For the New York State Bar Association Medical Aid in Dying Task Force Open Forum
November 27, 2023
The following supplemental information includes references and links to substantiate key points in my remarks presented on November 17th on behalf of Not Dead Yet, a national disability organization headquartered in New York with a Board of Directors and staff solely comprised of disabled people.
Not Dead Yet is part of the NY Alliance Against Assisted Suicide and is also among 17 major national disability organizations that oppose assisted suicide laws, including the United Spinal Association which is also based in New York. Not Dead Yet and United Spinal Association are now part of a major lawsuit filed under the Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act and the U.S. Constitution to challenge the California assisted suicide law as discriminatory based on disability. The New York bill, like California’s law, is closely modeled on Oregon’s law.
One of the most frequently repeated claims by proponents of assisted suicide laws is that there has not been “a single documented case of abuse or misuse.” To the contrary, I refer you to two resources describing problem cases. The first is from the Disability Rights Education and Defense Fund, Oregon and Washington State Abuses and Complications. The second is a journal article by two New York medical doctors, Drs. Herbert Hendin and Kathleen Foley, Physician-Assisted Suicide in Oregon: A Medical Perspective (2008).
Data from states where it’s legal show that all people who request assisted suicide have disabilities, even if some don’t think of their impairments that way, and that unmet disability related needs are their reasons for wanting to die.
Doctors are supposed to detect coercion, but how could they when, for example, Oregon’s state reports say that the median duration of the prescribing physician patient relationship was only 5 weeks in 2021 and 2022. Over all the years, lack of coercion is not usually determined by a physician with a longstanding relationship with the patient. This is significant in light of well-documented elder abuse-identification and reporting problems among professionals in a society where an estimated one in ten elders is abused, mostly by family and caregivers. (Lachs, et al., New England Journal of Medicine, Elder Abuse.)
In about half the reported Oregon cases, there is also no independent witness to consent or self-administration at the time of ingestion of the lethal drugs. If the drugs were, in some cases, administered by others without consent, no one would know.
In September, the U.S. Dept. of Health and Human Services proposed new regulations prohibiting healthcare discrimination based on disability. The federal Notice of Proposed Rule Making is full of examples of disability discrimination by healthcare providers. Making assisted suicide part of “end-of-life care” and designating doctors as its gatekeepers and administrators could only further undermine patient safety, particularly for older adults, disabled people, Black, indigenous, communities of color and other multiply marginalized people who have experienced healthcare discrimination.
The top five reasons Oregon doctors give for their patients’ assisted suicide requests over all reported years are not pain or fear of future pain, but psycho-social issues that pertain to disability. Three of these (losing autonomy, losing dignity, burden on family) could be addressed by in home personal care services, but the law operates as though the person’s reasons don’t matter, and nothing need be done to address them.
We should also look at Canada, where assisted suicide and active euthanasia were legalized in 2016. Only five years later, Bill C-7 was passed making assisted suicide and active euthanasia available to healthy people with disabilities. Canadian press has since reported on disabled individuals getting euthanasia by lethal injection when they want to die because they can’t get housing or otherwise can’t afford to live on government payments. Next year, Canadians whose sole illness is psychiatric are scheduled to become eligible for euthanasia. See Coelho R, Maher J, Gaind KS, Lemmens T (2023). The realities of Medical Assistance in Dying in Canada. Palliative and Supportive Care. https://doi.org/10.1017/S1478951523001025
Equal rights include equal suicide prevention, not suicide agreement and assistance for people who are too often devalued. New York should firmly reject the dangerous discrimination of assisted suicide.
This is an excellent summation of the problem. It will come in handy when the CT fight gears up again, very soon.
Thank you!