Health and Human Services (HHS) Office for Civil Rights statement on the ADA and assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The following message was released by the HHS Office for Civil Rights (OCR) on July 27, 2026.

As we mark the ADA's 36th anniversary, HHS Office for Civil Rights (OCR) reaffirms a fundamental principle of the Americans with Disabilities Act (ADA): people with disabilities have the same inherent dignity and equal worth as every other person.

The ADA and Section 504 of the Rehabilitation Act prohibit discrimination based on disability in many settings, including healthcare. Healthcare decisions must not be influenced by stereotypes, bias, or judgments that a person's life is less valuable because of disability. Steering an individual toward physician-assisted suicide because of disability or assumptions about that person's quality of life may constitute unlawful disability discrimination. The Affordable Care Act also prohibits the use of federal funds for physician-assisted suicide, euthanasia, or mercy killing and protects health care providers and entities that decline to participate in those practices.

HHS OCR is committed to enforcing these protections and ensuring that people with disabilities are treated with dignity and respect and receive equal treatment under federal law. If you believe you have experienced disability discrimination in healthcare, you can file a complaint at: hhs.gov/ocr/complaints…

The HHS OCR statement upholds the equality of every American while correctly acknowledging that assisted suicide can be based on discrimination.

The statement also reinforces the federal law prohibiting funding for assisted suicide, euthanasia or mercy killing and the importance of protecting health care providers right to decline to participate in assisted suicide.

The statement focused on three points. Some people with disabilities have felt pressured to assisted suicide. Research has uncovered the fact that the federal law prohibiting funding for assisted suicide is being circumvented. Several state assisted suicide laws, including New York, undermine the right of health care workers to refuse to participate in killing by assisted suicide.

I am proud to be an American. And I am not disposable.

The text of a speech by Meghan Schrader on July 3rd at an ADAPT of Texas rally to save the 2024 Final Rule’s updates to Section 504 of the Rehabilitation Act.

Meghan Schrader

Meghan Schrader

Disability activist and member of the EPC-USA Board

I am asking Attorney General Paxton to show compassion and respect to disabled people by dropping the Texas vs. Kennedy lawsuit, which seeks to have the 2024 Final Rule’s updates to Section 504 of The Rehabilitation Act, one of our nation’s flagship disability access laws, declared unconstitutional.

Some decent people I’ve tried to talk to about Texas vs. Kennedy dismiss disability advocates’ concerns about this lawsuit as “woke hysteria.” But the accessibility guidelines that are outlined in the Final Rule are not “woke politics” or a culture war issue, they are a matter of human dignity.

The practices outlined in the Final Rule are necessary to meet the human family’s moral obligations to people with disabilities.

The Declaration of Independence says, 

“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness."

“The Final Rule, Death And Disability Exclusion: There Is Nothing New Under The Sun”

Meghan Schrader

By Meghan Schrader

Meghan is a disability instructor and a member of the EPC-USA board.

As I’ve said, the Final Rule, a 2024 update to Section 504 of the Rehabilitation Act, especially Sections 84.56(a) and (b), contains some of the best regulations that the euthanasia prevention movement has had at its disposal in decades. Along with new opportunities for everything from home care to internet access, the Final Rule’s regulations elucidate what medical providers must do to make things like x-rays, mammograms, surgery suites, clinics, hospitals and other medical services accessible to disabled patients.

And in a substantial boost to euthanasia prevention, the Final Rule contains prohibitions on futile care laws, infanticide, and doctors “denying or limiting medical treatment based on the provider's belief that the life of a person with a disability has a lesser value than a person without a disability, or that life with a disability is not worth living.”

Yet, in the time since my last blog post about the Final Rule, there have been additional indications that these protections are at risk. As with the Final Rule’s protections for general internet access and better grievance system for disabled people struggling to access home care, the requirement that medical providers make their websites and apps accessible to disabled people has been delayed by the US Department of Health And Human Services.

The government has also indicated that it intends to “reconsider the substantive requirements” of the 2024 Final Rule more broadly. This suggests a risk that all of the Final Rule’s new healthcare accessibility requirements will be rescinded, just as HHS rescinded the Final Rule’s requirement that nursing homes maintain enough staff to prevent residents from experiencing bedsores and malnourishment.

This lackadaisical approach to healthcare accessibility is an absurd blow to euthanasia prevention.

HHS Secretary Robert F. Kennedy has said that Canada’s euthanasia program is “abhorrent.” That’s great, but the government he serves seems happy to dismantle bulwarks against euthanasia.

This is not a partisan statement. Leaders from across the political spectrum make budget cuts and policy decisions that harm people with disabilities. I would write the same things about current disability policies regardless of who controlled the government.

Meanwhile, seven states continue to press ahead with the Texas vs. Kennedy lawsuit, which seeks to repeal the Final Rule, especially its community integration mandate. This mandate is intended to prevent the unnecessary institutionalization of persons with disabilities. It does not require states to close institutions, but it does require them to institute new supports for disabled people at risk of being institutionalized. The plaintiffs are hoping to have a federal judge grant their petition without a full trial.

