Anita Cameron’s Remarks Before the New York State Bar Association Task Force

Anita Cameron’s Remarks Before the New York State Bar Association Task Force on Medical Aid in Dying

November 17, 2023

Good morning. I’m Anita Cameron, Director of Minority Outreach for Not Dead Yet, a national, grassroots disability organization opposed to medical discrimination, healthcare rationing, euthanasia and assisted suicide.

Assisted suicide laws are dangerous because though these laws are supposed to be for people with six months or less to live, doctors are often wrong about a terminal diagnosis. In 2009, while living in Washington state, my mother was determined to be at the end stage of chronic obstructive pulmonary disease. I was told her death was imminent, that if I wanted to see her alive, I should get there in two days. She rallied, but was still quite ill, so she was placed in hospice. Her doctor said that her body had begun the process of dying.

Though she survived 6 months of hospice, her doctor convinced her that her body was still in the process of dying, and she moved home to Colorado to die.

My mum didn’t die. In fact, six weeks after returning to Colorado, she and I were arrested together in Washington, DC, fighting for disability justice. She became active in her community and lived almost 12 years!

Assisted suicide laws put sick people, seniors and disabled people, especially, at risk due to the view of doctors that disabled people have a lower quality of life, therefore leading them to devalue our lives. In 2021, Lisa Iezzoni, a professor of medicine at Harvard University, conducted a survey of 714 doctors around the country as part of a study. She found “82.4 percent reported that people with significant disability have worse quality of life than nondisabled people. Only 40.7 percent of physicians were very confident about their ability to provide the same quality of care to patients with disability, just 56.5 percent strongly agreed that they welcomed patients with disability into their practices, and 18.1 percent strongly agreed that the health care system often treats these patients unfairly.”
https://pubmed.ncbi.nlm.nih.gov/33523739/

Now add race and racial disparities in healthcare to this. Blacks, in particular, receive inferior health care compared to whites in the areas of cardiac care, diabetes, cancer and pain management.

Let me address pain for a minute, because I have a personal relationship with pain. I live with intractable pain. I have multiple disabilities. Two are degenerative. One will take my life. I have personal experience with racial discrimination and disparities in healthcare. The most blatant example of this was when I went to the emergency department last year in intractable pain. A white woman, also in pain, was next to me in the hallway because it was very busy that day. We had the same ER doctor caring for us. She, without asking, got Dilaudid, a potent pain medication, while I got a pat on the shoulder and sent home.

Research shows that Black patients are less likely to receive adequate pain treatment due to false beliefs about biological differences between blacks and whites, which adds further pressure to seek assisted suicide.

How does racial disparities in healthcare relate to assisted suicide?

Research has documented Black, Asian, and Hispanic persons regularly experience barriers to palliative/hospice care utilization. A 2016 JAMA Internal Medicine study found that hospice patients were less likely to be visited by staff in their last two days of life if they were Black. Even more alarming, California nursing facilities with higher numbers of Black and Latino residents have “had higher rates of death.” Although black people and other people of color request assisted suicide less than white people at this point, as the practice is normalized, they are more at risk of pressure to do so. First, racial disparities in healthcare lead to limited health choices and poorer health outcomes including death. Economic disparities make it less likely that patients can afford life-saving treatment and more likely that doctors will “write off” patients as terminal and thus eligible for assisted suicide.

Blacks often die waiting for organ transplants. We are diagnosed with cancer at much later and less treatable stages. As stated above, we get inferior diabetes care, with more amputations. We’re more likely to be written off as terminal and less likely to have access to medical care.

COVID has killed Black, Latine and Indigenous people at higher rates than whites. In fact, some Indigenous communities have literally been wiped out.

As a Black Latina, I didn’t see assisted suicide as part of my culture. This is borne out in a Pew study that shows Blacks and Latine folks are 65% opposed to assisted suicide and in states where it’s legal, rarely use the program. Assisted suicide proponents tend to be white professional and managerial class folks, yet, recent data shows that a significant portion of those who used assisted suicide had Medicare and/or Medicaid as insurance. This confirms the data that indicates that fears of being a financial burden are among the top five reasons people have requested assisted suicide.

Assisted suicide laws are immunity for doctors; they’re written to protect them and designed so that there is no oversight, no reporting requirements and in most cases, the actual cause of death is not listed, rather, the underlying condition is listed. In fact, the word “suicide” is never mentioned. Even the name of the bills and procedures are euphemisms – medical aid in dying, death with dignity, etc.

Although proponents cite pain as the primary reason they want assisted suicide, the 5 top reasons people ask for assisted suicide according to the Oregon data are:

Loss of autonomy
Loss of dignity
Loss of the ability to do things they once loved
Loss of bodily control, such as incontinence and vomiting
Feelings of being a physical, emotional or financial burden on family, friends and caregivers

All these are disability related issues that can be addressed with home based care, services and supports, including mental health services. Pain can be addressed by effective pain control, palliative care, and palliative sedation.

What’s especially dangerous about these laws is that in states where it’s legal, if you lose access to healthcare, turning your chronic condition into a terminal one, you can request assisted suicide. It’ll be cheaper to kill you than to care for you.

And, pay no attention to those going on about safety measures included in assisted suicide legislation. That’s just something to get the legislation through. Once passed and enacted, safety measures are seen as barriers to be removed when the bills are expanded. Two doctors signing off on a request becomes a doctor and a nurse practitioner or physician assistant signing off on the request. A 15 day waiting period between the request and receiving the lethal prescription becomes 72 hours, or less. Residency requirements are no longer mandatory in Oregon and Vermont; indeed, in New York’s proposed legislation, there is no residency requirement! Safety measures in these bills means nothing.

As long as disability discrimination and racial disparities in healthcare exist and as long our broken, profit-driven healthcare system limits people’s access to treatment, services and supports, assisted suicide laws have no place anywhere in the United States. I ask the New York State Bar Association to decide that this is dangerous public policy for our state and say NO to assisted suicide!