Real “choice” belongs to insurers, whose business model is to delay or deny prescribed treatments, even if lifesaving. In Oregon, people can then be considered “terminal,” likewise if they can’t afford their treatment or if they stop maintenance treatment. Legalization makes assisted suicide a “medical treatment” and a “benefit” that will logically be extended to more people. Assisted suicide will always be the cheapest treatment.
It is estimated that 1 in 10 Massachusetts older adults are abused every year, and quarantining under COVID-19 has only made the situation worse. Many people associate nursing homes with where you go to die, born out by the news that 40% of all COVID-19 deaths come from nursing homes. At home, nothing in the law can stop an heir or abusive caregiver from steering someone towards assisted suicide, witnessing the request, picking up the lethal dose, and even administering the drug — no witnesses are required at the death, so who would know? The Oregon law has invited every sort of abuse.
Misdiagnosis and mistaken prognosis yearly puts 6 million Americans at risk of severe harm. S.2745/H.4782 could make that harm even more lethal. Thousands of Americans “graduate” hospice every year, and 12%-15% of people diagnosed with 6 months or fewer to live will outlive their diagnosis, sometimes by decades. Oregonian Jeanette Hall wrote the Boston Globe in 2011 that after a terminal diagnosis she sought assisted suicide, but her doctor persuaded her to try more treatment. “If my doctor had believed in assisted suicide, I would be dead,” she wrote. She has now lived more than 20 years post diagnosis.
The doctors who decide who is eligible for assisted suicide are the same doctors who have been promoting Crisis Standards of Care that in an emergency would deny ventilators or beds for older, ill and disabled people. Ableism crossed with racism to end the life of Black quadriplegic Texan Michael Hickson, against the wishes of his wife and 5 children. The doctor’s “quality-of-life” justification for denying Michael treatment for COVID-19 was contradicted by a family video showing the joyful connection he had with his family. Disability advocacy organizations have filed complaints with the federal Office of Civil Rights. Decision-making was arbitrarily taken from Michaels wife, while in other cases Do Not Resuscitate orders have been placed in patient files against their wishes.
As the voting results from Ballot Question 2 in 2012 show, assisted suicide pits wealthier, whiter districts against those with poorer people and people of color. For long-standing reasons, Black and Latinx people oppose assisted suicide by 2-1 margins. The four most Latinx cities in the Commonwealth – Lawrence, Chelsea, Holyoke, and Springfield – all voted strongly against Question 2. One social group’s preferences must not become a state policy that will place everyone under threat. Covid-19, meanwhile, is exposing the systemic racism of medicine. Black Detroit phlebotomist Deborah Gatewood was refused testing and sent home 4 times from her own hospital before succumbing to the pandemic.
Massachusetts shouldn’t be telling depressed and suicidal people that suicide is a good solution to suffering. At its recent annual suicide prevention meeting, the Massachusetts Department of Public Health had a speaker who championed Jack Kevorkian and assisted suicide. Oregon’s law doesn’t care about your depression as long as you have approved motives like “feeling like a burden.” The bill endangers bullied LGBTQ, autistic, intellectually disabled, and all young people who will be encouraged to see suicide as a reasonable response to suffering. “Suicide contagion” is real.
The end of life concerns reported in Oregon and elsewhere all have to do with negative reactions to disability: distress and shame over dependence on others, lost abilities, loss of dignity, feeling like a burden and incontinence. We don’t need to die to have dignity. We champion meaning found in mutual aid and interdependence.
In her New Year’s Eve 2019 ruling against a state constitutional right to die, Suffolk Superior Court Judge Mary K. Ames summed up some of the stresses that might hurry the moment when people ingest the poison.
“In such a situation, there is a greater risk that temporary anger, depression, a misunderstanding of one’s prognosis, ignorance of alternatives, financial considerations, strain on family members or significant others, or improper persuasion may impact the decision.”