Wednesday, February 15, 2023

Schrader: Disabled people must continue our unequivocal opposition to assisted suicide

By Meagan Schrader

Meagan is an instructor at E4 Texas at the University of Texas at Austin and a member of the EPC-USA board.

I started advocating against assisted suicide in 2015. I never had a terminal illness, but I had studied the issue because of my exposure to the field of bioethics, and to its generally negative, prejudiced conceptions of disability. Anyone who has read Peter Singer’s books, or studied the field of bioethics in general, will understand what I mean.

For me, that prejudice evokes my own experiences as a Special Education student, during which I observed people abusing loopholes in the Americans with Disabilities Act to get me to do things and make choices that I would never choose for myself. I was an honors student, but the pressure to make those choices-such as not taking college preparatory math courses, not taking the SAT or even dropping out of high school-was intense. Moreover, the systems put in place to prevent that kind of discrimination, such as the ADA, failed to stop this behavior. My experience as a Special Ed student and disability studies scholar taught me that ableism is baked into society and maintained by powerful forces that benefit from that ableism. 

Assisted suicide will always operate within that realm of systemic inequality. Disabled people’s experience of autonomy will always be constrained by systemic ableism because human beings have selfish inclinations. People will and have been pushed toward assisted suicide by systemic factors just like I was pushed towards dropping out of high school as a Special Education student. It’s inevitable. And forcing someone to justify their existence in a similar way that I was asked to justify my presence in the mainstream school system is disgusting. “Engage us in a debate about why you shouldn’t kill yourselves,” is a very cruel burden for pro-assisted suicide forces to put on disabled people. Standing with a despairing person as they move through the storms of life is an act of love. Helping people kill themselves is an act of hate. And, whether they know it or not, that’s what assisted suicide proponents are enabling: violence and hate against a disenfranchised minority group.

The assisted suicide laws in the US don’t currently apply to me personally, but the United States media has already published several treatises advocating for assisted suicide for mental disorders, and there my experience becomes relevant. If I lived in Canada, I would qualify for euthanasia. The psychotic depression that I experienced in 2016 was a quintessential example of what some assisted suicide advocates mean when they say that psychiatric disorders caused just as much suffering as terminal illnesses and that assisted suicide is a response to intractable mental health problems. 

By the summer of 2016 I had been in an episode of treatment-resistant depression for a year and a half. I had exhausted pretty much every treatment option available to people with treatment resistant depression-I had seen multiple psychiatrists at the top of their field, and no one had a solution for me. I had been hospitalized multiple times, and had tried multiple classes of psychiatric medication. I had Transcranial Magnetic Stimulation, a new treatment for depression that uses magnets to reorganize brain function. After my TMS treatments, I heard voices condemning me to Hell. I perceived things that weren’t there and lost pretty much all cognitive function. I was besieged by bizarre, repetitive muscle movements. I couldn’t remember who was president, or what day it was. I screamed incoherently for months & wandered around my house in a catatonic stupor. The stress of seeing me in that state was so severe that my mother vomited, which I had to watch. The experience was the psychiatric equivalent of shoving someone’s hand into a pan of boiling water, so I eventually found myself in a state where I was screaming, “Why was I born? Please God, just let me die!” I did eventually recover, but it took about two years.

Starting in 2024, some mentally ill people in Canada will never have the chance to recover, because a doctor killed them. The euthanasia laws there are already having a pernicious impact on disabled Canadians’ mental health;. For several months I’ve been corresponding with disabled friends in Canada who have been offered euthanasia as a “treatment” for their disabilities, and the offer itself was experienced as an act of abuse-because it is. I’ve heard a lot of people use the term “fear” to describe disability rights activists’ perspectives on assisted suicide, and I personally think a more appropriate term to describe my own feelings is anger. I’m angry on my friends’ behalf, and on my own behalf. It’s tough enough to get through the day with a mental illness or disability without society telling you that your darkest, most destructive inclinations are healthy, reasonable responses to your situation and that your suicide should be turned into a medical procedure.

