In the eleven American states where physician-assisted suicide is legal, the practice is currently restricted to the “terminally ill.” However, the definition of terminal illness employed is generous enough to encompass a wide variety of people with treatable conditions—including spinal cord injury.
If one has six months to live in the absence of medical intervention, one may be considered eligible. Therefore, quadriplegics may be eligible for physician-assisted suicide, along with diabetics and dialysis patients—who can live for decades with treatment.
There are few checks and balances in the states where physician-assisted suicide is legal. A person must say they are terminal to a physician (sometimes two physicians) and the clinician can prescribe a lethal medication, which the individual can administer themselves, if and when they desire. However, weary caregivers and greedy relatives who stand to inherit could administer the lethal dose without the individual’s consent, as well. No one would be the wiser.
Our rejoinder as a community to these statutes should be to ask their supporters why our lives are not worth living, and to oppose the practice so long as disabled lives are devalued. We must challenge statutes permitting physician-assisted suicide as long as the fundaments of a fulfilling existence are placed out of reach by an ableist society. Otherwise, vulnerable and underprivileged members of our community might opt to end their lives—lives that are worth living—due to social conditions that might otherwise be remedied by just policies.
Statutes that permit physician-assisted suicide needlessly imperil members of our community as long as there exist crises of homecare availability and eligibility, affordable and accessible housing, employment for people with disabilities, and access to adequate medical care and appropriate durable medical equipment. These crises can combine to make people with disabilities feel utterly hopeless. Moreover, when caregiving becomes an individual responsibility in the absence of robust social programs, it can fall on families—which can create interpersonal dynamics that compound a bleak outlook with additional feelings of guilt and shame.
The disability community needs to work with our allies on an agenda that facilitates successful community living for people with severe disabilities. We must develop advocacy strategies to compel the government and the medical community to address these longstanding problems.
Until then, the “choice” to take one’s own life under the supervision of a physician is a false one, offered to people in our community in bad faith. Those in acute rehabilitation following injury and those that treat them and their loved ones should be taught that life can begin again after disability—not told about suicide options.
Making physician-assisted suicide widely available appears as an easy way out of the transformation, conflict and growth that will be necessary to overcome ableism in our society. The impetus to invest in technology that improves quality of life and the need for insurance to cover specialized care become moot if assisted suicide is an option for overwhelmed people with disabilities. This cost-savings comes at the expense of human life.
We need to educate the medical community about the facts regarding quality of life after SCI, and the challenges newly injured individuals face—and how these hardships are in fact, addressable. Advocates need to tell their stories to confront the public with the difficult reality that people with disabilities can be encouraged to opt for death instead of fighting for a life well-lived with proper support and care. The onus is on medical and rehab professionals to rise to the challenge of treating depression after injury and working with people with disabilities to reintegrate them into society, legislators to enact policies that facilitate and support the integration of people with disabilities into the community, and society to accept people with disabilities as equals and encourage integration.