In every matter, when autonomy is the foundational argument, informed choice must be protected and made fully aware of underlying dangers.

Following the courageous lead of his predecessor who vetoed a similar bill last year, and on behalf of Delaware’s Not Dead Yet members, we urge Delaware Governor Matt Meyer to veto HB 140.

This bill, like all assisted suicide bills, is not truly about full autonomy and clear choice. It has been presented with an incomplete representation of the broader applications that proponents intend once it is signed into law. Once allowed in Delaware, efforts will begin to identify safeguards as barriers in order to begin dismantling them in order to ensure so-called “meaningful access.”

The sky isn’t falling…yet. But as of this moment, the fragile national infrastructure of the American disability community hangs in the balance. Many people with disabilities will pay a terrible price in loss of autonomy as federal agencies are being dismantled and seismic regressive policy changes and proposed budget cuts that will greatly reduce or eliminate critical programs, are poised to take effect.  Against this backdrop, it is a moral failing and a cruel hoax to endorse HB 140 as a way of effectuating autonomy, as this protest by ADAPT on cuts to Medicaid yesterday clearly demonstrates.

If Governor Meyer signs HB 140 into law, the only guarantee for Delaware’s most vulnerable – in the face of oncoming hardships under this federal administration’s vision for greater societal efficiency – will be a Delaware under  the specter of an already breaking healthcare system that will divide and in which those with serious illness and disabilities will be given assistance with their suicide as a so-called “right”, and those without will be provided prevention.

But if Governor Meyer vetoes HB 140, he will guarantee for another year that the only fight Delaware’s most vulnerable will have is with the federal government, as outlined HERE by the Bazelon Center for Mental Health Law’s Statement on Proposed Cuts in Budget Reconciliation Bill.

Delaware’s disability rights champions have been sounding the alarm in Delaware for over a decade while pointing to the same game plan used in every American jurisdiction where assisted suicide has been decriminalized.

When proponents campaign for an assisted suicide bill before it is passed into law, “assured safeguards” is the repeated stamp of authenticity that promises to assuage opponent concerns that the bill will remain as it is introduced and expand no further.  They say in effect: Don’t listen to those people trying to scare you. Everything is fine. It’s just an option if you need it and it’s your choice.

As Dr. Diane Meier, a palliative care specialist, has said, “the entire heartfelt adherence to restrictions that are announced when you first get the public to vote in favor of this go up in smoke once the practice is validated.” A proponent of assisted suicide working with Massachusetts Death with Dignity has said much the same thing, although with different emphasis, i.e., “Once you get something passed, you can always work on amendments later.”

The umbrella term “aid in dying” provides a sophisticated disguise meant to engineer public acceptance into law. In every jurisdiction where plain terminology is substituted for proponents preferred euphemisms, expansion follows at different but accounted for rates, depending on the cultural comfort of the jurisdiction.

But the delivery system – The Oregon Model – is universal:

On June 25, 2024, an email sent by a state’s representative of the nation’s leading donor-class professional assisted suicide advocacy organization, seemed to presume victory in Delaware’s razor thin one vote margin, and proceeded with outreach in an online dollar matching fundraising campaign and appealed with the following (available upon request):

“We have learned from our work in states like California, Colorado, Hawai’i and Oregon that authorizing a law is not enough; we must also ensure meaningful access. With your support, we will inform communities, medical providers and healthcare systems to ensure that all end-of-life options are available to Delaware.”

When proponents inform privately or  testify publicly before a people they target to turn that safeguards will remain as barriers but then petition their support base for money that these safeguards need to be removed in kind with other states where they have worked to remove them, it raises obvious questions about the actual nature of  the bill and the campaign behind the bill.

Note that the petition to “ensure meaningful access” after victory was presumed, cites the most aggressive examples of expansion in the country.

Like California expansion bill SB 1196 that was withdrawn last year. It included language used in Canada’s Track 2 (i.e. “grievous and irremediable condition”) which allows non-terminal people access to its assisted suicide/euthanasia regime. It included eligibility for people with dementia. And it included increased eligibility beyond six months, again, like Canada.

