Tuesday, May 29, 2001
 
 

        Suicide Prevention

        Double Standard

        Excludes Disabled

             By  Laura Remson Mitchell

        U.S. Surgeon General David Satcher has been telling us for almost two years that suicide is a significant public health problem, and on May 2, he publicly announced the National Strategy for Suicide Prevention. Sadly, this initiative fails to recognize the double standard that society applies to living with a disability — a double standard that in effect excludes many of us from the suicide-prevention effort.

        The regular devaluation of our lives has long been a warning bell for disability-rights activists, but since most nondisabled people don't like to acknowledge that they are likely to become part of this devalued population someday, they may not realize that the bell is tolling for them as well.

        The double standard is clear in public reaction to the deaths of children at hands of their parents.  Compare the cases of Mark Orrin Barton and Robert Latimer.

        Barton, a day trader who went on a murderous rampage in Atlanta in late July 1999, said he killed his children in order to "protect" them from a life without a mother or father.  (He had killed his wife earlier and, ultimately, killed himself.)  Appalled, we shake our heads and ask, among other things, "How could a father do that to his own children?"

        Yet, many continue to defend Latimer, a Canadian farmer who was sentenced to a minimum of 10 years in jail for placing his 12-year-old daughter Tracy in a truck, piping in the exhaust, and letting the engine run until the severely disabled girl died. Latimer's supporters think the punishment is too harsh.  They accept without question his argument that he was acting to end Tracy's "suffering."

        It was shortly after the Barton shootings that the Surgeon General first publicly identified suicide as a "serious public health problem" and called for action to improve the ability of doctors and educators to identify potential victims. A fact sheet linked to the Surgeon General's web site points out that suicide now accounts for more deaths than homicide.

        It is ironic that despite plans aimed at reducing the suicide rate in the general population, efforts to legalize physician-assisted suicide continue around the country.  Supporters of these efforts point approvingly to the Netherlands, which recently legalized physician-assisted suicide and euthanasia, even for children as young as 12 (with a parent's consent).

        Reports on Oregon's experience during its early years under legalized assisted suicide show that, as reported in the New England Journal of Medicine, "the decision to request and use a prescription for lethal medication was associated with concern about loss of autonomy or control of bodily functions."  In short, what has driven many in Oregon to end their lives is fear—primarily fear of becoming disabled!

        While there is some recognition in the National Strategy materials online that physical illness among the elderly may obscure depression — a major risk factor for suicide — I saw no acknowledgment of the role that negative public attitudes and stereotypes about living with a disability can play both in triggering depression and in preventing others from recognizing it.  This risk factor applies not only to the elderly but to individuals with disabilities of all ages.

        Helping to set and maintain the double standard are people like Australian bioethicist Peter Singer, who now holds a prestigious post at Princeton University.  In his bioethics writings and lectures, Singer defines "personhood" in a way that justifies killing newborn infants — especially disabled infants — and denies the status of "person" to adults with certain physical, mental or (especially) cognitive disabilities.

        Groups like Not Dead Yet, an international organization of severely disabled individuals who accurately see legalization of physician-assisted suicide and euthanasia as a threat to their survival, are fighting back.  Here in the Golden State, the California Disability Alliance has joined with others to fight for the things that people with disabilities need to live  meaningful, independent lives and against legalizing assisted suicide.  All this is very relevant to Satcher's call for recognizing suicide as a public health problem.

        If Satcher and society are sincere about wanting to address the public health problem of suicide, they should join the disability community in asking what messages the Oregon experience really sends.  The unspoken lesson is not only that it's all right to kill yourself if you're afraid of the future, but that if things look really bad, suicide is a rational course of action — maybe even noble, if you feel you otherwise may be a burden to your family and friends.

        How can we convince our children that things aren't as hopeless as they may seem — that it's worth working and fighting to make their lives better — if our laws endorse suicide as a "rational" response to fear of the future? 
 

       The Surgeon General has done a great service by drawing attention to the public health aspects of suicide.  His challenge — and ours — will be to make sure the problem is addressed on behalf of all our citizens, not just the ones that our fears, prejudices and people like Peter Singer deem worthy.

[Copyright 2001 by Laura Remson Mitchell.]