The National Council on Disability (NCD) has released a scathing analysis of the effect of assisted suicide laws in the United States on people with disabilities. It finds that safeguards are ineffective and that there is little oversight of abuses and mistakes.
In eight states and the District of Columbia it is legal for doctors to prescribe lethal drugs to patients diagnosed with terminal illness and with a prognosis of six months or less to live, if certain procedural steps are followed.
Pain relief is often described as the primary motivation for seeking assisted suicide. In its report, Assisted Suicide Laws and their Danger to People with Disabilities, NCD responds that the most prevalent reasons offered by someone requesting assisted suicide are directly related to unmet service and support needs. These should be dealt with through new laws and more funding, says NCD, not assisted suicide.
“Assisted suicide laws are premised on the notion of additional choice for people at the end of their lives, however in practice, they often remove choices when the low-cost option is ending one’s life versus providing treatments to lengthen it or services and supports to improve it,” said NCD Chairman Neil Romano.
Closely examining the experience in Oregon, where the practice has been legal for 20 years, NCD found that the list of conditions eligible for assisted suicide has expanded considerably over time, including many disabilities that, when properly treated, do not result in death, including arthritis, diabetes, and kidney failure.
Assisted Suicide Laws and their Danger to People with Disabilities also notes suicide contagion in states where assisted suicide is legal; as well as a loosening of existing safeguards both in states with legalized assisted suicide and states considering bills to legalize.
In the report, NCD exposes the limitations of purported safeguards. It says that:
Insurers have denied patients expensive, life-sustaining medical treatment, but offered to subsidize lethal drugs for them, potentially leading patients to hasten their own deaths;
Misdiagnoses of terminal disease can cause frightened patients to hasten their deaths;
Though fear and depression often drive requests for assisted suicide, referral for psychological evaluation is extremely rare prior to doctors writing lethal prescriptions;
Financial and emotional pressures can distort patient choice;
Patients may “doctor shop” limitlessly to find a physician who will obtain a colleague’s concurrence and prescribe a lethal dose
Evidence of suicide contagion in states where assisted suicide is legal has been found in several studies.
“As someone who has battled cancer and been given weeks to live and am still thriving years later, I know firsthand that well-intending doctors are often wrong,” said Mr Romano. “If assisted suicide is legal, lives will be lost due to mistakes, abuse, lack of information, or a lack of better options; no current or proposed safeguards can change that.”
The debate comes at a delicate time. Just as people are campaigning for the right to die through lethal injections, there is a big crack-down on the use of potentially habit-forming opioids. The report points out that “people who depend on opioids to manage pain often find themselves treated like criminals. It may become easier to obtain a prescription to die than one to relieve pain.
The NCD report also points out that many national disability rights organizations oppose the legalization of assisted suicide. All national groups that have taken a position are opposed.
The National Council on Disability is an independent federal agency which advises the President, Congress, and other federal agencies regarding policies, programs, practices, and procedures that affect people with disabilities. It was an early opponent of the legalization of assisted suicide and released a forceful statement in 1997 which it reaffirmed in 2005.
Michael Cook is editor of BioEdge
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