Webcast archive: Why do people ask for assisted suicide?

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

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

WHY PEOPLE ASK FOR ASSISTED SUICIDE

There are many reasons that euthanasia and assisted suicide affect people with disabilities.
To find the connection, you only have to look at the reasons given by people who ask for assisted suicide in Oregon.
The annual reports on Oregon’s death with dignity program since 1998 show that most of the reasons don’t relate to death, nor pain, but to disability.
In order of frequency, the reasons are:
- Loss of autonomy = 92%
- Less able to participate in activities they enjoyed = 89%
- Perceived loss of dignity = 79%
- Loss of control over bodily functions = 50%
- Fear of becoming a burden = 40%
- Fear of pain, or actual pain = 25%
- Financial concerns = 3%
The majority of these problems are directly related to discrimination against people with disabilities, and they can be dealt with through changes in attitudes and how services are delivered.

Loss of autonomy

When a person becomes disabled, she runs into barriers everywhere, and she needs help with many everyday tasks, partly because of the barriers, and partly because of her own functional limitations.
It’s very likely that she will end up in a long-term care facility, where her physical functions are controlled from morning to night.
To get home modifications to remove barriers is very difficult. It can take years to get to the top of the waiting lists for ramps and other home adaptations.
Usually a person has no choice in who will help with personal care.
If a person has needs that fall outside the norm, it’s hard to teach aides the correct method.
But there are other ways to do this.
- If society redirected funds toward home care, that would save money and increase individual autonomy.
- If each person received funds to hire her own aides, that she trained, supervised and even fired, if necessary, that person would probably retain a feeling of autonomy and control in her life.

Less able to participate in activities

The loss of physical capacity or an illness often brings a loss of energy. But it’s rare that an activity cannot be adapted to allow a disabled person to partake. These adaptations are usually simple, cheap and very clever. Where there’s a will, there’s a way.”

Perceived loss of dignity

This fear is related to a mania that begin during the Victorian era to hide bodily functions, which is especially strong in Britain and North America.
Though these cleanliness standards have helped to eliminate many diseases, they’ve also created a terror of all signs of our humanity.
This, in turn, has caused people to be ashamed of the normal phases of life where we all lose this artificial, rigid control of our bodies.
Capitalism to the rescue! Companies selling urinary incontinence products are doing everything possible to normalize urinary leaks.

Fear of becoming a burden

Governments, in doing everything to lower spending on people with disabilities, have relied heavily on the idea that the family caregiver is the “natural” order of things.
Family members (usually women) are obliged to provide personal care to disabled people, free of charge.
If there were respite services and supports to allow the caregiver to work, sleep and rest, and income guarantees, it might work, for some people.
But these support services are inadequate at best for family caregivers, which can sometimes lead to abuse and neglect of disabled people.
In addition, sometimes the “natural” role of caregiver is not “natural” at all under the circumstances.
- For example, it’s not appropriate to expect an adolescent boy to help his single mother with toileting.
- Nor is it appropriate to expect a woman to submit to abuse by her husband because he’s the only one available to provide personal care.
A person with a disability should have funds to hire and pay her own personal assistant.

Pain

Supporters of assisted suicide and euthanasia say they are necessary to prevent people dying in horrible pain.
They remind their audiences of family or friends who have died screaming.
But this doesn’t square with the low rank held by “pain” on the list of reasons, especially since it includes the fear of pain.
In fact, palliative care can eliminate physical symptoms in 95% of cases.
When people talk about “suffering” they mostly mean grief, loss of status in society, and the belief that they have less value as ill or disabled people.
When a person dies in pain, it’s not a problem with medical science, it’s a problem of medical practice.
Doctors receive little training in pain management, and they’re not oriented toward palliative care.
They don’t want to prescribe opiates, for fear of causing addiction.
Families are reluctant to question doctors, for fear of antagonizing the medical staff and of being labeled as “troublemakers.”

All that to say…

The problems named by people who ask for assisted suicide and euthanasia are linked to disability, and they have already been solved by disability rights activists. The solutions must be fully implemented by governments and by society in general in order to prevent the conditions that cause requests for assisted suicide.