Yesterday I testified before the Assembly Judiciary Committee against AB 1592 which would legalize physician assisted suicide in California. The L.A. Times and the Sacramento Bee quoted everyone else who testified on both sides of the issue, but not me. The SF Chronicle buried at the tail end of the article a misquote of what I said. Only the Oakland Tribune included the disability rights perspective accurately and equally.
The committee voted for the bill 8 to 7, after new Green Party Assembly member Audie Block changed her no vote to yes. She had misgivings about managed care, so I think she may be persuaded to change her mind again. Knox, another member, also was concerned about managed care. Steinberg wanted stronger protections to prevent assisted suicide from being extended to pwds. Assembly member Aroner, the author, promised to make changes to address their concerns. We need to work on these legislators and others. We have a long fight ahead.
I'm to talk to any group of any size anywhere in California about this bill. My testimony follows.
California Assembly Judiciary Committee Testimony, April 20, 1999
I am Paul Longmore, Professor of History at San Francisco State University. A handful of disability rights advocates support assisted suicide, but the vast majority of our leaders and more than a dozen major disability-rights organizations strongly oppose it. We empathize with the griefs that motivate bills such as AB 1592 because we understand firsthand and better than most of our fellow citizens the undertreated pain and unnecessary suffering of far too many patients. We also are more familiar than most people with the actual workings of the U.S. health care system. Thus, in opposing this bill, we speak with some authority.
The amended bill's intent to limit assisted suicide to the terminally ill is defeated by its definition of "terminal disease" as "incurable and irreversible" and medically expected to "produce death within six months." That describes many disabled people, including me. Also, many assisted-suicide advocates and newspapers such as the New York Times have long supported assisted suicide for disabled people, while some courts have extended disabled people that "right" by conflating disability and terminal illness.
Fear of disability typically underlies assisted suicide. All but one Oregonian who died under that state's law feared, not pain, but losing autonomy or control of bodily functions. The advocates play upon that horror of "dependency." Said one, "Pain is not the main reason we want to die. It's the indignity. It's the inability to get out of bed or get onto the toilet....[People]...say, 'I can't stand my mother - my husband - wiping my butt.' That's why everybody in the movement talks about dignity." If needing help is undignified and death is better than dependency, there is no reason to deny assisted suicide to people who will have to put up with it for 6 or 16 years, rather than just 6 months. Not that we favor assisted suicide if it is limited to terminally ill people. We simply want to ask, has this country gotten to the point that we will abet suicides because people can't wipe their own behinds?
1592 requires doctors to "inform" patients about alternatives such as "comfort care, hospice care, and pain control," but it does not guarantee them access to any treatment but assisted suicide. The bill also prohibits insurers from coercing patients into choosing suicide, but direct coercion is unnecessary. To cut costs and boost profits, managed care bureaucrats are already overruling doctors' treatment decisions, sometimes hastening patients' deaths. Some California hospitals now have committees to decide when care is "futile" and should be terminated regardless of a patient's or family's wishes. Under profit-driven managed care, no assisted suicide law, no matter how carefully crafted, can operate fairly. [Today's news carries the important story that Aetna was convicted under the RICOH racketeering law for its practices in marketing its services.] Disadvantaged groups who are heavier users of the health-care system and already find themselves discriminated against within it - seniors, poor people, members of racial minorities, disabled people, and anyone who is in fact terminally ill - will inevitably be put at risk. We think it unconscionable that a society that has failed to guarantee all its citizens the right to health care should even consider establishing a "right" to physician-assisted suicide.