Diane Coleman: Opposing New York's assisted suicide bill.

This article represents one side of the debate between Diane Coleman, the founder of the disability rights group, Not Dead Yet and Dr Timothy Quill, a long-time supporter of assisted suicide that was published in the Democrat and Chronicle on February 18, 2016.

Diane Coleman: Opposing the aid in dying bill

“I think there is a very strong alliance of different segments of society that are really concerned about the danger of legalizing assisted suicide from the culture we have today,” Coleman said. “Policy makers have to really consider not only the idealized case that proponents put forward on assisted suicide but the real danger that affects so many elderly, ill and disabled people in this society and be sure that the protection that current law offers are still in place to benefit everyone.”

What are the main concerns of people who are opposed to aid-in-dying legislation?

I don’t think I speak for all (opponents), but the disability community's core message is that if assisted suicide is legal, some people’s lives will be lost due to mistakes, coercion and abuse, and that’s an outcome that can never be undone. 

There’s inherent discrimination in assisted-suicide laws. Most suicidal people receive suicide prevention. Assisted suicide laws would carve out an exception to that, and that exception would apply to people who are elderly, ill, disabled, and those are devalued groups in society. ... Assisted-suicide laws would say, 'these certain people, we’ll not only agree with their suicide but give them the means to carry it out.' We’re saying it comes down to social justice. Equal rights means equal suicide prevention.

Isn’t this a matter of the individual’s right to choose?

We agree that people have the right to refuse life-sustaining treatment. We do think it’s important that that be based on informed consent, that there be protections against health care providers that overrule people who want treatment. We’re also concerned about (a health care proxy) decision being based on the choice of what the person would want if the person were able to speak for themselves. 

You should have the choice to get all the pain relief that you need in order to not have any physical pain. You should have the choice to get all the home care you need so you don’t have to feel like a burden on your family or friends. 

People do have the choice to commit suicide because suicide and assisted suicide are not exactly the same. It’s the discrimination that’s inherent in assisted suicide that is our concern. But assisted suicide needs to remain illegal because of all the dangers the public policy of assisted-suicide creates of mistake, coercion and abuse. We think everyone deserves suicide prevention no matter how old, no matter how ill, no matter how disabled.

What’s the difference between stopping or never starting treatment and asking for help in dying?

With withholding and withdrawal of treatment, you still have to die from an actual condition that is currently diagnosed. With assisted suicide, the person will die whether it’s an accurate prognosis or not. 

I can see why it seems similar, but the intent of the health care system cooperating in your refusal of treatment, the system still is trying to provide palliative care, to make you comfortable to do the best they can within that parameter. When it’s facilitating your suicide, that’s an intent to kill.

Can you see any benefit to terminally ill people who believe they are ready to die being able to ask their doctor for help?

The way the law is written, it’s based on an idealized view that everybody has a good doctor who understands palliative care and that everybody has a loving family and that neither the health care system nor family would ever steer the person in the direction of assisted-suicide. But that’s not reality. There are cost-cutting pressures that prevent them from getting the health care they need. One in 10 elders experience abuse. So the risks of mistake, coercion and abuse when assisted suicide is legal are simply too great.

What about the issue of severe pain?

Nobody should be in pain, we agree with that. Palliative care can take care of all pain. 

It’s really not about physical pain. If you look at Oregon reports, about reasons people want to commit suicide, the reasons are things like feeling like the person has lost their autonomy, they’ve lost their dignity, they can’t do the things they used to do. They feel like a burden on their families. Those are psycho-social reasons that relate to the disability that people have when they have an advanced stage or chronic condition.

You’re saying assisted suicide. Proponents use aid in dying. Are they the same terms?

Assisted suicide includes physician assisted or other. Physician-assisted suicide is the term in the bioethics arena and it’s in the literature. Aid in dying is the public relations term to make it sound more palatable and make it easy to conflate with palliative care and other support given to terminally ill people. 

Our society has a feeling about suicide and most important a commitment to suicide prevention as a concept. Yes, people commit suicide but if someone comes forward and says I want to commit suicide, then as a society we respond by saying, ‘How can we help you? We want to support you.’

Go to the Not Dead Yet website for more information about their opposition to assisted suicide.