Dear Rachel,

First of all, I appreciate the fact that you took the time to respond to my comments.. It's obvious that we have strong views about this subject and we're very passionate about the end-of-life issue. Regrettably, I have neither the time or energy to engage in a line-by-line response. I may really part of, as you say, a "vocal minority", but I don't feel that the fact my views represent a minority view makes them of less value.

I admit that I haven't had time to read evidence related to the prevalence of assisted suicide in countries where this is legal. This is something I hope to redress in the future.

Having said that, I have done extensive reading around the dark history of the Third Reich where the genocide and mass murder of millions started off with the T-4 euthanasia programme which targeted disabled people, especially those living in institutions. While this is euthanasia and different from assisted suicide, the range of people targeted for "elimination" were those considered to be unfit to contribute to the economy. While people wouldn't openly declare that disabled people are "burdens", that doesn't mean their attitude and actions ton]t indicate they perceive us as such. 

Yes, our decisions are all influenced by factors ranging from social to institutional but the decision to end one's life is, I reiterate, unlike any other decision we take for it's irreversible. Here, I feel that I can't really be completely objective about this topic as it may affect me directly in the future if the lobby to legalise assisted suicide gains more international support. Yet, remaining silent on this issue would mean denying me an opportunity to express my right to live.

I will end this email here. For, even if I wished to respond to your comments to greater length and to back it up with further evidence, I am currently in no position to do so. To be honest, this is why I hesitated to contribute to this topic in the first place. I remain unconvinced that any amount of regulations will remain strict and not permit assisted suicide to be available to more and more people and with regulations becoming more open. Again, I don't have any evidence at the moment. 

Thanks,

Gordon

On 06 Apr 2012, at 21:22, Rachel Williams wrote:

Gordon Cardona:

First, I would contest the distinction made between assisted suicide and euthanasia. While it is argued that the former is a request made by the person him/herself"


Rachel Williams: The distinction relates to the person carrying out the action/the causing of the death - assisted suicide is when death is facilitated, though not caused, by the assistance of another person(s); euthanasia is when death is caused by another person(s) with or without the dead person's permission.


Gordon: "it would be naïve for us to forget that there are social forces influencing such a decision - let alone family pressure. "


Rachel: As a rule, social forces impact human decisions.

This includes disability critiques of euthanasia.


Gordon: "Indeed, if assisted suicide is legalized, a decision to continue living might be deemed as selfish and irresponsible as it would pose an unnecessary burden on ones family or on society. "


Rachel: What does years of data on this very question say?


Gordon: "We also need to factor in the economic situation that often determines the funds allocated to proper health care and independent living services."


Rachel: Again, what does research say about the economic motivations behind euthanasia decisions?


Gordon: "Second, I think that before debating whether assisted suicide should be made legal, we have to ask ourselves why people are choosing to end their life in the first place,."

Rachel: Suicide has been a human phenomenon forever. That's not going to change.

There are many reasons for choosing euthanasia/assisted suicide. Again, there's plenty of research discussing the motivations. Why not refer to the research instead of raising hypothetical questions about this topic?

Gordon: "Of course, physical pain is one reason that is often cited."

Rachel: It's rarely the main motivation for seeking euthanasia.

Gordon: "However, are we ready to take an easy way out and encourage people living in already hard conditions to give up hope?"

Rachel: Does every medical condition provide someone "hope"? For example, does terminal cancer, ASL ("Lou Gehrig's disease"), Alzheimer's?

(These are the three most common conditions of the people opting for assisted suicide/voluntary euthanasia.)

Should we clump every impairment experientially into one basket ?

Gordon: "Should we perhaps invest in pain management and helping people to improve on their quality of life? "

Rachel: Where's the evidence that society hasn't invested in pain management and "helping people to improve on their quality of life" ?

Gordon: "Are we supporting people facing, in our case, terminal conditions, enough or are we reducing on their options?"

Rachel: Why not refer to the research on this topic?

Gordon: "Third, I understand that the end of life debate is a highly controversial and emotional one. I have been through moments in my life when I was experiencing excruciating pain and felt isolated. I admit that during these moments, I would have considered to die if that option would have been available or if I felt that any decision to prolong my life was proving to be a burden on others. I am afraid that there were occasions in life when I felt my life as a disabled person was being devalued when I hear people telling me that they would prefer to die rather than live like me. In this sense, wouldnt assisted suicide promote this kind of attitude that you have to prove youre worthy of living?"

Rachel: From survey data on many jurisdictions, the vast majority of people oppose making euthanasia available for depression alone or for someone experiencing excruciating pain.

I'm not clear why would you have to prove that you're worthy of living if there are restrictions placed on the circumstances allowing euthanasia.

It also begs the question why other policies (e.g., legalized abortion, the death penalty) haven't gone down a slippery slope.
 
Why would the situation be different for euthanasia?

Gordon: "I dont claim that my views represent the views of all disabled people."

Rachel: Far from it. You're amongst a vocal minority.

Gordon: "However, what I know is that if we insist on legalizing for assisted suicide, we risk to reduce any effort to make the life of people with terminal conditions better. "

Rachel: Again, refer to the evidence instead of raising hypothetical arguments.

