Assisted Suicide Issues - An Overview

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Assisted Suicide Issues - An Overview

Those advocating for assisted suicide believe the battle to allow people with disabilities or chronic and terminal health conditions to kill themselves is about choice. However, for those actually living with a disability or health condition, the truth is, choice is too often completely removed. For twenty years, Not Dead Yet – The Resistance has been reframing the assisted suicide debate through the lens of disability politics, power and pride: http://notdeadyet.org/.

Currently, there are around 450,000 people in the United States with spinal cord injuries, and according to United Spinal, a national organization that offers programs to promote independence and well being for individuals with spinal cord injuries and diseases, there are approximately 17,000 newly injured people each year with traffic accidents being the leading cause of injury. These numbers are in addition to the millions of other disabled people in the United States who have chronic health conditions or disabilities, and who deal daily with problematic symptoms, such as pain, that are  associated with their disabilities. People with disabilities face multiple barriers to medical care, personal assistance services, lack of access to adequate treatment options, and even the inability to receive equipment and assistive technology to encourage independence. This is equally true for people with terminal illnesses who struggle to obtain, or may even be unaware of, the palliative care and related supports they should be able to count on.

For insurance entities, both private and public, that implement increasingly narrow “managed care” approaches, death is the most cost-advantageous outcome. As a result, in states like Oregon where assisted suicide is legal, (and which is on the brink of being legal in California as of June 9, 2016), insurance entities have already demonstrated they are willing to help pay for assisted suicide services, rather than treatment services that happen to be less cost effective. 

This encouraging of disabled and seriously ill people to kill themselves instead of paying to help them live also affects older Americans, particularly those who live in poverty. As Americans continue to live longer, and the baby boomer generation continues to enter their disability and retirement years, insurance entities are seeing an influx of people needing both health and long-term care supports, including people who have been diagnosed as being terminally ill. The growing demand on both public and private insurance increases the potential to see elderly Americans encouraged, whether subtly or not-so-subtly, to choose death instead.

Elder abuse and the abuse of disabled adults and children is well documented and must be a consideration in states where assisted suicide is legal. Abusive caregivers, heirs to a  parent’s or relative’s assets, and a health care system looking for a quick solution for their elderly and disabled “patients” can all manipulate people into feeling like they are a burden to their loved ones. “Being a burden” is one of the leading reasons reported for why people request assisted suicide in Oregon, in addition to the psychological and social reason of feeling a loss of “dignity,” which may reflect the stigma and loss of respect our country often attaches to those who are no longer able to be productive in the workforce. Hollywood reinforces this narrative through movies like The Sea Inside, Million Dollar Baby, Whose Life Is It Anyway, and now Me Before You, all movies that strongly promote the theme “better dead than disabled.”

These films have the potential to lead to “suicide contagion,” where elder and disabled people are encouraged to see themselves as a burden to their family, friends and society, and, in an act of “self-sacrifice”, decide to kill themselves. Newly disabled individuals with spinal cord injuries (SCIs), who are in the throes of overwhelming immediate post-injury shock, confusion, and depression over the loss of their former selves and the uncertainty of an unknown future, are particularly at risk. Instead of encouragement to kill themselves, they need as much emotional support and peer support as physical and medical support, in order to help them deal with this life-changing transition, and to help them learn to live with a disability.

A critical issue is discrimination in how differently society treats suicide when it comes to healthy and nondisabled people. Most disabled and seriously ill people are not treated for depression or other potential mental health issues when they say they want to kill themselves. Their expressed desire to commit suicide is often met with acceptance by others who have been conditioned, whether by Hollywood or elsewhere, to buy into the myth of “better dead than disabled.” For physically healthy and nondisabled people, society typically goes to great lengths to provide suicide prevention, not suicide assistance, to ensure they do not kill themselves. However, for the disabled person, premature death by suicide is seen as a logical choice.

We want a world where disabled people, older Americans, and those with chronic health conditions have what they need to live as independently and self-sufficiently as possible. We want a world where people whose health conditions are in the terminal stages can count on receiving the full range of palliative care and related supports in their time of need. Millions of dollars, and a lot of lip service, are spent every year in support of assisted suicide. While savvy marketers have presented assisted suicide as being about “choice” and “rights”, for the disability and aging community, it is really about myths, managed care, and media-reinforced stereotypes that threaten our survival, and our desire to be fully included and participating members of our communities