In my role as a licensed clinical social worker and a mandated reporter in WA State, I am legally required to report anyone who is attempting to harm themselves or to die by suicide. So why does state law allow for certain people to end their lives legally? What factors contribute to the emerging support for such laws, especially among insurance companies and managed care organizations?
To be clear, widespread support for DWD is limited in the US and Sagebrush Crossing advocates for the expansion of DWD laws. We should, however, consider the implications of promoting choice in death for only certain people–those with terminal illnesses–and not all people. Is life with a terminal illness clearly worse than death? What ableist and capitalist viewpoints influence our answer?
People living with illness and/or disability are perceived as expensive for insurance companies. Physician aid-in-dying (PAD) and voluntary stopping of eating and drinking (VSED) are comparably inexpensive and result in zero further expenses. If individual life is valued in strictly financial terms, PAD and VSED result in cost savings for insurers. Do you think your insurance company has motivation beyond profit?
What about social safety net programs that people with chronic illness and/or disability rely upon for their income and medical care? Do we as a society value these lives enough to provide coverage and benefits comparable to those available to people who are employed full time with private insurance? Based on the unemployment rate and corresponding net wealth of people with disabilities, we can conclude that these lives are less valuable, if lives should be valued in dollars and cents. The solution to these issues is disability advocacy and challenging the cultural attitudes that disable people and equate value with productivity.
I recognize that our philosophy may appear to be in conflict with that of disability rights advocates who argue that supporting the euthanasia of ill and/or disabled people is socially unjust. I agree with these advocates and acknowledge the history of eugenics at play in this discussion, as well. Sagebrush Crossing is a place where people with a terminal illness can pursue choice in death. If people choose to end their lives because death is preferable to the life they are living, we support that decision. It is also our responsibility, as choice-in-death advocates, to simultaneously advocate for improved medical and social resources to help people make their end-of-life decisions free from financial and cultural pressures.
Check out this video on the topic of disability and MAID from the Hastings Center, a bioethics and disability justice organization.