Members of the Cambridge Commission for Persons with Disabilities have participated in the Somerville online transportation surveys and frequently collaborate with members of Community Access Project, Somerville to help raise awareness and lower barriers to disAbility rights and inclusion in MA. Here is their statement, published in the Access Letter, October 2012, regarding their recent resolution to oppose statewide Ballot Question 2, “Prescribing Medicine to End Life”:
CCPD Board Votes to Oppose Assisted Suicide Ballot Question
At its monthly Commission meeting on September 13, the Cambridge Commission for Persons with Disabilities (CCPD) Board voted to oppose the ballot initiative Question 2, “Prescribing Medication to End Life”, that will appear on the ballot November 6th.
If passed by the voters, Question 2 would allow a physician licensed in Massachusetts to prescribe lethal medication, at the request of a person diagnosed with a terminal illness, to allow that person to commit suicide. For more information, including the text of this question, visit: <www.sec.state.ma.us/ele/ele12/ballot_questions_12/quest_2.htm>.
At first glance, Question 2 might sound like it gives individuals choice and autonomy, but the experience in the two states that have passed such laws leads CCPD to be very concerned. Modeled after Oregon and Washington’s assisted suicide laws, Question 2 fails to correct problems that have led to documented cases of abuse, discrimination, and pressures to choose suicide over medical treatment based on cost considerations.
The National Council on Disability (NCD) Position Paper on Assisted Suicide states that: “The dangers of permitting physician-assisted suicide are immense. The pressures upon people with disabilities to choose to end their lives, and the insidious appropriation by others of the right to make that choice for them are already prevalent and will continue to increase as managed health care and limitations upon health care resources precipitate increased ‘rationing’ of health care services and health care financing.”
NCD continues: “The so-called ‘slippery slope’ already operates in regard to individuals with disabilities…If assisted suicide were to be legalized, the most dire ramifications for people with disabilities would ensue unless stringent procedural prerequisites were established to prevent its misuse, abuse, improper application, and creeping expansion.”
Members of the CCPD discussed a variety of concerns raised by Question 2. The following is only a partial list of issues relating to the proposed assisted suicide ballot initiative:
• Lack of safeguards: The current language shows a striking lack of oversight and safeguards, putting people at risk of being misdiagnosed and receiving inadequate treatment (including mental health treatment). This is a recipe for elder abuse — according to the Patients’ Rights Council, already 1 in 10 Massachusetts elders are abused, an increase of 31% in the last three years.
• Delegated Decision-making: The proposed law has a marked lack of clarity as to the impact of existing state laws regarding Health Care Proxy and Durable Power of Attorney in implementing assisted suicide. Under this initiative, an heir could be a witness and help someone sign up for assisted suicide despite a potential conflict of interest. Once a lethal drug is in the home, there is no requirement for professional oversight to monitor how that drug is administered.
• Expected Survival less than 6 months: A physician must diagnose a person as having a terminal condition with 6 months or less to live, opening the dangers of assisted suicide to many who are not terminally ill. Experience in Oregon and Washington shows that many people who appeared qualified within the defined time span, but declined assisted suicide, lived months or years beyond the doctor’s estimate, or even survived to recover from their disease.
• Lack of Mental Health Screening: The proposed law does not require an independent mental health evaluation of persons requesting lethal prescription medication (two physicians must agree that a patient qualifies for assisted suicide, but there is no requirement for either of them to be psychologists or psychiatrists). This reflects a widespread cultural and scientific bias that people with terminal diagnoses who ask for help to commit suicide are not in need of a screening for depression or an evaluation for any other mental health diagnosis.
• Continuity of Care: The proposed law does not include any requirement to investigate cases where physicians who have known a patient over time have found the patient ineligible for the criteria for assisted suicide. Physicians new to such cases who agree to assist in suicide are protected under the proposed law if they simply claim they acted in “good faith” — a standard so low as to make any purported safeguards unenforceable.
Many people in favor of assisted suicide are concerned about reducing unnecessary suffering in dying people; and many favor the idea of patients’ “right to self-determination.” Advances in palliative care and hospice medicine have made great strides in the last two decades. Yet the proposed law offers suicide as a resolution to suffering without any requirement that all avenues of palliative treatment be exhausted to alleviate a patient’s suffering before suicide intervention.
The CCPD Board strongly encourages readers in every Massachusetts city and town to seek out education and information on the complexities of Question 2, in order to cast an informed vote in November. For more information on assisted suicide, including those that particularly impact the human rights of individuals with disabilities, visit <www.second-thoughts.org> or <www.dredf.org>.