Thursday, January 4, 2024

Jesse Bethke Gomez Regarding Physician Assisted Suicide

In my healthcare career in service to people with apparent, and non-apparent disabilities and to older adults, I am deeply concerned about why legislation to legalize physician-assisted suicide in Minnesota is especially harmful to people with disabilities and also to older adults. The proposed bill would exacerbate many complex problems in healthcare, and would result in the devaluation of people with disabilities and older adults.

Physician-assisted suicide is opposed by the National Council on Independent Living, the National Council on Disability and the American Medical Association. In my role as Executive Director of Metropolitan Center for Independent Living, we provide services to people with apparent and nonapparent disabilities in advancing independent living. I join these national organizations and the Minnesota Alliance for Ethical Healthcare in opposition to this harmful legislation that has the potential to place in great risk people with disabilities and older adults.

As a former president for 17 years of a Rule 29 mental health clinic a licensed Rule 43 outpatient treatment center for children, families and individuals, and a licensed day center for older adults, I know that today, we face a severe mental health crisis for children, families and adults. The current level of need for mental health services surpasses the behavioral health sector’s ability to meet this demand throughout Minnesota. Legalizing physician-assisted suicide would make it a “standard of care” requiring providers to provide both life-saving and life-ending medical advice. Let’s stop for a moment and think about what that means especially for individuals with the nonapparent disability of severity, chronicity and acuity of an ongoing mental health diagnosis. Any individual with any level of a mental health diagnosis should not have to be placed in potential jeopardy by a physician in which the option is life or death; The proposed physician assisted suicide law would create such a reality. This potentially leads to the devaluation of people over time.

The devaluation of those who are at-risk is underscored by a 2019 National Council on Disability report that stated legalization of physician-assisted suicide perpetuates the “historical and continued devaluation of the lives of people with disabilities by the medical community, legislators, researchers, and even health economists” by promoting “unequal access to medical care, including life-saving care.” The report goes on to say where physician-assisted suicide laws have been enacted there is a suicide contagion such that, “In Oregon, government reports show a statistical correlation between assisted suicide under the Oregon law and an increase in other suicides.” Is this what we want in Minnesota?

For Minnesota, let’s make sure we understand the dire consequences of physician assisted suicide laws. Physician assisted suicide could potentially create a rise in other suicides in Minnesota. This would be especially concerning during a time in which the demand for services, are greater than our ability to meet the acuity, severity and chronicity of that demand. Physician Assisted Suicide legislation poses too many unintended consequences at a time our state’s mental health service providers are in crisis in meeting current demand for services.

Furthermore, to highlight the unequal access to care for people with disabilities and older adults, I point to federal laws, and related state services and benefits, that require asset limitations of $2,000 for individuals and $3,000 for couples in order to receive those services and benefits. Those monetary restrictions have been fixed at those same dollar amounts since 1983 – 40 years of the exact same dollar amounts as fixed asset requirements. As a Nation and for Minnesota we should not have laws with these fixed assets frozen in time for 40 years. People with disabilities and older adults already see their care options severely reduced due to these severe asset limitations. When real healthcare is expensive for people with disabilities and physician-assisted suicide is cheap how will life-saving care be denied or rationed to those most in need? I would rather see us as a Nation and as a State of Minnesota, eliminate the $2,000 individual and $3,000 couple asset limitations and include an adjusted cost of living for all on these benefits and services and to require a cost-of-living adjustment annually, not just for some services but for all benefits and services for people with disabilities and older adults.

Just as this notion of financial “burden” has become more prevalent, it’s not surprising that the Oregon Department of Health has reported that 52 percent of patients stated their fear of being a burden to family, friends and caregivers as a primary reason for seeking life-ending medication. Fear of pain and suffering did not even make the top five. This view of disability and of aging, also aligns with documented refusals by insurance companies to cover life-saving care, when we need to disrupt all this as conventional thinking. The real question here is what is our commitment to one another as a democracy, with regard to the historical gap in the level of benefits, services, supports and asset limitations endured by people with disabilities and older adults over many generations?

What is required, instead of physician-assisted suicide, is equity of care - better access to care and community supports and integration for all. I am in favor of increasing funding, services and benefits for people with disabilities and older adults. I am also in favor of increasing mental health funding, services and benefits for children, families and individuals who are in need of them throughout Minnesota especially in the area of suicide prevention. I am in favor of solving the PCA worker shortage crisis across Minnesota and throughout the United States of America. It is time to overcome the indifference to the needs of people with disabilities and older adults, which is at the root cause of the growing crisis to thousands of people in Minnesota and millions of people across the United States of America who seek to realize their inalienable rights to independent living.

Physician-assisted suicide legislation is not real healthcare. As we find our way as a society having endured a once-in-a-lifetime pandemic, too many individuals are already in crisis and too much is at risk for children, families, individuals, people with disabilities and older adults. If we have learned anything from this pandemic is that we are at our very best as a society, when we work together to advance the ability of people to care for one another, and that ought to be our guiding principle before us as a bridge over indifference in our legislative pursuits for the health, and well-being for all, along with needed human services and supports for people who rely upon them for daily living in Minnesota and throughout our Nation.

Jesse Bethke Gomez, MMA is Executive Director of the Metropolitan Center for Independent Living which is a member of the Minnesota Alliance for Ethical Healthcare.