We oppose killing people, we support better end-of-life care.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

We are incredibly thankful with the defeat of the assisted suicide bills in the UK and Scotland this year and the incredible victory in Slovenia in November 2025.

These victories are proof that there is not overwhelming support for the concepts surrounding medical homicide (euthanasia and assisted suicide). Nonetheless these victories also uncover significant cultural challenges, especially in the UK.

One of the major reasons that these assisted suicide bills were defeated was that the language of these bills lacked effective definition and adequate protections for people at a vulnerable time of their life. Would a bill with clear language and proper oversight have passed?

The problems with the language and definitions within the UK assisted suicide bills are the same problems that we have experienced in Canada with the lack of oversight and expansions of medical homicide based on undefined language in the law.

During the assisted suicide debates in the UK and Scotland, those who opposed and supported the assisted suicide bills recognized that it was necessary to improve end-of-life care. 

We agree. It is unacceptable that people do not get the care that they need as they approach the end of their life.

This is a significant challenge for the UK National Health Service (NHS) as the cost of care is significant and yet necessary. I hope that the UK and Scottish governments don't simply talk in platitudes but rather employ action.

We support caring for people and we oppose killing people.

There are many reasons to oppose medical homicide but the primary reason is the effect on the culture and every individual when the government gives medical professionals, or some other group (Swiss assisted suicide clinics) the right in law to be directly involved with killing people.

• Effective legislative language will not protect people once they are killed.
• Excellent end-of-life care will not safeguard people once they are killed.

Further to that, the incentive to kill is great.

• Dead people don't need medical treatment or pain control.
• Dead people don't collect retirement pensions.
• Dead people don't collect disability benefits.

The commitment to opposing medical homicide must come first and then jurisdictions must actually provide better end-of-life care, equality for people with disabilities, and support for people with chronic conditions.

This is similar to suicide prevention campaigns. A commitment to suicide prevention requires the resources to help people at their lowest point, but the commitment starts with recognizing that every suicide is tragic.

The Euthanasia Prevention Coalition celebrates the victories in the jurisdictions that have rejected medical homicide as we oppose killing people. We challenge these jurisdictions to improve end-of-life care, equality for people with disabilities and the care of people living with chronic and often painful conditions.

We oppose killing people, and we can, and must provide better care.

No One Has The High Ground On Disability Rights Part 2

By Meghan Schrader
Meghan is a disability activists and a member of the EPC-USA board.

No One Has The High Ground on Disability Rights Part 1 (Link).

Meghan Schrader

Like I’ve said, euthanasia falls on a spectrum of policies that marginalize and objectify people with disabilities. So, when I compare the policies of the United States and Canada, and look at the history of how American leaders from across the political spectrum have treated people with disabilities, I am tempted to despair about disabled people ever being any powerful leaders’ priority. This pattern of marginalization helps create the social conditions that make euthanasia seem like a legitimate solution to disabled people’s problems. 

We know that ableist institutional environments have contributed to coerced euthanasia in Canada. As I’ve mentioned, the USA Justice Department released a slip opinion saying that a 27-year-old federal community integration mandate that states provide enough community support for disabled people to avoid unnecessary institutionalization is essentially null and void; that mandate only forbids “unjustified” institutionalization and states can justify institutionalization however they want. 

In my opinion this development is selfish, bigoted and cruel. But the Province of Ontario in Canada has done the same thing with its More Beds Better Care Act, which allows euthanasia-eligible patients to be forcibly transferred to institutions far away from their families. 

In the past year and a half there have been several instances of USA disability policy regression that push disabled people towards bad life outcomes, and many disability advocates I know would go so far as to view the collective impact of these policies as a kind of authoritarianism. But the Canadian government taking over hospices that decline to participate in euthanizing disabled people that Canada has allowed to live in squalor and misery is no less authoritarian, especially when disabled Canadians have expressed the need for euthanasia-free healthcare spaces. “You had better kill people with disabilities on your property or the government will take over your hospice,” isn’t better than any disability policy being passed or suggested in the United States right now. 

Regardless of which political contingency most strongly influences US social policy, rhetoric that dehumanizes disabled people is everywhere. A conservative-leaning Catholic writer, JD Flynn, whose son has Down Syndrome, posted on X, “You’re not owning the libs by slurring disabled people.”

One X user tweeted back,

“As much as I understand your particular opposition to it, preserving the derogatory use of the word "retard" is in fact necessary for rejecting liberal control of language and defeating the euphemism treadmill which is taking over the English lexicon.”

Another X user wrote,

“Nobody calls disabled people retards anymore. They probably don't even remember what that word means. You're more likely to see a mentally handicapped person call you a retard for this post than to see one be offended by the use of the word.”

Bullies called me a retard when they threw rocks at me, pushed me into the dirt, used my blankie to clean a bathroom floor, pulled down my pants & said that they wished I was dead. I know what the r word means.

And disabled people who have been bullied with the r word do not exist to assist in “rejecting liberal control of language and defeating the euphemism treadmill which is taking over the English lexicon.”

Not that conservatives have a monopoly on this behavior. Remember back in 2008 when the leftist news site Wonkette wrote a despicable blog post about Trig Palin on his birthday?