Texas, Florida, Alaska, Kansas, Louisiana, Missouri and Montana, the states that remain involved in the Texas vs. Kennedy lawsuit, base some of their argument on “states rights.” The states’ attorney generals contend that the Final Rule’s integration mandate encroaches on their “budgetary and policymaking discretion.” They decry the Final Rule's “mandate for states to redesign their Medicaid programs.”

This is an argument for convenience. Texas and Florida, for instance, have some of the highest numbers of institutions in the US; those two states would have to do a lot of work to implement the community integration mandate. Even if there are some people who require institutional care, these states lock disabled people in institutions who don’t need to be there so that the staff can keep their jobs. And the attorney generals in those states wish to export their states’ dysfunction to disabled people across the country, because in their opinion, the best policies serve what’s best for their states, not disabled Americans.

This is what moral theologian Charlie Camosy and Pope Francis call “throwaway culture.”

Euthanasia opponents come from all religions and no religion at all. But I am now going to draw on passages from the Bible because I know that a lot of euthanasia opponents view it as the guidebook for their lives.

In Ecclesiastes 3:16, Solomon writes: “And I saw something else under the sun: In the place of judgment—wickedness was there. in the place of justice—wickedness was there.”

Ecclesiastes 3:16 is a statement about the reality of human injustice. It observes that corruption and wickedness frequently occur in places meant for fairness and righteousness.

That is what is happening when leaders say they oppose euthanasia while dismantling social structures that prevent euthanasia.

Before “MAID” supporters start congratulating themselves on how much more sensitive they think they are to injustice, allow me to direct them to my previous blog post “Many MAiD Proponents Want Credit For Fixing Problems They Ignored For Decades.” Often “MAiD” proponents shout that their cause is a “social justice issue,” yet they have a history of ignoring disability justice.

That’s why they’ve helped create a world where disabled people are offered “MAiD” instead of support.

As I ponder the actions of policymakers who view disabled people as acceptable collateral damage, I find myself reflecting on Ecclesiastes 1:9-“What has been will be again, what has been done will be done will be done again, there is nothing new under the sun.”

This pattern of regressive disability policy decisions is not new; disabled people have been experiencing the same ignominy for generations.

Of course there is a possibility that the Final Rule will not be repealed. Perhaps damage to the USA’s disability inclusion infrastructure can be prevented or repaired. I hope euthanasia opponents will work toward these efforts.

I urge readers to resist cruel policies that consign disabled people to what disability studies scholar Paul Longmore called a “social death.” Instead of allowing disabled people to be abused and ignored, society should base its disability policies on Isaiah 61:1-“He has chosen me and sent me to proclaim good news to the poor, to heal the brokenhearted, to proclaim release to captives and freedom to those in prison.”

Author Note:

It may still be possible to save the healthcare non discrimination regulations, and other parts of the Final Rule.

For information about how to contact your attorney general to ask them to drop out of the Texas vs. Kennedy lawsuit, see this link.

To write to the US Department of Justice, use this link

To write to the Department of Health and Hunan Services, use this link.

For a quick explanation of what Section 504 of the Rehabilitation Act is, see this Drunk History video about the history of the law.

For a compelling film about the harms of unnecessary institutionalization, watch the 2014 movie Love Land.

You can find a 2023 video of Pope Francis discussing the inclusion and dignity of people with disabilities at this link.

To read the Euthanasia Prevention Coalition’s statement against the Texas vs. Kennedy lawsuit, see this link.

Nothing about us, without us"

This article was published by Amy Hasbrouck on her substack on May 7, 2026.

Amy Hasbrouck

By Amy Hasbrouck

Get our words out of your mouth.

Rumour has it that the head of Dying with Dignity, Helen Long, invoked an axiom of the disability rights movement in advocating to expand eligibility for euthanasia to people whose requests arise only from a mental illness. Allegedly Ms. Long, who does not identify as disabled, criticized the parliamentary committee for not seeking input from people with mental illness who want government help to ensure fulfillment of their suicidal wishes. Specifically she said the committee had not respected the principle of “Nothing about us, without us.”

(Ms. Long was reading a text by Claire Brosseau, who is a woman who is seeking euthanasia based on mental illness alone).

Say what?

Assuming Ms. Long doesn’t have the lived experience of disability, one would think that, as a woman living in a culture of sexualized violence, she might be able to make the solidarity connection in a more genuine way than by simply claiming it. I get it that the issues raised by euthanasia of people with psychiatric disabilities may be too specialized for folks who are not disabled survivors of childhood trauma and the mental illness that often flows from it. It probably doesn’t occur to Ms. Long that allowing MAiD for people with mental illness undermines the public policy of Suicide prevention, by allowing (often ableist) mental health professionals to judge not just the remediability of a mental illness, but also the person’s quality of life and human worth. And maybe it doesn’t occur to Dying with Dignity that inappropriate or inadequate mental health care means that people with psychiatric disabilities are requesting MAiD because they haven’t gotten the help they need, and are subject to stresses like homelessness, addiction (from attempts at self-medication), and stigmatization.

