Society Should Treat Disabled People Like My Cousin Treats Me And "It"

Meghan Schrader

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

In early June I was with a group of protesters at a Massachusetts C&C lobby day and a death doula cited reasons for why someone might want “aid in dying.” In addition to various other motivations, she approvingly cited, “I don’t want to be a burden,” which elicited murmurs of assent from the crowd. That statement was obnoxious, both in terms of its reinforcement of our culture’s attitude that people with significant medical needs are “burdens” and the speaker’s privileged ignorance that that’s what she was doing.

Compassion and Choices’s employee Dan Diaz said something similar when he asserted:

“If I find myself in a situation where I can’t go to the bathroom on my own, where someone has to change my diapers, where I can’t feed myself, where I can’t care for the people around me, where other people have to move me around to keep me from having bedsores, is that really living?”  

Whatever the context of that quote, these are things that many disabled people without terminal illnesses experience every day. Disabled people trying to live with dignity don’t need people like Dan Diaz implying that they are not alive.

As I’ve indicated, I think that there’s a good chance that the death doula and Dan Diaz didn’t understand that their statements were ableist. In contrast, I think a willfully hateful statement about “MAiD” can be found on the blog of formerly closeted white supremicist Richard Hanania. In his blog post “Canadian Euthanasia As Moral Progress,” Hanania writes: 

“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. I’m sure Raikin and many others feel differently, and would want to hang around in a vegetative state and burden everyone else in their lives as long as possible.”

Wow, that’s pretty vicious. Why doesn’t Hanania just replace that blog post with the text of Die Freigabe der Vernichtung lebensunwerten Lebens? 

I understand that in contrast to Hanania, the death doula and Dan Diaz’s statements occurred in the context of advocacy for the Oregon model. Both Diaz and the death doula likely experienced their statements as expressions of sympathy for terminally ill people. I doubt that either Dan Diaz or the death doula are closeted white supremacists, as Hanania was. Nevertheless, all three people’s rhetoric draws on the ableist trope that being a “burden” makes killing yourself a commendable act. That’s the cultural and historical milieu of “MAiD,” regardless of individual context or intent.

As I consider these ableist statements, my mind contrasts them with the love I receive from my sweet older cousin Amy, who cares for me like an older sister. For instance, Amy has stood by me during my bouts of severe mental illness, even when that process wasn’t particularly convenient or fun. 

One of the things I most appreciate are Amy’s expressions of affection for my cat Lucy, even though she loathes cats. When Amy flew to Texas to help me during my manic episode in 2019, she took care of Lucy while I was in the hospital, and when Amy picked me up from the hospital, she remarked, “I pet It.” “It? You mean Lucy?” I asked. “Yes,” she said. “I thought It might be lonely, so I petted It on the head, and I said, ‘I think you’re disgusting but Meghan loves you so I guess I have to pet you.’” So now Lucy’s nickname is “It.” About a month ago I was talking to Amy on FaceTime and I jokingly showed her “It” sleeping on the porch. I asked her what she hated about cats. “I hate the way they rub up against your legs, I hate the way they cram themselves into small spaces, I hate the way they jump in your lap & turn around looking for a place to lie down-Yeah, I pretty much hate everything about It, but I know you love It, so I guess I have to accept It.” 

LOL.

I know very many Oregon model proponents would gladly fly across the country to take care of a sick loved one’s “It.” And obviously Amy wasn’t caring for me while I was dying. But unfortunately the Oregon model is still linked to the idea that maybe people should kill themselves because caregivers having to do things they hate is a pain in the head.  This ideology is poisonous for disabled people, as illustrated by situations like Canada’s “MAiD”  program and the high rate of suicide among people with disabilities.

Living in a culture where disabled people are treated as “burdens” makes it more difficult to cope with systemic ableism, overwhelming medical needs or both. In contrast, I think the way Amy treats me and “It” models disability liberation. Sometimes care work is very uncomfortable or painful. But true compassion and justice means that we don’t abandon disabled or dying people, even if we must change their diapers. Or visit them in the hospital. Or take care of their disgusting cats. 

Previous articles by Meghan Schrader (Link).

Massachusetts Committee delays vote on assisted suicide bill.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Massachusetts Public Health Committee is delaying their consideration of the state assisted suicide bill by 30 days. Chris Lisinski reported for Yahoo News on June 3, 2025 that:

Legislators last week asked for a 30-day extension on a bill that would authorize physician-assisted suicide (H 2505), according to the House clerk’s office, keeping it idling in the Public Health Committee through a Tuesday event that drew both supporters and opponents of the long-debated policy.

Backers of the proposal, which has stalled out without a House or Senate vote for multiple terms in a row, argued they made “historic progress” last session by winning support from both the Public Health Committee and Health Care Financing Committee.

Lisinski reported that Senator Jo Comerford told an opponent of the bill that:

“This is not an easy conversation to have, yet in this State House, we welcome democratic engagement, we welcome debate, we welcome dissent,” the Northampton Democrat said. “If we weren’t asking important questions about whether or not assisted suicide could be made safe — and I do believe it’s made safe in this bill, I do believe that — we wouldn’t be doing our jobs. This is too important a bill for us not to engage seriously with, so you are welcome here.”

