Contact Delaware Governor John Carney. Tell him to veto the assisted suicide bill.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Contact Delaware Governor John Carney and tell him to veto assisted suicide Bill HB 140. Contact him at:  john.carney@delaware.gov

Governor John Carney

People at vulnerable times of their life need proper care not assistance in being killed. 

In a roller coaster ride of votes, the Delaware Senate passed assisted suicide Bill HB 140 on June 25 by an 11 to 10 vote in a second vote on the bill.

On June 20 I reported that the Delaware Senate defeated the assisted suicide Bill HB 140 by a 9 to 9 vote. I thanked the many Delaware citizens who worked to defeat the bill.

The June 25 vote was based on all 6 Senate republicans voting No along with 4 Senate Democrats.

Eleven members of the Delaware Senate voted to legalize medical killing even after an assisted suicide lobby leader lied to them three times during the Senate hearing.

For more information read: The Delaware Senate would have been right to defeat assisted suicide bill (Article Link).

Heather's story of being pressured to "choose" MAiD.

"I am not you, and you have no right to push me to accept MAiD. I will never accept it! My life has value and no human being has a right to say otherwise." 

Heather Hancock

By Heather Hancock, an author and editor.

I've spent every moment from my first breath to the one a second ago fighting for what others take for granted. Why? I have Spastic Cerebral Palsy and have been labelled by doctors, teachers, therapists, lawyers, and society in general, as a second class citizen.

I live in Canada on the vast open prairies of Saskatchewan, but this province has only been my home for the last 5 years. I was born in Calgary, Alberta before there were NICUs and I weighed a whopping 1 pound 6 ounces at twenty-five weeks gestation. I should have died with less than a 2% chance of survival, but I was breathing on my own. There's no medical explanation for it... but God.

I was diagnosed with Cerebral Palsy when I was two. The doctors solemnly told my parents to put me into an institution for the rest of my short life as I "would never amount to anything." The medical community was in agreement that all disabled children were also retarded. A trip to the University of Alberta put an end to that false assumption.. At the age of three, I had the IQ of a five-year old. My disability is purely physical.

I was the first disabled child mainstreamed into the Calgary public school system. It was great for my education, but not for my social life. Fear and ignorance resulted in years of bullying and being ostracized by my peers and a few teachers. I graduated with Honours in 1986. Intermixed with all of this were multiple surgeries and regular physiotherapy appointments.

My adult life has been spent fighting for equity and accessibility in the workplace and the relentless toll that spasticity takes on the physical body. Chronic pain and fatigue became my new companions and I lost the ability to walk independently at thirty-three. The losses continued and by forty-four, I had to medically retire, after a quarter of a century working as a Unit Clerk in hospitals on Vancouver Island. I turned to writing and discovered I could educate others about my life through fiction, nonfiction, and poetry.

In 2017, all of the muscles in my legs spasmed simultaneously from the hips down both legs to the tips of my toes, and then the muscles just kept tightening and tightening. I could not move from the waist down. There were subsequent episodes in 2018 and 2019.

In hospital, I discovered a change in the attitudes of nurses, doctors, orderlies, and therapists. There was a subtle undercurrent that was almost tangible. I had nurses neglecting me, forcing me to try and walk while they stood at a distance and watched with arms crossed. It was evident the medical staff preferred not to treat me.

During my second episode of what I termed "spastic paralysis," there were words given to provide a framework for what quality of life should look like. If a person failed to meet that standard, then pressure was applied to get the person to accept medical assistance in dying (MAiD). It's a deceptively comforting term for euthanasia. It's been legal in Canada since 2016. I was in Victoria General Hospital in 2018 and was approached by a hospitalist who asked me if I had ever considered MAiD, given the incessant level of severe pain and fatigue I lived with. I made eye contact with the doctor and said, "God gave me life and He is the ONLY One who knows the number of my days. The answer now and from this moment on is NO."

The third episode in 2019 landed me back in the same hospital on a different unit, but my bed was in the hallway for my entire stay. It was humiliating. Again I was offered MAiD, and that doctor was given the same reply. It was the last straw for me. My GP retired in 2016 three years of lack of care had taken its toll and I left the Island and moved to rural Saskatchewan about an hour west of the Alberta border.

A month after moving into the new house, I had a very bad fall which landed me back in hospital, only this time it was the regional hospital in Medicine Hat, Alberta. A neurologist diagnosed what was happening and targeted a muscle in my lower back with therapeutic botox. It took three weeks for full effect and during my stay, the nurses and some doctors were very condescending.

One nurse came to my bedside in the early morning hours before breakfast and asked me "to do the right thing and consider MAiD." Her next words still ring through my head... "if I were you, I would take it in a heartbeat. You're not living, you're existing!"

