15 Women, Right to Suicide
Description
This article is from the Essays on the topic of Women and Disability.
15 Women, Right to Suicide
To Be Or Not To Be? Whose Question Is It, Anyway? Two Women With
Disabilities Discuss the Right To assisted Suicide
by Tanis Doe and Barbara Ladouceur
Women with disabilities have been assaulted not only by
individuals in their lives but also by a legal system and mass
media that claims authority over their physical bodies as well as
their minds. Women with disabilities of all types have had their
bodies measured, altered, and judged by medical
professionals, policy makers, and the general public. The
question of whether to live or die must come back to the
individual woman with a disability. The following dialogue is one
that does not only take place in faculty rooms or at
conferences, but also in living rooms, bedrooms, and sometimes
hospitals. To be or not to be. Whose choice is it anyway?
Tanis
I wanted to die. I know I wanted to die. I wanted life to end as
much as I wanted suffering to stop. I was not terminally ill. I
was not even severely disabled in a medical sense. I was
chronically ill and felt that my own depression was worse than
any possible disease or disability. But I am alive to talk about
it and glad that I am alive. I can honestly say that I am happy
to have survived depression and that others like me are still
alive. Some of us were rescued by friends or crisis lines and
others just didn't succeed at getting dead. But we are only one
side of the story. How can we ask the women who were actually
able to die? Why do we assume that all the women who failed at
suicide are the successful ones?
I do not want to debate the afterlife or the ethics of dying. I
want women to enjoy living, and to participate in a satisfying
life, but I also want to ensure that suicide is a choice for us.
Barbara
You say you wanted to die because you were chronically ill and
depressed; I can relate to your situation because twenty years
ago I was depressed and deeply dissatisfied with myself as a
mother shortly after my daughter was born--it was probably tied
in with post-partum depression. I remember how real my feeling
was that everybody including my daughter would be better off if I
was dead. But I'm glad I didn't "succeed." My failure at
suicide felt like a "success" because afterwards I saw my
attempt as a cry for help which I couldn't overtly articulate at
the time. Fortunately, I did receive counselling which helped me
build up the self esteem and confidence that I needed in order to
regard my life as worthwhile and fulfilling. Since then, whenever
I contemplate others' failed or successful suicide attempts, I
think of them as desperate cries for help, and thus if the woman
fails at suicide I do think of her situation as more positive or
successful than if she dies. I do think there is a reality that
there are many people who killed themselves who could have gone
on to live out their natural lives if their suicide had failed
and intervention had taken place. I do think of people who are in
a suicidal frame of mind as being
emotionally disabled. In your case, did you actually attempt
suicide or did you seek help beforehand?
Tanis
For me it was actually both. I did ask for help, and [I did] get
some help before I tried. I attempted suicide by over-dosing on
medication given to me by a doctor, combined with alcohol.
I remember waking up thinking I was once again a failure and
couldn't even kill myself properly, but that seems to be common.
It is actually difficult to know how to die safely. By "safely,"
I mean finding a way that will end your life rather than result
in permanent brain damage or further disability. Women tend to
attempt suicide more often than men, although men are more
likely to actually die during their attempts. I think many women
are medically treated or restricted during their expression of
suicidal thoughts, which makes it very difficult for them to
complete their wishes.
Barbara
You make an interesting point in saying that women are more
medically treated or restricted, and thus less successful in
their suicide attempts. The two most famous cases in the
Canadian "right-to-die" movement were initiated by women with
disabilities, Nancy B and Sue Rodriguez. I don't think either of
them thought of their legal battles as gender-based. However, if
we acknowledge that women in general and women with disabilities
in particular tend to have less control over their lives than
their male counterparts, it does seem most appropriate that it is
women leading the fight for the ultimate choice: to be or not to
be.
Tanis
I feel very strongly about the right to commit suicide because I
know that it was a choice for me. When I hear that for some
people it is not a choice because of disability, it scares me.