If you thought that Governor Palin didn’t have the spoons to assume the presidency if Senator McCain died or if you loathed her policy positions that‘s fine, But it wasn’t ok for some liberal to create a vulgar meme taunting that in contrast to the many “retarded” things Palin had said, she had only given birth to one “retarded thing.”

It’s my experience that no matter whether society’s most powerful people identify as conservatives or liberals, leaders habitually ignore disabled people’s needs. This pattern helps create the social conditions for the euthanasia movement to flourish.

United Nations Committee directs Canada to repeal Track 2 euthanasia deaths

PRESS RELEASE: “Do Better” – Inclusion Canada Welcomes UN Committee’s Concluding Observations on Canada’s Disability Rights Record

FOR IMMEDIATE RELEASE

MARCH 26, 2025

OTTAWA, ON – Canada has received a critical review by the United Nations Committee on the Rights of Persons with Disabilities (the CRPD Committee). Canada has been directed to repeal Track 2 medical assistance in dying (MAiD), raise the “woefully inadequate” Canada Disability Benefit rate, and address regional disparities in how the CRPD is applied.

Track 2 MAiD is for people with disabilities whose deaths are not reasonably foreseeable.

The CRPD committee says it “is based on negative, ableist perceptions of the quality and value of the life of persons with disabilities, including that ‘suffering’ is intrinsic to disability rather than the fact that inequality and discrimination cause and compound ‘suffering’ for persons with disabilities.”

“The UN is clear that our country must do better in upholding the rights and dignity of persons with disabilities,” says Krista Carr, CEO of Inclusion Canada, “A top priority is Track 2 MAiD – a real and dangerous threat to the lives of people with intellectual disabilities. It must be repealed.”

Among the key recommendations, the UN Committee has urged Canada to:

• Repeal Track 2 Medical Assistance in Dying (MAiD), including the planned 2027 expansion to persons whose “sole underlying medical condition is a mental illness,” and reject proposals to expand MAiD to “mature minors” and through advance requests,
• Implement a coordinated deinstitutionalization strategy across federal, provincial, and territorial governments with clear timelines and targets,
• Withdraw Canada’s interpretative declaration and reservation to Article 12, which limits equal recognition before the law for persons with disabilities and undermines their right to exercise legal capacity,
• Establish a national inclusive education action plan to transition from segregated education to quality, inclusive education across all provinces and territories,
• Develop a strategy with specific timelines to transition from segregated employment settings such as sheltered workshops to open, inclusive, and accessible employment for persons with disabilities,
• Invest significantly in comprehensive measures to address systemic failures in social determinants of health and well-being, including poverty alleviation, accessible housing, prevention of homelessness, and community-based supports.

“These recommendations align with what people with intellectual disabilities and their families have been saying for years,” says President of Inclusion Canada, Moira Wilson, “Canada has an opportunity to lead in disability rights, but only if provincial and territorial governments and the federal government take these findings seriously and move swiftly to implement meaningful reforms.”

Inclusion Canada calls on all levels of government to implement the CRPD committee’s key recommendations. We are ready to support these efforts and will continue to advocate for a Canada where everyone belongs.

-30-

For Media Inquiries, please contact:
Marc Muschler, Senior Communications Officer
Inclusion Canada
Email: mmuschler@inclusioncanada.ca
Direct: 416-661-9611 ext. 232

About Inclusion Canada

Inclusion Canada is the national federation of 13 provincial/territorial member organizations and over 300 local associations working to advance the full inclusion and human rights of people with intellectual disabilities and their families. Inclusion Canada drives social change by strengthening families, defending rights, and transforming communities into places where everyone belongs.

Section 504 of the Rehabilitation Act is one of the building blocks of equal citizenship for disabled people in America.

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.

Section 504 of the Rehabilitation Act is a cornerstone USA disability rights law that has existed since 1977. During the Biden administration, Section 504 of the Rehabilitation Act was updated to include new provisions, collectively referred to as The Final Rule. Among many important stipulations that have nothing to do with human sexuality, the Final Rule includes defining gender dysphoria as a disability for which people must receive reasonable accommodations. This change, has helped incentivize 17 states to file a federal lawsuit to block the implementation of the Final Rule. Some people who have filed the lawsuit have stated that it applies only to the Final Rule regulation about gender dysphoria, and some of the press coverage implies this as well.

But that’s not what the lawsuit says. Count 3 of the lawsuit reads:

DEMAND FOR RELIEF Plaintiffs respectfully request that the Court:

a. Issue permanent injunctive relief against Defendants enjoining them from enforcing the Final Rule;

b. Declare that the Final Rule violates the Administrative Procedure Act;

c. Hold unlawful and set aside (i.e., vacate) the Final Rule;

d. Declare Section 504, 29 U.S.C. § 794, unconstitutional;

e. Issue permanent injunctive relief against Defendants enjoining them from enforcing Section 504

“Hold unlawful and set aside (I.e., vacate) the Final Rule,” “Declare Section 504, 29 U.S.C. 794 unconstitutional” and “issue permanent injunctive relief against the defendants enjoining them from enforcing Section 504” indicates that the lawsuit would vitiate the whole Final Rule and Section 504 itself, not just the part of the Final Rule about gender dysphoria. In the lawsuit the states argue: “Section 504 is coercive, untethered to the federal interest in disability, and unfairly retroactive.” The lawsuit also asserts: “The Rehabilitation Act fails to provide clear notice to States, preventing States from voluntarily and knowingly exercising choice in accepting federal funds…Section 504’s universal scope unfairly surprises States by retroactively adding conditions to pre-existing federal spending programs.”