“If there are ways to make this stronger, let’s do it together, friends. We are not railroading this bill through the State House,” she added.

As stated by one of the signs at the Public Health Committee, Assisted Suicide Cannot Be MAiD Safe.

The Euthanasia Prevention Coalition urges our supporters to continue contacting their elected representatives in Massachusetts to oppose the bill. We oppose killing people.

Message to Scotland: Don't buy into McArthur's "bait and switch" assisted suicide bill

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

I was recently speaking to MSP's in Scotland about the upcoming assisted suicide bill sponsored by Liam McArthur (LibDem MSP). 

During several meetings many of the MSP's suggested that McArthur was promising a "heavier safeguarded" model than previous euthanasia bills that were debated in Scotland. 

My response was that it didn't matter how "heavily safeguarded" the bill is because the goal of the euthanasia lobby is to get the bill passed and expand it later.

McArthur was interviewed on March 24 by BBC Scotland on The Sunday Show where McArthur explained that the new bill will be released on Thursday March 28. McArthur stated the following about the proposed bill:

"I detect a real shift in the political mood, driven in a large part by witnessing countries and states across the world introducing heavily safeguarded provisions of the kind I'm looking to introduce here in Scotland."

He said his proposals would require diagnosis of a terminal illness by two separate doctors and a 14-day cooling off period after which a medical substance could be supplied, to be self-administered.

The reality is that McArthur is describing a bill that is similar to the original Oregon assisted suicide law, a law that was expanded in 2019 and further expanded in 2023.

McArthur stated that the mood in Scotland has shifted based on "heavily safeguarded provisions" but the provisions that he is referring to do not remain in the Oregon or other assisted suicide law provisions in the United States.

While in Scotland several of the MSP's told me that McArthur had invited them to go to California on a "fact finding" trip. California is the prime example of a state that has expanded its law since legalization. 

Recently Senator Blakespear in California introduced Bill SB 1196 an assisted suicide bill that would change the law to specifically allow utilization of the lethal poison by IV (intravenous). (my article on SB 1196)

In 2016 California legalized assisted suicide. California expanded the law in 2021 when it passed Bill SB 380. SB 380 reduced the waiting period from 15 days to 48 hours, it eliminated the final attestation, and it forced doctors who oppose assisted suicide to participate.

In September, 2022, U.S. District Judge Fernando Aenlle-Rocha ruled that California Senate Bill 380, which amended the End of Life Option Act (assisted suicide law) in California, violated the First Amendment rights of doctors by requiring them to participate in assisted suicide. Aenlle-Rocha granted a preliminary injunction barring the state from compelling health care providers to document a patient’s request for assisted suicide. (my article on the decision).

In other words, McArthur is basing his "heavily safeguarded provisions" on an American law that originally contained those provisions but has been expanded and it may be expanded again this year.

Recently I published an article titled The assisted suicide lobby wants to legalize assisted suicide and expand it later. 

In that article I explain that the assisted suicide lobby claim that no legislative creep exists. Yet in the past few years existing assisted suicide laws have been expanded in nearly every state that has legalized assisted suicide by: reducing or eliminating waiting periods, allowing non-doctors to participate in assisted suicide, allowing assisted suicide approvals by Telehealth, expanding the meaning of terminal illness and removing the state residency requirement.

Assisted suicide law expansion bills have been passed in California (2021), Hawai'i (2023), Oregon (2019, 2023), Vermont (2022, 2023) and Washington State (2023). There are several assisted suicide expansion bills being debated in 2024.

For instance, Colorado assisted suicide expansion Bill SB 068 would expand the assisted suicide law by: permitting non-physicians to prescribe the lethal poison, reduces the waiting period from 15 days to 48 hours and it allows the 48 hour waiting period to be waived.

In January Josh Elliott, a three-term member of the Connecticut House, and a sponsor of previous assisted suicide bills was interviewed by Paul Bass for the New Haven Independent on January 4, 2024. Bass reported Elliott as wanting to get a "heavily safeguarded" assisted suicide bill passed and then make amendments later. Since Elliott admitted to his "bait and switch" tactic, 2024 was the first year in the past eleven where no assisted suicide bill was introduced in Connecticut.

J.M. Sorrell, Executive Director of Massachusetts Death with Dignity, was quoted on a similar bill as saying,

“Once you get something passed, you can always work on amendments later.”

My message to Scotland's MSP's is don't buy into McArthur's "bait and switch" assisted suicide bill. 

McArthur realizes that the majority of the MSP's will not support a Canadian style euthanasia bille ha. He has decided to first legalize an Oregon style bill and then expand it later. The reality is, even the American assisted suicide bills have already been expanded

Supreme Judicial Court of Massachusetts decides that there is no right to assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Supreme Judicial Court of Massachusetts decided on December 19 to reject a challenge to the Massachusetts state prohibition of assisted suicide by finding that there is no right to assisted suicide in the Massachusetts Constitution.

