In “Assisted suicide is no answer for disabled like me” (Dec. 22), Jean Swenson argued against legalizing physician-assisted suicide. Swenson became paralyzed from the neck down more than 30 years ago after breaking her neck in a car crash. After leaving the hospital and coming to terms with how much autonomy she had lost, she became severely depressed. She wrote that, given how she was feeling at that time, she would have taken her life if physician-assisted suicide had been legal. I can’t imagine the struggle she has endured learning to live with her physical limitations. I am in awe of her courage.
However, Swenson’s view that physician-assisted-dying legislation would be applicable to disabled people — let alone lead disabled persons to end their lives or view their lives as less valuable — is entirely untrue.
I am a psychiatrist and hospice medical director. I have worked with both the terminally ill and people with disabilities. From my 40 years in health care, I know that doctors and nurses value and respect all people, whether or not they are disabled, and whether or not they are dying.
My colleagues and I work with all patients to help them find meaning in their lives and achieve their goals.
Swenson is a wonderful example of how someone can be successful when provided with compassion, rehabilitation and ongoing support — even after life-altering changes. This is the standard approach, and it includes vigorous treatment of the depression that often accompanies severe disability, be it from an accident, stroke or other medical illness.
Even if Swenson would have wanted to end her life through recourse to a law-allowing medical aid in dying — like those Oregon, Washington, Vermont and other states have passed — she would not have had standing to do so under such a law. Her disability, though severe, was not classified as a terminal illness (defined as having less than six months to live) and she was clinically depressed. Either of these circumstances would have made her ineligible.
Swenson believes that Death with Dignity legislation would limit real choices for the disabled and other vulnerable persons, and would work against advances in health care. There is no evidence for this belief. In fact, such legislation increases autonomy and respects individual choice.
Medical aid in dying is rooted in respecting an individual’s dignity and right to choose, even as they face one of life’s most difficult transitions. It strengthens medical ethics by respecting and valuing what patients know best: what they want for their own bodies.
Most individuals who do choose to end their lives are in hospice, lovingly supported by their families and the hospice care team. It is only after unabated suffering, failure to adequately treat intractable pain, and receiving a terminal prognosis that individuals make their choice to access this option.
I strongly agree with Swenson that we need to advocate for improving health care for all patients, not only those who are disabled. However, her assumption of what the legislation would allow or encourage is not accurate, and it does not reflect what over a decade of compassionate, end-of-life care in other states has taught us.
Swenson says there’s nothing dignified about “death with dignity.” But what could be more dignified than expanding individual choice and supporting Minnesotans as they come to terms with the end of their lives?
Richard Heinrich, of St. Paul, is a psychiatrist and hospice physician.