Dear Chairperson Alexander, Members of the Committee on Health and Human Services:
I’m writing to urge you not to pass on B21-38, the assisted suicide bill.
I am a severely disabled woman, and President/CEO of the national disability group, Not Dead Yet, which has members in the District of Columbia. I’ve spent a lifetime advocating for the rights of disabled people, young and old, to control our own lives and not have our choices dictated by doctors and other professionals. So you might wonder why I oppose a bill that is widely portrayed as giving people choice and control over their own death.
But who actually has choice and control under assisted suicide laws? Anyone could ask their doctor for assisted suicide, but the law gives the authority to doctors to determine who is eligible. Doctors make the determination that a person is terminally ill and likely to die in six months, and that the request for assisted suicide is voluntary and informed. The advertised “safeguards” in assisted suicide bills are entirely in the hands of doctors, from the diagnosis, prognosis, disclosures, request form, decision whether to refer for psychological assessment, prescription and report after death.
Who are the doctors who are giving lethal prescriptions? The public image is that one’s own doctor, someone who knows you and has taken care of you throughout your illness, will be the one who assists your suicide. But in Oregon, the majority of assisted suicides involve a doctor referred by Compassion and Choices (C&C). [See references under “Doctor Shopping” section of article at http://dredf.org/public-policy/assisted-suicide/why-assisted-suicide-must-not-be-legalized/#marker45] The median duration of the patient’s relationship with the prescribing doctor is 13 weeks, according to Oregon Health Division reports. [See https://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents/year17.pdf] The state does not interview doctors who said “no” to the person’s request, so we don’t know what their concerns were or why so many people felt they had to go doctor shopping at C&C.
The prescribing doctor’s also fill out a final report after the death, among other things stating the reasons for the request for assisted suicide. Among the top five reasons given are feelings of being a “burden on others” (40%) or feeling a “loss of autonomy” (91%) or “loss of dignity” (79%). These are all too familiar disability issues. Yet the law does not even require disclosures about consumer controlled home care options to address feelings of loss of autonomy or being a burden, much less require that those home care services be provided.
Still, you might say, didn’t the person initiate the request for assisted suicide? Didn’t they have to self-administer the lethal dose?
I understand that the media has been flooded with images of Brittany Maynard, who held the lethal drugs in her hand, and appeared to be in full control with a loving family supporting her choice to die in the spacious bedroom we saw on TV that she shared with her husband.
But most people who have been reported to use assisted suicide in Oregon do not resemble Ms. Maynard. Most are age 65-84, in a society where one in ten elders are abused according to federal figures [http://www.healthline.com/health-news/senior-elder-abuse-more-common-than-you-think-012714]. The abusers are usually family members. About half the people reported to use assisted suicide in Oregon did not have a health provider present at the time of death. With no independent witness required, there is no evidence that they self-administered the lethal drugs, or even that they consented at the time of death. These bills have to be considered in light of the sad reality that not all seriously ill people have loving family. Assisted suicide laws grant blanket immunity and effectively foreclose investigation of wrongdoing. As one elder law attorney, Margaret Dore, put it, they are a “recipe for abuse.”
Moreover, as a person who has been disabled all of my life, I’ve learned that some of the health care that I’ve needed will not be covered by the available forms of insurance, because it won’t cure me and it “costs too much”, things that would have helped me maintain more physical function longer or reduced the help I needed from family. The idea of mixing a cost-cutting “treatment” such as assisted suicide into a broken, cost-conscious health care system that’s poorly designed to meet dying patient’s needs is dangerous to the thousands of people whose health care costs the most — mainly people living with a disability, the elderly and chronically ill.
When you look at assisted suicide based on one individual, someone with good healthcare and a loving family, it may look acceptable. But when you examine how legalization affects the vast majority of us — especially those most vulnerable — the dangers to the many far outweigh any alleged benefits to a few.
Diane Coleman, JD, MBA
Not Dead Yet
497 State Street
Rochester, NY 14608