Section 504 is the legal scaffolding for society’s moral obligations to people with disabilities. As a disabled person, Section 504 has been one of the only ways that I have been able to protect my civil rights, such as when I was integrated into mainstream classes during my K-12 education and went through the process of earning two Master’s degrees. Section 504 forms the foundation for the Americans with Disabilities Act, Olmstead and the Individuals With Disabilities Education Act. Repealing any of these laws carries a very high risk of undermining disabled people’s access to education, jobs, social services, medical care and much more. The segregation and oppression of disabled people could increase exponentially.

Eliminating the Final Rule completely would deprive the disabled community of important new rights. The Final Rule contains new provisions to reduce disabled people’s risk of being institutionalized; it requires states to invest more resources in community supports. As someone who has had to spend a lot of time in psychiatric facilities but cannot get all of the community services I need, I promise that this part of the Final Rule is very important. The Final Rule also contains new protections for website accessibility, appropriate medical equipment and disabled parents.

The Final Rule contains a provision that is a huge boon to efforts to stop assisted suicide, coerced DNRs and other life-threatening medical discrimination against people with disabilities. The Final Rule “Requires that medical treatment decisions are not made on the basis of ableist biases or stereotypes about disabled people, assumptions or judgments that an individual with a disability will be a burden on society, or dehumanizing beliefs that the life of an individual with a disability has less value than the life of a person without a disability.” Even without the updated rules, incentivizing disabled people to die by suicide, either interpersonally or systemically, is a very clear violation of Section 504 and the ADA. That is why the United Spinal Association, Not Dead Yet and other groups have used both laws to file a lawsuit to try to eliminate the practice of assisted suicide. Eliminating Section 504 could hinder that lawsuit.

Repealing the entire Final Rule, much less repealing Section 504, could have devastating consequences for all people with disabilities. Section 504 of the Rehabilitation Act is one of the building blocks of equal citizenship for disabled people. It contains provisions that save disabled people’s lives and provide a bulwark against the assisted suicide movement’s attacks on disabled people in the United States.

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.

The American Special Education System Helps Us Understand the Pitfalls Inherent in Assisted Suicide

Meghan Schrader

By Meghan Schrader

Meghan is an autistic person who is an instructor at E4 Texas - University of Texas (Austin) and an EPC-USA board member.
 
The coercion I experienced when I was enrolled in the Special Education system are what drives much of my staunch opposition to assisted suicide. It’s my observation of the systemic oppression enabled by that system that makes me say, “no, assisted suicide is not a good idea” no matter what pro-euthanasia argument I’m confronted with.

When I talk about my experiences in the Special Education system, I am not comparing having a learning impairment to having cancer, and I am not saying, “Oh, well, I suffered so you have to do it too.” I am not operating from a petty grudge along the lines of, “My Kindergarten teacher held my hand-crafted duck project up in front of the class and told them it was a bad duck because I didn’t follow her directions correctly, and so you have to die a painful death.”

What I mean is that there are instructive parallels between how the Special Education system works and the systemic oppression in the medical system, and that people in both systems engage in coercion of subjugated people. That makes assisted suicide unfair to subjugated people. In Special Education disputes about how to educate disabled children, school districts typically hold most of the cards. School systems will fight tooth and nail to avoid paying for services for disabled kids, no matter how badly not having those services harms the child. Wealthy, privileged communities will happily build multi-million dollar playgrounds for predominately able-bodied children while loudly complaining about the money spent on accommodating disabled students, no matter what consequences students with disabilities experience as a result of not having those services. Similarly, it’s clear that some government and private healthcare programs will fund lots of things for able-bodied people before taking care of disabled people’s basic needs. 

School systems have engaged in inordinate amounts of expensive legal maneuvering to force disabled students to stay in public schools where they are subjected to daily toxic stress so severe that it leads to serious physical and mental health problems, just as futile care impositions manipulate the medical system to force disabled people to die. What special education students often experience is a phenomenon that disability studies scholar Paul Longmore would call a “social death”: The person metaphorically “dies” because systemic oppression constrains equal participation in the activities that anyone would want to engage in-education, jobs, community engagement, etc.

It's pretty much the same thing with utilitarian bioethics, Quality Adjusted Life Years, forced DNRs and “termination without request or consent” and euthanasia in some countries. There’s a system that enables powerful people to bully disenfranchised persons. This systemic bullying of disabled people has seeped into pretty much all social institutions and drives much of our public discourse, making it easier for people in power to enact policies that literally kill disabled people. 

Peter Singer is a professor at Princeton who tells disabled people to kill ourselves so that the money spent accommodating us can be sent to third world countries, and there’s nothing we can do about it. Because of thinking like Singer’s, doctors in states with futile care laws bully the families of dying and severely disabled people to withdraw life-sustaining care from a loved one, and there’s nothing they can do about that, either. The doctors are in control, and no matter what emotional, financial, or physical consequences it has for the patient and her loved ones. Are disability rights activists really supposed to believe that doctors aren’t going to try to force people to die by assisted suicide?

