Canadian Proposals for Assisted Suicide Eligibility for Mental Health Conditions

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Below is the text of Toujours Vivant/Not Dead Yet Canada‘s webcast today on a Canadian proposal to expand eligibility for assisted suicide and euthanasia (AS/E) to include people with labels of “mental illness.”

COUNCIL OF CANADIAN ACADEMIES “MAID” EXPANSION STUDY: MENTAL ILLNESS

  • This is the second part of our series on the three areas of assisted suicide expansion being studied by the Council of Canadian Academies. Today, we’re discussing mental illness as the main reason for assisted suicide eligibility.
  • The first and most obvious problem with allowing assisted suicide and euthanasia for people with psychiatric disabilities is that their wish to die is usually a symptom of the disability – as is the case with depression. The only way to know if the person is receiving the treatment that is best suited to their needs and most effective – and the person responds to treatment – will be a lessening of their wish to die.
  • The link between mental illness and the wish to die also calls into question a person’s ability to make a free and informed decision to end their life.  In a Dutch study of assisted suicides, in 24% of cases, there was disagreement among the doctors who approved the euthanasia about whether the person was competent, and whether all possible treatment options had been tried.
  • While 74% of people who asked for AS/E in one study had depression, many had other conditions that complicated matters, including substance abuse, intellectual disability or being on the autism spectrum.  About half the people had personality disorders, which increases the chances that their desire for assisted suicide would not be consistent and settled.
  • In addition, the ratio of women to men asking for assisted suicide was over 2:1.  This lines up with statistics showing that women are much more likely to attempt suicide (as a “cry for help”) than men, but men are three times more likely to complete suicide.  Thus, many “cries for help” from women will result in death in places where assisted suicide and euthanasia are legalized for psychiatric conditions.
  • More than a quarter of the people in the Dutch study asked for death from a doctor they didn’t already know – most at a specialized euthanasia clinic.  It’s hard to imagine that a family doctor or a clinic specializing in euthanasia would be able to correctly decide whether a person’s psychiatric disability interfered with their judgment, whether they were getting the best possible treatment, and if they had exhausted all treatment options.
  • Another concern is whether legalizing assisted suicide for psychiatric disabilities would lead mental health professionals to believe it is acceptable to give up on treating people with mental disorders.  Would that, in turn, cause people with psychiatric disabilities to lose hope about getting treatment or feeling better?
  • Allowing assisted suicide solely for mental health reasons is a form of legalized discrimination against people with psychiatric disabilities.  This discrimination already exists in our society’s very different approaches to physical and mental health care. Physical illnesses are considered uncontrollable, whereas mental illness is thought to be a moral failing.  Physical health is therefore seen as a priority, while mental health services have less funding and are unavailable to many who need them.  Only 1 in 5 young people who need mental health treatment get it; 2/3 of adults who need help don’t seek it out, either because it’s not available or because of the stigma associated with mental illness.
  • Mental health treatment has also changed drastically over the past few decades. Instead of interactive therapies, doctors are prescribing drugs. Talk therapy is often not covered.  If someone’s needs do not respond to pills, “the system” may claim it is unable to help them.
  • Reports from the Netherlands and Belgium have shown that many people who are euthanized because of psychiatric disabilities were physically and sexually abused. One example is the case of “Ann G.”, who sought treatment for anorexia.  However rather than being helped, Ann G. was sexually abused by her therapist.  After publicly accusing the therapist – who admitted what he had done, but was not punished – she was approved for euthanasia by another mental health professional.  Thus death became a second form of victimization.
  • In fact, people with psychiatric disabilities – who are often stigmatized as being dangerous – have the highest rates of abuse, poverty, homelessness, and lack of adequate health care.
  • Statistics also show many people asking for euthanasia are socially isolated and lonely.  Rather than providing psychosocial supports to these people, the mental health system “gives up on” them by euthanizing them.
  • Research shows that mental health professionals often harbour negative feelings toward suicidal patients. “Countertransference” describes a therapist’s reaction to their patient based on his or her own psychological issues or background.  If a therapist is having a negative reaction to a suicidal client, this can contribute to a “negative outcome”; in other words, the client’s death.

Portlight Strategies – Disaster and Disability

Our News & Commentary Blog, Paul Timmons, Portlight Strategies

In the early ’90s, I lived in rural Tennessee during an ice storm and two week power outage. I was lucky to have friends who rescued me and let me stay in their home outside the damage zone. Weather disasters can be deadly to anyone, but they’re especially life-threatening to seniors and people with disabilities.

I want to highlight two resources addressing the issues of disaster and disability. First: Partnership for Inclusive Disaster Strategies Hurricane Harvey Disability Hotline (800) 626-4959 has received hundreds of urgent requests for assistance for people with disabilities and older adults. Portlight Strategies and the Partnership for Inclusive Disaster Strategies Hurricane Harvey Disability Hotline have been able to offer emergency assistance to hundreds of people with disabilities since late last week.