I replied, "I am not you, and you have no right to push me to accept MAiD. I will never accept it! My life has value and no human being has a right to say otherwise."

The nurse stormed off and the next time she answered my call bell, she simply sneered at me instead of helping me get to the bathroom with my walker. I was very unsafe and talked with the head nurse of the unit and had her removed from my care. She wasn't reprimanded as the head nurse said it was a "personality clash."

I've had three stays in three different hospitals in Saskatchewan, and so far, this province has not pushed MAiD on me or anyone else within range of my sight or hearing. It's a wonderful relief.

With our federal government trying to manipulate the members of the House of Commons to pass laws that would throw wide open the criteria so more of the sick, terminally ill, disabled, mentally ill, elderly, and other vulnerable minorities could be coerced into accepting MAiD, or be given it against their will. That's a horrifying prospect.

I am a human being. My life has intrinsic worth. I won't allow anyone to say otherwise. I wasn't supposed to amount to anything, but I was a unit clerk, and I am now a published author and an editor. Words are powerful and I intend to wield them until my last breath. My stories educate and entertain. My poetry is raw and brings the reader into my world as a person with a disability. I fight many battles on different fronts, but the right to life is sacred, and should be treated with dignity and compassion. Sadly, the majority of our society have forgotten how.

The Delaware Senate would have been right to defeat assisted suicide Bill HB 140.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

On June 25 the Delaware Senate passed assisted suicide Bill HB 140 by a vote of 11 to 10. This was a reversal to their June 20 vote when the Delaware Senate defeated Bill HB 140 by a 9 to 9 vote.

As the Executive Director of the Euthanasia Prevention Coalition, it is obvious that I oppose euthanasia and assisted suicide. Opposition to HB 140 may be based on the same reasoning that I have or it may be based on the effect of legalizing assisted suicide. 

During the Senate hearing the President of Compassion & Choices lied three times.

The first lie was that there have been no abuses of the law.

An article by Jennifer Brown that was published in the Colorado Sun on March 14, 2022 reported that Dr. Jennifer Gaudiani, an internal medicine doctor who specializes in eating disorders published a paper on how she prescribed assisted suicide for three people with anorexia nervosa in Colorado. Gaudiani approved assisted suicide for Anorexia Nervosa by redefining this chronic condition as terminal.

Kevin Dias, the Chief Legal Advocacy Officer for Compassion & Choices responded to the Colorado Sun article by stating:

Medical aid-in-dying laws apply only to mentally capable, terminally ill patients with six months or less to live who are able to self-ingest the medication. Any deviation from these requirements violates the law and places physicians, family members and others in regulatory, civil and criminal jeopardy. This law does not and was never intended to apply to a person whose only diagnosis is anorexia nervosa.

Kevin Dias admitted that the law was violated. To make matters worse, the Oregon 2021 assisted suicide report listed Anorexia Nervosa as a reason for at least one assisted suicide death.

The second lie is her statement there is no "slippery slope." To summarize:

Oregon: In 2019 Oregon expanded their assisted suicide law by giving doctors the ability to waive the 15 day waiting period when a person was deemed as near to death. In 2022 Compassion and Choices launched a lawsuit to force Oregon to allow non-residents to die by assisted suicide. In 2023 Oregon removed the residency requirement extending assisted suicide nationally to anyone.

California: In 2021 California expanded their assisted suicide law by reducing the waiting period from 15 days to 48 hours and forcing doctors who oppose assisted suicide to be complicit in the process (later struck down by the court).

New Mexico: In 2021 New Mexico passed assisted suicide Bill HB 47 further codifying the assisted suicide lobby's expansion plans. HB 47 did not require a 15 day waiting period but rather it required a 48 hour waiting period that can be waived if the health care provider believes that the person may be near to death, technically allowing a same day death. HB 47 also had an expanded definition of who could prescribe and participate in assisted suicide by allowing non-physicians defined as "health care providers" to approve and prescribe lethal drugs. "Health care providers" includes physicians, licensed physician assistants, osteopathic physicians, or nurses registered in advanced practice. The assisted suicide lobby is expanding who can prescribe and participate since very few physicians are willing to assist a suicide.

Vermont: In 2022 Vermont expanded their assisted suicide law by removing the 48 hour waiting period, (allowing a same day death), removing the requirement that an examination be done in person, (allowing approvals by telehealth), and extending legal immunity to anyone who participates in the act. Compassion & Choices launched a lawsuit demanding that Vermont change their law to permit non-resident to die by assisted suicide. In 2023 Vermont expanded their assisted suicide law by removing the residency requirement to allow anyone to die by assisted suicide.

Washington State: In 2023 Washington State expanded their assisted suicide law by allowing advanced practice registered nurses to approve and prescribe lethal poison, by reducing the waiting period to 7 days and requiring healthcare institutions and hospices to post their assisted suicide policies.