The Special Education and medical systems also share commonalities in respect to the varying motivations for why people decide to pursue careers in those systems. Now, just as some disabled people are fortunate to have access to skilled and caring doctors, I did have some absolutely amazing teachers whose influence was critical in me accepting my disability, relying on my strengths and conscientiously working towards my goals. Those teachers loved me-they always had a hug for me, they valued my intelligence, they were more than happy to provide accommodations for my learning impairment. Similarly, many doctors are dedicated professionals who will do anything to care for their patients. But, not everyone goes into service professions out of love. Some special education teachers join that field because they like to be in charge of smaller, weaker people, just as some doctors go into the medical profession out of an arrogant desire to control sick people.

For instance, I once had a Special Education teacher who saw literally everything I did, even my smallest and most innocuous quirks, as “behavior.” She would punish me for something as small as fidgeting in my chair or not looking at her in the eye. At one point during mud season there was a group of bullies who would come up to me on the playground and repeatedly push me into the mud. I remember her angrily helping me take off my soiled jacket and jeans, and articulating what was essentially a utilitarian philosophy about her job: “I have multiple students that I have to be responsible for, and now I have to spend my time helping you take off your clothes,” she complained. This is essentially what some disabled people experience from nurses in hospitals-cleaning out bed pans is the nurses’s job, but the nurse is annoyed that they actually have to do that.

Neither the Special Education system nor the medical system can be trusted to implement legal procedures in a way that is fair to disenfranchised people, and that makes assisted suicide an unjust social policy. 

When I was growing up, I was fully aware that there were laws called Section 504 of the Rehabilitation Act, the Individuals with Disabilities Education Act, and the Americans with Disabilities Act. But, I also saw people blatantly violate those laws in spirit while using loopholes to essentially negate them. For instance, for whatever reason my high school Special Education team didn’t care that I was an honors student; they were dead set on forcing me not to take college preparatory classes or exams, because “Special Education students don’t go to college.” When I did those things anyway, they made sure that I suffered as much as possible. For instance, in addition to multiple other things my high school guidance counselor did to make the college application process miserable for me, he insisted on proctoring one of my college entrance exams. Even though my accommodations proscribed at quiet environment for ADHD, he made sure to tap papers against his desk, run his printer, and create various other sources of noise. When I asked him to stop, he said, “I’m only required to avoid unnecessary noise. I’m not making unnecessary noise. Other students have to deal with pencils scratching on paper and people breathing.” The toxic stress of being obliged to have my test proctored by this man was really, really unfair to me, but there was nothing I could do about that; the law allowed schools to pick whichever proctors they wanted to give tests to students, and if the evil guidance counselor wanted to force me to sit alone in a room with him for hours so that he could do disparaging things to me during a college entrance exam, well, tough crap.

What I experienced was essentially the non-lethal equivalent of what happened to Roger Foley. The guy was denied accommodations that he needed to live on his own, was confined to a hospital, an then was put in a room alone with a bioethicist who urged him to ask to be killed. Similarly, Canadian law did not allow Alan Nichols family to protect him. In the Netherlands, an advanced request for euthanasia led to a woman being held down and euthanized when she was clearly saying “no.” As a former Special Education student who was pressured to drop out of high school, I could see those scenarios coming, and that’s why I’ve always taken the position on assisted suicide that I do now.

I am sympathetic to people who want to legalize assisted suicide because they’ve had a deeply traumatic experience or they have no firsthand knowledge of how it will affect some people. It is not ethical for right to die activists to exacerbate already violent and unpredictable mechanisms of oppression and injustice so that they can die with a glass of rose champagne in their hand. (Article link) 

We live in a society where the able-bodied majority feels entitled to have what it wants at disabled people’s expense, and assisted suicide is just a very extreme form of that trend. Assisted suicide puts disabled people in a position in which it isn’t enough for us to be denied education and employment or endure various other forms of abuse, we also have to have our suicides turned into a “medical procedure” and maybe even be coerced into doing that so that the proponents can “chart their own end of life journeys.” That’s privileged arrogance. 

Disabled opponents of assisted suicide are not asking the proponents to die alone and in agony; we are simply asking that they use and improve the other multiple other techniques available to treat pain and disability at the end of life. We are asking that they give up some of the control they’d like to have so that disabled people do not experience even more vicious forms of oppression then we already do. That doesn’t seem like too much to ask to me.

Assisted dying would undermine the fight for equality

Dr Miro Griffiths

Dr Miro Griffiths is a Leverhulme Research Fellow in Disability Studies at the University of Leeds, a policy adviser and spokesperson for the Better Way campaign, was published by the Press and Journal in Scotland on September 27, 2021 explaining why assisted dying undermines the equality of people with disabilities.

Dr Griffiths establishes why the issue of euthanasia concerns him.

I have health conditions which are categorised as “life-limiting” and “progressive”. My strength, respiratory function and swallowing will continue to deteriorate.

Physical movement is primarily limited to my fingers. I require a power wheelchair, 24-hour personal assistance from trained professionals, and various medical interventions every day.

