Introduction

Webcast archive: Carol Gill’s response to assisted suicide supporters

Today, we discuss the stories of two disabled people in the mid-1980s, whose lack of support services prompted them to seek assisted suicide.

Webcast archive: Carol Gill’s response to assisted suicide supporters

In this episode of Euthanasia & Disability, Amy Hasbrouck and Christian Debray discuss:

  • Carol Gill’s response to assisted suicide supporters

Please note that this text is only a script and that our webcast contains additional commentary.

CAROL GILL RESPONDS TO DISABLED SUPPORTERS OF ASSISTED SUICIDE

  • In the year 2000, Dr. Carol Gill of the University of Chicago responded to an article by Andrew Batavia on the subject of assisted suicide.
  • Gill had already written about her opposition to the practice, and about the treatment of people with disabilities in the U.S. medical system.
  • We’re looking back at this article because her comments are still pertinent 15 years later.
  • People with disabilities, like nondisabled persons, are able to commit suicide if they really want to. Persons with even severe limitations are more resourceful than most people think they are.
  • Suicide is similar for persons with and without disabilities. In his article, Andrew Batavia talks about his friends’ suicides, which were not were not easy, painless, or certain. What he doesn’t say is that this is true of suicide for anyone, disabled or not.
  • It is certainly tragic that he lost three friends to suicide, but it is not unusual that at least one of them made two attempts before completing the act.  Most suicide attempts do not end in death; a completed suicide is commonly preceded by several attempts.
  • Longstanding laws against helping people commit suicide reflect society’s view that ending one’s life is so grave a matter that it should be a lonely and difficult endeavor, free from external influence or facilitation, and open to failure.  In other words, suicide is not supposed to be easy for anyone.
  • Although they criticize government intrusion into private affairs, advocates of assisted suicide push for new laws that, in effect, single out persons with incurable conditions for a guaranteed, bureaucratically facilitated death on request. Yet they don’t explain why people with illnesses and disabilities should receive this option, but nondisabled adults – however autonomous and well informed – are denied the same option when they find life unendurable.
  • The insistence by right-to-die supporters that physical loss justifies rational suicide leads to some logical contradictions. For example, Batavia says people with disabilities are “fully capable of autonomy” and “do not wish to be protected from themselves”  … Yet he feels justified in denying requests from disabled people when he decides they need protection. He argues that if they are not helped to die, they “will attempt to take their own lives, sometimes with disastrous results (e.g., coma, brain damage, further physical suffering)”. These are the same consequences faced by nondisabled individuals who attempt suicide, but he does not move to protect them.
  • Batavia refuses to believe that oppression can affect the freedom of people with disabilities to make truly free choices. In the face of well-known links between disability and poverty, social devaluation, exclusion, and medical abuse, he dismisses oppression as a source of coercion and despair in requests for assisted suicide. …[Yet, this was] the experience of many individuals with disabilities who have asked for help to die. Some have died to escape the isolation of medical institutions.”  Gill describes the case of Larry McAfee, who won the right to be allowed to die.  But in the process McAfee was contacted by a local independent living center, and was helped to move out of the nursing home into his own apartment with personal care attendants.  “McAfee lived long enough to denounce the social policies that he believed had pressured him to give up on life.  If assisted suicide had been legal and routine in the 1980s, it is possible that he would not have survived long enough to understand and voice the real cause of his despair.  He was, after all, a rational adult who was thoroughly informed by his doctors of his prognosis and options. His desire to die was clear and persistent over time. He was a perfect candidate for assisted suicide. However, he would have died unnecessarily.”
  • Real autonomy requires not just the ability to make competent choices but also real options. …Many persons with disabilities have few real options to live as they wish. No assisted-suicide guidelines guarantee those options.
  • Batavia confuses assisted suicide with the right to refuse treatment when he states, “People who are in the process of dying, and who are suffering intolerably according to their own assessment, should not be required by the state to continue to live and suffer if that is not their desire”.
  • First, the “state” does not require dying people to accept life-sustaining measures.
  • Second, expecting people to act on their own when they decide to commit suicide is not the same as forcing a dying person to go on living. Merging the two concepts may be dramatic rhetoric, but it is also misleading.
    • Gill responds to Batavia’s inaccurate description of opponents discrimination arguments.
  • Opponents use the term discrimination when the death wishes of disabled persons are “respected,” whereas the death wishes of nondisabled persons are treated as cries for help.
  • Opponents do, indeed, express grave concerns about the manner in which life support is withdrawn from persons with disabilities. From the Elizabeth Bouvia case in the mid-1980s, many disability rights activists have protested society’s and the medical system’s willingness to let people with disabilities die before they have been offered adequate supports to live as they wish. Most health professionals know so little about living with disabilities that they are incapable of providing sufficient information for informed consent.
  • Most health professionals know so little about living with disabilities that they are incapable of providing sufficient information for informed consent
    • Batavia cites a poll showing support for assisted suicide, but the truth is that there is still very little research on the views of people with disabilities.
    • Gill herself undertook such a study. In 2005, she assembled a group of 29 people with various disabilities, and asked a series of opinion questions before and after presentations for and against assisted suicide.
  • On the question “should assisted suicide be legalized for people with terminal illnesses?”
    • Before the presentation: 52% said yes, 38% said no, and 10% were neutral.
    • After the presentations: 52% said yes, 45% said no, and 3% were neutral.
  • On the question “should assisted suicide be legalized for people with disabilities?”
    • Before the presentations: 28% said yes, 55% said no, and 17% were neutral.
    • After the presentations: 31% said yes, 62% said no, and 7% were neutral.
  • These figures are far from the 85% support among people with disabilities claimed by supporters of assisted suicide.