Special issue of Disability and Health Journal

If assisted suicide is legalised most of
the people who will die are disabled. And American disability advocates
take a very dim view of it. This is the theme of a hard-hitting series
of articles in the latest issue of the Disability and Health Journal.

The editor, Suzanne McDermott, writes that
she changed her own mind after studying the issue. At first she
believed that assisted suicide was solely a personal autonomy issue.
But eventually she was persuaded that it is at the heart of the
movement for disability rights: “Almost all people at the end of life
can be included in the definition of ‘disability’. Thus, the practice
of assisted suicide results in death for people with disabilities.”

The special issue is a response to a
controversial 2008 decision by the American Public Health Association
(APHA) to back “aid in dying” (ie, assisted suicide). Several themes
emerge from the articles.

First, the very existence of legalised
assisted suicide threatens disabled people. It will lead to an
expectation that the disabled, elderly and infirm should shuffle off
their mortal coil a bit early to relieve the burden on their carers.
This fear has been ridiculed by supporters, who contend that all they
want is choice at the end of life. Dream on, says Diane Coleman, of the lobby group Not Dead Yet.
“Proponents of legalized assisted suicide are willing to treat lives
ended through abuses of the practice as ‘acceptable losses’ when
balanced against their wish for a pleasant way out and their
unwillingness to accept disability, or responsibility for their own
suicide. We disagree.”

Second, the danger is not mandated
euthanasia, as in Nazi Germany. Rather, it is a subtle and widespread
expectation that death is better than disability. “If the legalization
of assisted suicide continues, I believe the rank and file will some
day see nothing wrong with hastening the deaths of many people,” writes Dr Carol J. Gill.
“They will stand by and do nothing to stop it and will endorse the
policies and institutions that advance it–not because they are evil
people but because it will no longer be evil in our culture to do so.
It will be compassionate, respectful, routine.”

Third, several authors argue forcefully
that Oregon’s Death with Dignity Act, which is the model for assisted
suicide in the US, is deeply flawed. After about 15 years, several
intractable problems have emerged. The authors claim that there is very
little patient control; that statistics are incomplete; that oversight
is minimal and secretive; that safeguards are easily circumvented; and
that negligent doctors cannot be prosecuted. Allegations that in Oregon
and in the neighbouring state of Washington, which has also legalised
assisted suicide, the circumstances of deaths are routinely falsified
are especially disturbing. In fact, Washington actually requires that
doctors falsify the death certificate by listing the terminal disease
as the cause of death rather than the lethal dose of barbiturates. ~ Disability and Health Journal, January

Michael Cook
assisted suicide
disability
euthanasia
Oregon

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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