He then explains that he is a researcher and why he recognizes how legalizing assisted death will affect him. He writes:

I believe the introduction of assisted suicide in the UK will have a direct impact on me as a person, and my community as a whole – on how we are viewed and valued, and on the services and support available to us in the years ahead. It is my belief that the practice would undermine existing disability policy and legislative frameworks that aspire to protect disabled people’s rights.

The United Nations, human rights groups, and Disabled People’s Organisations have highlighted the social injustices encountered by disabled people. Legislative and policy interventions should focus on improving opportunities to participate in society and access sufficient healthcare across the life course. But in countries such as Canada that have legalised assisted suicide, the treatment of disabled citizens and their access to such services has declined.

Dr Griffiths shares a link from a Canadian physician concerning the effect of legalizing assisted death for people with disabilies:

Canadian doctors testify to disturbing changes in the way disabled people are now treated by the medical establishment. One doctor recounted how she has encountered “story after harrowing story of disabled people sharing their experiences being demeaned, disempowered, and denied dignity by the healthcare system”. 

“I learned more about power in society and who is written off and who gets given the benefit of the doubt,” she said.

Dr Griffiths discusses how people with disabilities experience human rights violations, denied opportunities to participate in the community, do not receive enough support or respect in society and how legalizing assisted death will compound these issues. He then discusses his further concerns:

Firstly, the legislation would likely be subject to legislative “creep”, where inclusion criteria is expanded to permit more people to access assisted dying mechanisms.

In other nations, similar laws were quickly extended to allow disabled people and people with mental health conditions to access assisted death. What possible assurance can lawmakers give that this will not come about in the UK five, 10 or 15 years down the line? They are opening the door to this if they agree to a narrow change.

The UK assisted dying proposals use arbitrary definitions that focus on individuals in the “last six months of their life”. It is difficult to determine timeframes for expected deaths, given the continued changes to health outcomes, emergences in medical technology, and advancements in health care provision. Access to treatments and support also differs across localities, which will affect health outcome expectations.

Assisted dying would inevitably result in patients thought to have less than six months to live ending their lives by suicide when they would, in fact, have gone on to live much longer. This is a significant ethical dilemma.

Finally, the necessary infrastructure to carry out the proposed assisted dying mechanisms also remains non-existent. No discussion has taken place on the time and resource allocation required to complete the declaration outlined in the bill, and to carry out due diligence throughout the procedures. It remains ambiguous as to how to determine the absence of coercion or duress when applications are made.

The article concludes with Dr Griffiths urging legislators not to legalize assisted death. He then calls on legislators to focus on a better way.

Computer Program Developed in Canada to Predict When Seniors Have 6 Months to Live

This article was published by the National Review on June 5, 2021

Wesley Smith

By Wesley Smith

As if we needed further evidence that medicine is growing increasingly impersonal, the Canadian Medical Association Journal has published a study that claims a computer program can predict when seniors have six months to live. From the Global News story:

Amid a lack of proper support for Canadians receiving home-based support towards the end of their lives, a new risk calculator is helping predict how long seniors have left to live.

The Risk Evaluation for Support: Predictions for Elder-Life in the Community Tool — dubbed ‘RESPECT’ for short — can predict death within six months, and was developed using data from more than 491,000 community-dwelling adults aged at least 50 years who used home care between 2007 and 2013.

Always with the acronyms to hide utilitarian protocols and procedures. Euthanasia in Canada is called MAID (medical assistance in dying), and now, RESPECT. Good grief.

“The RESPECT calculator allows families and their loved ones to plan,” said Dr. Amy Hsu, investigator at the Bruyère Research Institute and lead author of the study.

“For example, it can help an adult [or] child plan when to take a leave of absence from work to be with a parent or decide when to take the last family vacation together.”

Or it could be used to restrict care and/or push euthanasia. As one Canadian bioethicist noted:

If the calculator would ever be introduced to Canada’s healthcare system, Bowman believes that it would be interfaced with the country’s medical assistance in dying (MAiD), and could possibly shape the attitude of palliative care and end of life decisions.

“It will also shape the attitude of health care workers and it also raises a deeper question of who will interface with the broader question of what types of life are worth living and who decides, which is profoundly important stuff,” he said.

Ya’ think?

People don’t die by the numbers. Much depends on the kind of care they receive, their mental states, and individual differences that can be immeasurable. Even the study’s authors note a very big problem.

As with many prediction models, RESPECT is less well-calibrated at the extremes of the distribution. In particular, we found that RESPECT overpredicted the mortality risk of patients in our top 3 risk bins.

Oops.

The idea that crucial and intimate decisions about patient care could soon be driven by a computer-modeling system — rather than individual assessments — is very alarming. And it will often be wrong. I know of several patients given six months or less to live who got kicked out of hospice because their health improved unexpectedly. This includes the humorist Art Buchwald, who left hospice when he didn’t die from kidney failure and lived long enough to write his last book.

But then, with the quality-of-life ethic taking hold in medicine throughout the West, a “follow the science!” approach would make it much easier for clinicians, socialized-medicine bean counters, and family to abandon frail patients to comfort-care-only regimens — or worse — and still get a good night’s sleep.

We should treat all lives as equal. With assisted suicide we don’t.

This article was published by Mercatornet on June 11, 2021.

