February 3, 2014
Dear New Hampshire Judiciary Committee Members:
We are writing on behalf of Not Dead Yet, a national disability rights organization that opposes legalization of assisted suicide.
Leading proponents of bills to legalize assisted suicide for the terminally ill often claim that the views of disability organizations aren’t relevant. While it’s true that people with disabilities aren’t usually terminally ill, the terminally ill are almost always disabled. This is one of many reasons that our perspective may shed some light on this complex issue.
Our views are even more relevant in New Hampshire, due to the definition of “terminal” in HB 1325. On the face of it, it’s still a bill that would restrict “eligibility” for getting lethal doses in order to commit suicide to people with “terminal conditions.” But when you get into the actual definition, it’s clear that the sponsors of this bill want “terminal condition” to include people with disabilities who have years or even decades of life left.
XIII. “Terminal condition” means an incurable and irreversible condition, for the end stage of which there is no known treatment which will alter its course to death, and which, in the opinion of the attending physician and consulting physician competent in that disease category, will result in premature death.
Many people who are not dying have incurable conditions that are likely to eventually result in premature death. In fact, it’s difficult to think of a chronic health condition or significant disability that does not negatively impact one’s projected lifespan. Diabetes, heart disease, hypertension, spinal cord injury, HIV/AIDS, neuromuscular disorders, neurological disorders – there’s a very long list.
Of course, this definition is to be used only in terms of eligibility for assisted suicide. It doesn’t, for example, apply to hospice services which are limited by federal rules to those who are deemed as having six months or less to live. So, there’s no guarantee of palliative care for people with significant disabilities or conditions, unless they’re thought to be close to death. In contrast, this bill would offer help with easy and successful suicide for anyone with a serious, significant, potentially life-shortening condition/disability at any time at all. Nothing to help people who could have many happy years with the right supports – just an easy and cheap out.
Assisted suicide supporters often paint themselves as “compassionate progressives” fighting for freedom against the “religious right.” It’s a simple and savvy framing of the debate, if you ignore inconvenient truths, such as:
- People who want to die usually have treatable depression and/or need better palliative care;
- Pressures to cut health care costs in the current fiscal climate, including home care supports, make this the wrong time to add doctor prescribed suicide to the options;
- Abuse of elders and people with disabilities is a growing but often undetected problem, making coercion virtually impossible to identify or prevent.
Oregon is often touted as the model for legalized assisted suicide. Proponents claim that 15 years of data from Oregon show that safeguards to ensure that it’s voluntary are working. But how would they know? The Oregon Reports only tell us what the prescribing doctors indicated were the patients’ reasons for wanting assisted suicide by checking off one or more of seven reasons on a multiple choice state government form.
One of the reasons is feelings of being a burden on others, checked roughly half of the cases. But there’s no corresponding requirement that home care options be disclosed as part of informed consent under the law, much less that they be offered or funded.
Although the Oregon Reports admit that the state can’t assess compliance with the safeguards, some independent articles find that safeguards failed in individual cases (see, e.g., Hendin & Foley, MDs, “Physician-Assisted Suicide in Oregon: A Medical Perspective”, Michigan Law Review, June 2008, http://www.michiganlawreview.org/assets/pdfs/106/8/hendinfoley.pdf). But the law includes no authority for investigation or enforcement, so nothing happens as a result.
Elder abuse is a growing problem in the U.S., affecting an estimated one in ten elderly persons. Similarly, people with disabilities are up to four times more likely to be abused than their same-age nondisabled peers. In Oregon and Washington, legal assisted suicide has opened new paths of abuse against persons who may qualify to use these laws. One of the most obvious problems is a complete lack of oversight when the lethal drug is administered. If an abuser were to administer the drug without the person’s consent, who would know?
Many assisted suicide proponents are well meaning, but it is simply naive to suggest that assisted suicide can be added to the array of medical treatment options, without taking into account the harsh realities of elder abuse and the related potential for coercion. While some people are safe from these pressures, others are most certainly not. Legislators have an obligation to consider everyone when evaluating the risks and unintended consequences posed by such a major change in public policy.
Diane Coleman, JD, MBA Stephen Drake, MS
President/CEO Research Analyst
Not Dead Yet Not Dead Yet
497 State Street
Rochester, NY 14608