Hawaii: In 2023 Hawaii expanded their assisted suicide law by reducing the waiting period to 5 days, by allowing the waiting period to be waived if the person is near to death and by allowing advanced practice registered nurses to approve and prescribe lethal poison.

Colorado: On June 5, 2024 Colorado Governor Gary Polis signed Senate Bill 24-068 to expand their State assisted suicide law.

New Jersey. There is currently a lawsuit by Compassion and Choices challenging the New Jersey state residency requirement for assisted suicide.

Whatever language is contained within a state assisted suicide bill, Compassion & Choices will support it and then, within a few years, pressure states that legalize assisted suicide, to expand their law. Compassion & Choices will also launch court cases to force them to do so.

The third lie was stating that all of the laws are similar to the Oregon law.

I have no love for the Oregon law, but assisted suicide laws have similarities and differences to the Oregon law.

By reading the multiple expansions that have been approved in states that have legalized assisted suicide, it is clear that the laws differ in the states that have legalized assisted suicide.

A key question is: How do people die by assisted suicide?

How people die by assisted suicide is a fundamental question, but the question is often ignored based on people supporting the theory that assisted suicide is necessary to relieve suffering.

There are two key points concerning how people die by assisted suicide.

The assisted suicide lobby has been doing human experiments to find cheaper, effective ways to kill. When reading the Oregon Death with Dignity annual reports you will notice that the drug combinations used to poison people by assisted suicide are continuously changing.

These experiments have led to concerning results, such as painful deaths and long drawn out deaths. Assisted suicide activists have been experimenting with lethal drug cocktails on people approved for assisted suicide.

Some of the assisted suicide deaths are painful. The Seattle Times reported in September 2017 that:

The first Seconal alternative turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. The second drug mix, ... has led to deaths that stretched out hours in some patients — and up to 31 hours in one case.

An article by Lisa Krieger published by the Medical Xpress on September 8, 2020 uncovers information about the lethal drug experiments:

A little-known secret, not publicized by advocates of aid-in-dying, was that while most deaths were speedy, others were very slow. Some patients lingered for six or nine hours; a few, more than three days. No one knew why, or what needed to change.

"The public thinks that you take a pill and you're done," said Dr. Gary Pasternak, chief medical officer of Mission Hospice in San Mateo. "But it's more complicated than that."

In 2023, the longest time for an assisted suicide death in Oregon was 137 hours.

The second issue is how do people die by assisted suicide?

An article published in September 2021 by the Spectator reported on finding by Dr Joel Zivot who argues that assisted suicide is not a painless or peaceful death. Zivot states:

I am quite certain that assisted suicide is not painless or peaceful or dignified. In fact, in the majority of cases, it is a very painful death.

The death penalty is not the same as assisted dying, of course. Executions are meant to be punishment; euthanasia is about relief from suffering. Yet for both euthanasia and executions, paralytic drugs are used. These drugs, given in high enough doses, mean that a patient cannot move a muscle, cannot express any outward or visible sign of pain. But that doesn’t mean that he or she is free from suffering.

Assisted suicide is sold to the public as offering a quick and peaceful death. Assisted suicide is far more complicated than that.

Register for the next Compassionate Community Care - Visitor Training Program - July 3 & 4.

Kathy Matusiak Costa

Register for the free online visitor training program and becoming involved with visiting people in your community who are elderly and/or living alone.

 

Register online (Registration Link).

 

Caring for people. Gain the confidence to journey with those who are lonely, socially isolated, sick, or dying, to renew their hope and purpose in living until they die.

 

 

Alex Schadenberg

FREE Online Training – Live on Zoom! 

The Training Workshop is composed of two sessions, each session is two hours on: 

Wednesday July 3 (7 pm - 9 pm) (EST) and 

Thursday July 4 (7 pm - 9 pm) (EST)

With Kathy Matusiak Costa, Executive Director of Compassionate Community Care, and Alex Schadenberg, Executive Director of the Euthanasia Prevention Coalition. 

Register online now: (Registration Link)

 

Compassionate Community Care: 

383 Horton St. E, London, ON N6B 1L6
Office tel. 519-439-6445 

info@beingwith.org • www.beingwith.org

CCC Helpline: 1-855-675-8749

 

Charitable registration # 824667869RR0001

Hospice and Palliative Nurses Association proposes to support assisted suicide

This article was published by National Review online on June 24, 2024

By Wesley J Smith

When Dame Cecily Saunders created the modern hospice movement, she adamantly rejected assisted suicide as an acceptable hospice activity. Indeed, when I interviewed Saunders for the original edition of my book Culture of Death, she stated unequivocally that assisted suicide "rejects the equal dignity of my patients."