According to Portlight, “We have been working closely with the Houston Mayor’s Office for People with Disabilities, disability organizations, TX state government, the FEMA Regional Disability Integration Specialist and Partnership member organizations from across the country. Portlight has also joined forces with the Cajun Navy to optimize our shared commitment to rescuing people and with Trach Mommas to begin the process of getting disability supplies to people who need them to maintain their health and independence. We are also partnering with Anthem, and appreciate their generous assistance for our hotline and disaster relief efforts.”

An interview by David Perry with Paul Timmons, co-founder of Portlight, appeared this week in Pacific Standard, Inside the Organization Saving Disabled People During Hurricane Harvey. A key point Timmons makes is, “Where this [inclusive disaster response] works is where there are pre-existing relationships between people in the emergency management community and people in the disability stakeholder community. Where it doesn’t work is where those relationships don’t exist. It’s too late to build those relationships once the disaster has come.”

NDY’s Director of Minority Outreach, Anita Cameron, has also been heavily involved in disaster relief planning for people with disabilities over the years. In 2004, while in Washington, DC, Anita trained to become a CERT (Community Emergency Response Team) member. In 2008, she helped to form the first CERT class consisting of people with disabilities in Rochester, New York. After joining Denver CERT in 2011, Anita became the first visually impaired CERT instructor for the State of Colorado in 2012, and in 2013, became a CERT Program Manager for the State. She has assisted in numerous exercises and real-world incidents with Denver CERT, including serving as a radio communications operator during the Colorado Flood of 2013.

Anita wrote a very helpful article on personal disaster preparation that contains excellent and practical advice that is useful for people with or without disabilities, Emergency Preparedness – A Common Sense Measure for the Disability Community. Wherever you live, please prepare – it may save your life.

And please consider supporting Portlight Strategies by going here.

 

NDY Canada Explains the Dangers to Disabled Children of “MAID” Expansion to Minors

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This text is from today’s webcast by Amy Hasbrouck, Director of Toujour Vivant/Not Dead Yet Canada.

COUNCIL OF CANADIAN ACADEMIES “MAID” EXPANSION: MATURE MINORS

  • The preamble to Bill C-14 – Canada’s assisted suicide legislation – specifies three possible expansions of assisted suicide to mature minors, people with psychiatric disabilities, and those requesting assisted suicide in an advanced directive. Health Canada has asked the Council of Canadian Academies to study each of these areas. Today and over the next two weeks, we will look at each of these topics. Today’s webcast will focus on assisted suicide for “mature minors.”
  • Ill and disabled children often grow up in families where non-disabled parents see their lives as burdensome, tragic, a disappointment of their hopes for the future, and “not worth living.” The child’s disability, rather than the discrimination the family faces, is thought to be the source of the family’s problems. When these beliefs and feelings are accepted by the child, the result is low self-esteem.
  • Ill and disabled children, who may be the only disabled person in the family, lack positive role models at home and in popular culture, and are usually isolated from other disabled people with a positive view of themselves.
  • This experience, of being isolated from peers and the subject of parents’ negative feelings, is very similar to that of lesbian, gay, bisexual and transgender children growing up in a homophobic society.  And as with LGBT kids, disabled teens are at higher risk for suicide.
  • Parents who kill their disabled children are given more lenient treatment than those who kill non-disabled children, reflecting society’s devaluation of the lives of disabled children. Of 35 cases of parents who were sentenced for killing their disabled children, 15 received no jail time.  Eight more received up to five years in jail, and nine more spent less than 20 years in prison.  This compares to an average sentence of 30 years for child murder where the child is not disabled. (See Amy’s excellent article on this subject, Misplaced Mercy: Prosecution and Sentencing of Parent’s Who Kill their Disabled Children.)
  • Parents ordering surgery for their disabled children to make them easier to care for is another way disabled children are devalued.  For example the Ashley Treatment (named for the first person known to have had it) involves removing a child’s sex organs and stunting their growth with hormones so that they can never become adults.
  • Disabled children face a much higher risk of abuse than non-disabled children. They are often conditioned to be compliant in many painful and invasive situations – for example, medical treatment and personal care.  This makes them ideal victims of abuse, while denying the pain they feel and the lack of privacy they experience.
  • On top of that, ill and disabled children face the same teenage troubles as non-disabled kids, and some studies have found they are even more likely to attempt suicide.
  • Why should non-disabled adolescents benefit from suicide prevention, while ill and disabled youth are encouraged and enabled to kill themselves?
  • A case in point was that of Jerika Bolen who died in September of 2016.  Jerika, who had a neuromuscular disability, received widespread support and thousands of dollars in donations for a “Last Dance” when she publicly announced that she wanted to go to hospice to die.   Activists with similar disabilities expressed concern about whether Jerika was receiving good health care and pain management.  Disability rights activists also questioned the outpouring of public support for her death, while society pledges to prevent the suicide of non-disabled teens.
  • In fact, just this morning we learned of a 19-year-old in England, Tommy Swales, who had Friedreich’s Ataxia, who killed himself because of depression.  He had talked about his desire to commit suicide to his mother and on social media.
  • Many laws, such as those forbidding underage use of tobacco and alcohol, limit teenagers’ freedom in order to prevent self-inflicted harm. Preventing people under 18 years of age from having assisted suicide would be consistent with current public policy.