It was withdrawn by its sponsor, according to California’s assisted suicide bill author, Senator Susan Eggman because: “…pushing for too much too soon puts CA & the country at risk of losing the gains we have made for personal autonomy.”.

From the source itself, the rationale for the withdrawal had nothing to do with pushing past previously promised permanent safeguards and everything to do with correctly timing its always intended and fully unveiled identity in line with national aspirations.

Apples to oranges

Over the years, in state legislatures across the country, proponents have argued that comparisons to an external jurisdiction is an “apples to oranges” comparison. They characterize any mention of the word “suicide” as a “scare tactic.” This, despite the foundational argument being autonomy and control over one’s destiny, which necessarily requires self-administration of prescribed drugs that the person knows will be fatal.

These are state chapters of national facing organizations that fought for national access to assisted suicide and were unanimously rejected (Washington vs. Glucksberg) and were told to test the appetite of the states instead. They conduct up to (and past) 20 simultaneous bill campaigns every year, and their advisors and advocates wear both national and international hats, campaigning on the success of “The Oregon Model” both nationally and internationally.

Case in point: In 2016, Compassion and Choices applauded the Canadian government’s decision by posting the following on their website: “Canadian Government Follows Oregon Model.”

There are American ethicists who think that the scope of present assisted suicide laws should be expanded from people with terminal illness to anyone with a condition that could lead to suffering, just like in Canada.  As Thadeus Pope has asserted in his medical futility blog: “Canada is a model and not an anti-model.”

Make no mistake, the horror of Canada’s eugenical model is not an if it is a when, if assisted suicide isn’t called out for what it is and pushed back at every opportunity. Despite proponent’s insistence that comparing Canada to the U.S. is an “apples to oranges” comparison to skeptical audiences, within proponent war rooms, “Canada IS a model and not and anti-model”.

The rebranding is endless. The Hemlock Society changed its name to Compassion and Choices. And on the face of it, one might be tempted to think to market the promotion of suicide with assistance as a “compassionate choice”.  Fine. But mindful that these are national and even international organizations who fought for but lost in pursuit of imposing assisted suicide access to American national healthcare, the rebranding takes on a clearly ominous national characteristic.

On the heels of Washington v Glucksberg, selling assisted suicide as the natural outgrowth of individual states’ desires for this deadly public policy is tactical protocol, that an organization called “The Hemlock Society” might compromise from a marketing strategy.

While at first blush the following example might seem a touch too far in the weeds, but it is nonetheless interesting that the word hemlock is instantly identified with the poison Socrates drank to commit suicide rather than the fact that Socrates’ so-called choice was a death sentence compelled by the judgement of the city-state of Athens.

Not a very autonomous ending, but certainly an intended one.

The reality is that assisted suicide is all about disability rights and the bias against protections from discriminatory public policies that originate in their modern philosophical underpinning of assisted suicide, as created by Francis J. Galton who coined the term “Eugenics”.  Which says in effect: Assisted suicide is rational if the person being killed has a disability, is poor or has other immutable characteristics considered unhygienic in a pure and healthy society.

Moreover, Jack Kevorkian, modern American father of assisted suicide who practiced euthanasia until his arrest said in a 1990 interview (Link below connects to Cameron Mitchell’s 2025 breakthrough documentary about the Nazi Euthanasia Program – Disposable Humanity blogged about HERE at Not Dead Yet):

 “Intense emotionalism engendered by the concentration camp atrocities of World War II has unfairly stigmatized this honorable concept and cloaked it in silence.”

 Tim Stainton, Director of the University of British Columbia’s Institute for Inclusion and Citizenship echoed a similar observation differently when he called Canada’s eugenical descent into assisted suicide and euthanasia, “the biggest existential threat to disabled people since the Nazi’s program in Germany in the 1930s”.