EPC-USA is incredibly pleased by this decision. EPC-USA was the only group to submit a friend-of-the-court brief and also provide an oral argument before the Supreme Judicial Court of Massachusetts.

Mark Pratt, in writing for the Associated Press reported Chris Schandevel from ADF who represented the Euthanasia Prevention Coalition as stating:

“Patients should be able to trust their doctors to support and care for them,” said Chris Schandevel, senior counsel for the nonprofit Alliance Defending Freedom, which filed a friend-of-the-court brief in the case on behalf of Euthanasia Prevention Coalition. “Offering terminally ill or disabled patients a ‘quick exit’ through death-inducing drugs destroys that trust.”

The Massachusetts case known as Kligler v Healy concerns Dr Roger Kligler who is living with prostate cancer and seeking death by assisted suicide and Dr Alan Steinbach who is willing to prescribe a lethal drug cocktail for Kligler to die by assisted suicide. Kligler who claimed to be terminally ill when the case began in 2016 is very much alive today.

Kligler and Steinbach argued that doctors cannot be prosecuted for prescribing lethal drug cocktails for assisted suicide to competent terminally ill persons because there was a right to assisted suicide under the Massachusetts state constitution.

The Supreme Judicial Court of Massachusetts decided that:

Although we recognize the paramount importance and profound significance of all end-of-life decisions, after careful consideration, we conclude that the Massachusetts Declaration of Rights does not reach so far as to protect physician-assisted suicide. We conclude as well that the law of manslaughter may prohibit physician-assisted suicide, and does so, without offending constitutional protections.

As to the question of whether assisting a suicide can result in a charge of manslaughter which is described as wanton and reckless behavior. The Supreme Judicial Court of Massachusetts stated that:

As the motion judge concluded, physician-assisted suicide could constitute wanton or reckless conduct. Our case law demonstrates that knowingly providing someone who has expressed an interest in ending his or her life with the means to do so may be considered wanton or reckless behavior. ... That a doctor's intent in providing the lethal medication was to alleviate a patient's suffering is irrelevant, as conduct may be wanton or reckless even where the actor "meant no harm to the victim." ... (motive is irrelevant to crime of manslaughter).

Dr Steinbach argued that prescribing lethal drugs for assisted suicide is not proximate to the death and therefore cannot result in a charge of manslaughter. The Supreme Judicial Court of Massachusetts referred to the February 2019 decision upholding the voluntary manslaughter conviction of Michelle Carter for assisting the suicide of Conrad Roy (18). Carter, who was 17 at the time of the death, pressured Roy to die by suicide by urging him during the act while on her cell phone. She was sentenced to 15 months in prison.

The Supreme Court of Massachusetts settles the argument that assisted suicide is not proximate to the death by stating:

Steinbach argues that, regardless, doctors who provide physician-assisted suicide cannot be the proximate cause of a patient's death because the patient's decision to ingest the medication is a superseding event that extinguishes proximate cause. We do not agree. It is entirely foreseeable that a terminally ill patient who requests medication intended to bring about death may use the medication for such a purpose.

...In sum, under our existing law, doctors who engage in physician-assisted suicide may risk liability for involuntary manslaughter.

The question as to whether the Massachusetts Constitution could be interpreted to include a right to assisted suicide the Supreme Court of Massachusetts stated:

In sum, the history of suicide in general, and physician assisted suicide in particular, provides no support for the conclusion that physician-assisted suicide is an individual right protected by the Massachusetts Declaration of Rights.

Steinbach argued that the right to assisted suicide is a natural outgrowth to the right to refuse medical treatment. The Supreme Court of Massachusetts decided that:

We do not agree, but, rather, recognize an important distinction between the refusal of medical treatment and physician-assisted suicide, which lies in fundamental legal principles of cause and effect; whereas withdrawing or withholding medical care is not the primary cause of a patient's death, physician-assisted suicide is.

The Supreme Court of Massachusetts further analyses the question of the right to refuse treatment and states:

In medical ethics, "the right of competent, informed patients to refuse life-prolonging interventions . . . is firmly established," whereas the right to physician-assisted suicide is a matter of "ethical . . . controversy."

The American Medical Association has opined, for example, that although physicians should "honor patients' informed decisions to refuse life-sustaining treatment," physicianassisted suicide "is fundamentally incompatible with the physician's role as healer."

In their conclusion, the Supreme Judicial Court of Massachusetts states:

In sum, given our long-standing opposition to suicide in all its forms, and the absence of modern precedent supporting an affirmative right to medical intervention that causes death, we cannot conclude that physician-assisted suicide ranks among those fundamental rights protected by the Massachusetts Declaration of Rights. Thus, application of the law of manslaughter to physician-assisted suicide would not impinge on an individual's right to substantive due process.

The Supreme Judicial Court of Massachusetts then states:

Application of the law of manslaughter to physician assisted suicide passes constitutional muster because the law is reasonably related to the State's legitimate interests in preserving life; preventing suicide; protecting the integrity of the medical profession; ensuring that all end-of-life decisions are informed, voluntary, and rational; and "protecting vulnerable people from indifference, prejudice, and psychological and financial pressure to end their lives."