Gordon: "And, in the long run, assisted suicide will be presented as a free choice to people who are deemed by society to be undesirable and it will extend to include disabled people, minorities and so on. "

Rachel: There's been decades of data collected on euthanasia in Holland and more than a decade in Oregon. There's no evidence of "undesirable" groups being targeted in  either jurisdiction. There's also no evidence of euthanasia being LESS practiced in countries/jurisdictions that prohibit the practice in law. It's typically a tiny fraction of overall deaths in any jurisdiction,
(when coupled with withdrawal/withholding treatment, it's about 20 something percent of deaths per year, overwhelmingly of people who are hours or days from death).

Gordon: "Despite any claims that this process of providing this right will be regulated, if people find that their choices have been limited or that they see no other ways to solve their situation, then the choice to end their lives isnt rally free at all."

Rachel: Again, what does the evidence show on the motivations behind seeking euthanasia (e.g., the demographics of the people opting for euthanasia and of the people supporting euthanasia)? It's not what you're suggesting.

Of course, no one can predict the future - which applies to assumptions around the 'negative' consequences of legalizing euthanasia.

Gordon: "I apologize for my long response. However, today were discussing whether people should be given the right to be assisted in ending their life. "

Rachel: Suicide already occurs. It will never disappear entirely. The population is also continuing to grow older and with that comes more long term conditions, and often more progressive deterioration of the body. There is a 'vibrant' underground euthanasia movement throughout the world. Denying people the right to assisted suicide/voluntary euthanasia does NOT eliminate the prevalence of euthanasia in the world - rather it pushes the issue underground.

You've made a lot of assumptions in your e-mail that you haven't taken the time to support. Have you read literature on the "motivations for seeking euthanasia", on the pain management services available for the dieing, or on the underground euthanasia movement? If you haven't (which I assume from your points), are you in a position to be advocating so strongly against euthanasia?

Gordon: "Tomorrow we will be arguing that people who are facing difficult conditions have the responsibility to end their lives for the benefit of the many. "

Rachel: That assumes a lot.

Further, it flies in the face of all efforts on the part of medicine, policy makers, and society to keep people alive, and the amount of deliberation that goes into decisions around removing life support, withdrawing treatment, and certainly allowing people access to legalized assisted suicide/voluntary euthanasia for a minority of medical circumstances.

Gordon: "instead of focusing on assisted living, or ways we could improve independent living and pain management (where needed), we are instead focusing on how to get rid of what we perceive as the problem"

Rachel: Completely untrue.

Also, there are extremists in every society. The vast majority of people don't refer to disabled people as "the problem" that "needs getting rid of".

Gordon: "And that I cannot ever agree to. "

Rachel: I can accept that.

---

From: The Disability-Research Discussion List [mailto:[log in to unmask]] On Behalf Of Gordon C. Cardona
Sent: 02 April 2012 15:21
To: [log in to unmask]
Subject: Re: EPC - March 28, 2012 - Update

 

                I’ve been reluctant to get involved in this discussion on end of life issues. However, as a disabled person, I feel I can’t afford to remain silent about an issue which may have direct implications on my future and on the future of other disabled people. 

 

First, I would contest the distinction made between “assisted suicide” and “euthanasia”. While it is argued that the former is a request made by the person him/herself, it would be naïve for us to forget that there are social forces influencing such a decision - let alone family pressure. Indeed, if assisted suicide is legalized, a decision to continue living might be deemed as “selfish” and “irresponsible” as it would pose an unnecessary burden on one’s family or on society. We also need to factor in the economic situation that often determines the funds allocated to proper health care and independent living services.

 

Second, I think that before debating whether assisted suicide should be made legal, we have to ask ourselves why people are choosing to end their life in the first place,. Of course, physical pain is one reason that is often cited. However, are we ready to take an easy way out and encourage people living in already hard conditions to give up hope? Should we perhaps invest in pain management and id helping people to improve on their quality of life? Are we supporting people facing, in our case, terminal conditions, enough or are we reducing on their options?

 

Third, I understand that the end of life debate is a highly controversial and emotional one. I have been through moments in my life when I was experiencing excruciating pain and felt isolated. I admit that during these moments, I would have considered to die if that option would have been available or if I felt that any decision to prolong my life was proving to be a burden on others. I am afraid that there were occasions in life when I felt my life as a disabled person was being devalued when I hear people telling me that they would prefer to die rather than live like me. In this sense, wouldn’t assisted suicide promote this kind of attitude that you have to prove you’re worthy of living?

 

I don’t claim that my views represent the views of all disabled people. However, what I know is that if we insist on legalizing for assisted suicide, we risk to reduce any effort to make the life of people with terminal conditions better. And, in the long run, assisted suicide will be presented as a “free choice” to people who are deemed by society to be “undesirable” and it will extend to include disabled people, minorities and so on. DespiteDespite any claims that this process of providing this right will be regulated, if people find that their choices have been limited or that they see no other ways to solve their situation, then the choice to end their lives isn’t rally free at all.

 

I apologize for my long response. However, today we’re discussing whether people should be given the right to be assisted in ending their life. Tomorrow we will be arguing that people who are facing difficult conditions have the responsibility to end their lives for the benefit of the many. instead of focusing on assisted living, or ways we could improve independent living and pain management (where needed), we are instead focusing on how to get rid of what we perceive as the problem. And that I cannot ever agree to. 

 

 

Best,

Gordon

 

 

Gordon C. Cardona
BA (Hons.) Malta, MA (Leeds)
------------------------------------------------------  
e-mail:        [log in to unmask]
web:            http://www.gordonGD.com/
blog:           http://gdzone.gordonGD.com/
pod:            http://audioboo.fm/GordonGD

 

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