A few weeks ago on April 29, 2025, on WHYY Studio 2’s YouTube channel for the show titled Physician Assisted Suicide, an interview took place with retired Delaware representative and annual assisted suicide bill sponsor Paul Baumbach and celebrated healthcare champion and assisted suicide opponent, Dr. Daniel Sulmasy.

Dr. Daniel Sulmasy was invited on to the show to provide the opposing perspective and at one point, offered an overarching, albeit gravely concerned, summation of the “slippery slope,” citing Canada as America’s inevitable statutory destination if assisted suicide legislation isn’t stopped. In response, the now-retired politician singled out anorexia as a point of contention, saying:

“The anorexia thing just drives me absolutely batty…so uh, that is used by the opponents, it’s a flagrant – misrepresentation is the kindest thing I can think of to say. Complete crap would be much more accurate…”

In true charity, perhaps unknown to the show’s hosts who didn’t push back:

1. According to Oregon’s Death With Dignity Act for 2021 found HERE, anorexia is mentioned first in the footnote correspondent to the category of Other Illnesses (pg. 14). That’s interesting for a number of reasons: First, because it is listed in kind with other treatable non-terminal diseases. Second, after 2021, the Oregon DWDA Report continued to list “Other Illnesses” but ceased to footnote those other illnesses by name.
2. Eat Breathe Thrive, an organization whose sole mission is to help people recover from eating disorders, conducted a systematic review to assess the dangers of assisted suicide/euthanasia laws for people with eating disorders. This landmark study which was subsequently published in Frontiers in Psychiatry in July 2024,
3. Over 300 international and national experts and organizations signed a statement to call upon governments to act in the prevention of assisted suicide for people with eating disorders. Many of these same progressive organizations are also constant champions against assisted suicide laws and are among those prominent national disability rights organizations with a position on assisted suicide laws, none of which – NOT ONE – supports it.

Earlier in the interview, one of the radio hosts asked Mr. Baumbach a question about the nature of autonomy as it relates to the assisted suicide bill:

The host asked: “Paul you mentioned earlier that this is for people who are dying, facing imminent death. But if the bedrock issue is control over one’s destiny, why limit it to that window? Like if you have the right at 6 months or less to end your life why not make it seven, eight, nine, ten a year- um if that really is the core issue – autonomy?”

Mr. Baumbach replied: “So I think that, so…my main prior life, I was a legislator, and you write laws that match society. Society in the United States is not ready for that…So uh…”

The host continued: “So you’re not necessarily opposed to it you’re just saying…?

Mr. Baumbach replied: “Philosophically, I’m not, but I recognize that in the United States and since last century – I mean it’s in the 90’s that Oregon passed the first such law century – there’s been no slipping…”.

To the contrary, “slipping” is imbedded into the design of assisted suicide legislation, so say its authors, returning to California Senator Eggman and American assisted suicide thought leader Thaddeus Pope quoted above.

Again, we are at a terminological impasse in which plain language is substituted for definitions and representations which do not accord with plain inference to the best explanation. The measure of that impasse is simple enough to parse: For the slippery slope to happen with any bill, it must only happen ONCE because the campaign standard and definition for a safeguard before a bill is passed is absolute and non-negotiable, or “assured”.  And because we deal in constant clarification, assure in the secondary meaning is to make something CERTAIN to happen and in its primary meaning, to assure is to tell something positive to someone to dispel any doubts they may have.

It seems then that what proponents actually mean when they publicly testify before legislators and citizenry alike by “assured safeguards” is an impermanent safeguard certain to expand. This obvious paradox may be in part why the persuasiveness of our argument succeeds far more than the proponent argument, and by a monumental margin.

Since 1997 nearly 400 assisted suicide bills have been defeated or withdrawn. That’s an approximate 40:1 win/loss ratio and real momentum. Moreover, when we consider no new states have adopted assisted suicide legislation despite approximately 80 attempts in the last fast approaching four years.

