The Extreme Ableism of Assisted Suicide

I just came across a brilliant letter that John Kelly sent to the Washington, D.C. Council when they were considering an assisted suicide bill in 2016. I should have posted it here then, but I am doing so now (lightly edited), because it’s one of the best discussions I’ve read of the core problem that assisted suicide advocates have with disability.

Let me just highlight one example from the letter, a Washington Post quote from Dan Diaz, who is still working for Compassion and Choices, traveling around the country doing press conferences and testifying on their behalf in favor of these dangerous bills.

“If I find myself in a situation where I can’t go to the bathroom on my own, where someone has to change my diapers, where I can’t feed myself, where I can’t care for the people around me, where other people have to move me around to keep me from having bedsores, I would then submit, ‘Is that really living?’ ” Diaz said.

Although assisted suicide proponents often accuse opponents of fearing death, the letter below demonstrates how profoundly proponents fear and loath disability. Their ableism is so extreme that they want to carve a vaguely defined segment of old, ill and disabled people out of suicide prevention, enlist our healthcare system in streamlining our path to death, and immunizing everyone involved from any legal consequences, thereby denying us the equal protection of the law.

November 1, 2016

Chairman Mendelson, Councilmembers:

My name is John Kelly. I am the New England Regional Director for Not Dead Yet, the national disability rights group that has long opposed euthanasia and assisted suicide. I am also the director of Not Dead Yet’s Massachusetts state affiliate, Second Thoughts MA: Disability Rights Advocates against Assisted Suicide.

I refer you to two recent articles in the Washington Post. Read together, they must lead you to vote against assisted suicide bill B21-38. Assisted suicide is hardly about physical pain, despite what proponents have told you. And assisted suicide is promoted by one specific group in the district and country, wealthier white people, while resisted by poorer people and people of color specifically.

The first article came out last Monday, October 24. Titled “‘Death with dignity’ laws and the desire to control how one’s life ends,” this article exposes the main argument for assisted suicide, “that terminally ill patients have the right to die without suffering intractable pain in their final days or weeks,” as a big lie.

Author Liz Szabo reports that assisted suicide proponent group Compassion & Choices “focuses heavily on the need to relieve dying patients of pain.” One ad has the assisted suicide bill giving “a dying person the option to avoid the worst pain and suffering at the end of life.”

Yet the latest research shows that terminally ill patients who seek aid in dying aren’t primarily concerned about pain. Those who have actually used these laws have been far more concerned about controlling the way they exit the world than about controlling pain.

As one California doctor said, “It’s almost never about pain. It’s about dignity and control.”

And that’s what the Oregon and Washington data show. Pain is the least of people’s concerns. Doctors report people requesting the lethal drugs because of psychosocial suffering about becoming disabled through their illness. It’s mental distress about becoming dependent on other people (“losing autonomy” 92%), losing abilities (“less able to engage in activities making life enjoyable” 90%), shame and perceived/actual loss of social status (“loss of dignity” 79%), needing help with incontinence (“losing control of bodily functions” 48%), and believing that suicide would leave loved ones better off (“burden on family, friends/caregivers” 41%).

Dr. Ira Byock, a leading palliative care expert, told the Post, “it’s a bait and switch. We’re actually helping people hasten their deaths because of existential suffering. That’s chilling to me.” As Byock said, almost all pain is controllable. Hospice staff are on call 24 hours a day, and caregivers can be trained in administering emergency pain medication until staff arrive.

The real reasons that people want to commit assisted suicide, proponents admit, are about being dependent on other people for personal care. We disability rights activists have been pointing this out all along.

Barbara Coombs Lee, who as an insurance company executive wrote Oregon’s assisted suicide law, brought up the case of the woman who committed assisted suicide because she was incontinent. The woman wrote that “the idea of having somebody take care of me like I am a little 2-month-old baby is just absolutely repulsive. It’s more painful than any of the pain from the cancer.”

Lee described scenarios of disability that she said were “worse than death.” Proponent Dan Diaz emphasized the supposed horrors of disability.

“If I find myself in a situation where I can’t go to the bathroom on my own, where someone has to change my diapers, where I can’t feed myself, where I can’t care for the people around me, where other people have to move me around to keep me from having bedsores, I would then submit, ‘Is that really living?’

This isn’t a public health bill, it’s a death before disability bill.

So this is what some of you are planning to vote for. You are not protecting DC residents from agonizing pain. You are promoting the particular views of one specific group of people, described by Obamacare architect Ezekiel Emanuel as predominantly “white, well-insured, and college-educated.” People who are used to being in control of every aspect of their lives.

So, like so much in the US, assisted suicide is an issue that cuts across class and race. The 2012 election map in Massachusetts shows that wealthier, whiter areas voted heavily for legalization, while working-class whites and people of color voted strongly against. People turning out for Barack Obama and current Sen. Elizabeth Warren defeated the proposal.

The second article, from October 17, by reporter of color Fenit Nirappil, was titled “Right-to-die law faces skepticism in nation’s capital: ‘it’s really aimed at old black people.’” It details the opposition to assisted suicide of Washington’s black majority.

Many in the black community distrust the health-care system and fear that racism in life will translate into discrimination in death, said Patricia King, a Georgetown Law School professor who has written about the racial dynamics of assisted death.

“Historically, African Americans have not had a lot of control over their bodies, and I don’t think offering them assisted suicide is going to make them feel more autonomous,” King said.

District residents told Nirappil of concerns that “low-income black senior citizens may be steered to an early death”, and that in the end, assisted suicide is really all about reducing government healthcare costs.

Derek Humphry, who founded the Hemlock Society (Compassion & Choices’ original name), wrote years ago of the “unspoken argument,” that assisted suicide will gain traction because of “the realities of the increasing cost of health care in an aging society, because in the final analysis, economics, not the quest for broadened individual liberties or increased autonomy, will drive assisted suicide to the plateau of acceptable practice.”

Assisted suicide, like suicide in general, is primarily practiced and promoted by white people. Nirappil reported that national leaders in the assisted suicide movement are all white, and that most of the participants at a recent rally were white. In the 18 year history of the Oregon assisted suicide law, only one black person has used the program. In a state that is now 22% nonwhite, 97% of assisted suicide deaths have been white.

Non-Hispanic whites also commit regular suicide at a rate 2.5 times that of blacks. Rather than importing a predominantly-white practice as a solution for the district, you must say no to this bill and the big lie it hides behind. Assisted suicide is not about protecting suffering people from physical pain, it’s about satisfying the control needs of a group of people, predominantly white, who would rather die than become dependent on another human being.

Please respect your constituents, understand the danger this bill represents, and reject this bill.

Thank you.