Boston, MA: Boston Mayor Proclaimed July 26, 2012 ‘John B. Kelly Day’

activism, advocacy, Americans with Disabilities Act, disability rights, john kelly, Our News & Commentary Blog, Second Thoughts

Sorry we’re a little late with this.  As most of the folks who read this blog know, last Thursday July 26 was the 22nd anniversary of the Americans with Disabilities Act, or “ADA Day”.

In Boston last week, the ADA shared the spotlight with our very good friend John Kelly – ally, activist, scholar and Director of Second Thoughts, our sister organization in Massachusetts.

Last Thursday, John went to the ADA celebration in Boston to man the ‘Second Thoughts’ booth, which was his main role in terms of participation for the day – or that’s what he thought.  That’s not exactly how it went down, as told on the blog Somerville Voices:

July 26, 2012.  Boston, MA:  John B. Kelly, friend to all Somervillians and especially BFF with Community Access Project Somerville and human rights defenders throughout Massachusetts, arrived at the Boston 22nd Anniversary Celebration of the signing of the ADA (Americans with DisAbilities Act) today- and immediately got to work.

He had a table to organize (Second-Thoughts.org); people waiting for his answers on a number of other projects; and, he was also getting ready to participate in Boston Mayor Menino’s ribbon-cutting for the brand new Boston City Hall Plaza Access Route- an idea that John envisioned, provided Design Expertise for, and generated conducive conditions for, due to his many years of expert access advocacy.

So when he saw a big envelope with the words “John B. Kelly Award” being held by his good friend and colleague, Boston ADA Commissioner Kristen McCosh, he just laughed and asked,  ”What’s that all about?” And was about to go back to work.

At which point John learned that Mayor Menino was about to read a Proclamation aloud, naming today, “JOHN B. KELLY DAY.”

Please read the rest of the story here.

Please visit this link to see and read the proclamation.

Congratulations and thanks to John Kelly – for all the years of hard work, advocacy, activism and leadership!

Assisted Suicide Laws Violate the ADA

ADAPT, Americans with Disabilities Act, amicus brief, assisted suicide, Compassion & Choices, Montana, national council on independent living, national spinal cord injury association, NSCIA, Our News & Commentary Blog, Steve Gold, suicide prevention, VSED

The 22nd Anniversary of the Americans with Disabilities Act (ADA) seems like the perfect opportunity to set the record straight about how theADA relates to assisted suicide.

There’s a rarely articulated idea that assisted suicide is a sort of ADA“reasonable accommodation” to enable people who have serious physical impairments to have equal access to suicide.  This is the rationale for legalizing assisted suicide set forth in the recent Carter case in British Columbia (see our recent blog about that case).

This “reasonable accommodation” theory doesn’t really hold up on closer examination.  For one thing, none of the assisted suicide laws require any type of claim or proof that the individual cannot commit suicide without assistance.  In fact, anyone can commit suicide by refusing food and water, a method of committing suicide that even Compassion and Choices advocates as peaceful.  Furthermore, healthy and able-bodied people are more likely to survive a suicide attempt than die, but assisted suicide bills have never included eligibility for them.

Not Dead Yet has always taken the position that assisted suicide laws violate the ADA by setting up a double standard for how society responds to a person who says they want to commit suicide – some people get suicide prevention and others get suicide assistance, and the difference is the person’s health and disability status.

Below is the ADA excerpt from the Amicus Brief written by disability rights attorney Steve Gold and filed in the case of Baxter v. Montana on behalf of Not Dead Yet, ADAPT, Disability Rights Education and Defense Fund, National Council on Independent Living and the National Spinal Cord Injury Association:

Denying People with Disabilities the State Benefit of Suicide Prevention and Enforcement of Homicide Laws Will Violate the ADA

Congress clearly understood this history when, in 1990, it enacted theADA, the basic civil rights statute for people with disabilities. After extensive hearings, Congress made several Findings, including:

historically, society has tended to isolate and segregate individuals with disabilities, and despite some improvements, such forms of discrimination continue to be a serious and pervasive social problem;  42 U.S.C. Sections 12101(a)(2).

To address and remedy this pervasive and relentless discrimination, Congress substantively required that “no qualified individual with a disability shall . . . be excluded from participation in or be denied the benefits of the services, programs, or activities of any public entity….” 42 U.S.C. § 12132. See 28 C.F.R. section 35.130(b)(discrimination includes denying or not affording an opportunity for people with disabilities to benefit from services either equal to or as effective as those afforded nondisabled persons).

Providing assisted suicide only for people with disabilities and denying them suicide prevention services, based on a doctor’s prediction of terminal status or other justification, violates the ADA because the presence or absence of disability determines whether state and local governments:

  • enforce laws requiring health professionals to protect individuals who pose a danger to themselves;
  • respond to expressions of suicidal intent in people with disabilities with the application of lethal measures that are never applied to people without disabilities;
  • investigate and enforce abuse and neglect and homicide statutes in cases reported as assisted suicides.

