Thank you for an important and timely article. I am a licensed mental health counselor who sees people with chronic pain from workplace injuries, I’ve been a Hospice volunteer, and I’ve delivered mental health services to homeless individuals and families. Take my word for it, the system is stacked against the poor and disabled. As a new counselor I was told that the 1% uses our profession as a buffer between them and the masses, and it was therefore our calling to change that paradigm. But experience in the field has taught me the 1% have all the power. I could go into detail about how state and federal governments (don’t get me started on insurance companies!) control the ability of counselors to deliver services.
But your statement that the rich buy the laws is true—I would only add they also bend the good laws. As we move into the next administration, I’m afraid people will not need “assistance” to die.
When I had Medicaid I didn’t have any access to pain management, and nobody else is allowed to give pain medication to people with chronic pain I guess. My suffering was so profound. I was told that therapy could help with chronic pain yet when I saw a therapist for it there was no trick to take the pain away. And traveling there and sitting in a chair for an hour and traveling home just caused more pain.
Then once I got Medicare and I could go to pain management and I could get actual treatment for chronic pain I was well enough to get out of bed and clean my apartment, and cook food for myself, and I even got a part-time job for a few years until Covid rolled in.
The absolute rage I still feel about being forced to suffer for years because the specialist who are allowed to give Pain medication don’t accept poor people insurance. I’m so sorry that your comment triggered this rage and I hope you aren’t taking what I’m saying personally, but you really gotta tell doctors that you don’t have any trick to fix the pain. And I honestly didn’t want to get in a spot where I just accepted that I was going to have to lie in bed forever all day every day, and I’m pretty sure that’s all therapy was going to do for me. I mean except cause the extra pain from sitting in that chair for an hour.
Maggie JK: I am sorry you had this experience. I see people via telehealth precisely because they don’t have to travel and sit in a chair. Good therapists will advocate on behalf of their clients to get additional medication or medical services that they need. Unfortunately, the medical profession and insurance companies often ignore our perspective. Therapy CAN help with chronic pain, but it is not a substitute for proper medication. If a doctor led you to believe that, again, I am sorry, but not terribly surprised. I can’t tell you the number of clients I have seen whose doctor’s implied their pain was “all in their head”. I hope you will continue to have access to the services you need.
The chronically ill rack up enormous lifetime medical bills. This is a solution by the State is two pronged: The State offers no further medical solutions and it saves the State an enormous amount of money per patient.
I am in the US and your comment is making me realize that if we ever do get national healthcare over here everyone will have access to assisted dying because they will want us to choose that option.
Right now with Medicare that we pay into and private insurance plans there’s lots of economic activity, we stimulate the economy with all our pharmaceutical purchases and doctor visits and transportation to those visits. Yes I’m sure we cost money in the long run, but here in America the churning of funds seems to be a good thing.
Idk I am really worried about losing medicare and social security since he defunded it in 2020 by waiving payroll taxes that fund those programs. He vowed to make it permanent if he won, then Biden waived any unpaid payroll taxes so nobody had to pay a lump sum in January so a whole bunch of people forgot this even happened.
I don’t expect to live very long if I lose SSDI and Medicare. And I don’t know how long that program can stay operational if it immediately gets defunded in January.
Maggie, I’m also in the US. Even if he tries to defund SSDI and Medicare immediately it would take time to unwind so there is no immediate threat. There would also be pushback from some in Congress who want to be re-elected because Medicare is such a necessary program.
A privately run program would ideally have to be in place before Medicare shuts down. They want to hire private companies to run the programs from what I understand.
Nate Bear again says what I wish was in my capacity to write!
Due to my propensity to hit cars with my bicycle while out training (I'm using sarcasm) I live with chronic pain. If at some point that pain is overwhelming and my ability to function physically dissipates then I formerly anticipated a real battle for the right for an assisted death.
No longer do I have those worries. All that is necessary is to enroll in continuing education classes in the university building with the worst ventilation and not wear a mask. Problem solved!
Like you, Nate, I used to be in favour of assisted dying, especially in support of Sir Terry Pratchett, one of my favourite authors. Now, I think we're making a huge mistake. My husband & I watched Liz Carr's excellent documentary, Better Off Dead?, (available on iPlayer) last week and I'm truly scared at what will happen if this becomes law. The Canadian doctor Liz interviewed, Ellen Wiebe, was positively euphoric at the thought of helping ppl end their lives - it was truly uncomfortable and creepy to watch. A quick Google search at the end of the programme revealed that Wiebe has, no surprise, been been blocked (recently) by a court for attempting to euthanize someone with no physical ailment: https://www.theguardian.com/world/2024/oct/31/canada-medically-assisted-death-judge-ruling
Just to add to your point about healthy under-65s not receiving Covid jabs - as of next year, that's being expanded to those that actually do have health problems, like myself, meaning I either have to pay for my jabs or risk compromising my already dodgy kidneys further. Until we start valuing all lives and funding health services appropriately, we should not be going anywhere near assisted suicide.
