What Does ‘Suicide’ Have to do with the Oregon assisted suicide Model?

By Meghan Schrader

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

Meghan Schrader

One time when I was testifying at an Oregon model assisted suicide hearing I decided to describe one of my episodes of psychotic depression in detail, to try to get legislators to observe parallels between what I was describing and the experiences of terminal illness that the proponents were describing. It struck me as a way to illustrate the overlap between the Oregon Model proponents’ logic that assisted suicide is a valid response to end of life suffering, and expansionists’ logic that “psychiatric assisted suicide” is a valid solution for extreme mental suffering.

Also, the Oregon assisted suicide model proponents describe disturbing physical symptoms at hearings all the time. So it should be ok for me to describe my past severe psychiatric symptoms, right?

The legislators looked at me kind of like I was high and then made comments along the lines that what I had described had nothing to do with the proposed law, but they appreciated my bravery in sharing my story.

I feel kind of silly about that testimony now. After all, I was describing severe mental illness, not a terminal illness like cancer. Also, maybe providing all those details came across as trauma dumping and attention-seeking. Perhaps it would have sufficed to say, “Having experienced mental illness in the past and observed expansionists efforts to legalize psychiatric euthanasia, I think society should not take another step towards that world by legalizing the Oregon model.”

But I still think that talking about severe mental illness and suicidal ideation during discussions about the Oregon model is less ridiculous than those legislators seemed to think. As disability rights opponents of assisted suicide have pointed out, the distinction between “terminally ill” and “disabled” can be blurrier than the Oregon model proponents would like it to be. There are some people who can live for years with their disabilities with the proper support, yet would die quickly if that support were withdrawn. And some of those people experience suicidal ideation. Moreover, there have been instances of people with mental illnesses like anorexia nervosa dying by assisted suicide. This abuse thins the distinction between “suicide” and assisted suicide” that the Oregon model proponents perceive.

Furthermore, some proponents have openly admitted that they want to medicalize disabled people’s suicides; famous euthanasia activist, Thaddeus Mason Pope told me so.

Nevertheless, I’ll entertain the position that there may often be meaningful distinctions between the “Oregon assisted suicide model” and “regular” suicide, with respect to the reasoning behind the decision, the possibility of graphic violence, the typical impact on family members, the length of time that the person had left to live, etc. So, I can understand why there are a lot of people who think that equating the Oregon assisted suicide model and suicide is “silly.”

I’ll again use my former pastor as an example. This pastor was a wonderful person and a dedicated faith leader. She did a lot of great work with marginalized people. She was also very anti-suicide. One time when I was sobbing in front of her about how much pain I was in during a bad bout of depression, she asked, “I don’t want to scare you, but as your pastor I need to know: are you having any thoughts about hurting yourself? Is there anything that we need to do to keep you safe?”

I wasn’t planning to harm myself, but I appreciated the compassion behind the pastor’s question.

This pastor also did a lot of terrific work with terminally ill people, and she disagreed with me about the Oregon assisted suicide model. When we had a friendly debate about the issue, she said, “Having been with people who have experienced a horrible death from Glioblastoma, I strongly reiterate my comments. And I hope that I would have the grace to make a similar choice.”

Obviously I disagree with the pastor, but I feel able to respect her motivations and logic. After all, she had had years of working with terminally ill people and I hadn’t. And she had worked with a lot of people experiencing suicidal ideation. So although assisted suicide and “regular” suicide both involve dying by one’s own hand (and hence meet the technical definition of suicide) I can “get where she was coming from.”

Unfortunately, not all assisted suicide proponents think like my former pastor. Some of them would like to expand assisted suicide to disabled people who aren’t dying. And that’s a situation where I think proponents’ distinction between assisted suicide and suicide is indisputably linked to ableism.

Disabled people are already systemically excluded from suicide prevention. Peer-reviewed research shows that there is a high suicide rate among people with disabilities and that people are more likely to think suicide is acceptable if the victim is disabled. There is also a lack of suicide prevention resources designed for people with disabilities. In that context, suicide prevention organizations equivocating on whether disabled people’s assisted suicide deaths are suicides falls into a longstanding pattern of abandonment.