Mr. Baumbach notes in the interview linked above, his desire to have an American law that doesn’t require jumping across the Atlantic to do so. And yet across the Atlantic, the Oregon model has been and is right now, being touted by American ethicists and British advocates as a model for success in the United Kingdom just like it was in 2016 when Compassion and Choices celebrated Canada for following the Oregon Model.

In the same interview, Mr. Baumbach refers to the passage of Oregon’s bill in 1997 as “last century”, which sounds like 100 years have passed during the last 28. And it sounds like there’s been a “century’s” worth of acceptance of this deadly and discriminatory public policy. However, a complete understanding of the actual passage of what the past 100 years in this fight to protect the rights of people with disabilities looks like, sees the sequential defeat of assisted suicide’s eugenical partners in public policy, like American Sterilization Laws, the Nazi Euthanasia Program, Jack Kevorkian and the aforementioned nigh-400 wins in legislatures.

Call for action

Whether the rationale to veto is to follow Governor John Carney, who came to new conclusions when exposed to new information. Or to push back against the present precarious loss of federal support by a federal Republican administration. Or to defer to the authoritative consensus of progressive national disability rights organizations who have opposed assisted suicide laws since “last century”. Or because assisted suicide proponents admit that the potential of assisted suicide laws isn’t something America is ready for…

We ask Governor Meyer to steer Delaware’s most vulnerable citizens away from the profit lines of donor-class national assisted suicide organizations, big insurance, and big pharma, and over the finish line as full citizens of Delaware, who deserve protection, to know the whole truth, and help to live, now more than ever.

On behalf of Not Dead Yet’s members in Delaware, if autonomy is the bedrock issue at stake, we ask Governor Meyer to take the same courageous steps that the American Alzheimer’s Association took in reversing their previously incomplete understanding about this issue and its players when it terminated its relationship with the nation’s largest donor-class assisted suicide organization.

And we urge that Governor Meyer veto HB 140 and reject all of its eugenical roots.

It is disturbing that at a time when the healthcare system is so broken and so many people struggle to get the care and practical support, they need that New York would want to try repeatedly pass legislation which would legalize doctor assisted suicide. The state has shown good judgment in rejecting the idea before and should reject it now.

The pandemic has made evident the deadly health care disparities that people of color, older people and persons with disabilities have always been subjected to. Any law which enables doctors to write lethal prescriptions at the request of people deemed to have six months or less to live, as this bill would, increases risk for devalued patients.

Despite common misconceptions, uncontrollable pain is not a primary reason that people turn to assisted suicide. Data indicates that people often request lethal prescriptions due to perceived lessening of autonomy, or feelings of being burden. As Cliff Perez, a disability rights activist, states, “these reasons are… existential or disability related and ought to be addressed with quality, multidisciplinary care, not death.” It is not so much how individuals view living with limitations caused by illness or disability, but society’s stigma and failure to provide practical supports to address such limitations.

The assisted suicide bill does not address these concerns. One of its supposed “safeguards” is that a person’s doctors must consider him to be mentally capable of making an informed decision in order to eligible for assisted suicide. This means that the person must be able to understand that taking the pills will cause death. There is no requirement though that the individual be evaluated to determine whether he has a stress related mental health issue that might be fueling a desire to die. Terminally ill and newly disabled persons frequently experience demoralization syndrome, a condition which is different from clinical depression, but which is characterized by feelings of being a burden, hopeless and loss of purpose – feelings that could make anyone consider dying. Proponents of the bill can debate what does or does not constitute suicide, but an unbiased medical system does not view suicide prevention services as being only for the young and fleet of foot.

To the extent pain is a factor in sapping a person’s will to live, we should be ensuring doctors can provide patients with appropriate pain management, rather than authorizing them to prescribe drugs to cause death. As a result of mishandling of the opioid crisis, many people with long-term pain for which carefully monitored opioid medicine will provide the only effective relief have found it very difficult to obtain help. Again, there are disparities. Black and Latinx patients with advanced cancer appear less likely than whites to receive opioid medication to address pain in the last weeks of life.

