I received news of this excellent op-ed by disability activist Joelle Brouner late yesterday. I reserve my comments for the end of the article.
Published September 28, 2007
Physician-assisted suicide symptom of broken systemWashington state is no place for the Oregon-style legalization of physician-assisted suicide. Many people with whom I frequently see eye to eye disagree with me on this point. They view the issue simply as one of personal choice. They are mistaken because, for many, the only real choice would be death.
When so many people are uninsured or have inadequate access to medical care, who can choose to receive preventive health care? How many can choose to be diagnosed in time to undergo life-saving treatments? It is cruel to beat the drum of choice when so many are effectively left to choose between death and death.
Then there is the matter of pain. Nobody wants to be in pain and nobody should have to be. Advocating death as a solution to pain is extreme and betrays a lack of ingenuity. Pain does not have to be uncontrollable; it can be effectively managed. By enacting progressive drug policy, we would make more effective pain management strategies available to doctors and their patients and assuage their fear of prosecution. Rather than pave the expressway to death, the Legislature could provide incentives for researchers who expedite the development of innovative drugs and pain-management tools.
Physician-assisted suicide is less about choice or pain management than power. If legalized, physician-assisted suicide will inevitably align the power of the state, big money interests and a broken medical system. If the state sanctions the participation of medical professionals in the killing of patients, the matter transcends the individual who dies. We cannot divorce ourselves from policy decisions made in our name. As citizens, we would all be complicit, by extension, in these deliberate deaths.
Even under the best circumstances, people face disadvantages in navigating state and medical systems. Is it reasonable to expect a person to negotiate with these powerful interests at a time when he or she is likely to have the least energy or emotional reserve? These circumstances are ripe for abuse.
Some who support physician-assisted suicide argue that Oregon- style safeguards will prevent abuses. But in Oregon, the records regarding implementation of physician-assisted suicide are destroyed. There is no way to independently audit them. We are left to trust that the records were accurate and the people who recorded them were truthful.
The American medical system has a long record of bias. Disparities in access to care based on race, class and gender are well documented. Is it so great a leap to think that a system with a record of perpetuating bias could abuse its power to promote death as a management strategy to achieve cost savings?
As a person with a life-long disability, I am all too familiar with the institutional power of the modern medical industry. Like many, I have experienced the consequences of being objectified and discredited within that system. Those who are considered inconvenient, who require too many resources, or who fail to meet an arbitrary health standard, are too likely to be the casualties if death passes for compassionate health policy. I fear that death will become the logical expectation of a system that prizes cost savings above people.
Joelle Brouner, a member of The Olympian’s Diversity Panel, is a disability rights activist.
This blog has already addressed multiple examples of the lack of accountability for medical professional professionals in both California and Oregon, something Joelle expresses concerns about in this piece.
I was digging through old articles and found that Joelle might have hit an important point in the State of Washington. There is evidence in her state that an overwhelming number of people wanting to die due to the very pressures she talks about.
In 1997, Joe Shapiro, then an editor of U.S News & World Report, published a long article on what things looked like in the Netherlands and what it might mean for the U.S. in “Euthanasia’s Home.” He shared this interesting factoid about American motivations, specifically citizens of Washington State:
Most Dutch patients–56 percent–seek euthanasia to avoid “useless suffering.” On the other hand, Americans say they are motivated by the fear of burdening their spouses and families: In a study in Washington State, that reason was cited by 75 percent of those who asked physicians to help them die. No wonder. In the United States, hospitalization and nursing home costs can impoverish. The Dutch face virtually no out-of-pocket expenses at the end of life.
Don’t take that to mean that Shapiro didn’t find any problems with euthanasia practices in the Netherlands. His balanced article found several reasons for concern – such as the light hand with which the courts in the Netherlands have used in dealing with the handful of doctors charged with violating euthanasia and assisted suicide protocols.
Read it. The only way to learn from the past is to actually know something about it. –Stephen Drake
What does this mean then for those of you who are disability advocates and are also rabid socialized medicine advocates AKA Universal Health Care Advocates?
It means that peoeple with disabiltieis are not treated ANY BETTER under socialized medicine than they are under our system of care.
Preventative care is cited in this article? Does the writer intend to suggest that preventative care is what people with disabilities need, and what socialized system of medicine would provide? Are you kidding me? Public Health promotes preventative medicine as a means to PREVENT WHAT YOU / WE HAVE ALREADY BECOME: DISABLED.
Those of you that are disabilities advocates will regret the all your hard work and efforts to get free-health care insurance for your non-disabled 35 year old neighbor with the $65,500.00 per year income, who is self-employed, owns his home, and prefers not to purchase health care insurance. Money for him and access to health care for him, means less money for you, and less money for consumer directed, out of institution services.
You all keep advocating for free health care for everybody else, which most people with disabilities already quailify for under Medicaid or Medicare. Now, you want to complain about Medicaid Medicare? WELCOME TO YOUR FUTURE! Universal health care will be expanded Medicare for all.
It seems to me that there is more physician assisted suicide and more euthanasia in countries that currently have universal health care and socilized medicine in place.
I will stand back, watch my son’s services be wripped to shreds, and say thank you to you all and I TOLD YOU SO.
The simple truth is that the primary mission of our for-profit health care system is to maximize profit for shareholders by only spending as much on actual health care as the health care providers can get away with. I will follow up with a blog entry on this later in the week.—Diane Coleman
I just want to make a comment in addition to Diane Coleman’s.
I think that a lot of your concerns will become moot as long as long as Not Dead Yet has a place at the table in the discussion.
Also, note that Dane Coleman said this her October 4 entry.
“…No version of the health care system treats people with disabilities well [yet], but we’d rather pursue the goal of full disability respect and inclusion in the context of the fight for health care justice for all…”
In other words, I think that she is saying that it is just about doing the right thing. And I wholeheartedly agree. Just yesterday I went with a group to to demand that Congressman Steve Chabot of Ohio vote to override Bush’s veto of the SCHIP reauthorization. It was just the right thing to do.
As long as Not Dead Yet and NDY supporters like myself are allowed in the discussion, those who care more about promoting assisted suicide than they do with helping the poor, for example, will have a hard time insulting people with stereotypes.
And maybe we’ll get health care justice for all, including those with disabilities.
John
An NDY supporter from Ohio