That is why she designed hospice to engage in active suicide prevention when patients expressed suicidal desires as one of its most important services alongside pain control, social services, chaplaincy, and the like. In other words, as conceived by Saunders, hospices would be assisted-suicide-free zones.

Saunders would be spinning in her grave — she died in the St. Christopher’s Hospice, which she founded — if she read the proposed policy around assisted suicide that has been published by the Hospice and Palliative Nurses Association (HPNA). It is both abject and a betrayal of Saunders’s humanitarian vision for the care of dying people. And the statement contains not a hint of the many problems and abuses that have been associated with “medical aid in dying” (MAID), reasons why the European Court of Human Rights recently ruled that access to assisted suicide is not a human right.

First, the proposed policy position embraces the word-engineering tactic of calling assisted suicide MAID. I have repeatedly criticized this euphemistic deflection and won’t repeat those thoughts here.

Then, the statement calls participation in suicide a form of palliative care. From the proposed “HPNA Position Statement: Medical Aid in Dying (MAiD):

HPNA acknowledges that some patients with terminal illnesses may seek medical aid in dying (MAiD) as an end-of-life care option where legally available. Although suffering is not a requirement in order to qualify for MAiD in the United States, some patients may utilize this option to relieve their suffering, which is consistent with the ethical principles of palliative nursing care. Suffering at the end of life may be caused by loss of control; death anxiety; feeling like a burden; and refractory physical, social, emotional, spiritual, and existential symptoms. MAiD is consistent with the fundamental ethical principles of patient autonomy and beneficence.

It is actually the opposite. As Dame Cecily knew so well, the proper compassionate approach to suicidal ideation — whether in terminally ill people or otherwise — is suicide prevention, not participation and facilitation by medical professionals, of all people. Indeed, when I trained as a hospice volunteer in the 1990s, I was strictly instructed to alert the multidisciplinary team if a patient ever indicated a desire for suicide or immediate death.

Here’s the abject part:

HPNA adopts a stance of engaged neutrality regarding whether MAiD should be legally permitted or prohibited.

What in the hell does “engaged neutrality” even mean? But they really aren’t fooling anybody. The long statement is almost all pro, pro, pro. Even its suggested “resources” for further information are one-sided.

The policy urges nurses to participate in assisted suicide absent a moral objection. The only good news here is that the statement respects medical conscience and the right of nonparticipation. (One would hope all palliation and hospice nurses would refuse to be complicit in any patient’s suicide!):

Nursing care for patients considering MAiD (and their families) is crucial to ensure that patients and families are not overtly or inadvertently disenfranchised or stigmatized as they proceed with MAiD and that they experience a safe and comfortable death, free from complications.

“Safe” death “free from complications?” Good grief.

Once lethal injection is allowed legally, and eligibility expands beyond the terminally ill — as will eventually happen if the death agenda keeps marching forward — would the HPNA still suggest that nurses do the deed? Reading this proposed statement, I think it would.

The public is invited to comment on this (from my perspective) planned betrayal of vulnerable patients by July 7, which can be done by hitting the public comment link on this page.

Good Samaritans Help, They Do Not Kill

By Meghan Schrader

Meghan Schrader

Meghan is an autistic person who is an instructor at E4 - University of Texas (Austin) and an EPC-USA board member.

In the last year I’ve read several articles in publications, that reliably oppose assisted suicide and noticed that some politicians who tend to oppose assisted suicide, asserting that Daniel Penny, a man who is charged with killing mentally ill BIPOC disabled men Jordan Neely when he was having a mental health crisis on the New York subway in 2023 a “Good Samaritan.” 

The case hasn’t been in the news as often lately and Penny will not stand trial for manslaughter until October, but I’ve been thinking about that tragedy a lot, and I figure now is as good a time as any to share my thoughts on why Daniel Penny is not a Good Samaritan.

When I say I’ve observed news outlets and politicians that tend to oppose assisted suicide calling Penny a Good Samaritan, I do not mean that all publications or politicians that take a position opposing assisted suicide or that most opponents of assisted suicide take that view, nor do I mean that publications that have published pro-assisted suicide material haven’t also expressed ableist attitudes toward Neely, or towards disabled people in general. Nevertheless, I feel the need to respond in particular to assisted suicide opponents who have called Neely a “Good Samaritan.” Although this is a blog about assisted suicide, I am a disability justice advocate first and foremost, and I’ve lived with mental illness for most of my life, so describing Daniel Penny’s actions as the actions of a “Good Samaritan” really bother me. I appreciate Alex Schadenberg allowing me to use this blog to get these thoughts “off my chest,” and I hope that they will be instructive for people reading the blog.

