Response: “Neurologic Diseases and MAiD” in The American Journal of Bioethics

Jules Good writes in response to “Neurologic Diseases and MAiD: Aid-In-Dying Laws Create an Underclass of Patients Based on Disability” by Lonny Shavelson, Thaddeus M. Pope, Margaret Pabst Battin, Alicia Oulette & Benzi Kluger, published in The American Journal of Bioethics 16 August 2022:

Legal assisted suicide puts disabled people in danger of being killed on the basis of disability alone. This is especially true when assisted suicide laws allow someone otherthan the patient to administer the drug. The authors claim that denying someone euthanasia is an ADA violation. Their argument is that getting assistance in administering the lethal drug should be seen as a “reasonable accommodation” used to allow someone without the physical capacity to take the drug access to assisted suicide. The provision of the ADA cited in the article to support this claim states that “No qualified individual with a disability shall…be excluded from participation in or be denied the benefits of services, programs, or activities of a public entity, or be subjected to discrimination by any such entity” when reasonable accommodation can be provided.” 

There is a much more compelling case for invoking the ADA here that focuses less on making it easier for disabled people to die and more on making it easier for us to live life on our own terms. In places where assisted suicide is legal, disabled people who wish to die (some actually terminal, some not) are given the tools to do so, while nondisabled people who wish to die are given access to mental health resources. Is being coerced toward “choosing” death really an example of disabled people accessing the “benefits of services, programs, or activities of a public entity”? Is being denied mental health treatment because our lives are seen as less valuable than the lives of nondisabled people not a more pressing example of the ADA being violated? 

Thaddeus Pope, co-author of the article, has himself admitted that he sees having a disability, and not exclusively a “terminal” prognosis, as an acceptable reason for someone to be permitted to die by assisted suicide. We reject this notion. True healthcare includes treatment and resources that allow someone to live with as little pain and with as much independence as possible. Legal assisted suicide, which, on a systemic level, results in the premature and unnecessary deaths of our community members, is not a “service, program, or activity” that disabled people “benefit” from. This is a blatant misuse of the ADA. 

It is clear that the authors of this article are out of touch with the core tenets of disability justice, which state in part that we have a responsibility to keep each other safe. Policies that champion the desires of individuals over the safety and vitality of the most marginalized disabled people are not grounded in a true disability justice framework. Disabled people do not need more help dying. Crisis standards of care in the face of COVID-19 that deprioritize us for treatment, our profit-driven healthcare system that regularly denies care to those who need it most, and a general societal attitude that people are “better off dead than disabled” make death more accessible to us than life. The ADA, while imperfect, was passed because the disabled community worked to ensure that the inherent value of our lives would be recognized in the eyes of the law.  It should not be used to further jeopardize the safety of the most vulnerable members of our community.