As much as the Supreme Court of Massachusetts reject a right to assisted suicide they do keep the issue open to a legislative change by stating:

These questions are best left to the democratic process, where their resolution can be informed by robust public debate and thoughtful research by experts in the field.

The Euthanasia Prevention Coalition and EPC-USA would like to thank Christopher P. Schandevel from Alliance Defending Freedom (ADF) for representing us before the Supreme Judicial Court of Massachusetts.

EPC-USA not only submitted an excellent friend of the court brief but we were the only group that provided a friend-of-the-court brief that was also asked to provide an oral argument before the Massachusetts Supreme Judicial Court.

Links to more articles on the Massachusetts assisted suicide Kligler court case:

• EPC-USA presented oral argument before the Massachusetts Supreme Judicial Court in the Kligler assisted suicide case (Link).
• If assisted suicide were legal, plaintiff in Massachusetts assisted suicide court case may have died prematurely (Link).
• EPC-USA files brief to Massachusetts Supreme Court in the Kligler assisted suicide case (Link).
• Massachusetts Supreme Court to hear assisted suicide case (Link).
• Assisted suicide lobby to appeal Massachusetts court decision stating that there is no right to assisted suicide (Link).
• Disability leaders praise Massachusetts court decision stating that there is no right to assisted suicide (Link).
• Massachusetts court decision explains why assisted suicide should not be legal (Link).
• Massachusetts court rules that there is no right to assisted suicide (Link).

Boston Globe articles promote the legalization of assisted suicide.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Boston Globe published two articles by Robert Weisman on December 11, 2022 promoting the legalization of assisted suicide in Massachusetts. The articles, which are free advertising for the assisted suicide lobby, are oriented to helping the assisted suicide lobby urge legislators to legalize assisted suicide in the upcoming legislative session. (Article 1) (Article 2).

Based on the tone of the articles, it appears that the Boston Globe plans to strongly support the legalization of assisted suicide in Massachusetts.

The first article begins by quoting Rep James O'Day, a Worcester Democrat and the lead sponsor of the assisted suicide bill, who says that he hopes that the assisted suicide bill can pass in 2022.

The article then quotes Governor Maura Healey who states that she would support the bill under certain conditions.

In the last legislature, the assisted suicide bill passed in the Joint Committee on Public Health but failed to advance in the Joint Committee on Healthcare Financing.

The article does state that opposition to the bill continues. Weisman writes:

House Speaker Ronald Mariano last spring said representatives in his chamber remained “very divided” on the issue. Mariano, through a spokesman, declined a request for an interview for this story. Senate President Karen Spilka similarly declined to discuss the matter. In separate statements, both promised to continue reviewing the bill in conversations with their colleagues in the upcoming session.

But the article continues with promoting assisted suicide by quoting State Senator Joanne Comerford, the Senate sponsor of the past assisted suicide bill as stating:

The idea of government restricting the end-of-life options of people in pain “becomes dangerous,”

The reality is that legalizing assisted suicide is dangerous.

The second article interviews several people who had family members die a difficult death and a few people with terminal and chronic conditions who "want the option."

John Kelly

Nonetheless the second article does create some balance by interviewing John Kelly, the Director of Second Thoughts Massachusetts. Weisman writes:

Disability-rights advocate John Kelly, who lives in Boston’s Fenway neighborhood, is director of Second Thoughts Massachusetts, a group opposing what it calls “assisted suicide.” He’s also a quadriplegic who injured his spinal cord in a sledding accident 38 years ago.

Kelly, 64, has testified against medical aid-in-dying legislation and organized a rally against the appeal to legalize it through the Supreme Judicial Court. He condemns a “better dead than disabled” mindset he sees in those distressed about loss of control at the end of their lives.

“Proponents say it’s about pain and suffering,” Kelly said. “But it’s relatively privileged people’s response to their own disability and dependence on others.”

Folks with disabilities often grapple with a lack of access to health care and home care services, he said. “Everyone should receive effective palliative care,” he said. “But we also believe people should be able to stay in their home and have adequate care there. This is really a values discussion masquerading as a medical issue.”

Kelly is also highly skeptical of treating a physician’s six-month prognosis as an exact science.

“People have to remember that doctors are often wrong about predicting when someone will die,” he said.

The Massachusetts Supreme Court is deliberating on the Kligler case that asked the court to find a right to assisted suicide in Massachusetts. That decision is expected soon.

EPC-USA letter to Massachusetts legislators

June 8, 2022

President of the Senate Karen E. Spilka, Karen.Spilka@masenate.gov
Speaker of the House Ronald Mariano, Ronald.Mariano@mahouse.gov

RE: S.1384 and H. 2381 An Act Relative to End of Life Options, creating an exception to involuntary manslaughter for physician assisted suicide

Dear President and Speaker:

The Euthanasia Prevention Coalition USA supports positive measures to improve the quality of life of people and their families; we oppose euthanasia and assisted suicide. We are aging and disability advocates, lawyers, doctors, nurses and politicians.