In the United States, assisted suicide laws are a clear violation of the Americans with Disabilities Act, because suicide prevention is a public health service. When assisted suicide advocates offer suicide to disabled people, they deny us equal access to a healthcare service that able-bodied people take for granted. They are trying to add yet add an even deeper level of depravity to the systemic ableism that we experience on an everyday basis. Indeed, pro-assisted suicide violations of the ADA are already impacting equal standards of suicide prevention for disabled social media users. Twitter, for instance, has a clear anti-suicide policy. Users are not allowed to tell other users to kill themselves. Yet, Twitter allows Dying With Dignity Canada to have an account and blatantly sell suicide to people with disabilities. As such, Twitter is in violation of its own policies regarding bullying and hate speech, and it is violating the ADA by subjecting disabled users to a different standard for suicide prevention. Twitter blocks able-bodied, neurotypical users from seeing pro-suicide messages and helps send them to disabled people. This is the kind of thing that the Americans with Disabilities Act was meant to stop and that the disability justice movement was created to oppose.

Hence, I feel the need to remind readers that opposition to assisted suicide should be a non-negotiable component of disability justice work. Every state that legalizes assisted suicide brings our country one step closer to a Canada-like political landscape. I have observed some leaders in the assisted suicide movement trying to build bridges with the disabled community through token twitter posts lauding the Americans with Disabilities Act or appeals to shared values of “autonomy” and “dignity,” even as they encourage legislatures to lower disabled people to the status of animals. Based on my observations of their social media posts, it strikes me that the leaders of the assisted suicide movement are observing our arguments against assisted suicide and are attempting to punch holes in them with tokenism. I think that it’s important that we all shut those efforts down. 

Do not seek “common ground” with the assisted suicide movement. Although there may be some misguided individuals who honestly believe that suicide can coexist with disability justice, the dedicated leaders of the assisted suicide movement care about the disability rights movement in the same way that a driver of a car cares about a tree that has fallen across a road. Their aim in trying to connect with us to neutralize an impediment to their agenda.

In the case of assisted suicide, the proponents have twisted autonomy into an implement of violence. Assisted suicide isn’t just wrong because of the systemic circumstances that might push someone toward that choice, presenting the choice itself is an act of violence. Generally, the act of ending one’s life is considered “violence to yourself.” That’s the standard that is operative for able-bodied people in our culture. Assisted suicide proponents try to create a legally validated template for disabled people to engage in sanitized self-harm. They’re saying that in our case, suicide is acceptable, as long as a doctor approves it, and no one is traumatized by the sight of our violently killed bodies. The collective trauma that assisted suicide laws and messages do to the disabled community is completely ignored in order to satisfy assisted suicide proponents’ desire for control over every aspect of their lives.

There’s even evidence that for some assisted suicide proponents, advocacy and activities produces sexual pleasure. For instance, assisted suicide proponent Phillip Nitskche has admitted that assisting people's suicides in the 1990s caused him to become sexually aroused. Lonny Shavelson, one of the plaintiffs in a lawsuit seeking to bastardize the Americans with Disabilities Act and expand assisted suicide in California, has asserted that assisted suicide is one of the most “intimate” experiences that can be shared with another person. That’s depraved. Disabled people need to stand up and collectively say that we are not pornography videos. We are not condoms. And that’s the level of respect that the mainstream bioethics and assisted suicide movements have shown to disabled people-the quantity of respect that you’d show to a used condom.

As many assisted suicide opponents have pointed out, suicide advocacy typically stems from the more privileged contingent of society, the cohort of people who have actually endured the least amount of suffering possible and are unwilling to experience the suffering that is inherent to the human condition-nothing matters but them not suffering. Bioethics, a field that is preoccupied with autonomy and often promotes assisted suicide, is a big offender in this regard-the idea of not being in charge of one’s body is anathema to the field, which is dominated by white, upper class, educated individuals. These people are used to having what they want, and they are not concerned with the negative effects to others.