Women with disabilities are not able to make their choices
because society legally takes away their rights. Does this mean
that as women, we are devalued by society, labelled by medical
professionals and marginalized from the mainstream, and yet
refused this final dignity of choice? They try very hard to
prevent fetuses with disabilities from being born, yet once we
are alive they won't let us take our own lives?
It has a rather paradoxical ring to it: we don't really want you
here but we won't let you leave either. And this is important
because there are many ways to address the issue of wanting to
die.
Barbara
I agree with you that women with disabilities are especially
devalued and marginalized by mainstream society, including the
health care professionals to whom they go for service. When you
point to the issue of choice, it seems to come down to the
ongoing issue of women's control over their bodies, again.
I see parallels with the abortion issue--anti-abortion groups
wish to deny all women the choice to terminate pregnancy, yet
they do not on the other hand support every child's welfare after
birth. There are not large-scale efforts by society in general to
show that we value the lives of all children, or to alleviate
their problems.
So the message seems to be that all children are valued until
they are born, when they have to contend with mainstream
society's hierarchy of rights and privileges. Children are
certainly not born equal when there is still such deeply
entrenched sexism, classism, racism, and ablism in society.
Tanis
If everyone wanted us to be part of society, if all access
questions were already dealt with, and perhaps integration was
commonplace, would some women with disabilities still want to
die? Yes.
We still might want to die the same way thousands of non-
disabled women want to die, and their situations are often very
different from the lives of women with disabilities. The
complexity and diversity of motivations must be considered
because disability is not the only "justifiable reason " for
wanting to die.
Should it matter if you want to die because of Alzeimer's or
because of a personal crisis?In fact, it is silly that if
someone is not fatally ill but physically able enough to end her
own life we allow this, but if the person is so ill or
incapacitated that she requires assistance, then we don't allow
it.
Barbara
You are saying that we should separate the issue of disability as
the motivation for a women committing suicide. We are getting
into another paradox because the right-to-die movement is based
on the person having a "justifiable reason" for ending their
life. It is argued that if a person is terminally ill and/or
permanently and severely disabled, they have the right to end
their lives because their suffering has become unbearable or the
quality of their lives is non-existent. Women with disabilities
understandably feel devalued when the degree of physical
disability is put forward as justification for suicide. When I
follow your line of thinking to put aside motivation and focus
solely on the concept of every person having the right to decide
when and how they will die, I feel comfortable in saying that I
agree with this idea. If a woman kills herself then she has
successfully exercised this right. But I am still haunted by the
possibility that she was in a temporary state of mind--suffering
an emotional disability that could have been alleviated by
intervention.
Tanis
Intervention that might be drugs? Or maybe electroshock therapy
or restraints and isolation? It is difficult to condemn women 's
choices when their alternatives seem so poor. So there are two
questions about women with disabilities choosing death that need
to be thought through--one is their motivation and the other is
their ability to follow through with their ideas.
Barbara
You are so right. Given the reality of women's lack of self
esteem and/or lack of "success" in life being rooted in concrete
prescribed codes of behaviour according to gender which already
restrict their life choices, how can others tell us that we are
mentally incompetent if we want to die? Perhaps the opposite is
true.
Tanis
Motivation for death is not always due to one specific issue.
Some older women want to die to avoid wasting away or suffering
unnecessary and intrusive medical procedures. Some people feel
that pain is unbearable and prefer the shelter of death over
drugs to resolve their pain. Other women may want to die because
life has become so emotionally and spiritually empty that life is
of no value. The discussion about suicide usually ends up with
the issue of disability not being considered worth dying over. In
fact, it is not always their disability that motivates women to
want to die. In any event, the reasons women choose to die should
not affect the judgement of others in power.
Barbara
When I contemplate the overwhelming problems of our world--
hunger, war, environmental devastation--and when I visualize the
huge number of people, especially women and children, trapped in
oppressive and violent situations, it seems clear that a right-
minded person would certainly be justified in wanting to make a
final exit. I would still prefer to achieve more options and
control over our lives for all women, so that less lives are
"emotionally and spiritually empty," but such a revolution is not
likely to be achieved in the near future.
