Congress should keep the ADA in mind when setting assisted suicide policy

Lawmakers like Reps. Luis Correa (D-Calif.), Brad Wenstrup (R-Ohio), and Matt Cartwright (D-Pa.) have done the American people a great service by calling out assisted suicide for the dangerous public policy that it is. This newly introduced truly bipartisan Sense of Congress resolution shines a light on the many dangers of assisted suicide and is a concrete step toward protecting vulnerable patients across the country.

There are many dangerous aspects to assisted suicide laws and proposals, but one of the more disturbing is that they are inherently discriminatory against persons with disabilities.

Non-disabled persons often don’t appreciate the struggle people with disabilities face when trying to access the care that they need. A recent report published by the National Council on Disability (NCD) pointed out that people with disabilities regularly experience demoralization both because the need for help is perceived as undignified and burdensome, but also because many think that life with a disability is a fate worse than death. It is just this kind of ableist predisposition that, in the context of our broken health care system, allows public policy like assisted suicide laws to create a two-tiered system where some people get suicide prevention and others, namely people with life-threatening disability, get suicide help.

The inherently discriminatory nature of assisted suicide laws and practice against people with disabilities is unacceptable in the country that passed the Americans with Disabilities Act.

Under the ADA, a disability is defined as “a physical or mental impairment that substantially limits one or more major life activities.” To qualify for assisted suicide, the patient is supposed to have a six month or less prognosis, which can be with or without treatment, so treatable conditions like kidney disease, lymphoma, HIV, and diabetes – all disabilities – qualify a person for assisted suicide. In fact, all listed diseases that qualify people for assisted suicide in Oregon, by definition, make the patient a person with disabilities according to the ADA Amendments Act of 2008. That means only people with disabilities are eligible for assisted suicide. Everyone else will be given suicide prevention because, being non-disabled, their lives are viewed as worth living. Singling out one group of people, in this case people with disabilities, for disfavored and deadly treatment is discriminatory.

The prejudiced nature of assisted suicide laws and proposals are borne out in the reasons people give for requesting lethal drugs. The top five reasons are all disability-related. They include the loss of autonomy, being less able to engage in activities making life enjoyable, loss of dignity, losing control of bodily functions, and being a burden on family, friends or caregivers. Proponents of assisted suicide will claim that these laws are for the elimination of physical pain; but when physical pain doesn’t even make it into the top five reasons for choosing premature death, and when palliative care has come so far as to all but eliminate physical pain at the end of life, we must ask ourselves hard questions. Are we doing enough in policy and medicine to provide access to top quality care and supports that would address the existential concerns of people with chronic, life threatening disability? Is preventing some suicides and not others really equal protection under the law?

People living with disabilities, who face crushing demoralization when their lives are viewed by others as less valuable or even not worth living, are at much higher risk for being pressured into assisted suicide. This can happen on a number of fronts, for example, when insurers have denied or delayed coverage for expensive life sustaining care but offered coverage of lethal drugs instead. Financial pressures could easily create a perceived duty to die in some when continuing care is costly in our profit-driven health care system.

Among the recommendations of the NCD report is passage of a resolution like last session’s H. Con Res. 80. In a country where one in five are affected by these misguided laws, no one serving in Congress should hesitate to side with the vulnerable and vote to expose the dangers of assisted suicide public policy.

Matt Vallière is executive director of the Patients Rights Action Fund.