I write as Director of Public Policy of the Autistic Self Advocacy Network (ASAN) to urge the Governor to veto AB 2X 15, which would permit physician-assisted suicide in California.

ASAN believes that physician-assisted suicide legislation like AB 2X 15 discriminates against people who are aging, ill, or have disabilities. During the course of its advocacy for people with disabilities, we repeatedly encounter attitudes that life with a disability – not only developmental disability but also disability caused by age or illness – is “undignified” and that people with disabilities cannot live happy lives at home among their loved ones.

The belief that it is better to die than to depend on others for assistance is central to arguments in favor of so-called “death with dignity.” Supporters frequently focus on the “indignity” of needing help to eat, move, or take medications. In Oregon, which passed nearly identical legislation, 93% of those who died from physician-assisted suicide in 2013 cited “loss of autonomy,” or disability, as a motivation. Less than 28% cited concerns about pain control.1

This harmful mindset perpetuates stigma, isolation, and depression among people with disabilities and can create significant or even fatal barriers to accessing health care and needed services. Medical discrimination against people with disabilities is unfortunately widespread.

Moreover, although AB 2X 15 claims to limit its scope to people who have a terminal illness, it has the potential to affect nearly everyone who has a disability or a significant illness (including age-related illnesses). Doctors typically cannot make six-month prognoses with an acceptable level of certainty. The disability community is full of people who have outlived “six-month” prognoses by decades. There is every reason to believe that legalized physician-assisted suicide in California would shorten the lives of many people by months, years, or decades.

People facing life-threatening diagnoses – especially diagnoses expected to cause some level of disability as part of the diagnoses’ natural progression – are a highly vulnerable population. It is extremely common for people to feel depressed in the face of progressive disability. Moreover, people with disabilities, including disabilities resulting from age or illness, are also at heightened risk of abuse, isolation, and exploitation.

Instead of addressing these risks, legislation like AB 2X 15 actively exacerbates them. Neither the Oregon law nor AB 2X 15 requires that individuals be provided either accurate information on pain management, nor long-term supports or referrals to services such as peer counseling and mental health screening. These types of information and referral services are the gold standard in the disability community. In 2013, only two of the 71 Oregonians who died from physician- assisted suicide were even referred for formal psychiatric or psychological evaluation. It is unthinkable that a doctor would respond similarly to patients without disabilities expressing suicidal feelings in the face of serious life stress.

In addition, neither the Oregon law nor AB 2X 15 requires any sort of safeguard to ensure that the lethal medications are taken voluntarily after they were prescribed. Given the heightened risk of abuse and neglect among people who rely on others for help with day-to-day tasks, this is simply unacceptable.

People with significant disabilities, including people with life-threatening diagnoses, should not have to die in order to have dignity. Instead, they need access to the things that help them make the most of their remaining time: quality palliative care, respectful in-home supports, counseling, and assistive technology to maximize autonomy. Let’s focus on aid in living, not “aid in dying.”

Samantha Crane
Director of Public Policy
Autistic Self Advocacy Network

1http://public.health.oregon.gov/ProviderPartnerResources/EvaluationResearch/DeathwithDignityAct/Documents /year16.pdf.