Right to Die Law Raises Questions of Disability Discrimination in California
California's so-called right to die law went into effect June 9th, and its potential ramifications have been hotly debated between proponents of physician assisted death and disability advocates. Notably, the Disability Rights Education and Defense Fund, a group that seeks to ensure legal help for disabled people, has released an in-depth statement expressing vehement opposition to the new law (linked above).
The debate over physician assisted suicide has been raging since before the passage of the law late last year. Many physicians, notably, are expressing qualms about carrying out the new law, citing professional ethics and the hippocratic dictum to do no harm.
The arguments on either side of this debate are both convincing and personal to the debaters. Disability advocates cite a preponderance of instances involving patients opting for a physician assisted death who claim a loss of dignity, and the burden for loved ones, as the major reasons for the decision. The DREDF makes it clear that impairment of function through illness, that makes one effectively disabled, does not prevent one from living a full and happy life.
The main line of disability advocates across the country is that disability comes from society, and not just from physical impairment. They contest that the disabled don't owe it to society to try to fit and and make do, but that society owes it to the disabled to aid them. Their goal is not to make disabilities disappear, but to change our world to make room for disabled individuals.
The Americans with Disabilities Act supports this idea by mandating certain accommodations for those with physical disability. And laws like FEHA and FLSA seek to implement and enforce this idea in cases of employment and housing.
Opponents fear that the new law, like so many other laws, will have an entirely different effects depending on socio-economic class— raising the very real concern that low income patients will be pressured into ending their lives as a cost-effective alternative to further treatment and palliative care. Essentially, patients who don't want to leave their family with large expenses may feel forced to seek suicide when treatments are expensive and yield a small chance of recovery.
Assisted suicide advocates, like Compassion & Choices, say that terminally ill patients deserve a painless and dignified option in ending their lives. They contend that physician assisted suicide will allow patients greater freedom to spend what time they have without the fear suffering, or the thought of losing one's self in the illness. For them, it's about control and the relief that comes from having options.
The new law gives terminally ill patients, with less than six months to live, aged eighteen and older, the right to die with drugs obtained with a physician's prescription. It further stipulates that the patient must be mentally capable of making the decision, and that he/she must make two separate oral request for the assisted death drugs 15 days apart. Finally, the patient requesting assisted suicide must sign a written statement in the presence of two adult witnesses.
Proponents believe that these rather thorough safeguards will be enough to prevent elder abuse, coercion, and regret in cases of assisted death. But the question of the new law's unintended consequences remains unanswered. Last year, just as the law was about to pass, the Christian Science Monitor, a leading independent publication, ran a story proposing that California's new law will act as a test case for right to die laws across the country, saying that in states where such laws already exist "those who have ended their lives have tended 'to be white, well-insured, well-educated, and well cared for'.”
California, with its large, diverse population and substantial gaps in healthcare coverage may prove to be a live exercise in measuring the impact of right to die laws across the country.
The above linked story goes on to state that low income patients, with limited access to hospice and palliative care, may be coerced by their economic situation into ending their lives prematurely. For now there is little hard evidence supporting these propositions, but the debate goes on as the new law comes in to play.