About five minutes before I read this I was watching a news clip where there were a dozen people trying to rescue a lady from a sinkhole somewhere here in the US.
And of course they should, I’m just really confused about why the lady in the sink hole is so much more important than someone who needs a wheelchair. 12 people aren’t rushing to rescue them with massive equipment that costs 5 figures.
It’s just interesting to me that here in the US it’s OK if I die in the hospital from an airborne virus everyone is refusing to prevent spreading, but if I fall into a sinkhole the whole entire city will come out to save me. Or maybe they wouldn’t because I’m just a disabled person. Maybe the lady in the sinkhole is someone important but they didn’t say that on the news so I don’t know.
But how do they determine who gets a dozen people to help save their life and who has to sleep in a cardboard box without a wheelchair?
I so wish that we could start to talk about this topic not as an either or issue.
For me as a chronically ill person both sides of the discussion are important. The option of an assisted suicide does need to remain available with a reasonable degree of ease (because what is the alternative? Should i butcher myself using an unsafe methods with the risk that i might actually survive with an even more severe disability?). And it is just as important to point out and fight back against the tendency of the state to use assisted as an austerity measure.
The problem is the capitalist system and the neoliberal nation state. This system will always attempt to discard those it considers to be surplus. Under late stage capitalism this process will only accelerate (see the book: Health Communism).
But at the very same time, it's not that easy to change this system. I have tried, for many years, and it frankly seems quite impossible. Personally i do not believe that the world will get better for us (the chronically ill, disabled etc.) soon. Sure, let's keep fighting, but let's also be realistic.
So while we are stuck having to live under this fucked up, cynical system, assisted suicide must remain available as an option. Just to know that it exists and is easily available can offer some relief. Trust me, been there.
The key issue is the state's involvement. Assisted suicide gets then problematic, when the state uses it to discard or offload people, in order to save money, in an austerity effort. Which sound like what has started to happen in Canada.
In Switzerland assisted suicide is run by private nonprofit organizations. This model still has many problems. For one, it should never be run as a business, its rules are icky.
But i can think of other models of assisted suicide that seem actually beautiful, community based, ritualized, while at the same time tackling the suicide taboo. With fascism and eugenics coming back, climate change getting worse many people will start to contemplate how to end their lives. That's just inevitable.
I had a glimmer of hope that the world would get better for us, for about a year before the summer of 2021 anyway.
I have MECFS and for a brief moment in time people knew what that was and I didn’t have to explain it at every new doctor visit when I listed it as a medical condition. I remember going to the allergist and when the nurse got to that part on the form she was empathetic and curious, so we talked about it for a few minutes. It was delightful.
But now that the Covid gaslighting has fully kicked in in the US even my neurologist is trying to pretend they don’t know what MECFS is. I can’t get a new one just yet because I have a prior auth for botox and all kinds of CGRP meds from them. But once I get stable I am out because the gaslighting is dangerous. (For example she put in my medical records it was very important that I see a G.I. doctor. I’ve consulted with five G.I. doctors in three different states over the years, my G.I. problems are migraines which is a neurological thing, but if I go to the ER and they see that note they will assume I’m a drug seeker and I’m not going to the G.I. doctor because I want drugs from the ER and they won’t treat me.)
This makes me wonder about the organization Dying With Dignity in Canada. Are they similarly funded like in the UK? Hard to find much about their funding donors…
Thank you for writing another thought provoking article. I don't believe this is an easy topic. I live in Oregon and have followed the debate from the beginning.
A couple of questions I have no answer for:
If assisted suicide is ruled out, will it bring about a change in access to care for disabled and ill people?
Could living in a society that refuses to care for the sick and disabled be considered valid grounds for assisted suicide?
We don’t have assisted suicide in the state that I live in (NH, USA) and the disabled are still treated horribly here.
This is one of those states where businesses can pay disabled people sub minimum wage.
When the ACA started NH tried not to expand it. I moved back here in 2014 and because the SSA had not deemed me disabled yet I had to fight for health insurance (medicaid) for 10 months. I had to go to city welfare to get $ for medication (oddly there is a law here that if people can’t pay for meds the municipality has to) so I could be well enough to go into an appeal hearing and represent myself against the state.
