Introduction

Webcast archive: International Women’s Day – disability and femicide – Part II

This week, we look at some of the unique factors that make women more likely to opt for assisted suicide.

Webcast archive: International Women’s Day – disability and femicide – Part II

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

  • International Women’s Day – disability and femicide – Part II

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

INTERNATIONAL WOMEN’S DAY: DISABILITY AND FEMICIDE – PART II

  • On March 8th, we talked about how disabled women are more likely than disabled men or non-disabled women to experience the most serious forms of domestic violence, including murder.  This week, we’re continuing our discussion on femicide with factors that make disabled women more vulnerable to assisted suicide and euthanasia.
  • In her 1996 paper “Gender, Feminism and Death: Physician-Assisted Suicide and Euthanasia,” Professor Susan Wolf states that gender affects the number, reasons, approval of and public debate over assisted suicide and euthanasia.
  • More women than men may die by AS/E.
    • During the 1990s, “between 68% and 72%” of people who died at the hands of Jack Kevorkian were women according to Katrina George.
    • study of suicides in Switzerland found that the rate of unassisted suicides was higher in men than in women (71% to 29%), but the number of assisted suicides was slightly higher among women than men (57% to 43%).  This seems to support Professor George’s belief that more women die where the regulations governing the practice are more relaxed.
    • The method of death may also affect the men’s and women’s choices.  Katrina George found that while equal numbers of men and women opt for euthanasia (which requires no participation by the person who will die), more men elect assisted suicide, where the person must take action to cause their own death.
    • As well, proposals to allow euthanasia for mental illness alone appear to have a greater impact on women. Instead of a suicide attempt that is prevented, and recognized as a cry for help, AS/E ensures that such attempts are always completed. A study of euthanasia for psychiatric reasons in the Netherlands found that 70% (46 out of 66) of those killed were women.
  • Women choose AS/E for different reasons than men. 
    • Women face unique economic pressures not shared by men.
      • They tend to work in lower-paying fields, such as the service industry and child care;
      • Even when women work in the same jobs as men, they are often paid less;
      • Women’s career paths may be interrupted by taking time off to have children, or electing to work part-time, thus limiting their earning potential;
      • When women are single parents, their household expenses are usually higher than single men who don’t have full-time custody of children;
      • new report from DAWN shows that women with disabilities working full time earn about $2,250 less per year than women without disabilities.
    • Women live longer, and face health and economic consequences:
      • Katrina George says living longer exposes women to illness and disability, the need for help with personal care (which may only be available in a nursing home), and the death of a spouse or partner.
      • While Professor George emphasizes that elderly women do not have higher suicide rates, Colorado State University professor Silvia Canetto points out that an equal number of women choose assisted suicide as men.  Canetto says this may be behind the over-representation of middle-aged white women in the pro-euthanasia movement.
    • Women, especially disabled women, have greater health needs, and receive more, but less effective, health care.
      • In Katrina George’s article, she cites studies that find women receive fewer cardiac treatments and procedures than men and have worse outcomes;
      • She also found that women are more likely than men to receive inadequate pain management. This finding is echoed in a 2008 commentary in the American Medical Association’s Journal of Ethics, which notes that doctors frequently attribute women’s pain to a psychological condition. (“It’s all in your head!”)  According to the DAWN report Illnesses that mostly affect women such as fibromyalgia, chronic fatigue syndrome and Multiple Chemical Sensitivities “remain less understood than those associated with men, like spinal cord injury.”
      • 2013 study by the DisAbled Women’s Network of Canadacites a Canadian national survey stating that adults with disabilities reported more than three times as many unmet health needs as the nondisabled population
      • DAWN also noted that Women with intellectual disabilities are at a greater risk for leukaemia, uterine and colorectal cancers.
      • The DAWN report found that people with disabilities “experienced delayed detection and diagnosis and complicated treatment experiences that related to cancer care providers having limited knowledge of cancer and its interplay with specific ‘preexisting conditions’.”
