by John Kelly
[ This piece has be reprinted by permission of the author from the article of the same name, published in the Worcester Telegraph, December 24, 2018 ]
In a recent Wicked Local Lexington commentary (“Medical aid in dying important for some with disabilities,” Sept. 28), Michael Martignetti argues for the legalization of assisted suicide from the perspective of someone with the progressive neurological disability, Friedrichs ataxia. I can relate to the author’s disability experience, as 35 years ago a spinal cord injury left me paralyzed from the neck down. Like Martignetti’s, my disability will present challenges as I age.
But whereas Martignetti frames assisted suicide as a personal choice in the face of “unbearable suffering,” I see a state-run program that will result in people losing their lives to misdiagnosis, treatment denial, and coercion/abuse, and depression. Not all families are united in loving and supporting us.
Doctors often make diagnostic mistakes: between 12 percent to 15 percent of people admitted to hospice as “terminally ill” outlive the six-month prediction. Many more who never enter hospice also outlive their diagnosis. For example, the late Senator Ted Kennedy lived a full year longer than his diagnosis of 2 to 4 months, while Florence resident John Norton credits 60 years of good life to the unavailability of assisted suicide after a mistaken prognosis.
Late last year, the Oregon Health Authority explained that people can become “terminally ill” through insurance denial and unaffordability. For example, Nevada Dr. Brian Callister had two patients denied by California and Oregon insurers for what used to be routine, lifesaving, operations. The insurers only offered the “choice” of hospice or assisted suicide. It’s impossible to talk about individual choice when profit-maximizing companies can – with no accountability – make you terminal.
The Health Authority admits its involvement ends with the dispensing of the drugs by the pharmacy. Of the many reported abuses, see the cases of Thomas Middleton (financial abuse), Wendy Melcher (attempted murder of a trans woman), and Kathryn Judson (physician pressure).
The bill requires no independent witness at the death, so the supposed safeguard of “self-administration” is empty. Especially vulnerable will be the 10 percent of Massachusetts seniors estimated to be abused yearly. A caregiver or heir to an estate can witness a person’s request, pick up the prescription, and then administer the lethal dose without worry of investigation — the bill immunizes everyone involved.
Another safeguard requires applicants to be evaluated by a mental health professional, who in a one-time meeting is tasked with “determining that the patient is capable and not suffering from a psychiatric or psychological disorder or depression causing impaired judgment.” A survey of psychiatrist revealed that most said they could not diagnose depression in a single visit. Meanwhile, “impairing judgment” is what depression does. As peer advocate Ruthie Poole has testified,
“Depression does not cause black and white thinking; it causes black and blacker thinking. Absolute hopelessness and seeing no way out are common feelings for those of us who have experienced severe depression. Personally, as someone who has been suicidal in the past, I can relate to the desire for ‘a painless and easy way out.’ However, depression is treatable and reversible. Suicide is not.”
Martignetti insists that disability does not make people eligible, but the Oregon reports show that the 5 leading “end-of-life concerns” are not pain-related but the “existential distress” (New England Journal of Medicine) experienced through “loss of autonomy” (91%), lost abilities (90%), “loss of dignity” (76%), incontinence (46%), and feeling like a burden (44%).
Indeed, I have found that social prejudice and discrimination are far more injurious than the actual loss of abilities. People have told me to my face that they would rather be dead than like me, while the culture promotes a theme of “better dead than disabled.” Movie examples include “Me Before You,” “Whose Life Is It Anyway,” and “Million Dollar Baby.”
This helps explain why every major national disability rights organization that has taken a position on assisted suicide has come out in opposition.
The legislature should continue rejecting a bill that trades on disability prejudice to push vulnerable people toward early deaths.