So no I think the only thing that gets them to help people like us is when there are a bunch of homeless people existing in spaces that offend people with money. Then they start to care about people’s suffering, or at least getting it hidden away from the everyone else.
I agree 100% governments should assist people with living.
Be careful with this statement- “They are supposed to work for everyone and respond to the majority.” Through history around the world, the “majority of people” have supported the enslavement, the genocide, the incarceration and many other atrocities of other people. Californians approved a law to enslave prisoners. The law uses the word slavery. The majority of people who voted approved enslavement. Nothing has changed for prisoners in centuries because the majority of people don’t care about the incarcerated.
People with ongoing sars2 infections are signing up for assisted suicide. If they can’t get assistance, they are finding ways to end their lives. Not because they want to die, but because they can’t get help. The tests that show the damage of sars2 are not available to 99.999% of us. Tesla 7 mri shows the damage in our brains. A very special machine shows the microclots. Surgery can uncover lingering sars2 virus in our fat cells or show the damage to our muscle tissue. Blood tests can show the damage to our immune systems.
Sars2 damages our ability to make serotonin and our brains. Should anyone be trusted to make life and death decisions? No. I don’t think so.
I am against assisted murder. The rich people are not signing up…only the people who have no other options.
“Surgery can uncover lingering sars2 virus in our fat cells or show the damage to our muscle.”
My friend’s teenage grandson got Covid in California in early 2020, months and months after his infection he ended up having an abscess behind his eyeball. So he had to have surgery where they popped his eyeball out to scrape out the abscess, they told his family that it was a pocket of Covid behind his eyeball.
He’s OK now, but it grossed me out so much to think that it could gather and fester like that.
Every single organization working with disabled and vulnerable people have a credibility issue. When your fund development and staff salaries rely on the commodification of your clients, you are in a quandary. Experts in medically assistance in dying are the shells of once vibrant people 'living' in long term care institutions. We all have a best before date and it is being extended in quantity without consideration for quality.
Thank you for an important and timely article. I am a licensed mental health counselor who sees people with chronic pain from workplace injuries, I’ve been a Hospice volunteer, and I’ve delivered mental health services to homeless individuals and families. Take my word for it, the system is stacked against the poor and disabled. As a new counselor I was told that the 1% uses our profession as a buffer between them and the masses, and it was therefore our calling to change that paradigm. But experience in the field has taught me the 1% have all the power. I could go into detail about how state and federal governments (don’t get me started on insurance companies!) control the ability of counselors to deliver services.
But your statement that the rich buy the laws is true—I would only add they also bend the good laws. As we move into the next administration, I’m afraid people will not need “assistance” to die.
When I had Medicaid I didn’t have any access to pain management, and nobody else is allowed to give pain medication to people with chronic pain I guess. My suffering was so profound. I was told that therapy could help with chronic pain yet when I saw a therapist for it there was no trick to take the pain away. And traveling there and sitting in a chair for an hour and traveling home just caused more pain.
Then once I got Medicare and I could go to pain management and I could get actual treatment for chronic pain I was well enough to get out of bed and clean my apartment, and cook food for myself, and I even got a part-time job for a few years until Covid rolled in.
The absolute rage I still feel about being forced to suffer for years because the specialist who are allowed to give Pain medication don’t accept poor people insurance. I’m so sorry that your comment triggered this rage and I hope you aren’t taking what I’m saying personally, but you really gotta tell doctors that you don’t have any trick to fix the pain. And I honestly didn’t want to get in a spot where I just accepted that I was going to have to lie in bed forever all day every day, and I’m pretty sure that’s all therapy was going to do for me. I mean except cause the extra pain from sitting in that chair for an hour.
Maggie JK: I am sorry you had this experience. I see people via telehealth precisely because they don’t have to travel and sit in a chair. Good therapists will advocate on behalf of their clients to get additional medication or medical services that they need. Unfortunately, the medical profession and insurance companies often ignore our perspective. Therapy CAN help with chronic pain, but it is not a substitute for proper medication. If a doctor led you to believe that, again, I am sorry, but not terribly surprised. I can’t tell you the number of clients I have seen whose doctor’s implied their pain was “all in their head”. I hope you will continue to have access to the services you need.
The chronically ill rack up enormous lifetime medical bills. This is a solution by the State is two pronged: The State offers no further medical solutions and it saves the State an enormous amount of money per patient.
