Introduction

Webcast archive: How assisted suicide and euthanasia are changing how we think – Part II

This week, we discuss how assisted suicide changes the way we think about traditional suicides, as well as why supporting Autism Speaks is a bad idea.

Webcast archive: How assisted suicide and euthanasia are changing how we think – Part II

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

  • How assisted suicide and euthanasia are changing how we think – Part II
  • Autism Awareness Month; Don’t “Light It Up Blue”

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

HOW ASSISTED SUICIDE AND EUTHANASIA ARE CHANGING THE WAY WE THINK – PART II

  • Today, we’re picking up where we left off last week, exploring how the legalization of assisted suicide and euthanasia (AS/E) have changed the way our society responds to people who want to die.
  • “Exceptional measures” become “response to an urgent need.”  In Québec especially, euthanasia was sold as an “exceptional measure for exceptional cases.”  The minister of health estimated that there would be perhaps 100 cases per year.  So imagine their surprise when there were over 700 requests in the first year, and nearly a thousand in the second year of the program.  These resulted in 469 euthanasia deaths in 2016, and 638 in 2017.
    • It’s likely that, in making their estimates, politicians didn’t take into account the probable effect of inadequate palliative care and self-directed home-care services on the demand for AS/E.
    • Once the numbers came out, politicians and the media changed gears, ignoring the lack of palliative care and claiming the “problem” was “not enough access to euthanasia”. Instead of trying to figure out why so many people were asking to die, they put pressure on the Commission on end-of-life care to figure out how to eliminate “barriers” (or safeguards) to euthanasia.  This sidetracked the already overloaded commission’s function of monitoring the program.
    • In a related trend, “vulnerable person” is being re-defined to mean a person who doesn’t get AS/E as quickly or easily as they want.
  • “Eligibility criteria” become “grounds for unjust discrimination.”  Part of the effort to broaden access to AS/E has been re-defining eligibility criteria as “unjust” and “discriminatory.”  This is the driving force behind the Lamb and Truchon cases, which challenge the “reasonably foreseeable death” and “end of life” eligibility criteria in the federal and Québec AS/E laws.  Rather than challenging the discriminatory public policies that deprive disabled people of the supports they need to live in the community, Julia Lamb, Jean Truchon and Nicole Gladu, all of whom have non-terminal disabilities, are reinforcing the prejudice that life with a disability is a fate worse than death as a means to expand access to AS/E to people with disabilities.  Thus, a characteristic that should disqualify the plaintiffs would be re-defined as an eligibility criterion
  • (In Québec) “a law on access to end-of-life care” becomes “a law for access to euthanasia.”  Another hallmark of the selling of assisted suicide in Québec was the claim that the central purpose of the statute was to guarantee the right to high-quality end-of-life care, such as palliative care and (oh, by the way), “medical aid in dying.”  In the statute, the definition of “medical aid in dying” refers to administering drugs to a person to “relieve their suffering by hastening death.”
    • Though the Québec statute defines palliative care as providing services to ease a person’s suffering “without delaying or hastening death,” and the law does not require private hospices to euthanize people, hospices and palliative care units have nevertheless been pressured by the government to provide euthanasia.
    • As we said earlier, the government has emphasized access to euthanasia, at the expense of palliative care.  Though some funds were committed to hospice care when the law was adopted, this funding was not maintained, and hospices have been pressured to perform euthanasia.  As well, cuts to home-care services have increased the number of people forced into institutions.
  • Death is a pain reliever.  Relieving pain involves interrupting a process where electrical signals are passed along nerves up the spinal cord to produce a chemical reaction in the brain.  And while death is certainly one way to interrupt those signals, it cannot be said to be “pain relief” because the person no longer exists to experience the relief from pain.  Yet the phrase used in the Québec statute, “relieving suffering by hastening death,” perpetuates the myth that death is the most effective pain reliever.
  • Suicides linked to AS/E.  Promoters of AS/E claim that the it will curb the unregulated practice of involuntary euthanasia, and that relieving people’s suffering will decrease the number of suicides.  This is not the case.  The rate of suicides has increased in Oregon since the Death with Dignity law came into effect in 1998 and is higher than the national average.  Suicides have not decreased in Belgium or the Netherlands, despite the growing number of euthanasia, performed with and without consent.  AS/E seems to be changing people’s attitudes toward suicide as well.
    • In March of 2016, Québec’s College of Physicians had to post an advisory to its members concerning some incidents where emergency room doctors did not revive people who had attempted suicide.  It reminded doctors:
      • That they had an duty to intervene to save lives even if the person was not able to provide explicit consent;
      • Once stabilized, the person should be provided with mental health support and treatment;
      • Treatment can only be withheld if the person has signed a “do not resuscitate” order or similar advance directive.
    • The family of Gabrielle Alexandre “respected her decision” to commit suicide by parking her car in front of a train in the fall of 2016.  The 76-year-old woman was having difficulty walking, increasing pain, and was afraid of having to go into a nursing home.  Her daughter sympathized with Gabrielle’s desire not to “sponge off society.”  The article describing the coroner’s findings quoted Québec’s health minister as saying “choosing to end your life before the suffering becomes intolerable is not allowed in the current federal law, and I strongly doubt that will change anytime soon.”  (He surely meant that choosing to have someone else end your life is not allowed, though suicide is not prohibited.)
  • Active passivity or passive activity, (or “having something done to you equals doing that thing”).  There are two ways this comes up in the AS/E discussion:
    • The proposition that “refusing or withdrawing medical treatment is the same as being euthanized.”  Though this argument was legally “settled” by the Carter case, reasonable people continue to disagree.  These reasonable people believe that when medical treatment is withheld or withdrawn, the person’s underlying illness or condition is what causes death.  AS/E, on the other hand, are proactive interventions where a poison is introduced into the person’s body for the purpose of causing death, either by the person him/herself (as in assisted suicide), or by another person (which is euthanasia).  They can hide it behind euphemisms and word play, but the difference between withholding / withdrawing treatment and AS/E should be as clear as the difference between passive and active.
    • On the other hand, we hear: “my life, my body, my choice … doctor, would you please find me eligible and kill me?” AS/E promoters equate having a doctor administer a lethal injection with taking one’s own life.  It’s harder to maintain the illusion of control when there is a risk of being determined ineligible, hence the pressure to remove safeguards and eligibility criteria.  True self-determination would require people to find and use their own means of self-destruction.  But perhaps that’s not what people are really looking for.  Maybe they’re really asking for support in their distress, and for their wish that their distress would end.  These are reasonable demands.  But since society is not meeting them, and people don’t have the energy to fight for the treatment they need when they are in a bad way, they take the easiest and quickest way out, even if it puts many other people in danger.
  • Looking to the future, the changes we’ve already seen appear to lead in one of two directions.  In one, the public policy of “suicide prevention” is replaced with so-called “self-determination,” where everyone has easy access to a painless, quick and inexpensive means to commit suicide.  Another possibility is that AS/E will continue to be directed at old, ill and disabled people, though the criteria will be expanded to include children, incompetent persons and those whose suffering is purely psychological.  When and how the pendulum might swing back toward valuing the lives of people with disabilities is harder to predict.

