The following letter was Published by the disability rights group, Not Dead Yet, on March 25, 2019:
As a disabled MD resident, I implore you to vote no on this very harmful legislation. What has been marketed as a bill increasing choice of those with terminal illness (who almost always meet the federal definition of disability) in actuality reinforces stereotypes and systemic ableism that will do irreparable harm to disabled constituents and Marylanders as a whole.
I understand that several changes were made to the bill that some legislators believe will help protect disabled people from the harms of this bill, but they will not.
1. Raising the age that you can get the prescription from 18-21. This will not protect the most vulnerable–our elders who most report a fear of being a physical and/or financial burden on others. These folks are also most at risk of being pressured, or outright abused, by family members, or caregivers when they may not otherwise do so. Those who have intellectual/developmental disabilities who can pass the psychiatric test of knowing what can kill them or not, can still be easily swayed by those whom they trust to make decisions with them to take their lives when they may not otherwise do so. Nothing in this change will prevent these deaths.
2. Removing the shield that would protect Dr’s from being sued for prescribing the lethal drugs. Since the intended recipient of the lethal prescription dies after taking it, who will be there to sue the Dr? Especially considering that the pressure to take one’s life will likely be coming from a family member, or caregiver.
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3. Adding a requirement for a mental health evaluation. This does not mean the provision of crisis intervention services, nor long-term mental health treatment. The kind of evaluation that is possible in the timeframe that this situation presents, is, as described in the original bill, enough time to determine that the person understands that taking this prescription will kill them. Cognitively understanding the consequences of taking this action is very different from psychologically making an informed decision based on all the facts. When someone acquires a life-changing diagnosis, it takes time to gather the available information and even more time to process this information and to connect with others and begin to cope with the new reality. When coupled with the addition of treatments or medications or therapies, the time needed to adjust to a new reality of life is often lengthened. This bill puts bookends on what services can be provided and in what timeframes while if someone in the general public says they want to kill themselves, we rush in crisis intervention services and usually follow-up mental health services. When someone acquires a disability, there are professionals available to assist with the adjustment to the “new normal” no matter how long that is, from a day to a few weeks or months, to forty years or more. As children, this function is often served by Child Life Specialists. As adults, this service is often provided by Centers for Independent Living. This bill undermines the efforts of these whole professions to assist disabled people to live our best lives. It reinforces the stereotype that our quality of life is poor and that we are not worthy of life, without giving us the chance to use all of the resources there for us.
4. Requiring that Dr’s give patients written information about treatment options available for their condition. First, they should be doing this already and if not, then that should be addressed in a different piece of legislation, that is a Dr.’s job. However, when someone receives a terminal diagnosis, treatment is no longer the major issue, adjusting to the new situation and living with the best possible quality of life should be the top priority. This is not a Dr.’s job, nor specialty. Nothing in this bill requires this piece, as I stated above. There are whole professions dedicated to helping people adjust to life situations. This bill makes the assumption that because of terminal diagnosis (presence of progressive disability), these services should not be required. This is ableist and discriminatory and will turn back the clock on the progress disabled people have made in Maryland.
5. Setting a stricter definition of who can qualify. Despite the tweak in the language, it is an established fact that accurately diagnosing someone as having an irreversible condition and that will result in death within 6 months is near impossible. I wasn’t expected to live past 2 and am 43 now. I wasn’t expected to survive the first 12 hours after chemotherapy and I am here 6 years and 2 cancers later. We have all heard of miraculous recoveries and I urge you to see that making a mistake is one thing, but allowing that mistake to lead to the prescribing of a lethal overdose is something completely different and should not be allowed.
I am including here my testimony from two years ago, most of which is still relevant to the bill before you now: (Link to previous testimony).
I urge you to vote NO on S311.
Community Living Advocate, National Organizing Project
National Council on Independent Living