Dr Calum MacKellar

By Dr Calum MacKellar, Director of Research of the Scottish Council on Human Bioethics

At the beginning of this year, I was invited to take part in an online debate on the topic of assisted suicide organised by a Scottish university in front of a large number of students.

During the discussion, I argued that it would be irrational for the Scottish Parliament to support the legalisation of state assisted suicide while at the same time supporting the Scottish Government’s Suicide Prevention National Action Plan. This seeks to reduce the very high number of suicides in Scotland including amongst relatively young persons.

But during the question time at the end of the debate, one of the students commented that she could not understand or accept how I could consider the prevention of suicides amongst young people as being similar to the prevention of suicides amongst elderly or disabled persons. On hearing this comment, however, I must confess that I was quite shocked and dismayed.

I had never expected such a blatant ageist and ableist statement from a university student! Was this how many young people now considered elderly or disabled persons in Scotland?

In addition, I could not comprehend how the student had come to such a conclusion. Was it because modern society only recognises a good life by the amount of pleasure and lack of suffering it experiences? If it is, then the belief that a life can become unworthy of life and should be ended is indeed rational.

The expression of a life unworthy of life was coined in Germany in 1920 by the law professor Karl Binding and psychiatry professor Alfred Hoche. It then became a slogan used between the 1930s and 1940s in this country to defend the belief that if a person becomes unable to enjoy life, then his or her life could be ended.

But when the German government, at the time, also accepted the principle that certain lives were unworthy of life and that all lives were no longer absolutely equal in value, this then had catastrophic consequences. Indeed, it meant that some lives could be seen as having less worth than others, which eventually resulted in barbarity and the killing of many different kinds of persons.

As a result, Scottish society through its parliament should avoid being naïve or gullible when considering the consequences of accepting that some lives are unworthy of life and that assisted suicide should be legalised.

Of course, because a life is seen as belonging to an individual, it could be argued that he or she should be able to decide for himself or herself whether it is a life unworthy of life. But for state assisted suicide to be possible, those around this individual (including society as whole) would also have to accept that this life is indeed unworthy of life so that they can assist in ending it. In other words, it would mean that the equality of all human life is, for the first time, no longer accepted by society.

Thus, if a parliament legalises assisted suicide, the very basis of the equality of all lives on which this parliament is built would become a thing of the past. It would also mean that the protection in compassionate care of those whose lives are difficult or who experience suffering would become meaningless. Instead, it would be seen as preferable if the lives of such persons, considered to have unworthy lives, were ended even though appropriate palliative care may be available.

In conclusion, Scottish society can choose between absolute autonomy (enabling persons to believe whatever they want about the value of their lives) or absolute equality (enabling person to believe that all lives are equal). But it cannot have both.

The deadly Quality of Life ethic

This article was published by First Things on July 6, 2020

Wesley Smith

By Wesley J Smith

Something evil happened recently in Austin. Michael Hickson, a forty-six-year-old African-American man with quadriplegia and a serious brain injury, was refused treatment at St. David’s Hospital South Austin while ill with COVID-19. The hospital withheld his tube-supplied food and water despite the objections of his wife, Melissa—and even though Michael might have survived the illness with the medical care generally provided COVID patients. Michael died on June 11 because his doctors did not believe he had a sufficient “quality of life” to justify curative treatment, and that because of his disabilities, saving his life was “futile.”

Michael Hickson

Here’s the backstory: In 2017, Michael experienced brain injury after cardiac arrest. He was quadriplegic and had seizures. But he was conscious and, according to Melissa, able to do math calculations and answer trivia questions. Wasn’t his life as precious as everybody else’s? Not according to Michael's doctors. When Michael became sick with coronavirus, his doctor informed Melissa that treatment would not improve the quality of his life (meaning, he would remain quadriplegic and cognitively disabled if he survived), so the medical team “and the state,” through a court-appointed guardian, had decided all treatment except hospice comfort care should end.

Melissa was unable legally to save her husband’s life by insisting that he receive proper care. Having been appointed Michael’s temporary guardian, she was in a legal struggle with Michael’s sister over his custody, a dispute that predated Michael’s hospitalization. Family Eldercare, a nonprofit agency, had been appointed interim guardian until a final decision could be made about permanent guardianship. Doctors convinced Family Eldercare to approve Michael’s transfer to hospice care even though he was breathing on his own. Michael died of pneumonia after six days on hospice, the withdrawal of artificial nutrition and hydration having no doubt weakened his body’s ability to fight disease. Even without pneumonia, Michael would have soon died of dehydration.

Please note that this wasn’t a case of triage, a sad necessity required by a lack of resources in a time of pandemic emergency. Nor was it a situation of doctor said/wife said. Melissa recorded her conversation with the unnamed physician and posted it on YouTube so we can all hear for ourselves what families in these circumstances too often experience when dealing with the healthcare needs of disabled and elderly patients.

Here’s the substance of the conversation from the YouTube transcript, with my commentary.

Doctor: At this point, the decision is, do we want to be extremely aggressive with his care or do we feel like this will be futile? And the big question of futility is one that we always question. The issue is: Will this help him improve the quality of life, will this help him improve anything, will it ultimately change the outcome? And the thought is the answer is no to all of those.

Melissa: What would make you say no to all of those?