Please let S.1384 and H.2381 die this session (192nd General Court), while legislators are deeply divided amid heightened concerns about inequities for people of color and those living with disability. Proponents are trying to sell you a pig in a poke. It’s not about polls, pain or a quick, peaceful death. Instead, it spawns more suicides and provides less healthcare.

It’s Not about Polls

Proponents are touting a recent poll that pegs public support at 77%. As seasoned legislators, you know support drops off as people learn more which is exactly what happened with the 2012 ballot measure. Back then, support was pegged at 60%+, but fell off leading to the measure’s failure. Polling support may be wide but it isn’t deep.

It’s Not about Pain

I’m often asked if I want people to die in pain. You probably have been asked that
question, too. The answer is this is not about letting people die in pain. People don’t use these laws to escape pain.

Dr. Lonny Shavelson, a California doctor who helps people die says promoting “aid in dying” as avoiding pain is a political sales pitch. See webinar minutes 25:24-27:53. He says people choose assisted suicide because they are low energy or afraid of losing control.

It’s Not about a Peaceful or Quick Death

Dr. Shavelson says the idea that assisted suicide creates a peaceful beautiful death is another myth. See webinar minutes 37:35-41:00.

Dying this way can be very unpleasant and even painful. People are given “aid in dying” concoctions that burn their throats and extend the dying period. When drugs that had been used in the past became expensive, death doctors experimented on people with other drug cocktails, some of which burned people’s throats causing them to scream in pain and extended the dying process by more than 3 hours and as much as 31 hours. The FDA does not regulate these drugs because they are compounded. Currently severe burning is expected in 10% of cases with drug cocktails now being prescribed by physicians.

Assisted Suicide Spawns More Suicides and Attempted Suicides.

If you enact this law, more people will die by suicide, more will attempt suicide and more will visit Emergency Departments as a result. This is the collateral damage caused by these laws. They send a message that suicide is an acceptable way to solve problems. Publicity about suicide also leads to more suicides; this is called suicide contagion.

Legalization of Assisted Suicide especially impacts youths. A 2019 report found teen suicides in California increased by 34% since that state legalized Assisted Suicide in 2016. Oregon’s youth suicides increased 79.3% from 2000 to 2018. Research about completed suicides in four states that legalized Assisted Suicide (Oregon, Washington, Vermont and Montana) found it was associated with at least a 6.3% increase in the rate of all suicide deaths.

According to the 2020 Massachusetts Public Health Data Brief, 615 people died by suicide in 2020. There were 591 monthly Emergency Department visits for attempted suicide (7,092 per year) and 4,882 visits per month for suicidal ideation (58,584 per year) during 2019 to early 2020.

A 6.3% increase following enactment would result in more deaths and need for medical care.

• Fatal Suicides 39 more people would die by suicide 
• ED visits, Attempted Suicides 447 more ED visits, following suicide attempts 
• ED visits, Suicidal Ideation 3,690 more ED visits for suicidal ideation
  

Insurance Companies Use Assisted Suicide to Deny Curative Life-Saving Treatment

Insurers stop covering certain treatments due to the availability of Assisted Suicide. Dr. Brian Callister of Nevada says he was stunned when insurance would not cover life saving treatment for his patients who were transferring to California and Oregon, but the company offered to pay for Assisted Suicide instead. These were people who could be cured with the denied treatment rather than being rendered terminal. In effect, Assisted Suicide is being used to shunt people off the curative, restorative medicine track, especially if they cannot afford to pay for treatments out
of pocket.

People of color understand this will be used to provide them poorer care. 

Even with insurance, people of color get poorer hospital care and pain relief according to a New York Times article. They are still disproportionately dying of COVID-19. So, it is unsurprising that Black and Latinx people oppose Assisted Suicide by 2-1 margins ‒ “… the voting results from Ballot Question 2 in 2012 show Assisted Suicide pits wealthier, whiter districts against those with poorer people and people of color according to Second Thoughts – Massachusetts.

In closing, I urge you to let this bill die.

Sincerely,
Sara Buscher, Chair
Euthanasia Prevention Coalition USA

Take Action Now: Oppose the Massachusetts Assisted Suicide bills.

John Kelly Director, Second Thoughts

Second Thoughts MA is a grassroots group of disability rights advocates from Massachusetts and the region who oppose the legalization of assisted suicide as a deadly form of discrimination against disabled people. We demand social justice against laws, policies, and media messages fueled by a “better dead than disabled” mindset. 

We organized in 2012 to help defeat assisted suicide Ballot Question 2. High turnout among black and Latinx voters made victory certain. Since then, we have successfully advocated against three more assisted suicide bills, led a month-long campaign in 2016 against the disability euthanasia movie “Me before You,” and are now advocating against the assisted suicide bills S.1384 / H.2381 in the legislature.

Please! Take Action NOW and oppose bills S.1384 and H 2381!

Reject Assisted Suicide

Insurer control

Real “choice” belongs to insurers, who can deny prescribed treatments at will, even if lifesaving. In Oregon, you can qualify as “terminal” if you can’t afford your treatment, or if treatment stops for any reason. Legalization makes assisted suicide a “medical treatment,” a so-called “benefit” to be extended to ever more people, and that will always be the most profitable and “cost-effective.”

