Disability Rights Leadership Institute on Bioethics: Assisted Suicide Laws

Disability Rights Leadership Institute on Bioethics: Assisted Suicide Laws Marilyn Golden Senior Policy Analyst Disability Rights Education & Defense Fund (DREDF) 2

3 Assisted suicide proposals & laws Threat of major public policy changes, regularly & often Far more often fail than pass – if we stop them What does “assisted suicide” mean? Assisted Suicide Laws

4 Assisted suicide proposals & laws (cont’d.) Fought by coalitions spanning political spectrum Actually decrease choice and self-determination Think outside the medical model Terminology Assisted Suicide Laws

5 Legal Alternatives Available Today Which include: Palliative care Palliative sedation Assisted Suicide Laws

6 Some of our objections relate specifically to the disability community Assisted Suicide Laws

7 Disability-related objections 1.Suicide prevention vs. suicide assistance Assisted Suicide Laws

8 The “public image of severe disability as a fate worse than death … become[s] grounds for carving out a deadly exception to longstanding laws and public policies about suicide intervention services … Legalizing assisted suicide means that some people who say they want to die will receive suicide intervention, while others will receive suicide assistance. The difference between these two groups of people will be their health or disability status, leading to a two-tiered system that results in death to the socially devalued group.” – Diane Coleman, President, Not Dead Yet – Assisted Suicide Laws

9 Description of following cartoon: This cartoon shows a wheelchair user in front of a Suicide Prevention Program with many steps up to the door. But around the corner, there’s a wheelchair ramp leading to another door labeled “Assisted Suicide.” Assisted Suicide Laws

10 Assisted Suicide Laws

11 Disability-related objections 2. Consider the Netherlands Assisted Suicide Laws

12 “The Netherlands has moved from assisted suicide to euthanasia, from euthanasia for the terminally ill to euthanasia for the chronically ill, from euthanasia for physical illness to euthanasia for psychological distress and from voluntary euthanasia to nonvoluntary and involuntary euthanasia. Once the Dutch accepted assisted suicide it was not possible legally or morally to deny more active medical [assistance to die], i.e. euthanasia, to those who could not effect their own deaths. (Quote continues >) Assisted Suicide Laws

13 “Nor could they deny assisted suicide or euthanasia to the chronically ill who have longer to suffer than the terminally ill or to those who have psychological pain not associated with physical disease. To do so would be a form of discrimination. Involuntary euthanasia has been justified as necessitated by the need to make decisions for patients not [intellectually] competent to choose for themselves.” – Dr. Herbert Hendin, Congressional testimony – Assisted Suicide Laws

14 Disability-related objections 3. Terminal Illness Prognosis – A Fundamental Loophole Assisted Suicide Laws

15 Disability-related objections 4. Danger to people with depression and psychiatric disabilities Assisted Suicide Laws

16 The Myth of Free Choice and Self-Determination Assisted Suicide Laws

17 A Deadly Mix: \\\\ The deadly combination of assisted suicide and our broken, profit-driven US health care system Assisted Suicide Laws

18 \\\\ Description of following cartoon: To show we’re not the only ones this notion has occurred to, here’s a cartoon we found with a health care executive at a desk, commenting to a colleague, “We’re able to hold down healthcare costs through assisted suicide.” Assisted Suicide Laws

19 Assisted Suicide Laws

20 Other Failures of “Safeguards” in the Oregon law Assisted Suicide Laws

21 Other Failures of “Safeguards” in the Oregon law: Doctor shopping Assisted Suicide Laws

22 Percentage of Reported Oregon Deaths Through C&C Assistance (examples of particular years) Through 2002: “About 75%” In 2003: 79% In 2008:88% (These are typical, not outliers…) Assisted Suicide Laws

23 Other Failures of “Safeguards” in the Oregon law: Good faith standard Assisted Suicide Laws

The safeguards do work for someone: The doctors! Doctors are not held liable if they act in “good faith,” an impossible standard to disprove. The “good faith” standard makes all of the other “safeguards” unenforceable. For all other procedures, doctors are liable if they are negligent. Doctors are not held liable if they act in “good faith,” an impossible standard to disprove. The “good faith” standard makes all of the other “safeguards” unenforceable. For all other procedures, doctors are liable if they are negligent.

25 Oregon: Minimal Data & Fatally Flawed Oversight Reporting requirements lack teeth Non-compliance is not monitored Important questions go unasked No investigation of abuse No autopsies Underlying data is destroyed annually Assisted Suicide Laws

26 The Political Landscape also includes: Organizations such as Final Exit Network Assisted Suicide Laws

27 The Political Landscape also includes: The ACLU Assisted Suicide Laws

28 The Political Landscape also includes: Us! In multi-constituency coalitions Assisted Suicide Laws