Doctor: As of right now the quality of life, he doesn’t have much of one.

Melissa: What do you mean? Because he was paralyzed with a brain injury, he doesn’t have a quality of life?

Doctor: Correct

The doctor did not base his decision on the seriousness of Michael’s illness, but on his continuing disability. This is a classic example of applying the invidious “quality of life” ethic, which deems people with disabilities, the elderly, the chronically ill, and the dying to have a lower moral worth than the healthy, able-bodied, and young; this ethic sometimes translates into denying the weak and vulnerable medical care that others would receive readily.

Back to the conversation:

Melissa: Who gets to make that decision whether somebody’s quality of life, if they have a disability that their quality of life is not good?

Doctor: Well, it’s definitely not me. I don’t make that decision. However, will it affect his quality, will it improve his quality of life, and the answer is no.

Melissa: Why wouldn’t it? Being able to live isn’t improving the quality of life?

Doctor: There’s no improvement with being intubated, with a bunch of lines and tubes in your body and being on a ventilator for more than two weeks. Each of our people here have COVID and they are in respiratory failure. They’ve been here for more than two weeks.

A bit later, the doctor says that the decision is not Melissa’s to make.

Melissa: So the fact that you are killing someone doesn’t make sense in your mind?

Doctor: We don’t think it’s killing. Because I don’t know when or if he will die. But at this point I don’t think it would be humane or compassionate to put a breathing tube in this man and do the lines and the tubes and all that stuff because I don’t think it will benefit him.

Melissa: And I totally agree with you on the intubation part of it. I don’t want him intubated. But I also don’t think you should just sit him somewhere to be comfortable until he finally just drifts away. That to me is futile too. That’s saying you’re not trying to save someone’s life. You’re just watching them go. The ship is sailing. I mean that just doesn’t make any sense to me to not try. I don’t get that part. I don’t like that part.

Melissa is not asking for intubation. She is not asking for “everything possible” to be done. Rather, she wants proper care for Michael, which would presumably have included medicines and tube-supplied food and water.

The doctor becomes increasingly tired of the conversation:

Doctor: But what I’m going to tell you is that this is the decision between the medical community and the state.

Melissa: And the state. Forget about his wife and his family and his five kids.

Doctor: I have nothing to do with that.

The recording ends there.

What can we learn from this? First, people should sign advance directives naming legal surrogates who will make medical decisions for them in the event of incapacity. Michael had apparently not done that. Had Melissa been Michael’s legal surrogate, it is very possible he would be alive today, because she would not have consented to his transfer from acute care to hospice.

Second, the quality of life ethic is deadly. When doctors fail to recognize life itself as a good, and only deem as “good” those lives they perceive to be of sufficient quality, the weak and vulnerable are put at material risk.

Finally, our societal attitudes need adjusting. Rather than upholding a quality of life ethic, we should insist that society generally—and medicine specifically—adhere to the sanctity/equality of life ethic, according to which everyone is considered equally valuable and worthy of living and care. This ethic would not force people to accept medical treatment they do not want. But it would keep the most weak and vulnerable among us, people like Michael Hickson, from being pushed out of the lifeboat by doctors who can’t imagine why anyone with quadriplegia and cognitive incapacities should go on living.

Wesley J. Smith is a senior fellow at the Discovery Institute. His latest book is Culture of Death: The Age of “Do Harm” Medicine.

Oklahoma Bans ‘Quality of Life’ Health-Care Rationing

This article was published by National Review online on May 26, 2020

By Wesley J Smith

Wesley Smith

As many in the bioethics movement push various schemes to ration health care based on “quality of life” — such as the odious QALY (quality adjusted life year) system beloved of the New England Journal of Medicine — some are pushing back and insisting that health-care coverage and treatment public policy be predicated on the intrinsic equal dignity and moral worth of all patients.

Toward that end, Oklahoma’s governor just signed into law a bill that outlaws such invidious and bigoted discrimination. From HB 2587:

The Legislature finds and declares that:

1. Physical and mental disabilities, age or chronic illness should in no way diminish a person’s right to life, human dignity and equal access to medical care;
2. Historically, persons with disabilities, advanced age or chronic illness have faced discrimination in the health care system, including the denial of access to life-sustaining care;
3. Such discrimination is inconsistent with our society’s commitment to human dignity and the full inclusion of persons with disabilities throughout society;

Such discrimination is now legally prohibited:

An agency shall be prohibited from developing or employing a dollars-per-quality adjusted life year, or similar measure that discounts the value of a life because of an individual’s disability, including age or chronic illness, as a threshold to establish what type of health care is cost effective or recommended. 

An agency shall be prohibited from utilizing such adjusted life year, or similar measure, as a threshold to determine coverage, reimbursement, incentive programs or utilization management decisions, whether it comes from within the agency or from any third party.

More of this please, the sooner the better! Considering how shamefully and lethally New York and some other states treated the elderly residing in long-term care facilities during the worst days of the COVID-19 crisis, it is very clear that these laws are desperately needed.

Woman with brain injury communicates with mom after 21 years.