If Ms. Long really cared about disabled people, she would know that, while some disabled individuals support assisted dying, disability organizations that advocate for equality, acceptance and accessibility oppose medical killing. ADAPT and Not Dead Yet have opposed medical killing since the mid 1980s. The Council of Canadians with Disabilities took its position against legalized medical killing in 1996, at the height of public support for Robert Latimer, who murdered his daughter Tracy in 1993. Surely Ms. Long knows that disability advocates recognize and object to the belief that disabled people are (supposed to be) better off dead, and the growing popularity of assisted dying … as promoted by Dying with Dignity. She would also know that disability advocates are aware that the option to “choose” state-provided euthanasia is fast becoming a duty to die.

If she knew the first thing about ableism, Ms. Long would know that MAiD discriminates against disabled people by definition; disability is among the eligibility criteria enumerated in the definition of a grievous and irremediable medical condition. She would also know that MAiD was provided to many non-terminal disabled people even before the 2019 Truchon decision and the 2021 adoption of Bill C-7, which created “track 2” eligibility for people whose deaths were not “reasonably foreseeable.” Even if Ms. Long didn’t have the advantage of the lived experience of disability discrimination to guide her in evaluating Bill C-14, and its early implementation, anyone who claimed the solidarity of “nothing about us, without us” should have noticed what’s happened in the ten years since legalization; the failure to improve access to palliative care, the reports of same-day euthanasia and MAiD requests linked to “external pressure” (poverty, inadequate and inaccessible housing, and treatment denials) the 100,000 euthanasia deaths and the transformation of an “exceptional” measure to an “expected” response.

When people’s livelihood and self-image depends on not understanding something, they probably won’t understand it. Apparently, Ms. Long’s personal, pecuniary and political interests depend on her not knowing that it is very uncool to appropriate a disability rights principle in advocating a position the disability rights movement strongly opposes.

So please, get our words out of your (nasty) mouth.

Amy Hasbrouck is the director of Toujours Vivant - Not Dead Yet and a past-President of the Euthanasia Prevention Coalition. 

Repealing the Final Rule Would Be Tragedy For Opposition To Euthanasia.

Meghan Schrader

By Meghan Schrader

As I’ve mentioned, the Final Rule, a 2024 update to Section 504 of the Rehabilitation Act, is one of the best tools that the anti euthanasia movement has had in decades. The Final Rule strengthens Section 504 and the Americans With Disabilities Act in several ways, including new prohibitions against medical personnel pushing disabled people towards death. These provisions are new bulwarks against assisted suicide, coerced DNRs, futile care statutes and the infanticide of disabled babies; such as in the 1982 Baby Doe case. Everything groups opposing euthanasia need to avoid a Canada-like situation is in those regulations.

The Final Rule not only addresses futile care statutes, assisted suicide and infanticide, it also contains numerous other beneficial provisions. For instance, the Final Rule contains new protections for disabled parents, internet access, accessible medical equipment and better community services for disabled people at risk of being institutionalized. Hence, the Final Rule will help protect disabled Americans from the scarcity that is pushing disabled Canadians towards euthanasia.

But in 2025, 17 states filed the Texas vs. Becerra lawsuit, now called Texas vs. Kennedy. The original lawsuit sought to repeal the entire Final Rule, as well as Section 504 itself. (The challenge to Section 504 itself was dropped after backlash.)

In addition to multiple disability protections that I think EPC blog readers from across the political spectrum can agree on, one clause of the Final Rule defined gender dysphoria as a disability. This was one of the reasons that the 17 states filed suit against the Final Rule.

But the gender dysphoria issue is currently a moot point. Regardless of whether one believes that gender dysphoria ought to be defined as an impairment, the President’s executive order on gender issues means that this government will not enforce that part of the Rule. So, eight of the original 17 states dropped out of the lawsuit.

But 9 states still want to eliminate the rest of the Final Rule. Texas, Florida, Alaska, Indiana, Missouri, Louisiana, Kansas, Montana and South Dakota want the government to avoid “burdening” states with the Rule’s requirement that states institute new supports for disabled people at risk of being institutionalized. So, on January 23rd, 2026, those states filed an updated version of their lawsuit. This iteration of the lawsuit makes no mention of gender dysphoria or repealing Section 504 itself, but it still seeks to have the entire Final Rule set aside.

I am also very worried that even if the lawsuit is dropped, HHS and the Department of Justice will rescind the entire Final Rule anyway.

This would be a shame, because the Final Rule is a critical tool for achieving opposition to euthanasia.

Groups opposing euthanasia have always fought the infanticide of disabled babies, which we know happens periodically in hospitals across the US and abroad because doctors make prejudiced judgments about the value of the babies’ lives. (Such as the UK Alfie Evans case.) Section 84.56 specifically addresses this problem. To quote from the text of the Final Rule:

“Comments: Several commenters asked the Department to clarify the application of § 84.56 to newborn infants.

Response: As indicated within the NPRM, the Department considers section 504, including § 84.56, to apply to newborn infants. This includes the prohibitions against the denial of medical treatment under § 84.56(b)(1) and (2), and the prohibitions on the discriminatory provision of medical treatment under § 84.56(b)(3).

Comment: One commenter objected based on its understanding that the Department's proposed rule would not apply to decisions to withhold treatment from infants with disabilities in which the disabling condition is related to the condition to be treated, noting that § 84.56(b)(2) addresses treatment for a separately diagnosable condition or symptom and not for the underlying disability. The comment concerned infants with disability conditions such as meningomyelocele, hydrocephaly, microcephaly, or other anatomical anomalies. The comment noted that failure to treat these conditions represents discrimination against a child with a disability.