The Oregon assisted suicide model proponents’ argument that assisted suicide is never suicide would be on much firmer ground if the Oregon model had never been used to kill people with anorexia, and if it were the only assisted suicide model that existed anywhere in the world. But it isn’t. Moreover, the Oregon model movement leaders routinely do things that normalize discussions about expanding assisted suicide such as by rubbing elbows with assisted suicide expansionists who have said that medicalizing the suicides of disabled people is ok. Compassion and Choices leaders cannot possibly have missed People Magazine and the New York Times’ enthusiastic platforming of people with chronic mental illnesses who would like to die by assisted suicide. Compassion and Choices leaders have published statements declining to take a position on whether Canada’s euthanasia (MAiD) program is ok, even though the United Nations Special Rapporteur on the Rights of People With Disabilities says that it’s not.

In short, although the Oregon model is ostensibly limited to terminally ill persons, it is helping to normalize the expansive proponents’ position that disabled people’s suicides are therapeutic.

Author Note: For a nuanced discussion of why what the Oregon Model proponents call "MAiD" is best described as “Assisted Suicide,” and why such “MAiD” is most accurately understood as a variation of suicide, read Harold Braswell’s article, “In Defense of "Physician-Assisted Suicide": Toward (and Back to) a Transparent, Destigmatizing Debate.”

Disability Justice Opposition to MAiD: Some Clear, Accurate Data.

Meghan Schrader

By Meghan Schrader

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

Currently the Euthanasia Prevention Coalition and MAiD in Canada are having a mutually published debate about whether “MAiD” should be used to help people with mental illnesses kill themselves. I don’t want to distract from Gordon Frieson’s responses to Paul Magennis and Kim Carlson. But Magennis and Carlson also commented on my “Academia Routinely Dehumanizes Disabled People” post to counter my statement, “the majority of the disability community opposes “MAiD.” They claim that this statement is just an “opinion;” that it does not include enough “accurate data.” So, I thought I’d write a blog post responding to their claim.

Statistically, people with disabilities have a higher suicide rate, so I am sure that Magennis and Carlson can find lots of disabled people who would like to kill themselves with “MAiD.” I have also encountered a minority of people with disabilities who support some form of “MAiD;” my opposition to “MAiD” cannot speak for every disabled person on the planet. And, regrettably it is possible that majority opposition to “MAiD” could erode over time as euthanasia becomes more accepted by the dominant culture. But conducting my peer-reviewed research about representations of eugenics, disability and euthanasia in horror films showed me that opposition to “MAiD” is and has long been a part of disability justice culture. A few months ago I used that disability studies training to write a post titled, “Disabled Opponents of Assisted Suicide Are Not A Vocal Minority.” I’m going to re-quote two of the scholars I cite in that blog post.

In his essay in the peer-reviewed anthology The Disability Bioethics Reader, professional ethicist and disability studies scholar Dr. Harold Braswell asserts:

“The framework of this debate limits the potential for disability discrimination. PAS is itself a moderate iteration of the right to die. And this moderate iteration is, in the USA, only available to individuals who are terminally ill. This makes the American interpretation of PAS relatively conservative even relative to other countries where it is legal. This conservatism makes it possible for some disability bioethicists to justify supporting it, though such support is still relatively marginal within the field.”

A peer-reviewed anthology on disability bioethics is clearly a form of authoritative data, and as someone who has also conducted disability studies research on the euthanasia issue, I can tell you that Harold Braswell is right: support for assisted suicide is “marginal within the field.”

Self-proclaimed “disability rights advocate” and unrestricted assisted suicide enthusiast Christopher Riddle also admits that his efforts to sell death to disabled people set him apart from most of the disability studies field. In his 2017 Bioethics article “Assisted Dying and Disability,” Riddle writes:

“While academic literature has a multitude of perspectives on this issue, the public attitude amongst mainstream disability rights scholars, activists, and more generally, people with disabilities, is relatively consistent in its position: assisted dying should not be permitted.”

