The California state legislature is likely to pass an assisted suicide bill in the coming weeks. While I am a staunch defender of the right to bodily autonomy, this gives me worry. The bill in California is restricted to adults with fatal illness, so not all of my concerns will apply to it directly.
I worry about eugenics. Some lives are valued more than others, and I worry that will be reflected in who is sent for treatment and who is referred for suicide. I worry that homeless people, disabled people, and veterans will be pressured to consider suicide above other options.
I worry that the concept of death with dignity lets ableist assumptions about quality of life dictate policy. Many of the difficulties deemed undignified are symptoms of disabilities, both fatal and chronic. Difficulties chewing, swallowing, digesting, and ticketing are not exclusive to people in hospice care and people with these challenges don’t need to be made to feel undignified.
When people are abled, they often assume they would rather be dead than live with certain disabilities. These predictions may be true or may not. Regardless they are being made without all the data, and most people who become disabled learn to adapt to it rather than seek death.
The obvious exception is depression or other severe mental illness. In the U.S. poor mental health has several societal risk factors such as poverty and abuse. I worry that hospitals, insurers, and states will find assisted suicide cheaper and easier than fixing major social inequalities and prejudices. This has been the case in Finland where assisted suicide is legal and socially accepted but psychiatric treatment is highly stigmatized.
I’d rather see a national discussion on life with dignity rather than death. I want an end to poverty, an end to institutionalization of disabled people, an end to systemic inequalities that already value some lives over others.
In a perfect world where all lives were equal, disabilities were not despised, and no one faced depression due to racism or homelessness, I would give assisted suicide my unqualified support. But in this world, it makes ne worry.