Sent September 15, 1999
To: jfa@jfanow.org (Fred Fay, Chair, Justice For All)
Subj: re: [Gallagher and Batavia on Physician-assisted Suicide.]
CC: HGG@dgsys.com, CDA-announce@onelist.com
Dear JFA:
In response to the letter from Hugh Gallagher and Drew Batavia, we who represent the California Disability Alliance (CDA) wish to inform your readers of the other side of the Physician Assisted Suicide debate. The Gallagher-Batavia letter states that "...we believe certain persons and organizations who claim to speak for persons with disabilities may have seriously misrepresented the views of many of us." While recognizing that there will always be differing viewpoints, we find it necessary to point out the dangers to ourselves and to other vulnerable populations that we believe are likely to result from the legalization of physician assisted suicide.
We DO support personal choice. But those who support assisted suicide because they fear the suffering of a painful death do not see the looming larger danger--that managed care will push them into an early death whether or not that is what they really want. This isn't personal autonomy. This isn't a decision arrived at carefully between doctor and patient. This becomes a decision arrived at through an insurance company's profit-boosting policies. In our present environment, what APPEARS to be choice will actually LIMIT choice for many.
People with serious health problems, with severe disabilities, with little or no health insurance, with little extra money to buy what the inadequate government or private health care system fails to provide will find few options OTHER than the suicide "treatment." Although assisted suicide purports to be about choice, health care choices are never made in a vacuum. In the managed care cost-cutting environment, assisted suicide is a fictional freedom.
Consider those who cannot avail themselves of needed medication to alleviate pain, of consultations with specialists who can relieve pain and mitigate disabling conditions, of hospice care, of assistive technology (which might make life more interesting or even productive), of home health care (without which the dreaded nursing home is inevitable). Is this autonomy, for them, if they choose suicide as the only rational way out?
Consider those with no family and/or peer supports at the time when severe illness or injury strikes. When faced with permanent impairments, with little emotional support or guidance to help with initial adjustments, it is far too common for a despairing individual to make what appears to be an intelligent decision--to request assistance in dying, rather than living. But all of us who have lived for many years with such impairments know that there IS a life beyond this moment, if we can be helped to find it AND if we can find the resources to pay for our needs. Many of us who have been proclaimed "terminally ill," have managed to live for many years beyond this point because our doctors were mistaken, and because we did not choose to die at this very moment of bleakest hope.
It has been shown both in Oregon and the Netherlands that the majority of those who ask for assistance with suicide do so because they fear losing functional ability, autonomy, or control of bodily functions. It is the fear of having a disability and needing assistance--NOT PAIN--that is the real reason for exercising this final choice. Think of the danger this attitude poses: it is based on deep misunderstandings about disability--on stereotypes and ignorance--views which are all too common among our medical advisors as well. Too many, having these misconceptions about life with a disability, will choose to die before they can be enlightened.
We do agree with choice and self-direction for people with disabilities, as in most of the points in the "Declaration of Disability Rights" included in the Gallagher-Batavia letter. But it is hard for us to believe that the Messrs. Gallagher and Batavia are unaware of the severe constraints our medical establishment imposes on the elderly, the disabled, the poor, racial minorities, the non-English speaking--the many thousands (20% of the California population and rising) who have no health insurance or who are seriously underinsured.
The California Disability Alliance believes in doing its utmost to support ALL people by improving health care coverage, services and delivery BEFORE recommending new laws which make suicide an easy and "cost-effective" option. We believe in educating the public and the medical profession about disability, and about the value of the lives of those of us who have learned to live with ours. We invite all who are interested in this discussion to visit our webpages at http://www.dredf.org/cda/index.html.
Very Sincerely,
Laura Remson Mitchell, Jean Nandi, Marilyn Golden,
Executive Committee
California Disability Alliance (CDA)
1529 Josephine St.
Berkeley, CA 94703-1168
(510) 845-8236
email: jeannandi@aol.com
Web: http://www.dredf.org/cda/cdahome