Riddle is one of the generals in Kim and Paul’s pro-MAiD “army,” so I’ll repeat that quote again:

While academic literature has a multitude of perspectives on this issue, the public attitude amongst mainstream disability rights scholars, activists, and more generally, people with disabilities, is relatively consistent in its position: assisted dying should not be permitted.”

In the aforementioned comment thread, Magennis asserted that it is important to avoid arguments that are “stated sloppily” or “cause uncertainty about what exactly you are stating.” So, in the interest of avoiding any sloppiness or uncertainty, I’ll cite Riddle’s statement a third time:

“While academic literature has a multitude of perspectives on this issue, the public attitude amongst mainstream disability rights scholars, activists, and more generally, people with disabilities, is relatively consistent in its position: assisted dying should not be permitted.”

Riddle is Magennis and Carlson’s compadre, yet he acknowledges that the majority of persons with disabilities oppose “MAiD.”

What other sources do Carlson and Magennis want? Did every anti “MAiD” disability rights leader, scholar and disabled person have to be a co-author on my aforementioned blog posts?

Frankly, Magennis and Carlson’s determination to obscure disability rights opposition to “MAiD” despite their distance from the negative consequences of that practice shows a lack of humility. Magennis and Carlson defend their assertion that “support for MAiD might actually be quite strong among those living with a disability” using a paid for poll from a “MAiD” advocacy group. But the plethora of disability rights leaders, disability studies scholars and disabled people who have expressed opposition to “MAiD” lead lives dedicated to disability issues. We live with our disabilities and/or spend a significant amount of time studying the experiences, perspectives and rights of disabled persons.

Yet Carlson and Magennis want society to listen to them instead of us.

No community is completely ideologically monolithic. But Magennis and Carlson’s contention that there is widespread support for “MAiD” among people with disabilities, especially for expansive “MAiD” programs like Canada’s, is not intellectually honest. If Carlson and Magennis want their debates about euthanasia to be based on accurate data, they need to accept politically inconvenient data about disability justice opposition to “MAiD.”

Author Note 1: For a nuanced and thorough exploration of disability justice opposition to “MAiD,” watch the film Life After: A Film Maker Investigates Assisted Dying Through The Lens of Disabled Voices Missing From the Debate.

For information about the history of disability justice opposition to “MAiD” read Joe Shapiro’s book No Pity: People With Disabilities Forging a New Civil Rights Movement.

Author Note 2:

In his comments on my blog post, Magennis asserted that Sammy Choun, the author of the British Medical Journal article I quoted to support my statement that the majority of the disability community opposes “MAiD,” “stated that as fact in the article, but didn’t provide any references or links studies and surveys to back that up.” To read Magennis’s comment, one might think that Choun did not provide any citation for her statement.

But, Choun did provide a reference for that statement in the endnotes of that article, with citation 21. It cites the Third Reading of Bill C-62, which delayed the expansion of “MAiD” to include mental illness until 2027. During that debate Hon. Marilou McPhedran noted widespread opposition to Track 2 “MAiD” among both disability experts and disabled people more generally. She asserted, “The disability community has been articulate in asserting that MAID violates Canada’s international human rights obligations to people with disabilities under the UN Convention on the Rights of Persons with Disabilities in certain respects.”

I suppose one might interpret Magennis’s comment about a lack of references for Choun’s statement as reflecting his preference for “surveys and studies” over senate debate transcripts, the United Nations, statements from multiple disability policy experts, and the cries of individual disabled people about the trauma that “Track 2 MAiD” has caused for them. But Magennis’s comment did not acknowledge that Choun cited the 3rd reading of Bill-62; it implied that Choun did not provide any reference at all. Hence, Magennis’s comment strikes me as failing to embody his own admonishment about debate participants avoiding arguments that are “stated sloppily” or “cause uncertainty about what exactly you are stating.”

Author Note 3:

The Euthanasia Prevention Coalition did a Zoom panel on disability justice opposition to “MAiD” that includes nuanced discussion of widespread opposition to “MAiD” in the disabled community. It can be viewed here.