During my first bout of psychotic depression in 2016, I had to fly with my Mom to my biological mother’s funeral. During the flight I babbled that I was a rapist and a murderer. I screamed that I wanted to die, that the plane was going to crash and that it was all my fault. My limbs thrashed and jerked with involuntary muscle movements I couldn’t control-sort of like how Jordan Neely screamed that he was hungry and thirsty, threw his jacket on the ground, and allegedly yelled things like, “I’m going to kill you,” “I’m prepared to go to jail for life,” and “I’m willing to die.”

I am sure that my behaviour really sucked for the people sitting around me. But does that mean it would have been OK for a testosterone-flooded United States Marine to jump up from the seat behind me and put me in a choke hold until I died? Would that have made the Marine a Good Samaritan? That’s essentially the argument that I’ve heard some people make about Jordan Neely’s death: Daniel Penny was a “Good Samaritan” for killing “dangerous” Jordan Neely during a mental health crisis. And that argument is fallacious. Good Samaritans do not restrain severely mentally ill, hungry, disoriented people by putting them in choke holds until they suffocate. Good Samaritans do not live their lives feeling entitled not to encounter mentally ill people in public places, as some of the bystanders’ behaviour and statements about “fearing for my safety” indicate to me they thought they were.

Jordan Neely’s death fits into a longstanding pattern of BIPOC disabled people, and disabled people in general, being killed by the police or bystanders. For instance, Neely’s death reminds me of the case of Ethan Saylor, a 28-year-old man with Down Syndrome who was killed by off-duty police officers in 2013 because he tried to stay for a second showing of a film he had watched without buying a second ticket. The off-duty officers asphyxiated Saylor, all for the sake of an $8 movie ticket. And, although a medical examiner ruled Saylor’s death a homicide, the officers were not charged. People calling Daniel Penny a “Good Samaritan” want the same thing to happen in Jordan Neely’s case, apparently because that’s what fits into their preferred political narrative. But most political narratives do not account for the needs and experiences of disabled people, and that’s what’s going on when people call Daniel Penny a “Good Samaritan.”

Jordan Neely needed a Good Samaritan who would speak to him compassionately and “talk him down.” Jordan Neely needed a Good Samaritan to call his family. Jordan Neely needed a Good Samaritan who would have given him something to eat and drink. Jordan Neely needed a Good Samaritan who could have summoned medical help. That’s the Good Samaritan that Neely needed and deserved, and that’s the kind of person our leaders should rally behind as a “Good Samaritan,” not smug Ironmen like Daniel Penny.

Disabled people not only deserve the right to live in a society where their suicides will be treated like preventable tragedies, but also the right to ride the subway without the fear of being suffocated. Opposition to assisted suicide needs to involve a commitment not only to equal access to suicide prevention, but access to safe environments in general. It means advocating for disability justice more broadly. It means following the real Good Samaritan’s example of tending to a wounded man beat up by robbers, not Daniel Penny’s example of killing a mentally ill man who was hungry and thirsty.

So, EPC blog readers, get out there and be real Good Samaritans. Do whatever you can to ensure the well-being of the Jordan Neelys of the world, and couple with that with your opposition to assisted suicide. That’s the kind of Good Samaritan that the disabled community needs and is consistent with opposing assisted suicide.

Uruguayan Senate pressured to debate euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Uruguay Parliament

The Prensa Latina reported on June 21 that the euthanasia lobby is pressuring the Uruguay Senate to debate euthanasia. According to the report:

The shelving of a bill on euthanasia in the Uruguayan Senate has raised complaints from organizations that defend the right to assisted death.

This was a reaction to the delayed debate of a proposed law that the ruling National Party’s bench decided to postpone.

The legislative project is being studied by the Senate Commission, which has not met for two months.

The euthanasia lobby has complained that the National Party has prevented debate on a draft bill in the Senate.

The Uruguayan government needs to consider how legalizing euthanasia has negatively affected the rights of people with disabilities, the homeless and people living in poverty in Canada.

The role of countertransference in assisted suicide deaths.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Drs. Mark Ruffalo (right) and Ronald Pies have written an hypothesis concerning the role of countertransference with relation to assisted suicide deaths that was published by the Psychiatric Times on June 21, 2024.

This article is based on a hypothesis, but I found it to have significant merit, especially in relation to the approval of euthanasia or assisted suicide for people with psychiatric issues.

Zoraya Ter Beek

The article begins by referring to the case of Zoraya Ter Beek (29) who recently died by euthanasia in the Netherlands, The authors write:

Ter Beek, who was diagnosed with borderline personality disorder,1 among other things, had a history of chronic suicidality and self-injurious behavior. When she realized that her relationship with her new partner was not going to save her from her suffering, she sought physician-assisted suicide (PAS), which has been legal in the Netherlands since 2001.