Persuasion –> abuse

Everyone is vulnerable to suggestion and persuasion. Nothing prevents self-interested family members and medical professionals from pushing for assisted suicide. Meanwhile, it is estimated that 1 in 10 Massachusetts older adults are abused every year, and COVID-19 has only made it worse. Nothing in the law can stop an heir or abusive caregiver from steering someone towards assisted suicide, witnessing the request, picking up the lethal dose, and even administering the drug — no witnesses are required at the death, so who would know? The Oregon law has invited every sort of abuse. 

Misdiagnosis

Studies show that 12%-15% of people entering hospice with a terminal diagnosis outlive their prognosis. In 23 years in Oregon, 1900 people have been prescribed lethal drugs, but the survival rate past six months is only 4%. This suggests that a substantial number died by suicide when they were not dying. Oregonian Jeanette Hall wrote the Boston Globe in 2011 that after a terminal diagnosis she sought assisted suicide, but her doctor persuaded her to try more treatment. “If my doctor had believed in assisted suicide, I would be dead,” she wrote. She has now lived more than 20 years post diagnosis. Any other elective “treatment” with such deadly results would never be tolerated!

Not pain, but distress about disability

The Oregon reports show the first five “end-of-life concerns” deal with not pain, but “existential distress” over the disabling aspects of serious illness, from depending on others for care to grief over lost abilities, loss of social status (“dignity”), incontinence, and feeling like a burden. Proponents speak of “quality-of-life.”

Leading California prescriber Lonny Shavelson says, “It’s almost never about pain, it’s about dignity and control.” Palliative care expert Ira Byock said that almost all pain is controllable, and that marketing bills as all about pain “is a bait and switch.” In the eyes of the state, everyone must be seen as having equal dignity. We champion fully funded home and community-based services, for a caring society rooted in mutual aid and interdependence.

Medical Prejudice

In a recent national survey of practicing US physicians, “82.4 percent reported that people with significant disability have worse quality of life than nondisabled people. . . . [T]hese findings about physicians’ perceptions of this population raise questions about ensuring equitable care to people with disability. Potentially biased views among physicians could contribute to persistent health care disparities affecting people with disability.” Do Not Resuscitate orders have been placed in patient files against their wishes. Media messages and movies like “Me Before You” and “Million Dollar Baby” promote the mindset of “better dead than disabled.” 

Racial Disparities

Medical prejudice and neglect results in racial disparities in diagnosis and treatment of diabetes, cancer, and heart trouble. COVID-19 has killed Black, Indigenous, and People of Color (BIPOC) at a much higher rate than Whites. Assisted suicide legalization makes it more likely that Black patients will be “written off” as better off dead, like Black Texan quadriplegic Michael Hickson.

Social Divide

As the voting results from Ballot Question 2 in 2012 show, assisted suicide pits wealthier, whiter districts against those with poorer people and people of color. For long-standing reasons, Black and Latinx people oppose assisted suicide by 2-1 margins. The four most Latinx cities in the Commonwealth – Lawrence, Chelsea, Holyoke, and Springfield – all voted strongly against Question 2. For example, Lawrence voted 69%-31% no. White working-class and more socially conservative towns also rejected the ballot measure by strong majorities. The state must not adopt one social group’s focus on personal autonomy and status over communities that value above all connection and family.

Depression

Assisted suicide laws lead to the denial of suicide prevention services to seriously ill and disabled people, a violation of the Americans with Disabilities Act’s guarantee of equal program access. Assisted suicide laws redefine depression and feeling like a burden as “rational,” rather than as evidence of impairment or need for intervention. Suicide contagion is real and assisted suicide laws send the wrong message that suicide is an answer to personal problems.

Alternative of Palliative Sedation

Anyone dying in discomfort that is not otherwise relievable may legally receive palliative sedation. The patient is sedated to the point where the discomfort is relieved while the dying process takes place. So there’s no need for legalized assisted suicide.

Disability

In a society full of crushing ableism, reported “end of life” concerns all have to do with negative reactions to disability: distress and shame over dependence on others, lost abilities, loss of dignity, feeling like a burden and incontinence. But no one needs to die to have dignity. We champion meaning found in mutual aid and interdependence.

Outside Influence is Unavoidable

In her New Year’s Eve 2019 ruling against a state constitutional right to die, Suffolk Superior Court Judge Mary K. Ames summed up some of the stresses that might hurry the moment when people ingest the poison.

In such a situation, there is a greater risk that temporary anger, depression, a misunderstanding of one’s prognosis, ignorance of alternatives, financial considerations, strain on family members or significant others, or improper persuasion may impact the decision.

Summary

If Massachusetts legalizes assisted suicide, some people’s lives will be ended without their consent, through insurance denials, medical mistakes, and all the various forms of coercion and abuse. No safeguards have ever been enacted, or even proposed, that can prevent this outcome, which can never be undone.

Say NO to Physician Assisted Suicide in Massachusetts

This letter was distributed by the Massachusetts Catholic Conference (Link).