The doctor’s determination of someone’s eligibility for assisted suicide confers absolute legal immunity on the doctor, and all normal suicide-related procedures are set aside.  The existence of a disability should never be the basis for these distinctions.

***

So, Happy Anniversary to the ADA! – Diane Coleman

NDY Board Member Rhonda Wiebe in Winnipeg Press: Expensive to Support Disabled but Suicide Kits are Cheap

assisted suicide, Canada, cost containment, euthanasia, op-ed, Our News & Commentary Blog

On July 21, the Winnipeg Free Press published an op-ed by Rhonda Wiebe (see below for brief bio).

The op-ed is a response to ‘ethicist’ Arthur Schafer.  The newspaper published an op-ed by him on July 19 titled “Assisted-suicide slope not so slippery.”  Schafer is a poor choice to deny the existence of slippery slopes.  His name last came up on this blog in connection with his role in the Global News Live Blog event promoting the empowerment of parents and caregivers to be able to kill or order the deaths of children and adults with significant cognitive disabilities.  In essence, Schafer wrote an article denying the existence of a slope that he himself is coating with grease.

Rhonda’s response is titled “It’s expensive to support the disabled — suicide kits are $39.95.”

Excerpt:

The insidious bottom line is this — last I looked, a take-home euthanasia kit in Oregon cost $39.95. That’s a whole lot less expensive than providing someone with the supports they need to cope with the loss resulting from having a disability, and then providing them with the means to get on with the matters of daily living. It’s way cheaper to let people suffer, or cut back services so life is untenable, or subtly convince people with disabilities that they have lives that aren’t worth living. Imagine being inundated with the message that you have a right to end your miserable, burdensome, devalued life, because, really, it’s your choice. Unfortunately, some people with disabilities are starting to drink that Kool-Aid.

Please read the rest of the op-ed at this link.  Taking a few minutes to go through the free registration and leaving a comment would be great, too.

Rhonda Wiebe is a disability rights advocate from Winnipeg, Manitoba. She co-chairs the ending-of-life ethics committee of the Council of Canadians with Disabilities, and serves on the Board of Directors of Not Dead Yet. She has lived with disability since the age of thirteen.

Bill Peace’s Hastings Center Article (on a disturbing hospital experience) and Three Commentaries Are All Online

"end of life", bioethics, devaluation, life-ending decisions, medical bigotry, medical discrimination, Our News & Commentary Blog, palliative care, rush to judgment, william peace

As of today, Bill Peace’s essay “Comfort Care as Denial of Personhood” is online – and accompanied by three commentaries available at the Hasting Center Bioethics Blog.

Here’s what we wrote before about the experience at the center of Bill’s essay:

Back in 2010, our friend, colleague and ally Bill Peace, experienced a long, expensive health crisis when he experienced a stage IV skin breakdown – with a long treatment process that was physically and emotionally grueling by his own accounts.

While Bill was hospitalized – and at one of his lowest points healthwise – he was subjected to a late night visit by a hospitalist.  Laying out a grim set of possible outcomes for Bill’s health crisis, the doctor seemed to be urging Bill to just discontinue antibiotics and let himself be given palliative care to be pain-free until the infection took him.

Below are the links to Bill’s essay, and the three commentaries:

Comfort Care as Denial of Personhood by William J. Peace

Commentaries/Reactions to Comfort Care as Denial of Personhood:

  • “Disability Discrimination” by Diane Coleman and Stephen Drake – We discuss evidence that Bill Peace’s account of feeling devalued and threatened in a healthcare setting may be just the tip of an ugly iceberg.
  • “Disability Discrimination: Risky Business for “Consenting” Adults” – Philosopher Anita Silvers writes that Bill Peace’s account “stirs a familiar feeling of fear” – and one that may be shared by many visibly disabled people.
  • “Disability Discrimination: A Doctor’s View” – Palliative care physician Theresa A. Soriano offers Bill Peace an apology for “the fear and alienation” a member of her own profession caused him.  She outlines what the physician should have done, if he wanted to be helpful; things that are standard practice for those competent in communicating about palliative care.

Comments on any of  the essays reacting to Bill Peace’s article  are encouraged, but you have to register – which is a free and relatively painless process.

I’d like to add that the Hastings Center, like bioethics in general doesn’t “do” disability very often.  Reactions to these articles from anyone – but especially folks in the disability community – might make them think the time has come to “do” disability more often.

 

 

 

 

 

 

 

 

 

 

 

NDY quoted in article on New Mexico assisted suicide case

aid in dying, assisted suicide, Compassion & Choices, Connecticut, court decisions, diane coleman, Montana, New Mexico, Our News & Commentary Blog

On July 11, the online publication Solutions, “a project of the Buechner Institute for Governance at the School of Public Affairs at the University of Colorado Denver,” included an article by Diane Carman entitled “Doctors, patient challenge New Mexico’s assisted suicide ban.”

