Cathy Ludlum: Nietzsche and Assisted Suicide in Connecticut

Our News & Commentary Blog

Nietzsche and Assisted Suicide in Connecticut

by Cathy Ludlum

We are in trouble when our elected officials start quoting Nietzsche.

It was at the Public Health Committee meeting March 10 that one of our legislators framed her argument in favor of SB 1076 (assisted suicide) with these words: “One should die proudly when it is no longer possible to live proudly” (clip position 27:40).

She did not appear to know who Friedrich Nietzsche was, and admitted that she had probably mispronounced his name.  No doubt she had not read the rest of the paragraph from which that quote was taken.  Here are some highlights: “The sick man is a parasite of society… A new responsibility should be created, that of the doctor — the responsibility of ruthlessly suppressing and eliminating degenerate life.”

There are reasons why Nietzsche was admired by the perpetrators of the Holocaust, as well as proponents of eugenics and euthanasia.

But it gets worse.

The Public Health Committee had an opportunity to explore the numerous concerns raised by the disability community, and a new group of voices, Progressives Against Medical Assisted Suicide.  Misdiagnosis, coercion, disparities in healthcare, and erosion of suicide prevention efforts are just a few of the many issues.  Instead, the conversation was entirely focused on keeping religion out of our personal choices.

It was as if all the opposition testimony from a secular social justice perspective—whether offered in person, on Zoom, or in writing—had never happened.

One representative had the nerve to say, “We are looking at the fact that there are zero reported cases of coercion” (Clip position 17:30).  Think that through.  If the person was coerced into ingesting the lethal prescription, they are dead.  How would anyone know?  For 20 years, disability rights organizations have made available anecdotal evidence of abuse in the system.  More recently, there has even been an acknowledgment by pro-assisted suicide supporters of abuse in the deaths of several women with anorexia nervosa.  This information has been presented time and again to legislators.  Yet suddenly they were oblivious to it.

Remember also, that states shred records from their death-making programs after they issue their annual report.  In addition, they require that death certificates only list the cause of death as the underlying illness.  There are reasons why the Connecticut Division of Criminal Justice has repeatedly submitted testimony warning that falsified death records could interfere with a murder investigation.

The same legislator went on to say, “There has never been a report of the meds failing” (Clip position 17:30).  Apparently, she has not read the articles about difficult deaths, or the annual reports from Oregon and Washington that include things that have gone wrong.  People have had uncontrolled vomiting, seizures, long protracted deaths, and sometimes even woken up, only to die in deeper agony from the underlying illness.

People who are not religious testified about how they were relentlessly pressured by the healthcare system to withdraw treatment from loved ones who wanted to keep living.  And this happened in the current healthcare system, not one under the shadow of legalized assisted suicide.

We in the disability and progressive communities implore the members of the Judiciary Committee to take our concerns seriously.  Do not echo the Public Health Committee’s laser-like focus on people’s negative experiences with religion while ignoring inconvenient but important facts.

Embracing Nietzsche’s worldview is not the way to empower people with terminal illnesses.  If you read it in context, it does exactly the opposite.

Cathy Ludlum is a member of Second Thoughts Connecticut, a grassroots disability organization opposed to the legalization of medical assisted suicide.

[This appeared in the CT Mirror today.]

 

 

 

 

 

 

 

 

Progressives Against Medical Assisted Suicide Holds Press Conference; Members Testify at Public Hearing

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Progressives Against Medical Assisted Suicide Holds Press Conference; Members Testify at Public Hearing on February 27th

Progressives Against Medical Assisted Suicide held a press conference at the Legislative Office Building in Hartford, CT on February 27th, just prior to a public hearing before the Public Health Committee to discuss this year’s proposed Connecticut assisted suicide bill, SB 1076. Co-sponsored by Second Thoughts Connecticut, speakers included Cathy Ludlum, a Second Thoughts leader; Dr. Diane Meier, Director Emerita and Strategic Advisor at the Center to Advance Palliative Care and Professor of Medicine at the Icahn School of Medicine at Mount Sinai; and PAMAS members Nancy Alisberg, Elaine Kolb, and Joan Cavanagh.