Response: The Department believes that this comment misconstrues the section 504 rule. The Department intends that this rule will generally apply to the provision of medical treatment for infants, including those seeking treatment for separately diagnosable symptoms or conditions related to their underlying disability, when medical treatment is provided to other similarly situated children. For example, an infant with microcephaly may experience seizures. This would constitute a separately diagnosable symptom or condition for which treatment would be subject to the protections of § 84.56(b)(2) despite the fact that the seizures are a symptom of the infant's microcephaly. As the Department's NPRM made clear, with respect to separately diagnosable conditions, the rule will not require that the condition be entirely unrelated to the underlying disability. “Nor does it matter for these purposes whether the condition for which the individual is seeking treatment is in some sense causally related to the underlying disability if the decision to refuse treatment would not be made as to similarly situated individuals without the disability.” 88 FR 63405. In addition, § 84.56(b)(1) prohibits denying or limiting medical treatment to a qualified individual with a disability based on bias or stereotypes about that patient's disability, judgments that the individual will be a burden on others due to their disability, or a belief that the life of a person with a disability has a lesser value than the life of a person without a disability or that life with a disability is not worth living. Under such circumstances, the discrimination described by the commenter would also be covered under § 84.56(b)(1) even if the condition for which the patient sought treatment was not a separately diagnosable symptom or condition from their underlying disability.”

So, if you are fighting infanticide, the Final Rule is your best friend. 

Opposition to euthanasia has also always fought futile care laws, like those that exist in Texas and California, which allow hospital ethics committees to override patients’ and families’ desires for life-saving care that ableist physicians consider “futile.” For instance, the anti-futility provisions in the Final Rule were inspired by the case of Michael Hickson, who was denied treatment for COVID-19 because he was a quadriplegic. The Final Rule forbids such authoritarianism. It is the anti euthanasia movement’s best shot at eliminating futile care laws once and for all.

An excerpt about the Final Rule’s prohibition on medical futility reads as follows:

“The Department proposed §  84.56(b)(1)(iii) to prohibit recipients from denying or limiting medical treatment based on the provider's belief that the life of a person with a disability has a lesser value than a person without a disability, or that life with a disability is not worth living.

Comments: The Department received a broad array of comments from disability organizations, civil rights organizations, and other stakeholders supporting this approach. We received stories from people with disabilities describing their own experiences or those of friends regarding the denial of life-sustaining treatment and the difficulties involved in accessing it after such denials. We also received similar stories from providers. For example, one provider association described a 25-year-old patient with a developmental disability who had been referred to an inpatient hospice unit after becoming poorly responsive with brain imaging demonstrating a shunt and severe abnormalities. After the provider learned from a family member of a recent sudden change in the patient's behavior, the patient received a second opinion, leading to the shunt being surgically revised, the patient's condition improving, and her enjoying her life for many more years. In the words of this commenter, the patient's “referral to hospice without sufficient exploration of other treatment options was inappropriate and may have been driven by a mistaken clinical assumption regarding her baseline quality of life.”

Response: The Department will retain the provision as proposed. We respond to specific questions regarding the application of this requirement throughout this section.”

Hence, this section of the Final Rule forbids the futile care impositions that groups opposing euthanasia have fought for decades.

Moreover, we know that disabled Canadians are agreeing to be killed by “MAiD” because they aren’t getting the supports they need: not having wheelchairs, pain control, food, housing, jobs, etc. These conditions also contribute to high rates of suicide among US citizens with disabilities. Hence, the Final Rule helps prevent disabled Americans from experiencing Canada-like tragedies.

And, given that the Final Rule prohibits federal funding recipients from “from denying or limiting medical treatment based on the provider's belief that the life of a person with a disability has a lesser value than a person without a disability, or that life with a disability is not worth living,” it precludes turning disabled people’s suicides into a “medical procedure.” Think of the efforts we will have to expend against assisted suicide in the future: wouldn’t you like to use the Final Rule to fight those bills?

I urge other euthanasia opponents to do what they can to defend the Final Rule. Time is of the essence, because many of the regulations in the Final Rule are supposed to take effect this month and federal officials have already eliminated or delayed some of them. For instance, officials have rescinded new provisions requiring adequate staffing in nursing homes. New rules about internet access and home and community based services have also been paused. Therefore, the aforementioned anti-death provisions could soon be paused or eliminated as well.

So, if you are someone in Washington DC who interacts with officials at HHS or the Department of Justice, make the importance of the Final Rule part of your conversations. If you live in one of the states that is bringing the Texas vs. Kennedy lawsuit, write to your attorney general and ask them to drop it.

The Final Rule furthers compassion and dignity for disabled persons. It is also one of the USA’s most urgent anti-euthanasia issues in decades.

Author Note:

For information about how to contact your attorney general to ask them to drop the lawsuit, see this link.

To write to the US Department of Justice, go to this link.

To write to the Department of Health and Hunan Services, use this link.
For a quick explanation of what Section 504 of the Rehabilitation Act is, see this Drunk History video about the history of the law. 

Meghan is a disability instructor and a member of the EPC-USA board.