The New Mexico court case was brought by Compassion and Choices attorney Kathryn Tucker on behalf of two doctors and a woman with cancer and, according to the article, asks what is the meaning of “assisted suicide”?  Carman begins by asking:

If a terminally-ill patient refuses a ventilator or a feeding tube and the physician yields to that decision, is that assisting suicide? If the patient is in excruciating pain and requests total sedation and no nutrition or fluids, can the doctor be held accountable for his death? What if the patient seeks a prescription from her physician so that when the pain of dying is overwhelming she can seek the ultimate relief on her own?

Throughout the 1980’s and across the country, courts repeatedly and unequivocally answered “no” (i.e. no problem) to the first two questions, but Compassion and Choices (C&C) often raises the specter of being hooked to unwanted tubes and forced to endure unwanted medical treatments when advocating for something completely different than the well established right to refuse treatment.  Despite nearly 25 years of widespread public education about using advance directives to refuse unwanted treatment, C&C counts on people to forget these facts and conflate the issues.  C&C is pushing for the term “aid in dying” to include not only refusing treatment, palliative care, and hospice, but also assisted suicide, rolling it all into one focus group tested phrase.

C&C claims that state laws banning assisted suicide were never intended to refer to doctor assisted suicide of a person given a terminal prognosis.  The article discusses two other cases that have looked at this issue, one in Montana and the other in Connecticut.

Baxter v. Montana was decided by the Montana Supreme Court in 2009.  According to the article, “In a 5-to-2 ruling, the Montana court said that physician aid in dying was protected under the law providing for living wills.”  More accurately and narrowly, the court held that the patient’s consent to assisted suicide would constitute a defense that a physician could raise if they were charged with homicide.  (Baxter v.Montana at page 25 – available at the Court’s website.)  A court or jury would still be able to consider all the facts and circumstances (e.g. misdiagnosis, malpractice) in deciding whether to acquit or convict.

The Connecticut case more closely resembles the New Mexico case in that it considered whether a state ban on assisted suicide could be applied to doctor assisted suicide of a person with a terminal prognosis.  As Carman reports it, the case was “dismissed by the state Superior Court in 2010. In its ruling, the court said, ‘taking one’s life even for a sympathetic reason is suicide’ and therefore physician immunity from prosecution does not apply.”  The actual reasoning of the Connecticut court has quite a bit more substance, including a discussion of why the legislature is the better venue for evaluating a policy change like assisted suicide:

Legislative determination is particularly important given the significant medical legal and ethical concerns about legalized physician assisted suicide that have been raised across the country. Among the other difficult and important public policy concerns that the legislature would have to evaluate – and is uniquely positioned in our system of government to evaluate – are the following:

–           Whether physician-assisted suicide threatens the most vulnerable in society, including the poor, the elderly, and the disabled, who are at risk of being threatened, coerced, or influenced to end their lives to spare their families the financial costs and emotional strain of caring for them; …

–           Whether physician-assisted suicide shifts the focus of physicians and insurers away from vitally important measures such as identifying and treating depression and providing end-of-life pain control and palliative care; . . .
–           Whether physician-assisted suicide undermines the physician-patient relationship and the integrity of the medical profession by eroding patient trust in the doctor’s role as healer;…

–           Whether physician-assisted suicide opens the door to the possibility of involuntary euthanasia, as has occurred in the Netherlands, because “what is couched as a limited right to ‘physician-assisted suicide’ is likely, in effect, a much broader license which could prove extremely difficult to police and contain,” Washington v. Glucksberg, 521 U.S. 702, 733 (1997). (Blick Decision on Motion to Dismiss.)  

The New Mexico resident who wants the option of getting a doctor’s assistance to commit suicide reportedly says that “it’s important to remember that the only patients who would be allowed to obtain physician assistance in suicide would be those who are terminally ill and mentally competent.  ‘This is something the patient chooses and does for herself. It’s not the doctor doing it,’ she said.”

On a superficial level, that sounds good.  But what about people who are not terminally ill or depressed?  In reality, such persons, or indeed any suicidal person, could ask for doctor assisted suicide, but the doctor has to decide who is eligible for their assistance and who is not.  Assisted suicide laws like Oregon’s grant blanket legal immunity to the doctor’s decision to prescribe lethal drugs, along with immunity for any witnesses and other participants who are involved in the death. 

Carmen included a fair representation of some of the disability community’s concerns about assisted suicide.  One of the risks of such a law is that an heir or burdened care giver could take the ill individual to the doctor to request assisted suicide, be a witness to the signature, pick up the prescription and, once the pills are in the home, administer the lethal dose with or without the person’s consent.  With no independent witness required at the time of death, who would know?

The New Mexico plaintiffs are all people who seem privileged enough to be justified in their confidence that the patient in this case will not be coerced into assisted suicide, will not be denied care that she wants, will not be treated like an unwanted burden on those around her, and is not at risk of being administered the lethal drugs without her consent.

It would be nice if everyone with a difficult illness could have the same confidence.  But in the real world, where elder abuse is on the rise, C&C’s platitudes should not distract us from our collective obligation to consider the impact on everyone, not just the privileged few. – Diane Coleman