Assisted Suicide Is Not Autonomous

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Emily Munson

March, to me, is synonymous with the state legislative season. In Indiana, I’ve been monitoring bills about tax credits for ABLE account contributions, Lyme disease, and exiting Vocational Rehabilitation Services’ self-imposed order of selection. I’ve also followed disability-related legislation in other states, including attempts to legalize physician-assisted suicide (PAS). Fortunately, these PAS efforts were defeated in Arizona, Arkansas, New Mexico, and Virginia. Unfortunately, Maryland’s Senate is now considering whether to pass a PAS bill approved by the House of Delegates.

Because much of my disability advocacy efforts involve persuading entities to respect the autonomy of individuals with disabilities, I understand that some initially find it hypocritical to simultaneously advocate for the State to deny individuals the opportunity to direct their own deaths, through euphemistically-dubbed aid-in-dying programs. The facts, however, support the conclusion that PAS is much less about self-direction then it may initially appear. Consider that Oregonians seeking PAS have historically cited the loss of autonomy the primary cause of their desire to die. Thus, PAS is generally not about making a choice to die, but is instead a hasty compulsion generated by fear.

It is also notable that PAS requires the facilitation of another – namely, a physician – to bring death. Although people with certain disabilities may need assistance from others with activities of daily living, I firmly believe all of us are capable of finding creative ways to kill ourselves. Drive your wheelchair down a flight of stairs or into a lake, if you really must go. Not comfortable enough? Then perhaps you are not so committed to dying, after all. Physicians are simply not a necessary component of a successful suicide plan.

Even more disturbing is the trend of PAS legislation to turn a healing profession into a killing profession. European physicians, who have practiced PAS for some time now, have no qualms when a family member requests drugs to euthanize a terminally ill individual without capacity. When I began studying bioethics, professors warned against “slippery slope” arguments, claiming there is no evidence that PAS programs would expand and target people with disabilities. Yet countries like the Netherlands now demonstrate the slippery slope is real, and paved with good intentions. Assisted suicide morphed into euthanasia, and people with intellectual disabilities and autism – without any terminal illness diagnosis – are now eligible for “help” dying.

And what of autonomy at the very end, when the individual actually ingests the drugs designed to poison them? How do we ensure that no abusive caregiver or impatient heir is influencing, let alone forcing, that final act? The Maryland bill, like Oregon’s program, precludes investigations, granting those involved statutory immunity. Is it even possible for a psychiatrist to verify that the individual is not subject to the even more insidious threats posed by fear and depression? Remember, other leading justifications for PAS in Oregon are not wanting to burden a loved one and fear of losing control of bodily functions.

PAS lobbyists like to refer to PAS as “death with dignity,” suggesting it is preferable to die while moderately healthy rather than live as disabled. Their slogan suggests that living with disabilities is undignified. I disagree; life is the dignified choice.


Published on March 25, 2019