A response to disability rights activists’ opposition to the right to die, PART 2

In Part 1, I began explaining why the disability rights group Not Dead Yet opposes Death With Dignity laws and the right to die. I also provided the most recent data from Oregon’s experience with its DWDA to refute some of the claims of Not Dead Yet.

All of the arguments made against the DWD laws by Not Dead Yet are false or misleading. First, Not Dead Yet argues that doctor’s cannot accurately predict when a patient will die, therefore, the DWDA system is fatally flawed. In Oregon, two doctors must find that the person requesting a lethal prescription has six months or less to live. It should be obvious that no one can accurately predict exactly when a person with a terminal illness will die, but physicians apply their clinical experience and their knowledge of the course of an illness to approximate life expectancy in each case, something they do everywhere, not just in DWDA states.

Yet, it matters little whether I have six days or six years to live. If I decide that it is time for my life to come to an end for reasons important to me, that should be my decision. The accuracy of the informed opinions of two doctors about how long I might live is beside the point. And no DWD law prevents me from getting as many opinions as I want to get.

If we accept the position of Not Dead Yet on the imprecise ability of doctors to predict death from a terminal illness, we should also not approve of the same hospice admission criterion.

Not Dead Yet wants patients to be required to involve family members in their decision that it is time to end their suffering. In Oregon, dying patients who want to use the DWDA have autonomy over their decision. Although they are encouraged to talk with their families and loved ones about their decision to request lethal medication, it is the patient’s choice whom to talk to about it.

Similarly, if I need a “feeding tube” to get adequate nutrition, whether I get it is my choice. I may or may not talk with family members about the decision, though I am sure I will be encouraged to do so by medical professionals and others. This is true, throughout the US, of all medical decisions made by mentally competent adults. A decision about asking for a lethal prescription should be no different.

As a matter of policy, the Final Exit Network, too, encourages such communication with family members to the extent feasible when a person requests exit training and education. But talking with family members adamantly opposed to hastening one’s death could be counter-productive when it is reasonable to believe that the person might try to prevent such an autonomous decision. The same circumstance can be true in Oregon, as well, which is why the patient must decide this matter.

The argument about “no required psychological evaluation” is likewise specious. In Oregon, two independent physicians evaluate the patient for signs of depression. If they detect signs of depression, they must refer the patient to a mental health specialist. Although many people believe that those who choose to stop their suffering before what we call a natural death are mentally ill, there are no data to support such a position. And having my life controlled by another person’s fear or belief takes away my autonomy to decide what is best for me. There is no evidence that doctors in Oregon are shirking their duties under the DWDA to adequately assess patients’ mental states.

Other arguments against death with dignity laws made by Not Dead Yet activists are equally unpersuasive. Lack of access to adequate health services is unlikely to be a reason for choosing to end one’s life. The overwhelming number of Oregonians who choose to use the DWDA are in hospice care and nearly all have health insurance– over 99% of them. About one-third of Oregonians who obtain lethal medications do not use them, which indicates that the system is not pushing people to hurry up and die, another argument frequently used by Not Dead Yet to oppose death with dignity laws.

Apparently the Not Dead Yet activists are concerned about a variation of the slippery slope argument, applied to those with permanent disabilities. Their position is that some people fear disability more than death, which is true for some of us for some disabling conditions that we might encounter in our own lives. But they claim that we have an ideology that supports the proposition that people are better off dead, than disabled. This is absolutely false. I have never heard anyone in the right-to-die movement make such a general assertion or anything close to it in the twenty-five years of my association with it. In fact, many DWD supporters are themselves disabled and determined to make their own decisions about their lives and their deaths.

A related assertion of some Not Dead Yet activists is that all people with a terminal illness will become disabled at some point during their illness. Because some people can’t accept this disability, according to the activists, they want to die rather than live through the disability to a “natural” end. They argue that such a desire is an indirect threat to people who choose to make the best of their disability and live with it. They fear that disability will come to be seen as a condition that should not be tolerated or accommodated, leading to the killing of disabled people against their will.

But DWD laws can be used only by mentally competent adults for themselves, not by a third party on another’s behalf. Involuntary euthanasia is not a part of any DWD law in the US.

In effect, Not Dead Yet activists are saying that if I have a terminal illness, I can’t decide to end my life at a time of my choosing because it is not the decision they would make, and it might, somewhere, lead to involuntary euthanasia of the disabled, though no example of this speculation has ever been presented. This astonishing position is based on a false belief that they have a right, legal or otherwise, to decide for others a course of medical treatment or assistance when such people are capable of making that decision for themselves.

No disability activists have a right to make that decision for me or anyone else. They choose to deny me and others the rights they hold precious for themselves – to decide how to live and die on their own terms.

“My Life – My Death – My Choice” has been a rallying cry of the Final Exit Network for many years. It means that others have no right to impose their values on another person’s life. The alternative is “My Life – My Death – Your Choice,” which is no choice at all for me, a position that robs me of my autonomy and individual liberty. No person, whether abled or disabled, should have the right to deny me choice about my own life and my own death.

I’m Not Dead Yet, either, but I’ll not try to control how others live or die, which is exactly what the Not Dead Yet activists want to do to you and to me.  They want to control the choices of everyone who would make choices different from theirs.  Their hypocrisy is astonishing.