The right to die is such a complex issue, I have conflicting
ideas within me. Yes, I can agree that all women should have
total control over their lives including whether to end them but
if it was my daughter or friend who successfully committed
suicide, I'd be devastated and definitely regret that I hadn't
been able to intervene. I guess you could say that sometimes the
political conflicts with the personal. So let's move on to the
second issue.
Tanis
The second issue is being able to carry through wishes.
Searching out and being able to administer a method of death is
problematic for women with disabilities. Often the difficulty is
finding one that is fatal enough that one can be sure of death
and not another version of existence which could possibly be
worse than the current situation. But women with severe physical
disabilities who need assistance with daily chores and personal
care may be dependent on others for several types of assistance.
In fact it is the issue of assistance that is almost more
contentious than that of choice. Once a woman with a disability
who is dependent on others has made the choke to die, who will
help her ? Can she ask her friends or doctors to do this ? If she
asks and they refuse, what action can she take? It seems almost
cruel to deny a person who normally receives assistance without
question this final assistance. Can I have a glass of water
please? Can you move my left arm onto my lap? If an
assistant ignored these requests and continually denied the woman
food or comfort it would be criminal. In fact, it would be
considered abuse and neglect if it continued.
Barbara
Yes, it may be that relatives of caregivers are just not
emotionally or morally capable of enabling a woman with a
disability to end her life. Perhaps our society will have to
support more doctors like Kavorkien who are physically and
emotionally removed from such situations. They are perhaps in a
better position to "objectively" and non-exploitively agree to
assist people to die. If we put aside the potential for
exploitation and the issue of motivation in order to morally and
legally recognize the right to die, then maybe we need "death
doctors" just as there are abortion doctors and still others who
won't participate.
Otherwise we run into another tragic paradox. I can agree with a
woman's right to choose death, but I also think whoever is
requested to assist her death has the right to say no for
whatever moral or emotional reasons they may have. Following this
logic, it is unfortunately quite possible that although women
with disabilities may have the legal right to die, there will be
no one in her life who can or will assist her to die. Because no
one should be forced to help someone die, we are possibly moving
towards the ultimate conflict of interests.
Tanis
But women with disabilities who are asking not to be fed, or not
to be connected to machines or even to be given medication that
would result in death, are not being helped. The helpers
themselves are not necessarily making these judgements. There are
countless situations that have never been publicized in the media
in which women had their friends help them make the final exit
without much attention. However, once the public sphere is
involved, once there are media, courts, and politicians, death no
longer becomes a choice. Death becomes a legal debate, an ethical
question, and a political issue.
In many cases women with disabilities have had their rights taken
away by the medical system which labels them as
incompetent. An insidious legal technique is to institutionalize
and medicate her, this process also dehumanizes the woman.
Judges look favourably on a medical doctor's opinion regarding
the mental competency of a patient, particularly suicidal ones.
In fact, even a lay person would agree that no one in their right
mind would want to die. Ergo, suicidal women are mentally
incompetent, with legal and medical procedures to support this.
But the politicians have a hand in this too.
Barbara
I like your point that it is only when the issue of suicide
becomes public that choice is eliminated and suddenly strangers
are given the right to tell us whether or not we can choose to
die. But I do think it is more a question of the final and
irreversible consequences of assisted suicide rather than the
apparent inequality of rights we see when we acknowledge the
ability of an able-bodied woman to kill herself versus the
inability of a woman with a disability to kill herself due to
lack of assistance. If a person assists a suicide, then they may
wonder if the suicidal person might have later changed their
minds about wanting to die. They may question themselves as to
whether they made a correct assessment as to whether the
assisted suicide was actually in the suicidal person's best
interests. In any other "helping" situation, you can still see
and communicate with the assisted person and evaluate how they
are doing in order to adjust or change strategies accordingly.