The ter Beek case raises important questions around PAS of psychiatric patients, including, in our view, the role of the physician’s countertransference in the PAS situation. While much has been written about countertransference in psychotherapy and psychiatric treatment more generally, relatively little attention has been paid to its relevance to PAS. Here, we briefly offer some preliminary ideas on countertransference in PAS, including in particular the role of projective identification—a particularly perilous countertransference reaction.

Dr Ronald Pies

The authors then explain, with clinical terms, what they mean by countertransference or what is known as projective identification. They provide this example:

"A patient insists to inpatient staff, day after day, “You all hate me and want to kick me off the unit!” The more staff denies this (“No, no—we want to help you!”), the more insistent the patient becomes, repeating the same charge over and over. Soon enough—after about a week or so—many staff members do wind up feeling hatred towards the patient and advocate kicking her off the unit. The patient, entirely blind to what has occurred, proclaims, “I knew it! I told you so!”

They then explain how this may relate to euthanasia and assisted suicide:

How does all of this relate to PAS? We believe that there is a risk—indeed, a real danger—that in at least some cases of PAS, projective identification plays a central role in the physician’s evaluation and decision-making. In considering the issue of PAS, we must ask ourselves what happens in between the patient’s request to die and the physician’s granting of such a request. In our view, much of this process occurs outside of the awareness of both patient and doctor. That is, it is motivated by unconscious mental forces.

For example: Why would patients who could easily take their own lives by various means want to involve physicians in that process? Leaving aside those who may be physically infirm and unable to do so, we hypothesize that the rest may derive some psychological gratification by involving a caregiver or authority in their suicide.

With respect to the physician, we hypothesize that in at least some cases of PAS—especially those complicated by the patient’s personality pathology or traits—the physician unconsciously identifies with the patient’s hostility and self-destructiveness and subsequently assumes the role of aggressor. That is, the physician is unconsciously induced by the patient to play out the patient’s projected aggression and self-destruction. If the physician does not come to understand this phenomenon, the result may be the termination of the patient’s life.

The authors provide more proof that their hypothesis is correct and they state that further research is necessary. The authors conclude:

In sum, we believe that any comprehensive understanding of the PAS situation must include an examination of the powerful psychodynamics at play between patient and doctor, including the experience of countertransference and projective identification. We ignore these things at our own—and our patients’—peril.

Dr Ruffalo is an assistant professor of psychiatry at the University of Central Florida College of Medicine in Orlando and adjunct instructor of psychiatry at Tufts University School of Medicine in Boston, Massachusetts. 

Dr Pies is a professor emeritus of psychiatry and a lecturer on bioethics and humanities at SUNY Upstate Medical University in Syracuse, New York; a clinical professor of psychiatry emeritus at Tufts University School of Medicine in Boston, Massachusetts; and editor in chief emeritus of Psychiatric Times (2007-2010). Dr Pies is the author of several books. A collection of his works can be found on Amazon.

Acknowledgments: They thanked Drs. Mark Komrad and Cindy Geppert for their helpful comments on countertransference that informed the preparation of this manuscript.

Meghan Schrader: Reflections on Juneteenth

Meghan Schrader

By Meghan Schrader 

Meghan is an autistic person who is an instructor at E4 - University of Texas (Austin) and an EPC-USA board member.

This week the country celebrated Juneteenth, a holiday marking the end of slavery in the United States. I thought it would be a good idea to do a post marking the holiday, discussing the history of disabled African American slaves, considering the experiences of disabled BIPOC people, discussing trends in intersectional justice advocacy, and discussing how the intersection of race and disability is relevant to efforts to oppose assisted suicide. I know that I cannot do as good a job at this as Not Dead Yet Minority Outreach Director Anita Cameron or Keith Jones from Krip Hop Nation, but I will do my best.

First I thought it would be instructive for me to share a summary of the parallels between ableism and racism from a disability studies scholar who has studied the issue extensively. In a 2011 Society of Disability Studies Conference Presentation entitled "Expanding Our Theoretical Toolbox: The Politics of Dis(Ability) in Black Feminist Scholarship" professor Sami Schalk distinguished ableism, or the privileging of able-bodiedness, from “disableism,” or the network of practices that discriminates against people with disabilities. Schalk asserted that:

“Racism is discrimination against people of color while white supremacy is the overvaluing whiteness. Sexism is discrimination again women and femininity while patriarchy is the systematic privileging of men and masculinity. So, going back to those lovely days of standardized testing, we could think that disableism is to ableism as racism is to white supremacy and sexism is to patriarchy."

Schalk has since written a book on racial and disability justice that can be purchased on Amazon. I think that Schalk’s summary is an instructive starting point for the EPC blog’s readers to think about the parallels between ableism and racism, and how they intersect.