    • Disabled women face other barriers to health care:
      • A lack of information in simple language and accessible formats,
      • A lack of support and assistance at the screening facility.
      • Negative childhood experiences with medical professionals, including being forced to strip and being examined by groups of clinicians;
      • Physical barriers, like inaccessible examination tables;
      • Lack of knowledge about reproductive health, due to overprotective family members;
      • Focusing on “cures” and normalization rather than comfort, health and wellness;
      • Inadequate attendant services;
      • Lack of insurance coverage or funding for necessary medications, equipment or procedures; and
      • Inflexible or unreliable transportation.
    • Professor Wolf believes women sometimes choose assisted suicide as an escape from dangerous and oppressive situations. This can happen when a woman feels trapped in an abusive relationship, or when she sees no way out of inhumane institutional care.
    • Some of the reasons women ask for AS/E are based on gender stereotypes.
      • Professor Wolf relates women’s assisted suicides to the “long history of cultural images revering women’s sacrifice and self-:sacrifice.”
      • Katrina George notes that “good” women are supposed to sacrifice their own interests in favour of the needs of others.
  • Doctors are more likely to approve requests for euthanasia from women.
    • Professor Wolf believes physicians are likely to approve assisted suicide for a woman if they believe her life has become “meaningless” and “a burden,” because they can no longer care for others.
    • Professor George cites a study of 252 Australian physicians, which found that, given the doctor’s “perception of a patient’s emotional distress and hopelessness, combined with a doctor’s limited psychological training and his or her own difficulty in caring for the patient, the doctor may be more inclined to hasten the death of the patient.”
  • Gender affects the public debate on euthanasia.
    • Professor Wolf stated that much of the early debate centered on the cases of women, including those killed by Jack Kevorkian. She also notes that the images in these cases “have a long cultural lineage … a long history of portrayals of women as victims of sacrifice and self-sacrifice.” She adds that even while we rationally debate questions of autonomy and interdependence, self-determination and discrimination, we may be driven by images of women’s self-sacrifice that give AS/E a certain gendered logic and felt correctness.
  • The effects of combined discrimination: A new article from A new article from Silvia Canetto discusses the lack of support for AS/E among women of colour.  Professor Canetto notes that, because women of colour have less access to financial resources, and face greater discrimination in the healthcare system, they are less likely to place their trust in a process overseen by doctors, insurance companies and publicly-funded medical providers.
  • In her presentation to the federal Joint Committee on Physician-Assisted Dying, former DAWN president Carmela Hutchison told the story of Misty Franklin, who became disabled as a result of domestic abuse, and ultimately chose to end her life because she lacked the supports she needed to control where and how she lived. She explained that the life and death of Misty Franklin reflect the link between sexism and disability discrimination.
    • Ms. Franklin grew up in a “violent” home.
    • She met Trevor Fontaine, “who had an extensive criminal history for sexual assault and violence against women,” in September of 2003 at the age of 24.  Three months later he stabbed her in the neck with a pair of scissors during an argument.  When she awoke from a coma, Misty was quadriplegic and needed to use a ventilator.
    • A lack of resources (including home care, good pain management and mental health services) meant that Misty spent most of her time isolated and in pain. The few supports she could obtain required her to live far away from her daughters, family and friends.
    • Ms. Franklin set a date in the fall of 2013 to have her ventilator removed. As the date approached, however, she realized that “time was going by too quickly. There were still things she wanted to do,” so she postponed her death. She eventually followed through with her plan and died in January of 2014.
  • We were excited to see the new article by Silvia Canetto, and it reinforced a lot of points we wanted to make.  It was a shame, then (if not a shock) to discover that the disability rights opposition to AS/E was completely absent from her text and her ideas.  It just goes to show that when the subject is the intersection between two or more kinds of discrimination, chances are someone will lose out.