Patti's Blog - Advocate for Elders, People with Disabilities and Their Families

New England Journal of Medicine – Pro and Con Assisted Suicide Essays and a Poll

Excerpt from: Not Dead Yet (click for full article)

 

A recent (I don’t think it’s quite the latest) issue of the New England Journal of Medicine (NEJM) features a “case vignette” of a terminally ill man who requests an assisted suicide prescription from his doctor.  Here’s part of that vignette:

John Wallace is a 72-year-old man with metastatic pancreatic cancer. At time of diagnosis, the cancer was metastatic to his regional lymph nodes and liver. He was treated with palliative chemotherapy, but the disease continued to progress. Recently he has become jaundiced, and he has very little appetite. He has been seeing a palliative care physician and a social worker on an ongoing basis. His abdominal pain is now well controlled with high-dose narcotics, but the narcotics have caused constipation. In addition to seeing the social worker, he has also been seeing a psychologist to help him to cope with his illness.

The response against assisted suicide is written by J. Donald Boudreau, M.D., Margaret A. Somerville, A.u.A. (pharm.), D.C.L.  Here’s an excerpt – read right after vignette:

Permitting physician-assisted suicide creates a slippery slope that unavoidably leads to expanded access to assisted suicide interventions — and abuses. Advocates of euthanasia deny that slippery slopes exist, arguing that legal constraints and administrative safeguards are effective in preventing them. But the evidence is clearly to the contrary, as the High Court of Ireland recently affirmed. In upholding the constitutionality of the prohibition on assisted suicide, the justices wrote, “. . . the fact that the number of LAWER (`life-ending acts without explicit request’) cases remains strikingly high in jurisdictions which have liberalised their law on assisted suicide . . . speaks for itself as to the risks involved.”2 Vulnerable communities in our societies — persons who are old and frail and those who are disabled or terminally ill — perceive themselves to be threatened.3 Physicians must not be willfully blind to these serious dangers.

The response in favor of assisted suicide is written by Nikola Biller-Andorno, M.D., Ph.D. – her response can be found in the “option 2” page, which is identical to the page with the response against assisted suicide – same vignette, and the comments after the response are also the same ones.

Amanda Baggs, the Pressure To Die, and the Case Against Assisted Suicide

Excerpt from: Disability and Representation (click for full article)

 

What happens to people who don’t have the support that Amanda has? What happens to people who are sick, and in pain, and alone, and don’t have a fierce advocate? What happens to people who aren’t well known in the disability community? What happens to people who do not realize that they have worth, who do not realize that they have the right the right to live? What happens to people lying in hospital beds, uncared for, feeling that their lives means nothing because of all of the genteel and not-so-genteel ways in which that idea is communicated? How many people feel that they are simply a waste of space because they’re being pressured to choose the alternative of death?

In this kind of environment, no free choice is possible. And I think that the proponents of assisted suicide know that. I really do. In fact, I think that the very reason that people put assisted suicide on the table at all is that they know the kind of treatment in store for them if they become ill or disabled. It’s not really illness or disability they fear, because it’s entirely possible to live a very good life with illness and disability in it. What people fear most is being treated as though they have no dignity, as though they have no worth, as though their lives matter not at all. This is the deepest fear: to not matter. Even pain and death pale in the face of it.

I think that many people feel that they would rather die than to be treated as though they are worthless. And so they put forward legislation that will give them a way out. But they don’t realize that we can fight the idea that it’s better to be dead than ill or disabled — that we can react to it with outrage, and that we can create communities of support so that none of us ends up with our worst fears realized.

Canada: CBC Interview with Norm Kunc About Disability Rights Advocates’ Opposition to Legalization of Euthanasia/Assisted Suicide

Excerpt from: Not Dead Yet (click for full article)

 

"Well, I’m trying to make it known that the disability rights community has serious concerns about the legalization of euthanization. When you cut through the arguments on each side, there is one fundamental difference. Those people in favor of legalization believe that they can have a choice to end their own life without having an impact on disabled people. The disability rights community, we say that’s naïve; If we legalize euthanasia based on anecdotal end of life experiences, there will be systemic repercussions in terms of our health system, our legal system – it will have a profound detrimental impact on people with disabilities."

Princeton Attorney Anne Studholme to Testify on Behalf of Disability Groups in New Jersey Assembly Hearing on Assisted Suicide

Excerpt from: Not Dead Yet (click for full article)

 

On February 7, 2013, Princeton attorney Anne Studholme will testify on behalf of two national disability rights groups in a hearing held by the [New Jersey Assembly Health and Senior Services Committee on a proposed bill to legalize assisted suicide. Studholme will be representing Not Dead Yet and ADAPT, which oppose the legislation.

Assembly bill 3328, entitled the “[New Jersey Death With Dignity Act,” was introduced by Assemblymen John Burzichelli and Timothy Eustace on September 27, 2012 and is patterned after laws passed by ballot referenda in Oregon and Washington states.

Studholme’s testimony will emphasize the disability groups’ charge that assisted suicide legislation discriminates against old, ill and disabled people. According to her testimony:
“Central to the civil rights of people with disabilities is the idea that a disabling condition does not inherently diminish one’s life; rather, surrounding barriers and prejudices do so. In contrast, assisted suicide gives official sanction to the idea that life with a disabling condition is not worth living. It sets up a double standard for how state licensed professionals respond to someone who says they want to die, mandating suicide prevention for one group, authorizing suicide assistance for the other.”

