Wednesday, September 9, 2015

Diane Coleman letter to California Assembly Members opposing assisted suicide Bill AB2X 15.

This letter was written by Diane Coleman, the President and CEO of the disability rights group, Not Dead Yet and published on the Not Dead Yet website on September 8, 2015. This letter has been sent to members of the California assembly to oppose assisted suicide bill AB2X 15.

Diane Coleman (Not Dead Yet)
Dear Assembly Member:

I’m writing to urge you not to pass on AB2X 15, the CA assisted suicide bill.

I am a severely disabled woman, and head up the national disability group, Not Dead Yet, which has members in California. 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 entitled Why Assisted Suicide Must Not Be Legalized.] 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 doctor shopping at C&C.

The prescribing doctor’s 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 not about pain from a terminal disease, but are psychological and social issues that cry out for meaningful supports and genuine care. Yet the assisted suicide 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.

The bill specifically provides that depression is not a barrier to getting a lethal prescription. All that is required is that the depression is viewed as not impairing the person’s judgment, a subjective and speculative assessment at best. Psychiatrists and psychologists are not immune from prevailing social biases against people whose illnesses make them dependent on others for basic physical care. In some cases, they are just as likely as anyone to say, “If I were in your shoes, I might want to die,” and render an opinion that treatment for depression is not necessary, paving the way for a lethal solution.

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. 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.”

Moreover, as a person who has been disabled all of my life, I’ve learned that some of the health care that I’ve needed will not be covered by the available forms of insurance, because it won’t cure me and it “costs too much”, things that would have helped me maintain more physical function longer or reduced the help I needed from family. 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 a seriously ill 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.

Finally, it doesn’t increase my comfort to know that the CA medical group has gone neutral. When push comes to shove over the health care needs of a disabled Californian, whose corner will the doctor be in? The CMA amendments to the bill were more designed to protect doctors than patients.

When you look at assisted suicide based on one individual, someone with good healthcare and a loving family, it often looks acceptable. But when you examine how legalization affects the vast majority of us — especially those most vulnerable — the dangers to the many far outweigh any alleged benefits to a few. Please vote NO on AB2X 15.

Sincerely,

Diane Coleman, JD
President/CEO
Not Dead Yet

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