Meghan Schader: Please Do Not Use the R Word: Part 2

Meagan Schrader

By Meghan Schrader

As I’ve written, some people have begun incorporating the words “retard” and “retarded” (known in disability circles as the R word) into their political identities; people are using the R word as a way to signal their frustrations with political correctness. Hence, public usage of the R word has increased significantly.

I want to help other euthanasia opponents understand why it’s important to resist this fad.

So I’m offering a more detailed account of a few of my experiences of being called the R word; I think they might help euthanasia opponents understand why participating in the R word craze trivializes the word’s connection to disabled people’s experiences of abuse, even if the people using the term as a badge of honor don’t mean it that way.

One day at church when I was eleven, another girl randomly walked up to me and said, “Meghan, you’re a retard and everyone hates you.” “That’s not a very Christian thing to say,” I answered. “I’m not Christian, I’m Episcopalian,” she said. (LOL).

This girl was not alone in using that term. During one Sunday School class when the teacher finally told an aggressive bully to stop calling me the R word, he said, “She’s like an animal, she has no feelings anyway.” This abusive behavior spread among other children in the class, until pretty much everyone was calling me the R word and saying that they hated me. The problem became so severe that my parents pulled me out of Sunday School.

In sixth grade there was one bully who not only called me the R word, but also taunted me with comments like, “Did your mother drink when she was pregnant with you?” “Did your parents lose a bet with God or something?” “I’m going to throw acid on you in science class.” Then he stole metal pellets from the science classroom and threw them at my head. After that, the principal ordered us to attend a peer mediation session with two peer mediators and a police officer. The bully had no compunction. He proudly admitted that he had, in fact, called me the R word, threatened my life, etc. “Yeah I hate her; everyone in the school hates her,” he said.

These are only a few examples; I could go on and on about all of the times that bullies did vicious things while calling me the R word.

In short, when you use the R word to prove how bravely politically incorrect you are, you are ignoring the term’s link to dehumanization and prejudice.

So, please: Don’t use the R word.

Meghan is a disability instructor and a member of the EPC-USA board.

• Previous article by Meghan Schrader on this topic: (Read).
  

Is Mental Illness Irremediable?

This article was published by Amy Hasbrouck on her substack on April 12, 2026.

Without adequate supports, MI under MAiD could be a death sentence.

Amy Hasbrouck

By Amy Hasbrouck

The central question when considering if Euthanasia and Assisted Suicide (E/AS) should be allowed for people whose requests arise solely from a psychiatric disability is whether mental illness is irremediable. The answer depends on many factors; the origins, causes and history of the mental illness, the infrastructure in place to support healing, whether the treatment approach is holistic or symptom-focused. Possibly the most important predictor of success is the ability to retain hope that recovery is possible. As a starting point, hope requires trust in the therapeutic relationship, but trust and the hope of recovery are both undermined by allowing E/AS for psychiatric disability alone.

While my physical and sensory disabilities might or might not qualify me for euthanasia under Canada’s Medical Assistance in Dying (MAiD) regime, it is my psychiatric disabilities (mental illnesses) that are most likely to induce me to request euthanasia.

Evolving diagnoses

The day after I graduated from secondary school in 1979, I realized that the “childhood abuse” I had experienced might be connected to the exhaustion, low self-esteem, and depressed mood I had struggled with as far back as I could remember. Since then, I’ve had two hospitalizations, and a series of diagnoses – from depression, to PTSD, to dissociative identity disorder – and I’ve been prescribed at least 15 psychiatric medications. At the moment I’m taking five meds with (unofficial) diagnoses of Complex PTSD,1 Treatment Resistant Depression,2 along with the complicating and compounding effects of ableism.

My experience supports the conclusions reached by Mark Konrad and Catherine Ferrier in their recent article “MAID: No Evidence Base for Futility and Irremediability in Psychiatric Disorders”;3 that “diagnosis and prognosis of mental disorders are unreliable,” and there is an “enormous and nonspecific variety of treatments for mental disorders.”

Origins, Causes and History

Nearly 2/3 (63.9%) of adults report having at least one Adverse Childhood Experience (ACE) such as divorce or death of a parent, physical, emotional or sexual abuse or neglect, or substance abuse by family members.4 Studies have found “a strong relationship between exposure to abuse or household dysfunction during childhood and multiple health risk factors for the leading causes of death in adulthood.” The 17% of adults with an ACE score of four or more (of which I am one) have a “12 times higher prevalence of health risks such as alcoholism, drug use, depression, and suicide attempts,” chronic illness (such as fibromyalgia and chronic fatigue) and autoimmune disorders (such as Lupus or Crohn’s disease). Yet when I asked my primary care doctor about whether Québec used ACE scores to screen for physical and mental health risks, she didn’t know what I was talking about.

I have been unable to see a psychiatrist to adjust the medications I am prescribed for symptoms of my mental illnesses since I arrived in Canada more than 22 years ago. The meds are only partially effective in managing symptoms related to Complex PTSD and depression, but I don’t know what my official diagnosis is, and despite several referrals, I have never actually spoken to a psychiatrist. I have been referred for counseling twice to professionals who had no background in working with people who have experienced disability discrimination; in one case, the therapist’s insensitivity led me to abandon the sessions, while the other therapist left a few months into the treatment. I have had limited success finding qualified therapists on my own, and I must pay for my own therapy since I do not have insurance aside from the provincial health plan.

