an alarming 75 percent. Not being able to pay for expensive curative treatments out of pocket means suicide may be one of the only “treatments” to which one may have equal access. When financial pressures reduce life-giving options, personal autonomy is diminished. As we at NCD can attest to, persons with disabilities are still fighting for equal access to basic health care, and yet assisted suicide bills could give them one lethal choice while precluding others.
Schreck then comments on assisted suicide in relation to other suicides:
Since suicide is a societal and personal tragedy, and never a good, legalizing assisted suicide forces lawmakers to draw arbitrary distinctions between which suicides are “rational” and which should be prevented at all costs. State and federal governments invest heavily into efforts and programs to lower suicide rates among veterans, teenagers, first responders, and clinicians. And yet, just 10 years after the practice became legal in Oregon, the suicide rate was 41 percent higher than the national average. The line between who gets suicide prevention and who gets suicide assistance will always delineate some subset of people with disabilities if the practice becomes more acceptable.
The article concludes with the concern how assisted suicide devalues the lives of people with disabilities:
If law is the teacher, then this bill perversely devalues the lives of those with disabilities. Most assisted suicide laws refer to “dignity,” but suicide does not confer dignity, it undermines it. When assisted suicide becomes legal, lives are ended without consent through mistakes, abuse, societal pressure, and the unjust lack of better options. We should not make policies which see illness, disability, or age as something to be “cured” by death. Instead, millions of Americans with significant physical and developmental disabilities, like my daughter Rose, ought to be protected and loved for the inherent dignity they already possess.
Editor’s note. This appeared on Mr. Schadenberg’s blog and is reposted with permission.