(RNS) — A controversial law passed Thursday (March 11) in the Canadian Parliament that has extended the right to physician-assisted suicide (or PAS) to disabled people has been received by many of those people as an attack on their well-being. By offering death as an option to those expected to die in the “reasonably foreseeable” future, Bill C-7, many disabled people fear, would provide an incentive for their mistreatment or even unwanted death.
One person who has spoken out against Bill C-7 is Harold Braswell, an associate professor of health care ethics at Saint Louis University who thinks broadly about the connections between how we live and how we die and how our biases affect both.
I recently had an email exchange with Braswell to talk about Bill C-7 and similar measures in the United States. Our conversation has been edited for clarity and length.
Can you give us a brief update with the latest going on with the assisted suicide law in Canada?
We’re witnessing the extension of so-called justified killing to mentally ill and disabled people in the midst of a pandemic. The situation is so dire that the United Nations has, in two separate statements, condemned this particular bill, as well as the broader practice of PAS on the basis of disability. Nothing about this is ambiguous or complex.
For the U.S., what’s happening is, at minimum, a cautionary tale. Less than five years ago Canada legalized PAS for terminally ill people, as we are increasingly doing now. Now, in the midst of a pandemic, they are revving it up for the same people that they left to wither in nursing homes. “Conservative” PAS has undoubtedly primed the pump for its much-less-careful counterpart.
There seems to be a growing sense that legalizing PAS helps “normalize” suicide. In the Canadian debate, First Nations’ leadership oppose the legislation, not least because suicide is already such a problem in their communities.
When the leaders of First Nations communities say — again and again — that this will dramatically increase suicide, I believe them. The only evidence proffered to the contrary has been via sleight of hand: Instead of referring to this as “suicide,” proponents now call it “assistance in dying” or some term that simply omits that word.
Such euphemisms can, theoretically, be defended when referring to terminally ill people, who are “dying” in a broadly understood sense. They are not defensible with disabled and mentally ill people who would otherwise live for decades. No arguments have been made that this is not both suicide and suicide-promoting — not that have any evidence.
When I addressed Connecticut legislators recently about PAS, I was struck that even the Democrats sounded like libertarians on this issue. What’s going on here?
Some have argued there is a double standard: suicide prevention, which is given to everyone else, is denied on the basis of disability status. Imagine if we stopped trying to prevent suicide among African Americans, women or LGBTQI individuals! It would be viewed as an almost unimaginable form of bigotry.
But this otherwise obvious bigotry goes unnoticed when leveled at disabled people. This is because, while these other categories are largely viewed as social — hence subject to discrimination — disability is considered primarily medical. When disabled people suffer — as they, like all people, do — this suffering is presumed to be inherent to their disability: part of its biology. When this disability can’t be cured, killing the disabled person seems like the only way to end their suffering.
Look at Canada. Nearly two years ago, the UN special rapporteur declared herself “extremely concerned” about the country’s tendency to institutionalize disabled people, rather than giving them the support necessary to live in the community. Instead of remedying this systemic problem, the liberal government rushed an extremely reckless euthanasia law under the rubric of “individual rights.”
The message was clear: You, as a collective, must be punished in perpetuity, but, as “individuals,” we will give you this way out. It’s bigoted nonsense.
There is a long history of the left’s hostility to disability, premised, as Dorothy Roberts has shown, on eugenicist foundations. When not vilified, disability is ignored: Eric Foner’s 2003 book, “The Story of American Freedom,” though otherwise excellent, contains not one word about the 1990 Americans with Disabilities Act, the most significant advancement of American freedom since the ’60s.
I sometimes feel as if a thick vision of the good — religion’s moral-theological vision, as opposed to a political vision — could help here.
I am a secular Jew. But I work with theologians, and, as I’ve written, I’ve been personally moved by religious communities that live the kind of “thick” ethic you describe. Theological conceptions of the good can be more inclusive of frailty, dependency and lack of control than the dominant secular alternative of liberal capitalism.
Theology can remind secular people like myself that it’s entirely possible to talk about disabled people without floating the idea of killing them or mentioning that, if I were to become one, I’d want to end my own life. I think we irreligious have largely forgotten how to talk this way.
PAS is opposed by people of color who would rather have equitable access to palliative care (and) by disability-rights activists. Why don’t we see more progressive activists heeding these voices?
I identify more closely with their silence than I would like. I myself have never publicly criticized PAS for terminally ill people. I have also never spoken in favor of it. I have viewed it as a small topic whose importance has been blown out of proportion by proponents and opponents alike.
I argued in my book that we should move “beyond the right to die” to consider more fundamental problems in our end-of-life care. To be fair, PAS for terminally ill people — though still open to the criticisms raised above — is much more defensible because of its highly limited nature. This has explained — though, I fear, not wholly justified — my silence and may account for the broader silence you refer to.
But silence is not an option before what is happening in Canada.