Infrastructure for Healing

Physical security promotes healing

For me, successful treatment of mental illness depends on diverse, often intangible elements, some of which I already have in place. I have physical security in that I am lucky enough to have a home, a loving and beloved spouse, and economic stability.5 I have some social support through Adult Survivors of Child Abuse (ASCA), an online community with a focus on recovery from the effects of complex trauma. I am looking for a well-matched, skilled and respectful therapist to work with me on managing my nervous system’s dysregulation and hypervigilance. I am hopeful that someday I may recover some self-esteem and lose some of the chronic depression that drains and immobilizes me. I am aware, however, that my situation is precarious; that I am one setback away from suicidal depression, and that I do not have the full range of supports I need to meet the inevitable hazards of life.

Emotional healing

Healing from complex PTSD is – not to put too fine a point on it – complicated when you also have a disability. The usual feelings of shame and self-blame that come from long-term emotional and sexual abuse were magnified by my parents’ profound discomfort with my blindness. The discovery of my cataracts during a hospital stay for pneumonia at four months precipitated a major domestic crisis (with accompanying violence); my father thought the condition was caused by (and was therefore the financial responsibility of) the treatment I received for pneumonia, while my mother believed that the cataract diagnosis while I was hospitalized precluded the possibility that the oxygen treatment was the causal factor. Regardless, I was expected to keep up with my siblings in household chores, academics and play, even as I was shamed for blindness-related behaviours (like rocking or turning my head from side to side). These “self-soothing” behaviours, and accompanying shame, metastasized with the sexual abuse which started when I was about three years old.6

When my mother told me the bullies at school were wrong to say I was “blind as a bat” I thought she must be right because I had usable vision. I figured comments about my vision problem meant that I was just too stupid to learn how to see, since “seeing” generally meant being able to predict events based on applying learned experience. My father’s insistence that I learn touch-typing at the age of 10 – though invaluable when I studied journalism and the Law – was a double-edged sword. He wanted to be sure I would have “something to fall back on” because, after all, “boys seldom make passes at girls who wear glasses;” the response of my classmates suggested I probably wouldn’t land a husband/provider/protector. My father’s plans for my security, while insulting, also seemed sensible, since I was too stupid to see and unworthy of being seen.

Validation in a world gone mad

I left the U.S. in 2003 because I experienced the collapsing democracy and military imperialism of that era as an existential threat and profound cognitive dissonance. My job (advocating for the rights of disabled people), was threatened by state budget cuts and the failure to recognize health care as a human right. I had also been harassed and assaulted by a stranger in what was clearly a disability and gender-based hate crime, yet was denied the opportunity to report it as such at the (state) police station where I fled after the event.

My first 20 years in Canada were taken up with (re)learning French, making a marriage work and following my spouse to foreign postings, bringing the disability rights-based opposition to E/AS to Canada and Québec, and observing the continued political and social deterioration in the United States.7

I was aware of the negative effect of the E/AS work on my mental health, and did what I could to mitigate the damage. The situation was aggravated with the pandemic (and its triage policies that threw disabled people under the bus) and the inauguration of Trump 2.0; I became unable to manage the writer’s block that had been getting worse for years. This substack has taken me more than two months to write. But as I said, I got no support from provincial health services for managing psych meds or getting effective treatment.8

Treatment approaches

Holistic v. symptom-based

Recently I was reminded of the importance of a holistic approach (in the realm of physical health), when I awoke on March 14 with a 50% loss of usable vision in my “good” eye. I took it easy that day, and (to my great relief) the problem cleared up after about 36 hours. (10% of normal vision is a lot better than 5%). I am at a loss as to how to address the underlying problem; I suspect I may have had a partially detached retina due to ocular pressure caused by Continuous Positive Airway Pressure (CPAP) treatment I’ve used for 33 years to control obstructive sleep apnea. The ophthalmologist who prescribes the eyedrops for my glaucoma has never asked about the possible cause of the glaucoma, or whether it might be related to the CPAP, nor has my primary care doctor. So I don’t know which professional to consult, or how to raise my concerns, without giving the impression I am trying to tell the medical professionals how to do their job.

The same principle applies to mental health care; I believe that I probably need to do some sort of somatic-based therapy to bypass my tendency to intellectualize and avoid feeling, but am I asking too much by insisting on psychiatric support for medications specifically for Complex PTSD, or a therapist who can provide a treatment such as EMDR,9 and who understands my trauma history and experience of disability oppression?

The most appropriate therapies, the best-suited provider(s)

In November, the counsellor I had been working with for three years (who had the requisite expertise and background) abruptly terminated the therapy relationship. Since then I have interviewed several possible therapists, only to discover either that they do not provide the treatment I am looking for, or that they cannot work with me because of my location. I am searching for a therapist who is trauma informed and can work online, who is certified in EMDR and who works from a disability justice perspective.10

I have been sending the following introductory email to counsellors I find on therapist referral cites: “I’m a 64-year-old disabled, cis, white woman looking for a counsellor to work with me on complex PTSD from full-spectrum child abuse, medical trauma and ableism, as well as grown-up issues like lawyer recovery, expat status/second language self-expression, and burn out from 30 years of (draining and triggering) work opposing the legalization of assisted dying from a disability rights perspective. Specifically, I’m hoping to use adapted EMDR (I’m legally blind, so the EM part doesn’t work for me) to deal with the CPTSD; I’m open to suggestion on the other stuff.”