It is true that some assisted suicide proponents don’t mean harm to the disabled community; they are unaware of the historical connection between eugenics and euthanasia and they honestly believe that assisted suicide will function as a legitimate failsafe, without causing harm to disenfranchised people. It’s appropriate to sympathize with such people, or try to educate someone who is on the fence about the issue. However, some pro-assisted suicide academics and activists know that they’re harming the disabled community, and they don’t care. Autonomy is their “religion.” They love their god of autonomy like Christians love Jesus and Muslims love the Koran. Disability rights activists need to collectively communicate that assisted suicide leaders are welcome to practice their religion in private, but they are not entitled to conscript disabled people into the role of human sacrifices to their god.

For me personally, this understanding of autonomy seems like a mystical unicorn that exists only in the minds of the proponents. It’s a totally alien concept. My brain was injured at birth, which means that my body frequently does things that I didn’t give it permission to do. I may not always be happy about that, but it is what it is. I can’t drive a car, for instance, because my perception of spatial relationships is too weak. Driving a car would put my own life and the lives of others at risk, so even though I’d like to drive myself to the grocery store or to the mall, I can’t. During my last two episodes of psychotic depression, I wasn’t able to have autonomy at all, because I needed constant care and was too sick to make decisions for myself. This is the situation that assisted suicide proponents are trying to avoid. But their desires cannot reign supreme. That’s not fair to the disabled community.

My experience, and I think the experiences of most disabled people, teaches us that sometimes autonomy is the most just principal for a person to uphold in a given situation, and sometimes it is not. Autonomy is a great thing, and the disability rights movement values autonomy highly. However, the disability rights movement’s understanding of autonomy is different from the experience of autonomy reflected by pro-assisted suicide academics and activists. The latter idea of autonomy reflects the influence of white, upper-middle class ideals-it’s a privileged conception of autonomy based on the experiences of people with the resources and power to have control over most aspects of their lives. This is the conception of autonomy that predominates in white Anglo Saxon culture. Western culture is an individualistic one that emphasizes self-gratification and control. Disabled people, in contrast, cannot always control our bodies and we can’t always make any choice that we want. We are more vulnerable to being pressured into making a choice, and we are used to accepting limitations on our choices. So, our conception of autonomy is closer to that found in the Latino culture. That culture places more emphasis on family and community-the individual is regarded as being part of a cohesive whole, and the impact of individual choice on that whole matters. I think disability studies scholar Paul Longmore puts the difference between the disability rights movement’s conception of autonomy and assisted suicide supporters’ conceptions of autonomy best when he asserts:

“Some people with physical disabilities have been affirming the validity of values drawn from their own experience. These values are markedly different from, and even opposed to, nondisabled majority values. They declare that they prize not self-sufficiency but self-determination, not independence but interdependence, not functional separateness but personal connection, not physical autonomy but human community.”
And, that’s what the motto of the disability rights movement is: “Nothing about us without us.” “We” and “us” are the operative concepts. The assisted suicide movement’s motto is, “My life, my death, my choice.” To impute that conception of autonomy to the disability rights movement is an act of ideological colonialism. No matter how many times assisted suicide proponents may close their eyes and wish, the conception of autonomy that underpins disability justice and that underpinning assisted suicide are simply not compatible with one another.

There are times when what one individual may want is not as important as what’s just for the collective, and assisted suicide is one of those situations. Disabled people should not have to accept dramatic injustices, such as lack of access to suicide prevention, so that assisted suicide proponents can die at the exact moment and in the exact way that they want. That’s not progressive, and it’s not ethical. Disabled people must continue our unequivocable opposition to assisted suicide as a matter of self-respect. In the case of assisted suicide, autonomy needs to take a backseat to the values of love, justice and equality.

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