Disability Council says no to assisted suicide and euthanasia laws

In a report released on 9 October 2019 entitled "the dangers of assisted laws" the (US) National Council on Disability has reiterated its longstanding opposition to legalising assisted suicide or euthanasia, concluding after a comprehensive review of the available evidence that:

States should not legalize any form of assisted suicide or active euthanasia, whether called by these terms or any other terms. States must, rather, ensure a strong healthcare system that includes LTSS [long-term services and supports] for all, including people with disabilities with or without a terminal prognosis; ensure that people with disabilities are protected from discrimination; and provide services that enable independent living and supported self-determination for people with disabilities.

The idea that hastened death is a pathway to dignity for people facing physical decline reveals the public’s extreme disparagement of functional limitations and a perception that “dignity” is not possible for people who rely on supports, technology, or caregivers to be independent or alive. Many hold the attitude that a person with a disability may be better off dead than alive.

Legalizing assisted suicide means that some people who say they want to die will receive suicide intervention, while others will receive suicide assistance. The difference between these two groups of people will be their health or disability status, leading to a two-tiered system that results in death to the socially devalued group.

All state agencies that deal with suicide prevention should address the specific challenges of people with disabilities and people with chronic conditions, including people with a terminal prognosis.

A request for assisted suicide is . . . usually made with as much ambivalence as are most suicide attempts. If the doctor does not recognize that ambivalence as well as the anxiety and depression that underlie the patient’s request for death, the patient may become trapped by that request and die in a state of unrecognized terror. . . . Patients who request euthanasia are usually asking in the strongest way they know for mental and physical relief from suffering. When that request is made to a caring, sensitive, and knowledgeable physician who can address their fear, relieve their suffering, and assure them that he or she will remain with them to the end, most patients no longer want to die and are grateful for the time remaining to them.

Thus, the challenge for doctors is to find out what is behind the patient’s request to hasten death, and address it. Yet, where assisted suicide is legal, such a request begins a legally sanctioned process. The depression remains undiagnosed, and the only treatment consists of a lethal prescription.

NCD has considered recommending ways to “improve” assisted suicide proposals and laws by making their provisions more stringent, but has decided against doing so, because the Council does not believe that added safeguards, modified safeguards, or indeed safeguards of any kind, will remove the inherent dangers in assisted suicide laws. Also, such a message can be readily confused with the idea that legalized assisted suicide is acceptable as long as its rules are stronger, which is not true.

On the contrary, the basic dangers of legalizing assisted suicide are inherent and cannot be eradicated.

Implementation of assisted suicide laws has demonstrated that even the current “safeguards,” which are modest at best, are easily circumvented. Rather than strengthening safeguards, the tendency has been either to propose looser rules or to simply disregard them, notwithstanding the letter of the law. Examples from other countries have also demonstrated that once assisted suicide seems “safe,” then euthanasia and assisted suicide for nonterminal diseases becomes a reasonable next step. Thus, there is no reason to believe that better laws, training of physicians, data collection or safeguards will provide real protection from harms and abuse in any meaningful way.