Assisted Suicide - A Feminist Issue

[10 January 1997]

(On 8 January 1997, the US Supreme Court heard oral arguments on doctor assisted suicide. In the Glucksberg and Quill cases doctors and some terminally ill people, who have all since died, challenge bans on assisted suicide. The following views are those of Barbara Waxman Fiduccia, who is associated with Not Dead Yet, a US disability rights organization opposing euthanasia.)

I am here today as a disabled feminist to speak to those women's civil rights organizations supporting assisted suicide under the rubric of "choice". If passed, assisted suicide policies will not in fact extend the principles of bodily integrity and autonomy to women. I am here to tell members of feminist organizations that the cases heard by the Supreme Court today, Glucksberg v. State of Washington and Quill v. Vacco, are not the end-of-life equivalents of Roe v. Wade.

What do we know about disabled and ill women who want to die? They are depressed and in despair. The majority have experienced some sort of violence: be it emotional, physical, sexual, or financial. The violence may also take the form of neglect. They are isolated from their families and their community. They are isolated from the essential treatment and resources they need. The women's community has abandoned these women. In fact, the political, social, and economic predicament of disabled and ill women have been excluded from the feminist platform time and time again. Instead, by supporting the availability of assisted suicide, feminists are unwittingly sacrificing the protection of all women's lives.

The availability of assisted suicide supported by feminist organizations such as the National Organization for Women, and my friends over at the Centre for Reproductive Law and Policy which support Glucksberg and Quill will not: free women from the care giver role; and extend a woman's autonomy and privacy in health care decision making. These are two halves of the feminist argument for assisted suicide. And these arguments are more instances of medical thinking which feminists abhor.

What do the proponents of the medical model have to say about assisted suicide. First, this way of thinking defines women's problems as individual problems to be solved by medical treatment and cures. So small breasts get medically augmented, women's moods get medicated, and birth gets technology. Likewise, medical model proponents contend that a disabled or ill person's suffering has more to do with physical pain, and that death is the answer to pain, isolation, and oppression.

In contrast is the Minority Model which feminism is founded on. This theory suggests that the major problems of individuals are not found in any defects or deficiencies in one's body. Instead, the sources of most difficulties faced by minority folks are in the social and political environments. Likewise, minority model proponents contend that a disabled or ill person's suffering has more to do with depression, political oppression, and social isolation, and that policy change is the answer. But not the type of change desired by Quill.

Feminists have for decades been fighting for safe and affordable child care. Similarly, feminist activists should be joining disabled and senior activists in our political efforts to shift federal and state dollars to long-term home health assistance provided by semi-professionals who provide personal services for extensively disabled and ill individuals.

Now let us consider the feminist contention that the assisted suicide option will extend a woman's autonomy and privacy in health care decision making. While every individual has a right to control her life, the physician assisted suicide option has the potential of becoming a practice similar to the way sterilization has been performed on poor Black and Latin women after childbirth. These women were asked to sign a consent form for tubal ligation while they were in the throws of labor. In fact, today when an individual checks into a hospital, she is routinely given the choice of signing a "do not resuscitate" (DNR) order. DNR's direct physicians to withhold measures such as cardiopulmonary resuscitation or assistive ventilation to keep an individual alive. And consent should be voluntary. In practice, some disabled people report instances in which hospitals have pressured people to sign—in particular disabled people, extensively ill people and uninsured people. In other cases, the DNR is not explained clearly. The person or her next-of-kin is not adequately informed of the nature of the order. The DNR is often included in other routine administrative papers to be signed. This cannot be considered "informed consent".

Death is not liberation from depression, isolation, powerlessness, violence, and sexism. The only means of extending every woman's autonomy and privacy in health care decision-making is to make sure that every woman has the resources she needs to live her life, and for each woman to know she is valuable whatever her condition. In practical terms this means: the availability of suicide prevention counseling which is sensitive to the disability and illness issue; the training of physicians and allied health professionals about the resources and life skills used by disabled and ill people and use that knowledge to offer life-sustaining measures; the reaching out by the disability community to disabled and ill people at risk for suicidal depression.

And Now A Short History Lesson.

During the first half of this century, most states had at some time a eugenic law which enabled doctors to perform involuntary sterilizations. These were performed on both women and men. There were two major categories of women and men targeted by their states for sterilization: criminals and people considered to be disabled and called "feeble-minded." It was a time when criminals were considered to be defective and when disabled people, also called "defectives," were considered criminals especially if they had children. Indeed, also common to those two groups of people was poverty. To prevent more criminals and defectives from being born, thousands of people were involuntarily sterilized, especially women. Reproduction by those deemed undesirable was considered a crime against society.

What does this eugenic history have to do with today's topic of assisted suicide? Disabled and ill people are beginning to be treated like capital murderers facing lethal injection. There has come a time when our very lives are deemed expensive for our families, the economy, and society. Every fiscal year we are told we are an economic drain on society. Indeed, to prevent disabled and ill individuals from continuing life at the expense of tax dollars, not only Quill's prescription of lethal doses of seconal will be offered. Glucksberg in Washington state is looking for a lethal injection.

With the establishment of managed care, especially Medicaid managed care—an alleged cost saving measure—people are beginning to be encouraged to forego medical intervention and accept both passive and active life-ending measures. As with involuntary sterilization, the groups most targeted will be poor and uninsured disabled and ill women of color. Remember that women live longer than men.

Lethal injection is the method of choice for capital punishment and assisted suicide. Where is the distinction between disability and criminality today? It almost doesn't exist.

I am here today to challenge feminist activists to reject the eugenic thinking they have embraced. I am here today to remind feminists that they will be complicit in the denial of medical treatment, not expanding choice for medical treatment. Finally, I am here today to remind feminists that the very women they regard as exploited, will be those whose death warrants they will be co-signing under the banner of "choice".

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