Hope and trust in the therapeutic relationship

Recently I got some feedback on the introductory email; I was told that it could be off-putting, or even intimidating to some potential therapists. I responded by saying “That’s kind of the point.” I don’t want to waste my time interviewing counsellors who do not understand complex trauma, or who hold medical-model views of disability, or who see assisted dying as a good idea for disabled people.11 I’m also not confident I could gain much insight in talk therapy when my nervous system reacts like a three-year-old kid who can’t see if my rampaging father is about to attack me, every time someone raises their voice. Each time I question myself about one of my criteria (“do I really need a therapist who understands ableism?” or “Do I really need to do nervous system regulation?”) I have to remind myself that I’m not asking for too much, and that I deserve to get the help I need.

Back to the question of irremediability

Is my mental illness irremediable? I hope not, and I don’t think so. I’m hoping I can cobble together the pieces of a treatment and support system into a coherent care plan for myself. But given the lack of support and help I have received from Québec’s health providers, I cannot feel assured that if I experience a sudden setback (major vision loss, death in the family) I will get the support I need without having my trauma exacerbated by the intervention of an ableist, paternalistic mental health system.

In 2022, Québec decided not to legalize euthanasia for mental illness alone, but what guarantee do I have that some well-meaning doctor or nurse practitioner might not decide that losing my remaining vision, combined with the effects of childhood trauma and any other crisis that pops up, isn’t enough to justify substituting euthanasia for suicide prevention?

Bill C-218

Disability rights activists oppose E/AS because we understand that, while cloaked in “good intentions” the state only intervenes to end disabled lives, because of the belief that disability is a fate worse than death. Bill C-218, which would prohibit MAiD for people whose request is based only on a mental illness, is a small step toward redressing the deadly, eugenic, ersatz form of “care” that is MAiD.

1 World Health Organization’s International Classification of Diseases for Mortality and Morbidity Statistics, 11th Edition, (2022), 6B41 Complex Post Traumatic Stress Disorder https://icd.who.int/browse/2024-01/mms/en#585833559.

2 Oliveira-Maia AJ, Bobrowska A, Constant E, Ito T, Kambarov Y, Luedke H, Mulhern-Haughey S, von Holt C.; Treatment-Resistant Depression in Real-World Clinical Practice: A Systematic Literature Review of Data from 2012 to 2022. Adv Ther. 2024 Jan;41(1):34-64. doi: 10.1007/s12325-023-02700-0. Epub 2023 Oct 26. https://pmc.ncbi.nlm.nih.gov/articles/PMC10796703/.

3 Konrad, M., and Ferrier, C., “Commentary: MAID: No Evidence Base for Futility and Irremediability in Psychiatric Disorders,” Psychiatric Times, April 6, 2026, https://www.psychiatrictimes.com/view/maid-no-evidence-base-for-futility-and-irremediability-in-psychiatric-disorders.

4 The ACE survey is far from complete; it does not account for medical trauma, discrimination, bullying, witnessing domestic violence, or the effects of war, natural disasters, displacement and migration. The World Health Organization’s ACE International Questionnaire takes more factors (such as discrimination, bullying and collective violence) into account, but does not include medical trauma.

5 One fly in my security ointment comes from the fact that my husband, who can no longer work and is losing mobility, finds meaning in life through helping homeless and marginalized people (some of whom are active alcoholics and drug addicts), who come to the house for loans emotional support or to do odd jobs. We have agreed that, for my sense of safety, they will only come between 1 and 5 in the afternoon, and that people who are intoxicated may not come into the house.

6 In 1991, at a workshop I gave (along with colleagues in a support group of disabled women survivors of child sexual abuse) called “Adding Incest to Injury” we presented on the multiplier effects of ableism and child sexual abuse. We described how being trained to compliance and treated as objects of medical care increased our vulnerability to sexual abuse, while the loss of control during sexual violation made us more susceptible to shame and existential confusion caused by disability discrimination.

7 Forever wars, anti-immigrant policies, the #MeToo movement in response to the predator-in-chief and the Epstein files, the failure of democracy and the backlash against diversity, equity, inclusion and accessibility.

8 From what I can gather, the only way to get comprehensive mental health services in Québec is to be in crisis, which would precipitate a response from the system that would deprive me of control over what treatment I receive and where and how I received it. This is highly triggering for a person with Complex PTSD, as I learned when I was hospitalized in 1991 and 1997, and can do more harm than the beneficial effects of the treatment.

9 Eye Movement Desensitization and Reprocessing (EMDR) therapy is an extensively researched, effective psychotherapy method in which the person focuses briefly on the traumatic memory while simultaneously experiencing bilateral stimulation, which can reduce the vividness and emotion associated with the trauma memories. Ongoing research supports positive clinical outcomes, showing EMDR therapy as a helpful treatment for disorders such as anxiety, depression, OCD, chronic pain, addictions, and Complex PTSD (Maxfield, 2019). EMDR therapy has even been superior to Prozac in trauma treatment.)

