Second Thoughts - Disability Rights Advocates Against Assisted Suicide

Blog > A Protective Service Worker's Perspective

Submitted by Cassie Cramer

We would like to assume that before any bill legalizing assisted suicide could pass, proper safeguards would be in place. That people would be made aware of all of the options for community support and services, and always treated with dignity and compassion by providers. That they would be screened for depression and offered mental health and wellness supports. That a spouse or adult child surely has their family member's best interest at heart. That instances of exploitation and abuse are rare.

As a Protective Services Worker, I have a different perspective. I see financial exploitation, neglect, and abuse of elderly and disabled people everyday. Most cases aren’t clear cut. One person feels guilty about the cost of their care, talks about leaving their money to others, and doesn't notice that their own basic needs are not being met. Another person lives with a caregiver who is verbally abusive and controlling, spends their money, and provides inconsistent care; the elder says they don’t want help right now, but thank you, they will call back if it gets worse. Someone else has signed away the deed to their home or added another person to their bank account without understanding what they have done. When their physicians get asked about competence, they are surprised; they had not questioned the elders' capacity because they only see them for a short appointment.

I am against Question 2 because it leaves too much room for oversights that would undoubtedly lead to tragedy. There is no requirement that individuals get referred for counseling: last year in Oregon just 1 out of the 71 people who used the program were referred. There is also no requirement that a provider be present for the administration of the medication, leaving open the possibility that it could be given without consent. And, there is nothing preventing someone from subtly coercing another individual into making this decision. In the era of managed care, it is very naive to think cost will not come into play in the prescription of lethal medications.

There are already many measures in place to ease our passage at the end of life, such as hospice and palliative care, which include the withholding of life sustaining treatment and in some cases, the use of palliative sedation. There are also growing options for community-based care, including PACE, Senior Care Options and the Adult Family Care and the PCA programs. The agency I work at has many wonderful volunteer-based programs, such as the Medical Advocacy Program, providing assistance with managing medical care; the Aging and Spiritual Well-Being Program, offering non-denominational spiritual visits, or the Senior Pet Program. There are even programs available offering affordable and/or insurance-covered holistic therapies, such as acupuncture or reiki.

However, the quality and accessibility of statewide mental health and wellness supports lag behind other supports. It is difficult to find in-home therapy and places that offer it are overstretched.   If you don’t hit it off with your therapist, many places will say “forget it,” you are “being difficult." We need to focus on ensuring that people are educated about all their care options; on expanding our community care options; and on improving the quality and accessibility of our mental health and wellness supports. There is a long way to go until all people, no matter their ability or health status, have access to the type of supports that foster mental health recovery and enable them to live full, meaningful lives. And there is a very long way to go until we can be sure that an assisted suicide bill would not endanger some of the most vulnerable members of society.

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