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Why Assisted Suicide Laws are More Dangerous Than People Acknowledge

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The story about Brittany Maynard, who on Sunday died under Oregon’s assisted suicide program, dominated American news for the last month. As former New England Journal of Medicine editor and leading assisted suicide advocate Marcia Angell wrote October 31 in the Washington Post, “Maynard, the 29-year-old with incurable brain cancer, is the new face of the movement to give dying patients the choice to end their lives faster and more humanely. Her youth and attractiveness have helped make her a national media story.”

Indeed. The celebrity rag People put Maynard on its cover,and CNN, NPR, PBS, the New Yorker, and a host of others gave her and her backers a forum to promote their cause. Maynard especially targeted her home state of California. Assisted suicide, typically sanitized by supporters as “Aid in Dying” and “Death with Dignity,” is also legal in Washington state and Vermont. It has been rejected scores of times in other state legislatures, and recently failed in a 2012 Massachusetts referendum. Maynard’s YouTube video announcing her suicide plan will soon cross the 10-million-views mark.

Maynard had teamed up with the group Compassion & Choices, the saccharine rebranding of the old Hemlock society, to promote the cause as one of civil rights ( “Right to Die”) and consumer choice (“My Life/My Choice/My Death”), repurposing successful advocacy framings of the last 50 years. Allied pollsters conduct polls without the words “assisted suicide,” omit breakouts by race and class, while their surveys of “likely voters” get reported as “residents.” In so doing, the views of wealthier whites get made over into social consensus.

In the echo chamber of white elite media discourse, C & C has sought to frame the issue as a simple iteration of the so-called “Culture Wars,” in which fair-minded and forward-thinking folks courageously beat back the puritanical meddling of the medieval Church. In a recent case, Time’s lazy reporter talks to C & C slickster-in-chief Barbara Coombs Lee, the former HMO executive who designed the Oregon law, calls up a church leader for “balance,” and voila!, “journalism.”

Brittany Maynard offered (and will continue to offer) a powerful point of identification for the social faction in play, that of white, secular, professional, socially liberal, often monied people on the east and west coasts of the country. If this group, which sets the cultural agenda of many non-military institutions, were to unite behind assisted suicide as a progressive cause like gay marriage, liberal- and libertarian-leaning states might indeed legalize.

Excluded from this “national debate” are people of color and Latino ancestry (both of which oppose assisted suicide by 2-1 margins) and progressive disability rights groups, who represent the population most threatened by the “quality of life” judgments inherent in an assisted-suicide program.

Disability rights opposition is based in reality. While Compassion & Choices and its media friends push policy on the back of one photogenic person’s “choice,” we look at the social impact on vulnerable populations. The media repeats the falsehood that there been no abuses in Oregon, we present evidence that shows the opposite.

Occasionally, disability opposition is credited. When New Jersey’s assisted suicide bill was pulled in June for lack of votes, reporter Susan K. Livio wrote in the Newark Star-Ledger “Disability advocates, fearing the legislation could be manipulated to prematurely end patients’ lives, turned out in force to testify against the bill when it passed the Assembly Health and Senior Citizens Committee earlier this month.”

Livio’s was the only story in a major New Jersey paper that covered the impasse, and has been ignored since by other media. This follows the long-standing pattern of a flurry of promotional stories before legislative consideration, followed by… nothing when the bill fails.

The Star-Ledger ran my op-ed on October 30, which follows:

The media is flush with the sympathetic story of Brittany Maynard, the 29-year-old newlywed with aggressive brain cancer. Her video advocating expanded assisted suicide laws has been seen millions of times, prompting another push in the State Assembly to pass an assisted suicide bill.

When the focus is on an individual, assisted suicide can sound good – who’s against compassion or relieving suffering? But a closer look reveals that assisted suicide puts vulnerable people in mortal danger. The more people learn about the real-world implications of these bills, the more they oppose them. (Our group takes its name – Second Thoughts – from this fact). Last year, the Legislatures of New Hampshire, Massachusetts and Connecticut rejected assisted suicide bills.

The simple truth is that not all families are loving. Elder abuse is a nationally recognized epidemic. Every year, New Jersey elders suffer an estimated 175,000 cases of reported and unreported abuse, most by adult children and caregivers. Financial gain or emotional relief creates motives for steering someone toward death. The two witnesses to the death request could be an heir and the heir’s accomplice. Once the lethal prescription leaves the pharmacy, there is no further supervision and no independent witness required at the death to ensure that the lethal dose is self-administered.

Depressed people will be harmed. Under Oregon’s program, Michael Freeland obtained a lethal prescription for his terminal diagnosis, despite a 43-year history of severe depression, suicide attempts and paranoia. The prescribing doctor said a psychological consult was not “necessary.” When Freeland received volunteer suicide prevention services, he was able to reconcile with his estranged daughter and lived two years post-diagnosis. Oregon’s statistics for the last four years show that only 2 percent of patients are being referred for psychological evaluations.

In our era of imposed austerity, the media is full of calls for reducing late-life care in the name of cost containment. Insurers are notorious for delaying treatment, while state programs have cutoffs. So it was that Oregon Medicaid denied prescribed chemotherapies for cancer patients Barbara Wagner (www.youtube.com/watch?v=UduKJhIDcEI) and Randy Stroup. Yet the rejection letters gave notice that the minimal cost of 100 Seconal capsules would be covered.

These real-world outcomes help explain why the leading national disability rights groups oppose assisted suicide. We are progressives at the forefront of a grassroots coalition spanning the political spectrum, joined by medical associations, palliative care experts, hospice workers and faith-based organizations.

Star-Ledger Editorial Page Editor Tom Moran predicts that assisted suicide will become a progressive cause like gay marriage. But while almost all progressives (including this one) support gay marriage, many oppose assisted suicide because of the real-world harm it inflicts on innocent people, including those with a terminal diagnosis.

For example, one out of six people admitted to hospice with a six-month prognosis outlives the doctor’s prediction (a common experience in the disability community), but nevertheless remain eligible. In fact, Oregon data shows that every year people who turned out not to be terminal received lethal prescriptions.

Many people do not realize that palliative care has advanced tremendously in the last 20 years, that there is no reason for anyone to die in uncontrolled pain. As leading expert Ira Byock testified against assisted suicide:

“If I thought lethal prescriptions were necessary to alleviate suffering, I would support them. In 34 years of practice, I have never abandoned a patient to die in uncontrolled pain and have never needed to hasten a patient’s death. Alleviating suffering is different from eliminating the sufferer.”

Finally, people should be aware that the group sponsoring Maynard’s campaign is Compassion & Choices, formerly the Hemlock Society. At a recent Connecticut forum, C & C president Barbara Coombs Lee indicated a broader long-term agenda. “Coombs Lee also said the legislation would exclude people with dementia and cognitive declines, since they could not make the choice for themselves. ‘It is an issue for another day but is no less compelling,’” she said.

Death for people unable to choose is “no less compelling?” What starts today with Maynard’s choice ends with the euthanasia of grandma (“she’ll be better off”) with Alzheimer’s.

The Assembly must resist the pressure to make public policy based on one person. Assisted suicide laws are just too dangerous.

John B. Kelly is a disability rights activist and writer based in Boston. He is the director of Second Thoughts Massachusetts and New England regional director for Not Dead Yet, grassroots disability groups opposed to the legalization of assisted suicide. His piece on Michael Moore appeared in the March 7, 2002 CounterPunch.

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