The Massachusetts State Legislature is considering passing into law two deeply troubling bills this session which would legalize Physician Assisted Suicide. The bills, House 2381 and Senate 1384, are identical in text and titled “An Act relative to end of life options”.

“The Catholic Bishops of Massachusetts stand united in our strong opposition to Physician Assisted Suicide. It is an affront to life and a dangerous precedent for determining end of life issues. Physicians are trained to care for the ill, not to hasten death.”

Here are some troubling facts to consider before you act: 

1. The bills would allow a physician to provide a deadly drug mixture to an individual diagnosed with less than 6 months to live that, when consumed, would cause death. NOTE - The diagnosis could be wrong. Countless individuals have outlived that 6-month diagnosis and enjoyed many more precious months and years with family and friends. 
2. No Real Safeguards - A vulnerable individual who is physically disabled, depressed, or fears being a “burden” may be subject to undue influence by others to take the drug mixture, especially if there is a financial benefit as an incentive. 
3. The primary focus of elected officials should be dedicated to legislation providing quality health care, mental health care and palliative care to the sick and dying – particularly in the underserved, poor and minority communities that suffer the most at the time of need. 

How can your voice be heard? 

Call or email your legislators, let them know you are a Massachusetts voter, and say NO to Physician Assisted Suicide! 

• Members of the legislative Joint Committee on Health Care Finance who will be considering these bills can be contacted (Link to Committee members).
• Your individual State Senator and Representative via address and zip code link. (Link here). 

EPC-USA responds to Massachusetts assisted suicide bill - The cost of suicide/assisted suicide.

May 29, 2022

Senator Cindy Friedman, Co-Chair
Representative John J. Lawn, Jr., Co-Chair
Joint Committee on Health Care Financing
24 Beacon Street, Room 313
Boston, MA 02133

RE: S.1384 An Act Relative to End of Life Options, creating an exception to involuntary manslaughter for physician assisted suicide

Dear Chairpersons Friedman and Lawn:

The Euthanasia Prevention Coalition USA opposes euthanasia and assisted suicide, supporting positive measures instead to improve the quality of life of people and their families. We are aging and disability advocates, lawyers, doctors, nurses and politicians.

We are asking you to let S.1384 (also H.2381) die in your committee. Enactment will likely increase your Medicaid budget by an estimated $14 million, with another $12.2 million for the uninsured (using publicly available data) as this letter explains.

Assisted Suicide Laws lead to More Suicides

Overall, Massachusetts has avoided the upward trend in suicide seen in other states, but that could change if S.1384 is enacted due to publicity, increased knowledge of methods, and normalization. Publicity or knowledge about suicide leads to more suicides, attempts and ideation. In 2017 when Netflix released 13 Reasons Why, the story of a 17 year old girl’s suicide and its aftermath, teen female suicides went up by 21.7% (95% CI, 7.3%-36.2). For every person who dies by suicide, another 30 attempt suicide. Legalizing Assisted Suicide sends a message that it is a normal way to solve problems which leads to more suicides, attempts and ideation.

Research about fatal suicides in Oregon, Washington, Vermont and Montana, the first four states to do so, found legalizing Assisted Suicide was associated with at least a 6.3% increase in the annual suicide rate. The study reported:

PAS [Physician Assisted Suicide] is associated with an 8.9% increase in total suicide rates (including assisted suicides), an effect that is strongly statistically significant (95% confidence interval [CI] 6.6%--11.2%). Once we control for a range of demographic and socioeconomic factors, PAS is estimated to increase rates by 11.79% (95% CI 9.3%--14.1%). When we include state-specific time trends, the estimated increase is 6.3% (95% CI 2.7%--9.9%).

Massachusetts Experience

According to the latest Massachusetts Public Health Data Brief, 615 people died by suicide in 2020, down from 642 in 2019. There were 591 monthly Emergency Department visits for attempted suicide (7,092 per year) and 4,882 visits per month for suicidal ideation (58,584 per year) during 2019 to early 2020.

As detailed below, a 6.3% increase would result in the following annual medical costs.

Fatal Suicides                 $3.47 million
Attempted Suicides     $29.84 million
Suicidal Ideation          $15.94 million
Total Added Costs        $49.25 million

The Medicaid share of these costs would be 28.4% or $14 million. When it comes to medical costs for suicide, 28.4% are paid by Medicaid and 24.8% are incurred by the uninsured. The uninsured costs of $12.2 would mostly be absorbed by hospitals.

Medical Cost Calculations

Total 2019 medical costs for fatal and attempted suicides in Massachusetts are estimated to be $33.3 million ($3.47 million for fatal suicides and $29.84 million for attempted suicides). Medical costs for fatal suicides are collected and reported by the CDC WISQARS Cost of Injury system. During 2019, WISQARS shows fatal Massachusetts suicides had medical costs of $3.47 million. The medical costs for attempted suicides ran about 8.6 times that for fatal suicides in the latest national study of 2013 data. So, the estimated cost of attempted suicides for Massachusetts would run about 8.6 times the $3.47 million estimated above for fatal suicides or $ 29.84 million.