I am in the US and your comment is making me realize that if we ever do get national healthcare over here everyone will have access to assisted dying because they will want us to choose that option.
Right now with Medicare that we pay into and private insurance plans there’s lots of economic activity, we stimulate the economy with all our pharmaceutical purchases and doctor visits and transportation to those visits. Yes I’m sure we cost money in the long run, but here in America the churning of funds seems to be a good thing.
Idk I am really worried about losing medicare and social security since he defunded it in 2020 by waiving payroll taxes that fund those programs. He vowed to make it permanent if he won, then Biden waived any unpaid payroll taxes so nobody had to pay a lump sum in January so a whole bunch of people forgot this even happened.
I don’t expect to live very long if I lose SSDI and Medicare. And I don’t know how long that program can stay operational if it immediately gets defunded in January.
Maggie, I’m also in the US. Even if he tries to defund SSDI and Medicare immediately it would take time to unwind so there is no immediate threat. There would also be pushback from some in Congress who want to be re-elected because Medicare is such a necessary program.
A privately run program would ideally have to be in place before Medicare shuts down. They want to hire private companies to run the programs from what I understand.
Nate Bear again says what I wish was in my capacity to write!
Due to my propensity to hit cars with my bicycle while out training (I'm using sarcasm) I live with chronic pain. If at some point that pain is overwhelming and my ability to function physically dissipates then I formerly anticipated a real battle for the right for an assisted death.
No longer do I have those worries. All that is necessary is to enroll in continuing education classes in the university building with the worst ventilation and not wear a mask. Problem solved!
Like you, Nate, I used to be in favour of assisted dying, especially in support of Sir Terry Pratchett, one of my favourite authors. Now, I think we're making a huge mistake. My husband & I watched Liz Carr's excellent documentary, Better Off Dead?, (available on iPlayer) last week and I'm truly scared at what will happen if this becomes law. The Canadian doctor Liz interviewed, Ellen Wiebe, was positively euphoric at the thought of helping ppl end their lives - it was truly uncomfortable and creepy to watch. A quick Google search at the end of the programme revealed that Wiebe has, no surprise, been been blocked (recently) by a court for attempting to euthanize someone with no physical ailment: https://www.theguardian.com/world/2024/oct/31/canada-medically-assisted-death-judge-ruling
Just to add to your point about healthy under-65s not receiving Covid jabs - as of next year, that's being expanded to those that actually do have health problems, like myself, meaning I either have to pay for my jabs or risk compromising my already dodgy kidneys further. Until we start valuing all lives and funding health services appropriately, we should not be going anywhere near assisted suicide.
I appreciate the link, I saved a screenshot so I can click on it after the guardian gives their striking employees what they want.
About five minutes before I read this I was watching a news clip where there were a dozen people trying to rescue a lady from a sinkhole somewhere here in the US.
And of course they should, I’m just really confused about why the lady in the sink hole is so much more important than someone who needs a wheelchair. 12 people aren’t rushing to rescue them with massive equipment that costs 5 figures.
It’s just interesting to me that here in the US it’s OK if I die in the hospital from an airborne virus everyone is refusing to prevent spreading, but if I fall into a sinkhole the whole entire city will come out to save me. Or maybe they wouldn’t because I’m just a disabled person. Maybe the lady in the sinkhole is someone important but they didn’t say that on the news so I don’t know.
But how do they determine who gets a dozen people to help save their life and who has to sleep in a cardboard box without a wheelchair?
(Edited to remove an extra “spread”)
I so wish that we could start to talk about this topic not as an either or issue.
For me as a chronically ill person both sides of the discussion are important. The option of an assisted suicide does need to remain available with a reasonable degree of ease (because what is the alternative? Should i butcher myself using an unsafe methods with the risk that i might actually survive with an even more severe disability?). And it is just as important to point out and fight back against the tendency of the state to use assisted as an austerity measure.
The problem is the capitalist system and the neoliberal nation state. This system will always attempt to discard those it considers to be surplus. Under late stage capitalism this process will only accelerate (see the book: Health Communism).
But at the very same time, it's not that easy to change this system. I have tried, for many years, and it frankly seems quite impossible. Personally i do not believe that the world will get better for us (the chronically ill, disabled etc.) soon. Sure, let's keep fighting, but let's also be realistic.
So while we are stuck having to live under this fucked up, cynical system, assisted suicide must remain available as an option. Just to know that it exists and is easily available can offer some relief. Trust me, been there.