Alex Schadenberg
Executive Director - Euthanasia Prevention Coalition

Joellen Huntley

A good news story was published by the Canadian Press on December 29 about a Nova Scotia woman who communicated with her mother on Christmas day, the first time in 21 years. Her mother called it a "Christmas miracle." According to Keith Doucette:

Louise Misner said her 37-year-old daughter Joellen Huntley used eye-motion cameras and software on an iPad to respond to a comment from Misner about her clothes. 

Huntley has been severely disabled since she was 15, unable to walk or talk and fed through a tube. She has always responded to family members' presence by making sounds, but was unable to communicate any thoughts. 

Huntley was thrown from a car that had swerved to avoid a dog that was running loose along a road in Centreville, N.S., on April 18, 1996. The accident claimed the life of her boyfriend and a young girl who was the sister of the driver.

The article reports that the Christmas miracle happened in this way:

The breakthrough occurred during a Christmas Day visit at the Kings Regional Rehabilitation Centre in Waterville, N.S. 

"I said 'Joellen I like your new Christmas outfit you got on,'" Misner said in a telephone interview on Friday. 

Misner said her daughter then used the technology to find an icon for a short-sleeve shirt.
"And then she said no, and went to a long-sleeve shirt because she was trying to tell me what she had on." 

Misner said her reaction was immediate to what had been a long hoped for personal communication.

The computer equipment was purchased for Joellen with the proceeds from a court settlement. The story states:

Misner said the settlement money helped the family purchase the computer equipment she is now using with the help of a speech pathologist. 

"We had to go through two or three different screens until we found the right one for her and it's called Eyegaze. Her eyes focus on the icons to answer questions." 

Misner said one of Joellen's nurses told them she is "doing really well with it." 

"I knew she just needed time for technology to catch up with her," Misner said.

In the past few years Dr. Adrian Owen, a researcher at the University of Western Ontario, has developed technology to communicate with people who are believed to be in a Persistent Vegetative State. The computer technology used by Joellen is different than the technology used by Dr. Owen but this article shows how technology is opening the window of life for people who were considered by many to be "hopeless."

The "Christmas miracle" teaches us that we should never consider a human being with disabilities as less than an equal person. It also teaches us that every human life has value.

Many people believe that euthanasia should be considered for people in Joellen's condition.

Australia 1996 euthanasia debate, arguments opposing euthanasia remain intact.

This is an exerpt of a longer article published by Paul Russell on the Hope Australia website on August 5. 

Paul Russell

Paul Russell states that the arguements made twenty years ago to support The Euthanasia Laws Act 1997 and oppose euthansia, remain intact today.

The Euthanasia Laws Act 1997 was passed by both houses on the 25 March 1997. It became the first and only legislative measure anywhere in the world to completely overturn existing euthanasia and assisted suicide legislation. 

The following objections were argued by MPs who supported Kevin Andrew's initiative, perhaps the best speech was by the Member for the seat of Melbourne, The Hon Lindsay Tanner MP.

Tanner came to politics through university student movements and into the Australian Labor Party's Victorian faction known as the Socialist Left or simply 'SL'. That Tanner, a self-identified and career-long progressive-thinking politician should oppose euthanasia and assisted suicide once again highlights the reality that opposition to legislative change is not characterised by a 'left-right' divide any more than it can be said to be a division along religious lines, as Tanner himself notes.

The following excerpts are from his speech supporting the 'Andrews' Bill' given in the House of Representatives on the 28 October 1996 (headings have been added):

Hon. Lindsay Tanner

On the question of autonomy:

"But there is a very different question at stake here; that is, not whether in some individual circumstances there is something morally wrong, but whether the state should legalise and indeed can safely legalise such practices. This debate should not be about one or two individual experiences, not about our own experiences, but about the broader social question. Just as the question of capital punishment cannot be determined by one or two murders, by one or two gross and appalling examples of killing, neither should our view on euthanasia be determined by our own experiences of one or two personal tragedies. We must look beyond those experiences to the broader view of the interests of society at large and the interests of the individuals who make up society."

On Church v State:

"It has been argued that this bill put forward by the member for Menzies (Mr Andrews) is about the separation between church and state. I would disagree with that analysis. I think it is also worth noting that just because the churches take a particular view does not therefore make it wrong. Most of us would probably agree with the churches on a few fundamental issues like murder, rape, assault and so forth. So whether the churches take a position is really neither here nor there. 

"To me this is an issue about the relationship between state and citizen—not between church and state."

On the lack of safety:

"I am troubled by euthanasia because I think it is virtually impossible to draw safe boundaries, because I think it is virtually impossible to prevent abuses and mistakes and because I think it is virtually impossible to justify offering the option of assisted suicide to one category of people when you deny it to others. That is a necessary implication of the Northern Territory legislation."

Euthanasia as a misuse of power:

"I regard individual freedom in our society as essentially very fragile, as very vulnerable to misuse of state and bureaucratic power. Intrinsically, the state assuming the right to sanction killing of a citizen, for whatever reason, troubles me a great deal. Even with apparent consent, it worries me. I refer those in my part of the political spectrum, most of whom have a different point of view from me, to debates that have occurred on issues like the Australia Card (1), where the same sorts of concerns about fears of misuse—obviously not on the same life or death scale, but fundamentally the same framework—occurred. Others laughed and said, `You are paranoid, it is excessive,' and the like, but many on the Left had the same sorts of concerns there."