You can watch the press conference (thanks to Stan Heller, who videotaped it) here: 

 

Six PAMAS members also testified against the bill at the public hearing, including Alisberg and Cavanagh as well as Deborah Elkin, Paula Panzarella, Monica McGovern, and Frank Panzarella.

The Public Health Committee unfortunately passed the bill, at a meeting where none of the legislators who spoke even mentioned the many objections raised not only by PAMAS but also by disability justice activists. We expect that it will now be taken up by the Judiciary Committee. We will continue our struggle there to defeat this dangerous legislation. 

Joan Cavanagh

Progressives Against Medical Assisted Suicide 

Progressives Against Medical Assisted Suicide Mission Statement

Progressives Against Medical Assisted Suicide seeks to build a progressive, disability and human justice-based movement to prevent the legalization of medical assisted suicide and euthanasia and to end these practices where they exist. As progressives, we believe that these issues cut to the heart of what kind of society we want to live in.

We believe that the people who stand in the greatest danger of being further victimized by MAS are the poor, elderly, disabled, and people of color who are already marginalized, devalued, and threatened daily under the current medical system.

We stand for economic and civil justice; universal, comprehensive, quality, and unrestricted healthcare for all; reproductive rights; and justice and safety for LGBTQIA people. We work to open a path for our fellow progressives who share these values to also recognize the dangers of Medical Assisted Suicide and euthanasia and to join us in opposing these practices.

 progressivesagainstmas@hotmail.com

Oregon Assisted Suicide Data Analysis

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Not Dead Yet, the Resistance

Oregon Assisted Suicide Data Analysis

March 16, 2023

How Assisted Suicide Laws Endanger People With Disabilities and Chronic Conditions

A disabled or chronically ill person who depends on life-sustaining treatment, even basic medications, would be able to qualify for assisted suicide if they lived where assisted suicide is legal. Oregon’s “Death With Dignity” law is the model for all U.S. states. As an Oregon official has clarified in writing, any person who becomes terminal because they do not receive treatment, for any reason, would qualify for assisted suicide under an Oregon type law.[1] If the reason they could not get treatment were an inability to afford insurance co-pays, they would be eligible for assisted suicide.

Anyone could ask for assisted suicide, but doctors are the gatekeepers with the power to decide who’s eligible. Since early 2020, the COVID pandemic has revealed that people with disabilities have been denied treatment for the virus due to their disabilities and pervasive healthcare provider biases about “quality of life.”

 

Assisted Suicide Laws Violate the Americans with Disabilities Act

By denying equal suicide prevention and other supports to people deemed “terminal”, assisted suicide laws are inherently discriminatory against older, ill and disabled people. The discrimination of state licensed health professionals denying equal suicide prevention and instead providing suicide assistance is a fundamental violation of the Americans with Disabilities Act.

 

The Oregon Assisted Suicide Data Substantiates Disability Concerns

Oregon’s assisted suicide law, the oldest in the U.S., is held up as the model for other states. One of the most frequently repeated claims by proponents of assisted suicide laws is that there is “no evidence or data” to support any claim that these laws are subject to abuse, and that there has not been “a single documented case of abuse or misuse” in the 25 reported years. Based on the Oregon state assisted suicide reports, these claims are demonstrably false.

Regarding documented cases, please refer to a description of individual cases and source materials compiled by the Disability Rights Education and Defense Fund entitled Oregon and Washington State Abuses and Complications.[2].[3]

The focus of the discussion below is the Oregon Public Health Division data.[4]

 

Non-Terminal Disabled Individuals Are Receiving Lethal Prescriptions In Oregon

The Oregon Public Health Division assisted suicide reports show that non-terminal people received lethal prescriptions every year except the first. Prior to the 2020 report, the online state reports did not reveal how many people outlived the 6-month or 180-day terminal prognosis. In 2019, at least one person lived 1503 days. The 2020 – 2022 reports revisit this “terminal” survival issue and state that 4 percent of individuals outlived their 6-month prognosis[5] in 2020, 3.8% in 2021[6] and 5.8% in 2022.[7] This does not take into account the individuals who took the drugs quickly but may have survived if they had waited longer. There is no requirement that the doctor consider the likely impact of medical treatment in terms of survival.