One thing to note when celebrating Juneteenth is that most discussions of slavery, like most discussions of history, leave out the experiences of slaves with disabilities. I think many of the EPC’s blogs readers may be unaware that kidnapped Africans on slave ships who were found to have disabilities were thrown overboard as “defective merchandise.” Harriet Tubman’s disability isn’t typically addressed the way it needs to be. Growing up I remember learning that Tubman had a traumatic brain injury, but that injury wasn’t discussed in the context of what 19th century disabled people or disabled BIPOC people experienced as a group. Other scholars have noticed this problem as well. Disabled people are still struggling to make our communal history visible to the predominant culture, and I think it is reasonable to conclude that this invisibility is helping to drive popular support for assisted suicide. 

If a disenfranchised people group’s history is erased from the public consciousness, lack of historical knowledge makes it easier for people to tolerate killing members of that group, and harder for people to think about how doing that will intersect with expressions of systemic racism. Lack of attention to how the history of slavery intersects with the history of disabled people is bad for disabled people of all colors, and for BIPOC people of all abilities.

Two other issues that Juneteenth provides the opportunity for EPC blog readers to think about are current trends in how intersectional justice advocacy approaches discussions about disability and race, and how people advocating for disability justice can best empower BIPOC people with disabilities.

It may surprise some EPC blog readers to learn that BIPOC disability justice advocates have asked white disabled people to please avoid race and disability analogies. To many people these analogies seem fine; just a handy way of pointing out how bad ableism is. I think that these analogies are particularly enticing when one is interacting with a vocally anti-racist person who is a virulent ableist. And, in the spirit of honesty I must admit that I am often sorely tempted to continue doing exactly this, especially in regard to mainstream bioethics and the assisted suicide, which so many progressive-identifying people ignore or support. I find myself wanting to scream, “You mainstream progressives wouldn’t tolerate the Ku Klux Klan, why do you tolerate Peter Singer, who compares disabled people to chimpanzees and thinks it’s fine to rape us? You presumably wouldn’t tell an ablebodied BIPOC person to die by suicide, why do you think it’s acceptable to send that message to disabled people of all creeds and colors? WHY???

However, I’ve been trying to learn not to frame my criticisms of people’s hypocrisy in that particular way nowadays, because people like Anita Cameron have asked me to stop doing it. And I respect and admire Anita and these other disability justice leaders so much, that I’m trying to learn other ways of illustrating the moral perils of ableism. 

My friendships with intersectional justice advocates and my exposure to the field of disability studies has taught me that BIPOC people with disabilities have their own history and experiences that are distinct from what what a white disabled person like me might experience. The need to foreground the experiences of BIPOC disabled people is where the X hashtag #DisabilityTooWhite and Anita Cameron’s project We Were There Too: Blacks in The Disability Movement come from. My interactions with BIPOC and intersectional justice advocates have taught me that many of the BIPOC people killed by the police have disabilities, and that many BIPOC migrants and incarcerated BIPOC people have disabilities. As such, effective and equitable disability justice work accounts for these intersections. In my Special Education program at the University of Texas, I learned that educational researchers had developed evidence-based practices for instructing and assessing BIPOC children with disabilities, because instruction and testing that does not take disabled culturally and linguistically diverse students backgrounds into account can lead to poor learning outcomes for those students, or to those students being overdiagnosed or underdiagnosed with disabilities. Considering the specific needs and experiences of BIPOC people with disabilities is an important contribution to establishing disabled people’s equal human right to live, which is what anti-assisted suicide advocacy is all about.

So, what are the most direct ways that the intersection of ableism with racism is relevant to the issue of assisted suicide? According to a 2013 Pew Research poll, the majority of BIPOC people oppose assisted suicide, which makes sense, given that BIPOC people of all abilities have a history of being abused by the healthcare system. One can see the intersection of ableism and racism in the case of Michael Hickson, the quadriplegic black man who was forced to die in Texas during the COVID pandemic. Moreover, BIPOC people on Medicaid are more likely to be the target of futile care impositions, which provides a preview of how things would play out if people like Thaddeus Mason Pope get their way and the United States eventually allowing involuntary euthanasia. In considering the issue of race, disability and assisted suicide, it is also important to consider the issue of class. The fact that so many of the targets of futile care laws have been people of color on Medicaid indicates that while assisted suicide is supported by some middle and upper class BIPOC people, the practice would further oppress working class and disabled BIPOC people. All of these dynamics are why our Indigenous Canadian neighbors have generally come out strongly against that country’s “MAiD” program, and why Anita Cameron’s work organizing BIPOC opponents of assisted suicide is so important.