The key issue is the state's involvement. Assisted suicide gets then problematic, when the state uses it to discard or offload people, in order to save money, in an austerity effort. Which sound like what has started to happen in Canada.
In Switzerland assisted suicide is run by private nonprofit organizations. This model still has many problems. For one, it should never be run as a business, its rules are icky.
But i can think of other models of assisted suicide that seem actually beautiful, community based, ritualized, while at the same time tackling the suicide taboo. With fascism and eugenics coming back, climate change getting worse many people will start to contemplate how to end their lives. That's just inevitable.
A while ago i wrote a blog post about it:
https://pieceoplastic.com/2023/08/18/an-anti-statist-view-on-assisted-suicide/
I had a glimmer of hope that the world would get better for us, for about a year before the summer of 2021 anyway.
I have MECFS and for a brief moment in time people knew what that was and I didn’t have to explain it at every new doctor visit when I listed it as a medical condition. I remember going to the allergist and when the nurse got to that part on the form she was empathetic and curious, so we talked about it for a few minutes. It was delightful.
But now that the Covid gaslighting has fully kicked in in the US even my neurologist is trying to pretend they don’t know what MECFS is. I can’t get a new one just yet because I have a prior auth for botox and all kinds of CGRP meds from them. But once I get stable I am out because the gaslighting is dangerous. (For example she put in my medical records it was very important that I see a G.I. doctor. I’ve consulted with five G.I. doctors in three different states over the years, my G.I. problems are migraines which is a neurological thing, but if I go to the ER and they see that note they will assume I’m a drug seeker and I’m not going to the G.I. doctor because I want drugs from the ER and they won’t treat me.)
This makes me wonder about the organization Dying With Dignity in Canada. Are they similarly funded like in the UK? Hard to find much about their funding donors…
Thank you for writing another thought provoking article. I don't believe this is an easy topic. I live in Oregon and have followed the debate from the beginning.
A couple of questions I have no answer for:
If assisted suicide is ruled out, will it bring about a change in access to care for disabled and ill people?
Could living in a society that refuses to care for the sick and disabled be considered valid grounds for assisted suicide?
We don’t have assisted suicide in the state that I live in (NH, USA) and the disabled are still treated horribly here.
This is one of those states where businesses can pay disabled people sub minimum wage.
When the ACA started NH tried not to expand it. I moved back here in 2014 and because the SSA had not deemed me disabled yet I had to fight for health insurance (medicaid) for 10 months. I had to go to city welfare to get $ for medication (oddly there is a law here that if people can’t pay for meds the municipality has to) so I could be well enough to go into an appeal hearing and represent myself against the state.
So no I think the only thing that gets them to help people like us is when there are a bunch of homeless people existing in spaces that offend people with money. Then they start to care about people’s suffering, or at least getting it hidden away from the everyone else.
Hi Nate-
I agree 100% governments should assist people with living.
Be careful with this statement- “They are supposed to work for everyone and respond to the majority.” Through history around the world, the “majority of people” have supported the enslavement, the genocide, the incarceration and many other atrocities of other people. Californians approved a law to enslave prisoners. The law uses the word slavery. The majority of people who voted approved enslavement. Nothing has changed for prisoners in centuries because the majority of people don’t care about the incarcerated.
People with ongoing sars2 infections are signing up for assisted suicide. If they can’t get assistance, they are finding ways to end their lives. Not because they want to die, but because they can’t get help. The tests that show the damage of sars2 are not available to 99.999% of us. Tesla 7 mri shows the damage in our brains. A very special machine shows the microclots. Surgery can uncover lingering sars2 virus in our fat cells or show the damage to our muscle tissue. Blood tests can show the damage to our immune systems.
Sars2 damages our ability to make serotonin and our brains. Should anyone be trusted to make life and death decisions? No. I don’t think so.
I am against assisted murder. The rich people are not signing up…only the people who have no other options.
“Surgery can uncover lingering sars2 virus in our fat cells or show the damage to our muscle.”
My friend’s teenage grandson got Covid in California in early 2020, months and months after his infection he ended up having an abscess behind his eyeball. So he had to have surgery where they popped his eyeball out to scrape out the abscess, they told his family that it was a pocket of Covid behind his eyeball.
He’s OK now, but it grossed me out so much to think that it could gather and fester like that.
Every single organization working with disabled and vulnerable people have a credibility issue. When your fund development and staff salaries rely on the commodification of your clients, you are in a quandary. Experts in medically assistance in dying are the shells of once vibrant people 'living' in long term care institutions. We all have a best before date and it is being extended in quantity without consideration for quality.