It is also a myth that the pills will always cause a quick, peaceful death. In Oregon, it has sometimes taken people up to 72 hours to die. (9) The FDA has not approved any drug specifically designed to cause death. With doctors free to devise the drug cocktail, side effects like burned mouths occur. Terry Law, a frequently active assisted suicide doctor, says “There’s lots of data on stuff that helps people live longer, but there’s very little data on how to kill people.”

The bill, like most assisted suicide proposals, mandates deception on the death certificate. The bill provides that the death certificate must state the patient’s underlying terminal condition as the cause of death. This hides mistakes in diagnosis and prognosis – demonstrated by the fact that 12%-15% of hospice patients outlive their prognosis by six months or more. It provides a barrier to identifying potential wrongdoing.

As Dr Joseph Marine, professor at Johns Hopkins University School of Medicine, has stated, assisted suicide “has no basis in medical science or medical tradition…no one will be immune to its long-term corrosive and destructive effects on the health care system.” (13)
Legalizing assisted suicide for one patient group would clear the way to normalizing death-making as “medical treatment,” in an increasing number of instances leading our healthcare system to further endanger those who are already devalued.

Lisa Blumberg is a lawyer, writer and disability activist.

This report comes in large part owing to the exceptional work done by Inclusion Canada -years in the making – who first issued this Press Release to announce this monumental news:

On Wednesday March 26, 2025, the UN Committee on the Rights of Persons with Disabilities released a set of recommendations calling on the government of Canada to repeal Track 2 of its assisted suicide and euthanasia program. Specifically, Canada’s 2021 amendment to its Criminal Code that expanded through Bill C-7, which expanded eligibility passed promised safeguards.

Track 2 of the Canadian assisted suicide and euthanasia program allows people with disabilities (“grievous and irremediable medical condition”) whose natural death is not reasonably foreseeable to request assisted suicide or euthanasia.

Arguing against the very premise of Track 2, the report notes that the Canadian federal government,”…did not challenge the Quebec Truchon decision which fundamentally changes the whole premise of medical assistance in dying when natural death is reasonably foreseeable to a new program that establishes medically assisted dying for persons with disabilities based on negative, ableist perceptions of the quality and value of the life of persons with disabilities, including that ‘suffering’ is intrinsic to disability rather than the fact that inequality and discrimination cause and compound ‘suffering’ for persons with disabilities.”

The recommendations, known as “Concluding Observations,” are issued after United Nations treaty bodies review state reports to determine and summarize a country’s progress and the committee’s concerns and recommendations for improvement. These reports offer an authoritative view of human rights in a country. And while the United Nations’ “Concluding Observations” are specific to Canada, their explanation and justification bear welcome validation to the arguments advanced by opponents of legalization efforts in the United States and will function as authoritative guidance in international human rights law for years to come.

Here, we should recall that the United Nations Convention on the Rights of Persons with Disabilities (CRPD) is modeled on the Americans with Disabilities Act (ADA, 1990) and was inspired by American leadership. In 2009, President Obama signed the treaty, but as of this moment it still awaits ratification from the United States Senate.

The UN report also directly addresses a common argument advanced by advocates of assisted suicide in the U.S. – namely, that assisted suicide is all about “choice” and an extension of unrealized autonomy, and the so-called “right to die” being fought for; In stark contrast, the committee writes:

“The concept of ‘choice’ creates a false dichotomy by setting up the premise that if persons with disabilities are suffering, it is valid for the State Party to enable their death, with safeguards not guaranteeing the provision of support, and ableist assumptions deemphasizing the myriad of support options for persons with disabilities to live dignified lives , and the systemic failures of the State Party to address the social determinants of health and well-being, such as poverty alleviation, access to healthcare, accessible housing, prevention of homelessness, prevention of gender-based violence, the provision of community-based mental health supports and employment supports;”

Or, as Diane Coleman and Marilyn Golden and others repeated for decades in their predictive warnings, suicide only becomes a rational “choice” when offered to people with disabilities whose lives are seen as not worth living by a system steeped in ableism, and inequality and social consequences arising from bigotry and poverty.