Oregon reports [show] that non-cancer conditions found eligible for assisted suicide have grown over the years. The addition of anorexia as a condition some physicians have viewed as warranting assisted suicide demonstrates how empty the law’s purported “safeguards” are.

 

The Only Certifiers of Non-Coercion And Capability Need Not Know the Person

Four people are required to certify that the person is not being coerced to sign the assisted suicide request form, and appears capable: the prescribing doctor, second-opinion doctor, and two witnesses.

In many cases over the years, the prescribing doctor is a doctor referred by assisted suicide proponent organizations. The Oregon state reports say that the median duration of the physician patient relationship was 5 weeks in 2021 and 2022, and 11 weeks over all years (2021 Report, page 13). Thus, lack of coercion is not usually determined by a physician with a longstanding relationship with the patient. This is significant in light of well-documented elder abuse-identification and reporting problems among professionals in a society where an estimated one in ten elders is abused, mostly by family and caregivers. (Lachs, et al., New England Journal of Medicine, Elder Abuse.[8])

The witnesses on the Oregon request form[9] need not know the person either. So neither doctors nor witnesses need know the person well enough to certify that they are not being coerced. What might be an example of coercion? Many elder and disabled people would say the threat of being put in a nursing home.

 

No Evidence of Consent or Self-Administration At Time of Death

In less than half the reported cases, the Oregon Public Health Division reports state that no health care provider was present at the time of ingestion of the lethal drugs or that it is “unknown” whether a provider was present (2022 Report, page 14). Without requiring an independent witness, there is no way to confirm whether the lethal dose was self-administered and consensual.

 

Pain Is Not the Issue, Unaddressed Disability Concerns Are

The top five reasons doctors give for their patients’ assisted suicide requests over all reported years are not pain or fear of future pain, but psycho-social issues that are well understood by the disability community: “losing autonomy” (90%), “less able to engage in activities” (90%), “loss of dignity” (72%), “burden on others” (48%) and “losing control of bodily functions” (44%) (2022 Report, page 14). These reasons for requesting assisted suicide pertain to disability and indicate that over 90% of the reported individuals, possibly as many as 100%, are disabled at the time of their assisted suicide request.

Three of these reasons (loss of autonomy, loss of dignity, feelings of being a burden) could be addressed by consumer-directed in-home long-term care services, but no disclosures about or provision of such services is required. Moreover, only 3% of patients who request assisted suicide were referred for a psychiatric or psychological evaluation (and only 3 patients in 2022), despite studies showing the prevalence of depression in such patients.

 

Conclusion

The Oregon assisted suicide data demonstrates that people who were not actually terminal received lethal prescriptions in all 25 reported years except the first, and that there is little or no substantive protection against coercion and abuse. Moreover, reasons for requesting assisted suicide that sound like a “cry for help” with disability-related concerns are apparently ignored. For all these reasons, assisted suicide laws should be rejected and repealed.

[For a slightly more detailed version of this analysis, go HERE.]

Endnotes:

[1] https://www.washingtontimes.com/news/2018/jan/11/diabetics-eligible-physician-assisted-suicide-oreg/;

https://drive.google.com/file/d/1xOZfLFrvuQcazZfFudEncpzp2b18NrUo/view

[2] https://dredf.org/wp-content/uploads/2015/04/Revised-OR-WA-Abuses.pdf

[3] https://dredf.org/wp-content/uploads/2012/08/Hendin-Foley-Michigan-Law-Review.pdf

[4] https://www.oregon.gov/oha/ph/providerpartnerresources/evaluationresearch/deathwithdignityact/pages/ar-index.aspx

[5]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year23.pdf(page 11)

[6]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year24.pdf(page 12)

[7]https://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/year25.pdf  (page 13)

[8] http://www.nejm.org/doi/full/10.1056/NEJMra1404688 ; See also, “New Report on Elder Abuse in Australia: Implications for Legalising Euthanasia” (Jan. 2022) https://www.australiancarealliance.org.au/new_report_on_elder_abuse_in_australia_implications_for_legalising_euthanasia

