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PHYSICIAN-ASSISTED SUICIDE

 

POLICY STATEMENT

 

The Arc strongly opposes physician-assisted suicide for people with mental retardation and related developmental disabilities[1].  Laws and procedures, however strict, are not sufficient to protect them from being coerced into ending their lives

 ISSUE

 As the nation and individual states consider the adoption of physician-assisted suicide[2] policies, it is essential that The Arc take a strong position on this issue to protect the rights and interests of people with mental retardation and related developmental disabilities[3]. Because historical ignorance, prejudice and discrimination against people with mental retardation continue, The Arc must educate society.

 Major problems that exist are:

bulletDespite well-intended laws designed to protect our constituency, the nature of their condition continues to leave them at risk.
bulletThe current system of health services, particularly managed care, provides economic incentives for rationing health care, which could lead to the encouragement of physician-assisted suicide.
bulletSociety often incorrectly perceives that our constituency, by definition, has a poor quality of life.
bulletPublic perception on this issue is sometimes confused with specific issues related to advance directives[4] and death with dignity.
bulletIndividuals with mental retardation may be unduly influenced by authority figures such as doctors, health care workers, social workers, family, guardian/conservators and friends. This can result in a lack of true informed consent.

  

POSITION

 The Arc strongly opposes physician-assisted suicide for our constituency. This is based on its beliefs that:

bulletLaws and procedures, however strict, are not sufficient to protect our constituents from being coerced into ending their lives.
bulletWhen the person is seriously ill and in pain, the use of appropriate medical or palliative care to reduce and/or eliminate pain can and must be provided.
bulletAdvance directives for our constituency are appropriate whenever informed consent is assured and should be honored. 
bulletThe death of any person with mental retardation and related developmental disabilities by way of physician-assisted suicide is unacceptable.

 The Arc’s Congress of Delegates:            2004

 

[1] “People with mental retardation and related developmental disabilities” refers to our constituency, i.e., those defined by the AAMR classification and the DSM IV.  In everyday language they are frequently referred to as people with intellectual, cognitive, or developmental disabilities although the professional and legal definitions of those terms both include others and exclude some defined by DSM IV.

  [2] Physician-assisted suicide: Occurs when a physician provides a medical means for death, usually a prescription for a lethal amount of medication that the patient takes on his or her own. (In euthanasia, the physician directly and intentionally administers a substance to cause death.) (Ethics Manual, American College of Physicians, 1998.)

 

[3] See note 1.

 

[4] Advance directive: An individual’s written or oral preferences regarding life-sustaining medical treatment decisions. (Ethics Manual, American College of Physicians, 1998.)