February 4, 2015
I am a lifelong Democrat, the CEO of a national disability organization, and I am also a severely disabled woman, writing to urge you to vote against New Jersey’s assisted suicide bill (S382). I’ve spent a lifetime advocating for the rights of disabled people, young and old, to control our own lives and not have our choices dictated by doctors and other professionals. So you might wonder why I oppose a bill that is widely portrayed as giving people choice and control over their own death.
But who actually has choice and control under assisted suicide laws? Anyone could ask their doctor for assisted suicide, but the law gives the authority to doctors to determine who is eligible. Doctors make the determination that a person is terminally ill and likely to die in six months, and that the request for assisted suicide is voluntary and informed. The advertised “safeguards” in assisted suicide bills are entirely in the hands of doctors, from the diagnosis, prognosis, disclosures, request form, decision whether to refer for psychological assessment, prescription and report after death.
Who are the doctors who are giving lethal prescriptions? The public image is that one’s own doctor, someone who knows you and has taken care of you throughout your illness, will be the one who assists your suicide. But in Oregon, the majority of assisted suicides involve a doctor referred by Compassion and Choices (C&C). [See references under “Doctor Shopping” section of article at http://dredf.org/public-policy/assisted-suicide/why-assisted-suicide-must-not-be-legalized/#marker45] The median doctor-patient relationship is 13 weeks. The state does not interview doctors who said “no” to the person’s request, so we don’t know why so many people had to go “shopping” at C&C.
The prescribing doctors also fill out a final report after the death, among other things stating the reasons for the request for assisted suicide. Among the top five reasons given are feelings of being a “burden on others” (49% in 2013) or feel a “loss of autonomy” (93%) or “loss of dignity” (73%). These are all too familiar disability issues. Yet the law does not even require disclosures about consumer controlled home care options to address feelings of loss of autonomy or being a burden, much less require that those services be provided. As someone who uses consumer controlled home care, I know how important it is. When I hear that feelings of being a burden are someone’s concern, assisted suicide sounds more like a “duty to die” than a “choice to die.”
Still, you might say, didn’t the person initiate the request for assisted suicide? Didn’t they have to self-administer the lethal dose?
I understand that the media has been flooded with images of Brittany Maynard, who held the lethal drugs in her hand, and appeared to be in full control with a loving family supporting her choice to die in the bedroom we saw on TV that she shared with her husband.
But most people who have been reported to use assisted suicide in Oregon do not resemble Ms. Maynard. Most are age 65-84, in a society where one in ten elders are abused according to federal figures [http://www.healthline.com/health-news/senior-elder-abuse-more-common-than-you-think-012714]. The abusers are usually family members. About half the people reported to use assisted suicide in Oregon did not have a health provider present at the time of death. With no independent witness required, there is no evidence that they self-administered the lethal drugs, or even that they consented at the time of death. These bills have to be considered in light of the sad reality that not all seriously ill people have loving family. Assisted suicide laws grant blanket immunity and effectively foreclose investigation of wrongdoing. As one elder law attorney, Margaret Dore, put it, they are a “recipe for abuse.”
Finally, as a person who has been disabled all of my life, I’ve learned that some of the health care that I’ve needed, things that would have helped me maintain more physical function longer or reduced the help I needed from others, will not be covered by the available forms of insurance, because it won’t cure me and it “costs too much”. The idea of mixing a cost-cutting “treatment” such as assisted suicide into a broken, cost-conscious health care system that’s poorly designed to meet dying patient’s needs is dangerous to the thousands of people whose health care costs the most — mainly people living with a disability, the elderly and chronically ill.
Assisted suicide ultimately affects everyone’s health care. In Oregon, where assisted suicide is legal, in 2008 cancer patient Barbara Wagner was prescribed a chemotherapy treatment by her doctor, but Oregon’s state-run health plan sent a letter which denied coverage of this chemo, yet offered to cover other “treatments,” including assisted suicide. The same scenario happened to another Oregon resident, Randy Stroup. The Oregon assisted suicide reports tell us that over 95% of those who supposedly received lethal prescriptions in Oregon had insurance, but how many got a denial like the ones sent to Wagner and Stroup? When assisted suicide is encouraged, it becomes a covered “treatment” and ultimately removes choices from patients.
When you look at assisted suicide based on one individual, it often looks acceptable. But when you examine how legalization affects the vast majority of us, the dangers to the many far outweigh any alleged benefits to a few. Please vote “No” on S382.