Carol Cleigh Sutton: I Oppose Assisted Suicide and Euthanasia Because It Is Ableist

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The very heart of the argument for assisted suicide/euthanasia (AS/E) is that an individual may be better off dead than disabled.

The fact that this argument can be made in respectable public forums demonstrates just how ableist this society is. How deeply the severely abled fear and loathe those of us who live with disability.

Ableism, like racism and sexism, is an ugly prejudice that society holds towards its minority members.

What does ableism look like? First you exclude us from nearly all public life and especially gainful employment and instead put us ‘on the dole.’ Then, periodically, you cut those supports from under us or make us try to prove that we’re ‘worthy’ of such supports. You openly stare at us and your comments and prurient questions make public spaces hostile. If we object, you accuse us of being maladjusted or just not being able to take a joke. A disabled man in the Netherlands is constantly told that it is ‘his fault’ that he lives with a disability; after all, he could kill himself. Where AS/E has become the norm, disabled people are even more outcast.

Our lives are seen as not worth living, but these are the lives we have.

This ideology, which we call BDTD (Better Dead Than Disabled), permeates ableist society, but even more deeply infects the medical system, and the more society in general accepts it, the more we encounter it every time we have to deal with medicine. My husband, who was nearly 80 and disabled, was brought to the hospital by ambulance after a heart attack. Until I arrived and started raising the roof, they put him in a dark room in the back. He should have been connected to an EKG and given aspirin, and IV lines should have been established. But because he was disabled, he received none of this. They assumed he’d want to die. Thankfully, we had years after that, but if I’d been held up in traffic? Would their killing him have been prosecuted? Investigated?

Are you really wanting to create this ‘special class’ of people who can be killed and no one prosecuted? A class whose deaths won’t even be investigated? Is your ableism so strong that you’d change the law to allow others to kill us without consequence? That is what happens in Oregon. Thomas Middleton’s death was not prosecuted. Did he ingest the poison willingly or was his death part of the real estate fraud for which his ‘caregiver’ was prosecuted? It’s already all too easy for those who would inherit, or steal, our property to arrange our deaths. Do you really want to make it easier? In US jurisdictions, assisted suicide laws give immunity to those who kill so long as they choose their victims from among the old, ill and disabled.

Before you say that this isn’t about disability, it’s only for those who are imminently dying, let me remind you of two things: First, physicians are notoriously bad at predicting when we’ll die. Oregon state data show that people outlive their 6 month prognosis every year; one lived for 1009 days. (2016 report, page 11) I’m 10 years past my last expiration date, and more than 60 years past the first, and still going strong. Secondly, and perhaps more importantly, there has never been an instance where this is legalized that it hasn’t expanded far beyond those at whom it was originally aimed, sometimes with breathtaking speed. Canada is already moving to use it on people who are not imminently dying and they legalized it just a year ago and, in the Netherlands, even those who advocated for it say that it is out of control.

Because the argument is based on BDTD, all who are considered disabled are at risk.

Not Dead Yet Statement Condemning Racist Violence in Charlottesville, VA

Our News & Commentary Blog

Beginning on August 11, 2017, hundreds of white nationalists have marched and committed racially motivated violence on the streets Charlottesville, Virginia. Today, on August 12th, a car driven by one of those racists plowed into a crowd of anti-racist protesters, killing one and injuring 19.

Not Dead Yet is horrified by and condemns this violence and the racism and anti-semitism that motivated it, and we deplore the failure of police and other authorities to protect innocent people.

As people with disabilities and our allies, Not Dead Yet acknowledges the shameful reality that our country was founded on racism and oppression of Indigenous people, African slaves and other marginalized immigrants.

In solidarity with the victims, their families and the city of Charlottesville, we state in the clearest terms that racism and anti-semitism, like misogyny, homophobia, transphobia, ableism and religious bigotry, has no place in our society.

[Thank you to Anita Cameron, NDY’s Director of Minority Outreach, for her assistance in preparing this statement.]