[9]http://www.oregon.gov/oha/PH/PROVIDERPARTNERRESOURCES/EVALUATIONRESEARCH/DEATHWITHDIGNITYACT/Documents/pt-req.pdf

Press Release: Legislative Committee Does An End Run Around Disability Advocates

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Contact: Deidre Hammon 775-544-9338

Legislative Committee Does An End Run Around Disability Advocates

March 14, 2023

A bill to legalize medically assisted suicide is being railroaded through the Nevada legislature in a manner that appears designed to exclude the voices of people with disabilities, people put most at risk if this bill passes.

The assisted suicide bill was added to today’s Senate Health and Human Services Committee hearing agenda at the last minute this morning.

“The legislature has just engaged in a blatant act of discrimination on the basis of disability for hearing the Physician Assisted Suicide bill (SB 239),” said Deidre Hammon with Nevada Not Dead Yet. “Less than 5 hours turn around for a hearing they know the Nevada Disabled Community including disabled veterans oppose. This demonstrates loudly and with malice aforethought that the Physician Assisted Suicide Bill is just codification of ‘Better off dead than disabled.’”

SB 239 was only introduced last Wednesday, March 8th. Disability advocates who have opposed these bills in prior years and were holding an advocacy day that same Wednesday, but had no prior notice of the bill’s planned introduction and only learned of it afterward.

The 2023 version of the bill would allow not only a physician but also a “physician assistant or advanced practice registered nurse to prescribe a medication that is designed to end the life of a patient….”

#

NDY’s Anita Cameron Featured in Media This Week

Our News & Commentary Blog

NDY’s Director of Minority Outreach, Anita Cameron, was featured in some important news pieces about medical bias against autistic people and proposed cuts to Medicaid. We applaud Anita for her incredible advocacy and we are so grateful to have her on Team NDY!

https://prescottenews.com/index.php/2023/03/07/above-all-else-believe-us-doctors-biased-behavior-toward-autistic-adults-taints-treatment-cronkite-news/

“For queer and gender-diverse autistic people, their gender or sexuality may have a larger impact than their autism on their medical treatment.

“It would literally be unsafe to disclose that I’m a lesbian,” said Anita Cameron, 57, a longtime disability activist and director of minority outreach at Not Dead Yet, a disability rights group.

“You literally get treated different…. It’s a little safer to be autistic than to be a lesbian, to be queer these days,” said Cameron, who lives in Rochester, New York. “Autistic people are six times more likely to be trans and non-binary.”

Cameron, who is Black, added that Black autistic people may be perceived as threats, due to others misinterpreting their behavior as dangerous. She notes the deaths of Black people with developmental disorders in encounters with police, making her careful of how she presents herself to health workers, even while living with chronic pain.

“If I go up in that emergency room crying and screaming … at the very least, I’ll get mocked,” Cameron said. “At the very worst, I will be escorted out of the emergency room or even arrested.” ”

https://spectrumlocalnews.com/nys/capital-region/politics/2023/03/08/advocates-want-medicaid-cuts-to-home-care-eligibility-blocked-in-budget#

“Anita Cameron, of Rochester, is visually impaired, and has issues related to autism and diabetes.

The 57-year-old currently qualifies for home care under the state’s Medicaid rules because she needs help with medications, house cleaning and bill payments, but would not qualify for one of the seven approved activities under the new law because she’s mobile.

Advocates worry the changes will force more people into nursing homes or adult-care facilities.

“Although I have mobility issues, I can transfer, I can maneuver — I can turn myself over in bed,” Cameron explained. “So under the proposed changes, I wouldn’t even get attendant services. I wouldn’t even be able to attempt to apply for services.”

Cameron, who works as a disability rights activist at events across the state, says the cuts will likely result in her being sent to an adult-care facility when she spends time in the hospital for medical care throughout the year.

“I have a job part-time, but I have a job,” Cameron added. “I wouldn’t be able to work from a nursing home.” “