National Federation of the Blind Comments on Belgian Euthanasia of Deaf Men Losing Sight

Excerpt from: National Federation of the Blind (click for full article)

 

The National Federation of the Blind, the largest organization of blind people in the United States with over 50,000 members, including many deaf-blind individuals,  commented today on the state-sanctioned death by lethal injection of deaf twins in Belgium.  Upon learning that they were also going blind, the deaf twins sought and were granted euthanasia.

 

Dr. Marc Maurer, President of the National Federation of the Blind, said: “This disturbing news from Belgium is a stark example of the common, and in this case tragic, misunderstanding of disability and its consequences.  Adjustment to any disability is difficult, and deaf-blind people face their own particular challenges, but from at least the time of Helen Keller it has been known that these challenges can be met, and the technology and services available today have vastly improved prospects for the deaf-blind and others with disabilities.  That these men wanted to die is tragic; that the state sanctioned and aided their suicide is frightening.”

More on Double Euthanasia in Belgium, National Federation of the Blind Reacts, and Other Suicides in the News

Excerpt from: Not Dead Yet (click for full article)

 

Read through the comments on any of the countless articles covering these suicide stories and you’ll be hard-pressed to find anyone reacting like this:

• “It’s their body, their choice.”
• “When people decide they need to end it, they should be able to get help to do so.”
• “It’s too bad they had to use violent means – animals can get euthanized; we treat animals better than humans.”

The lack of statements like those struck me because they’re common sentiments expressed in article “comments,” and interactions on Facebook when people react to “double euthanasia” of Marc and Eddy Verbessem, the identical twins whose deaths are still making news.

I think that we don’t see those comments in the cases of Aaron Swartz and the military because those people are valued.  I know that euthanasia proponents say that their movement is all about respecting individual choice, but why are the “choices” of  Marc and Eddy Verbessem “respected” while the suicides of military personnel and the suicide of Aaron Swartz are treated as preventable tragedies?  The answer, of course, is that euthanasia isn’t about “respect,” but agreeing that another person’s continued existence is pointless.

Belgium: “Double Euthanasia” of Deaf Twins Losing Vision and Reactions from a Deaf-Blind Blogger

Excerpt from: Not Dead Yet (click for full article)

 

I agree with Coco – the Deaf-blind organization in Belgium should speak out on this.  In fact, I think it would be a big mistake for organizations and individuals outside of Belgium not to speak out about this double-killing.  Otherwise, the discussion will be dominated by Belgian euthanasia apologists, euthanasia advocates of all stripes, and bioethicists talking out the “problem” of “extreme” cases.  And then everyone will forget – until the next and more extreme killing comes along.

Americans Support Physician-Assisted Suicide For Terminally Ill

Excerpt from: NPR (click for full article)

 

The results from the latest NPR-Truven Health Analytics Health Poll show that most Americans favor physician-assisted suicide for people with less than six months to live.

Overall, 55 percent of respondents favored it, and 45 percent were opposed. Those proportions were unchanged from July 2011, when Truven asked the same questions.

Support for the idea varied by age and income.

Fifty-six percent of people 65 and older opposed physician-assisted suicide for the terminally ill; 44 percent supported it. Among people younger than 35, the results were reversed: 59 percent for and 41 percent against.

Death by Bedsores

Excerpt from: Planet of the Blind (click for full article)

 

My friend and colleague William Peace writes about bioethicist Art Caplan over at Bad Cripple in a post about an elderly man who had a series of debilitating strokes and decided he wanted to die of bedsores--in effect he instructed his nurses not to turn him over in bed. Caplan argues that the man should have the right to demand withholding medical treatment--though he spends a good deal of time arguing that the process of letting a patient die of bedsores inevitably affects the morale of caregivers. Caplan argues that there's a delicate balance between end of life decision making and the morale of caregivers but in the instance above, the old man's wish to die should trump the feelings of the nursing staff. It's interesting to assess Caplan's argument because its a palimpsest of philosophical assertions and I must confess I like a good palimpsest as much as Umberto Eco.

Human beings cannot be erased in secret. And whether Caplan likes it or not, medicine, even hideous, post-modern, corporatized, neo-utilitarian "hospitalist" driven medicine is still a community. The passive acceptance of pain in others undermines not only medicine but civic life itself, a matter that Franz Kafka underscored famously in his story "A Hunger Artist".

Final Exit Network Argues Assisted Suicide Law Violates Free Speech Rights in Court

Excerpt from: Not Dead Yet (click for full article)

 

Members of a national right-to-die group are challenging Minnesota’s assisted-suicide law, saying it violates constitutional rights to freedom of speech and freedom of association.

The group Final Exit Network is challenging the law after four of its members were indicted in May in the suicide of a Minnesota woman. Prosecutors say the defendants not only supported Doreen Dunn’s decision to kill herself in 2007, but provided her with information and support to follow through.

Final Exit members claim they do not encourage suicide, but that the act of giving information and emotional support could be interpreted as “encouraging” under a Minnesota law that makes it a felony for someone to intentionally assist, advise or encourage suicide.