One of the most illustrative examples of the intersection between ableism and racism that I have come across is the work of Richard Hanania, a right wing conservative supporter of assisted suicide who used to be a fellow at the University of Texas’s conservative think tank the Salem Center. In a blog post entitled “Canadian Euthanasia As Moral Progress,” Hanania wrote:

“One could just as easily say that people who want to kill themselves after becoming disabled are seeing things more objectively, and when they accept their condition they’re coping and living under a kind of false consciousness. I’m pretty sure I would want to kill myself if I was ever paralyzed, and I grant it’s possible that maybe I would change my mind after a while. But I wouldn’t want to become reconciled to living with such a condition. The idea that I might accept it would for me be even more reason to commit suicide, lest I get used to accepting a defective version of myself.”

In response to this post, professor of Mental Health Law Isabel Grant tweeted, 

“How is this not hate speech?” 

Professor Trudo Lemmens tweeted back, 

“I thought the same. His vile suggestions about who is better off dead would definitely be treated as hate speech if you change who he is talking about. Yet some of our colleagues endorse this crap with enthusiastic fervor.”

Another X user called Brendan wrote, 

“This is honestly the most disgusting piece I’ve ever read on the topic of MAiD. I was half expecting the phrase “lebensunwertes leben” to show up somewhere in the piece.” 

Lemmens tweeted back, 

“It is there, just not in German, worded slightly differently, and adding “choice” to turn it into a liberal ideal.”

Exactly. Hanania’s pro euthanasia screed is hateful. He may as well republish the text of Life Unworthy of Life verbatim. And that’s not ok, even if Hanania doesn’t want to round unwilling disabled people of all creeds and colors up and gas them in vans.

Predictably, some of the leaders in the right to die movement thought that Hanania’s blog post was delightful. Canadian Queen of Expanding Euthanasia To Everything And Everyone Jocelyn Downie tweeted, 

“This thread. This piece on Substack. Antidotes to the recent waves of misinformation and flawed analysis of assisted dying in Canada.”

Downie was unaware of the rest of Hanania’s background. In 2023 The Huffington Post did an expose on Hanania that revealed that he had posted on white supremacist websites under a pseudonym, and he lost his post at UT. (In the tradition of disabled people being left out of social justice efforts, Hanania of course did not get in trouble for his retread of lebensunwertes leben, because apparently no one at the Huffington Post or UT thought to consider how that attitude affects BIPOC people with disabilities.) So, Downie wound up boosting the work of a white supremacist because the surrounding culture has enabled her to think that systemic ableism is fine. Hanania’s attitude towards disabled people of all colors and BIPOC people of all abilities elucidates what leading scholars of race and disability studies and the history of eugenics tells us: the legacies and ideologies of racism and ableism are intertwined like the roots of a tree. A government policy of helping disabled people die by suicide and the worst expressions of racism that disabled BIPOC people experience are part of the same ideological phylum: hating or ignoring the members of disenfranchised groups so much that you don’t mind if they die.

As we mark Juneteenth, I must admit I do not know exactly what solutions are the best for repairing the damage that both systemic racism and systemic ableism have done to the world, or how best to integrate anti-ableism with anti-racism. But, my relationships with people like Anita Cameron and others in the disability rights movement indicate to me that the process of doing that starts by compassionate listening and learning. It involves humility, open-mindedness and creativity. And integrating racial justice into disability rights advocacy involves a firm commitment to the ideal that no one should have to live in a world where they are so oppressed that they are encouraged to kill themselves. Marking the abolition of slavery should remind us that all people have an equal right to live with dignity and respect.

Great news: Delaware assisted suicide Bill HB 140 was defeated.

Alex Schadenberg
Executive Director,
Euthanasia Prevention Coalition

I have incredible news. 

The Delaware State Senate defeated HB 140 in a tie vote today 

A key reason that HB 140 was defeated was that Senator Bryan Townsend (District 11) a sponsor of the bill, voted NO at the final vote. (Link to the vote).

There are several reasons why some Senators shifted their votes and voted NO.

The key reason was the many people worked to defeat HB 140. Congratulations. You have truly made a difference.

Another reason is that during the Senate debate several key questions came up. One of those questions was - How do the assisted suicide drugs work? This is a significant question since we know that many assisted suicide deaths are not quick or peaceful.

• Here is an article concerning the research on how assisted suicide drugs cause death (Link).
• What the assisted suicide lobby doesn't want you to know (Link).
  
• Recently Kelsi Sheren and Jordon Peterson did a podcast titled: The Horrifying Truth Behind MAiD that they aren't telling you (Link). 
• Another article was recently published on this topic titled: Canadian veteran slams euthanasia law for targeting her peers (Link). 

During the debate several Senators became concerned about how people die by assisted suicide. Delaware doesn't support capital punishment, why would they support assisted suicide?

As stated earlier, the key factor was the many people who worked so hard to defeat the assisted suicide bill.

Here are some more articles about the Delaware assisted suicide bill.

• Clarifying comments on Delaware assisted suicide Bill HB 140 (Link).
• Nearly every US State that has legalized assisted suicide has expanded their law (Link).