Ian McIntosh

Interim Executive Director

If there is implementation of radical cuts to Medicaid prescribed by Congress, it  will be catastrophic for people with disabilities. Medicaid provides millions of people with access to medical care, nursing care and home and community-based services (HCBS) which people need to get out of bed, go to work, and live vibrantly in their communities rather than being warehoused in institutions. Medicare is no fringe program. It is a pillar of American society.  More than half of all Americans say someone in their family has used the program, and only 17 percent support cutting its budget.

As Marc Morial of the National Urban League has stated,  “Medicaid provides health care to almost half children in the United States. It allows elderly parents and grandparents and people with disabilities to remain in their homes and communities, easing the burden on their loved ones. It covers the costs of life-saving medications for chronic diseases. Ripping away this lifeline for millions of working families… will further deepen the already-severe health inequities for people of color and other marginalized communities. It is a shocking betrayal of our nation’s values…”

Moreover, a New York Times article describes how Medicaid should be considered  to be a middle class benefit. It notes that millions of people who are financially comfortable now may be just one bad break away from needing Medicaid for themselves or a member of their immediate family.

Rachel Litchman is a cartoonist, writer, consultant and full-time wheelchair user. The HCBS component of Medicaid allows her to live independently in her home. In a searing article in Stat, she writes of her concern that the “shadow of the nursing home looms” for her if the cuts happen. She states that “even if Medicaid itself continues to exist, I fear a return of policies of the past that aimed to keep disabled people out of the public sphere, segregated in institutions, and further exposed to death.”

Programs like HCBS give people a range of choices and that is what we all want. It is the dearth of choice that leads people to wonder whether going on is worth it. It is unimaginable what it must be like to say goodbye to a trusted aide with whom you have a respectful and professional relationship and to ask a friend or family member with their own problems and concern to do the most intimate of tasks for you gratis.  It is unimaginable to think of leaving your home where you feel comfortable for the alternative of a semi-private room in an understaffed place run by a for-profit organization and where you must eat dinner at 4:45 pm.   Indeed one of the leading reasons why some people lose the desire to live is fear of confinement in a nursing home.

Whether this is intended or not, Medicaid cuts would fuel the “better dead than disabled” ethos.  We simply cannot allow substantial cuts to occur. Please contact your elected representatives of both  parties and ask them to do all they can to stop them.

For more information on what drastic cuts would mean to people with various types of disabilities, click here.

About the Author: Lisa Blumberg is a lawyer, writer, and disability rights activist.

Out of nearly two thousand entries, 146 films were selected for the 2025 Slamdance Film Festival in Los Angeles. Disposable Humanity captured the Audience Award and received an Honorable Mention for the Slamdance Unstoppable Feature Grand Jury Prize.

In Disposable Humanity, a profound, unforgettable documentary of historic disability injustice, Cameron Mitchell and his family guide the viewer down corridors of Nazi era eugenical horror into a past that many of us think we know but don’t.

Tim Stainton, Director of the University of British Columbia’s Institute for Inclusion and Citizenship once called Canada’s eugenical descent into assisted suicide and euthanasia, “the biggest existential threat to disabled people since the Nazi’s program in Germany in the 1930s”.

For anyone engaged in fighting health disparities and disability discrimination today, it becomes plain by the end of the film that the present-day creep of assisted suicide laws in America has an essential part of its ancestry rooted in the international ideas, language and maps of Aktion T4 – the Euthanasia Program of yesterday.

In vivid sequence, Disposable Humanity bears witness to the philosophical underpinnings of The Final Solution through a primary disability lens. This moving, living memorial reminds us that without the initial unchallenged idea that disabled lives are lives worth less than others, over 300,000 lives might have been saved, and the Holocaust might have been just an exercise in exile, rather than extermination.

Disposable Humanity is a production about, by and for people with disabilities and their families and friends and is essential viewing.

Ian McIntosh

Interim Executive Director