10 Disability justice is an intersectional framework and movement, coined in 2005 by queer disabled people of color, that centers the lives and leadership of marginalized disabled people. It moves beyond legal rights to address how ableism, racism, colonialism, capitalism, and heteropatriarchy intersect to harm people, the biome, and the environment)

11 FN One therapist wondered why I was working so hard to prevent people from having euthanasia if they wanted to be dead. It made me wonder if she provided suicide prevention intervention to all clients who were suicidal, or just non-disabled ones.

Amy Hasbrouck is the director of Toujours Vivant - Not Dead Yet and a past-President of the Euthanasia Prevention Coalition.

Social Sin and The Rollback of US Disability Rights

Meghan Schrader

By Meghan Schrader

As I’ve mentioned, there are many policies being proposed or implemented right now in America that are extremely harmful to people with disabilities.

These policy efforts are largely driven by the current administration’s determination to eliminate anything related to the concept of “diversity, equity and inclusion” and “diversity, equity, inclusion and accessibility.” In my opinion no ideology is perfect, including those underpinning DEIA programs. Yet the current radical changes to or elimination of any initiative attached to the concept of DEIA violate social, moral and theological conceptions of human dignity.

In its zeal to eliminate anything it perceives to be a form of DEI, this administration has rolled back changes to society that have nothing whatsoever to do with our country’s moral and political deadlock other than to make the world easier for people with disabilities to navigate. In this blog post I will focus on policies affecting people with vision disabilities, wheelchair users, disabled people who make sub-minimum wages, nursing home residents and disabled people who are at risk of being institutionalized.

In 2023 the government started using Calibri font on government documents to make them easier for people with vision disabilities to read, but this administration has reverted to the Times New Roman font. I have several Facebook friends with vision disabilities, and they have said that Calibri does make documents easier to read. Making government documents easier for people with vision disabilities to read is not a “culture war” issue. But disappointingly, Secretary of State Rubio, who has done some very good work opposing euthanasia, described the return to Times New Roman as necessary “to restore decorum and professionalism to the Department’s written work products and abolish yet another wasteful DEIA program.” He called the switch to Calibri “wasteful, confusing and unbefitting the dignity of US government documents.” Denying disabled Americans the dignity of reading government documents more easily so that government documents can be “dignified” shows an extreme mismanagement of priorities.

The government has also frozen higher accountability standards for airlines that damage travelers’ wheelchairs. I have many Facebook friends who use wheelchairs and it is common to see Facebook posts about airlines treating their wheelchairs with apathy, causing experiences of humiliation and potential bodily harm. Again this is not a “culture war” issue, nor is it “woke hysteria.” I know one conservative disability rights advocate who was one of President Trump’s disability policy advisors during his first term, and she worked very hard to help implement those new standards.

The current administration also eliminated federal plans to gradually phase out subminimum wages for persons with disabilities and provide training for jobs that allow them to make at least minimum wage. This would not immediately eliminate the current system; it would put social structures in place that would allow for it to be replaced gradually. This is a change that disability rights advocates like those at the National Down Syndrome Society, the National Association of Councils on Developmental Disabilities, the National Federation of the Blind and the American Association of People With Disabilities, had fought for for years. But now we are back to square one.

Another seriously dangerous decision by the administration is to rescind a recent requirement that nursing homes maintain a minimum number of staff, a change decried by groups like the American Association of Retired Persons. Lack of staffing results in nursing home residents going unfed, unbathed, developing bedsores and even dying because of that neglect. If your loved one were in a nursing facility, wouldn’t you want to make sure that there was enough staff to take care of them? Think about this issue in terms of the Golden Rule: what if you had to live in a nursing facility?

And as I’ve mentioned, 9 states has have filed Texas vs. Kennedy, a lawsuit seeking to have all of the new disability rights protections contained in the 2024 Final Rule, an update to Section 504 of the Rehabilitation Act, repealed. The Final Rule contains Section 84.56(a), which forbids doctors from making “quality of life” decisions that cause disabled people’s deaths. This is one of the most important tools that the anti euthanasia movement has had in decades. The Final Rule also institutes new rights for disabled parents, accessible medical equipment, internet access and more community support for disabled people at risk of being institutionalized. But all of those protections are at risk because nine states would rather not experience the “burden” of implementing them.

In order to explain the moral implications of this situation in a way that I think many other euthanasia opponents will understand, I will draw on the Catholic concept of social sin. The US Conference of Catholic Bishops defines that concept as follows:

“From the encyclical, Charity in Truth (Caritas in Veritate), Pope Benedict XVI: “The Church’s wisdom has always pointed to the presence of original sin in social conditions and in the structure of society: Ignorance of the fact that man has a wounded nature inclined to evil gives rise to serious errors in the areas of education, politics, social actions and morals….Social sin resides within a group or a community of people. It exists within any structure in society that oppresses human beings, violates human dignity, stifles freedom and/or imposes great inequity.”

All of these policies do exactly that. I strongly urge other euthanasia opponents not to support these policies and to work with the disability rights movement on developing policies that protect disabled people’s dignity.

Meghan is a disability instructor and a member of the EPC-USA board.