The medical costs for suicidal ideation are also significant. According to a study of 2013 data by the federal Agency for Healthcare Research and Quality, 72% of those visiting an Emergency Department for suicidal ideation are hospitalized or institutionalized. On average, the length of stay was 5.6 days for a cost of $6,000. Recall, Massachusetts had 58,584 suicidal ideation visits in 2019. A 6.3% increase would be 3,690 visits with 72% incurring inpatient costs or 2,657 at $6,000 each for $15.94 million per year. (Note this ignores the Emergency Department costs for the other 28% of ideation visits.)

Cost Shifting to Medicaid due to Availability of Assisted Suicide

An additional cost to Medicaid could come from people whose insurance stops covering treatments due to the availability of Assisted Suicide. Dr. Brian Callister of Nevada says he was stunned when insurance would not cover life saving treatment for his patients who were transferring to states where Assisted Suicide is legal. Some of those people could turn to Medicaid to get their treatments paid for.

In closing, I urge you to consider the financial impact on your state’s budget and hospitals; and then, let this bill die in your committee.

Sincerely,

Sara Buscher, Chair
Euthanasia Prevention Coalition USA

EPC-USA presented oral argument in Massachusetts Supreme Court Kligler assisted suicide case.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

EPC-USA filed a powerful Amicus brief to the Massachusetts Supreme Court in the Kligler assisted suicide case. 

EPC-USA was the only friend-of-the-court brief that was also asked to provide an oral argument before the Massachusetts Supreme Court.

The case known as Kligler concerns Dr Roger Kligler is living with prostate cancer and seeking death by assisted suicide and Dr Alan Schoenberg, is willing to prescribe a lethal drug cocktail for Kligler to die by assisted suicide.  Kligler who claimed to be terminally ill when the case began in 2016 is very much alive today.

Kligler and Schoenberg are arguing that doctors cannot be prosecuted for prescribing lethal drugs for assisted suicide to a competent terminally ill person under the Massachusetts state constitution.

An article by Sean Salai for the Washington Times on March 11 reported that Alliance Defending Freedom (ADF) which represented EPC-USA were the only group asked to provide oral argument before the court in defense of maintaining the Massachusetts law prohibiting assisted suicide. Salai stated:

In a friend-of-the-court brief, ADF attorneys argue that the two doctors “seek to establish a previously unrecognized right to ‘medical aid in dying,’ where a doctor prescribes lethal medication for use in committing suicide.”

“Creating a right to physician-assisted suicide would not be a mere expansion of the right to refuse life-saving treatment,” the ADF said, adding that the “vast majority” of U.S. states and medical associations oppose it.

Salai reported that Sara Buscher, the chair of EPC-USA stated:

Sara Buscher, chair of the nonprofit Euthanasia Prevention Coalition USA that filed the amicus brief through Alliance Defending Freedom, said the two doctors want to redefine the purpose of medical treatment. 

“Major medical organizations like the American Medical Association oppose the practice of assisted suicide for good reason: turning doctors into killers is the opposite of a doctor’s role in medicine,” Ms. Buscher said. “Assisted suicide treats some people, particularly the disabled, as better off dead.”

The EPC-USA brief agrued the following:

• There is no fundamental right to physician-assisted suicide in the Massachusetts Constitution.

The Appellants seek to establish a previously unrecognized right to “medical aid in dying,” where a doctor prescribes lethal medication for use in committing suicide. But the widespread prohibition—not acceptance—of assisted suicide is deeply rooted in Massachusetts’ and the Nation’s history and tradition. And the vast majority of states and secular medical associations oppose it today.

• There is a fundamental difference between refusing medical treatment and assisted suicide.

Creating a right to physician-assisted suicide would not be a mere expansion of the right to refuse life-saving treatment. The right to reject treatment is based on the common-law right to reject a battery. And death occurs, if at all, by natural causes. Assisted suicide is different: it invites the intrusion of a lethal agent into the patient’s body, intentionally causing death.

• A right to assisted suicide cannot be a limited right as claimed by the appellants.

Appellants are wrong to suggest a constitutional right to assisted suicide could be limited to a narrow class of people. And that would create problems courts are not equipped to solve.

EPC-USA argued that if there is a right to assisted suicide then it would be soon declared discriminatory to limit that right to certain groups of people, such as people who are terminally ill leading to an ever expanding assisted suicide regime.

Links to more articles on the Massachusetts assisted suicide Kligler court case:

• If assisted suicide were legal, plaintiff in Massachusetts assisted suicide court case may have died prematurely (Link).
• EPC-USA files brief to Massachusetts Supreme Court in the Kligler assisted suicide case (Link).
• Massachusetts Supreme Court to hear assisted suicide case (Link).
• Assisted suicide lobby to appeal Massachusetts court decision stating that there is no right to assisted suicide (Link).
• Disability leaders praise Massachusetts court decision stating that there is no right to assisted suicide (Link).
• Massachusetts court decision explains why assisted suicide should not be legal (Link).
• Massachusetts court rules that there is no right to assisted suicide (Link).