AUTISM AWARENESS MONTH – DON’T “LIGHT IT UP BLUE”

  • April 2nd marked “World Autism Awareness Day” and the start of “World Autism Month.” The colour blue will show up on puzzle pieces, sweaters, and even famous landmarks as well-meaning people attempt to “support” the autistics in their lives.
  • Unfortunately, this “Light it up Blue” campaign is led by Autism Speaks, an organization run by relatives of, and professionals who work with autistics. Autism Speaks is a great example of every possible problem that can occur when disability advocacy is not carried out by people with disabilities.
  • Autism Speaks is one of many disability-specific group run by people who do not actually have the condition they are supposed to represent.  Autism Speaks announced its priorities early on when they merged with organizations that focused on research to find a “cure” for autism. Until 2016, one of the main goal outlined in the Autism Speaks mission statement was “funding global biomedical research into the causes, prevention, treatments and a possible cure for autism.”  Now, the mission statement talks about researching “causes and better interventions,” but this still suggests a “disorder” that needs to be “prevented.” Only about 5% of their funding goes to support services autistics need to live in the community.
  • Autism Speaks also promotes the belief that parents of autistics have difficult lives because of the children’s neurodiversity. As a 2009 promotional video put it, parents of autistics will be left with a failing marriage, be bankrupt, have no social life, and will even be “robbed of” their kids. While parents may not expect to have an autistic child, autism isn’t a “monster” who “stole” a typical kid and replaced them with a defective one. Autism speaks would have parents love the kid and hate the autism, but you can’t separate autism (or any disability) from the person, their identity, or their experience of the world. This divide is also reflected in the language Autism Speaks uses; “person with autism,” rather than “autistic person.”
  • Autism speaks promotes Applied Behavioural Analysis (or ABA), an “intervention” that is designed to make autistic people appear “normal.” It includes forced compliance with neurotypical behaviours (like eye contact), suppression of self-regulation (like stimming), and essentially eliminating any visible signs of autism. Many autistic adults have come forward to talk about the trauma ABA has caused, and the healing they’re seeking years later.
  • In response, neurodiversity advocates have created campaigns like Tone It Down Taupe or Red Instead.  They’re promoting acceptance and pride in neurodiversity, instead of erasure, as the real answer. Anyone who wants to create meaningful change can consult groups run by autistics and leave the “blues” behind.  Visit https://www.facebook.com/AutisticAdvocacy/ for more information.