Tanis
Suicide has been decriminalized as an act, and yet assisting or
encouraging suicide is still against the law. It seems quite
discriminatory that this law about suicide was made by able
bodied people who would be able to take their own lives without
assistance if need be. However, if a woman with a disability
makes the choice to die on her own, and needs help to carry it
out, is she a criminal ? More specifically is her assistant a
criminal ? The injustice is obvious: there are two types of
equality--equality for those who are able-bodied, and equality
for those who are different. Women are already subject to many
kinds of violence and control over their bodies. Women are
raped, assaulted, battered, stalked, and robbed by people who
have power over them. Suicide is a way for woman to have control
over their own lives.
Barbara
At an abstract level, I agree with the right-to-die concept, but
when I visualize concrete situations, I start having doubts
because once the person has died, they can't come back and
assure you that the right decision was made. It's one thing to
decriminalize suicide when a person commits the act on their own,
but when other people become involved, the issue becomes much
more complicated with a wider range of circumstances and
variables to be assessed.
Tanis
The question of abortion, of fetal testing, or genetic
manipulation is not being debated in this case. It is adult
women, not science that is being discussed. Some women have
become disabled, and generally feel it is tragic that their lives
have changed. Some women have had disabilities throughout their
lives and continue to lead happy productive lives.
Regardless of their status in life, all women must have death as
an option. Not because society wants them to die, but because it
is a legal and moral obligation of society to allow the dignity
and security of the person. Choice.
Choosing death over life is not a decision made hastily. In fact,
there are probably many women who have regretted attempted
suicides and are now leading fulfilling lives after treatment or
life situation changes. But there will always be women who do
want to die and do need help in order to kill themselves. If you
are so physically dependent on others for assistance that you
need to ask to eat, then you should also have the right to not
eat. Forced tube feedings and intrusive operations against
personal wishes seem far more criminal than the issue of
assisting a choice of a woman.
Questions are raised about abuse, or rather overuse of this
process should it be legalized. Too many people would "help"
others die, and there would be ulterior motives in assisting
suicides, issues of living wills, estate, inheritance, and
burden would come up. There are equally large numbers of violent
crimes that now occur, particularly against women, which are not
being adequately addressed by the existing laws.In fact, there
may eventually be a long list of situations which allow for
assistances and others which preclude it. Yet this again avoids
the question of choice.
Barbara
Yes, women with disabilities must have the right to refuse care
or treatment. However, the ending of life-support efforts does
appear more feasible in terms of merely requiring the cessation
of intervention by health-care professionals. But actually
taking action to kill a person, even when the person has
requested death is more problematic. There is always the
legitimate concern that care givers who are already powerful
forces in the lives of women with disabilities could exploit a
woman's right to die in the interests of the care giver and not
the woman. So I can only agree that on the one hand women with
disabilities must have their choice to die respected and, if
necessary, assisted, but as long as society builds in safeguards
to assure that the woman with a disability herself has decided to
die and that no one coerced them into their decision in order to
exploit her.
Tanis
Lawyers and medical professionals are paid well for their
work but women with disabilities, for the most part, are poor,
and they are not able to spend their last dollars on hiring
specialists to defend or evaluate them, and often would be
unwilling to use their time and money for this. The issue of
choice must be a personal one, and that choice should be
legalized so that no procedures are initiated once the choice is
made.
The trouble that some disabled women have with this issue
relates to quality of life. Women with disabilities suffer
higher rates of sexual and physical abuse, live with
psychological abuse, and generally are mistreated by society.
Some women with disabilities advocate for better education,
safety, and employment while others work for better personal
assistance, transportation, and housing. Regardless of the
status of women with disabilities in general, a woman with a
disability can personally make a choice to die. The issue of
birth and death is also tied in with the issue of choice--
thousands of women have taken their own lives because of
inaccessible abortions. Thousands of women have died because of
illegal and unsafe abortions. Choice is a matter of life and
death for all women. But even if the situation for all women with
disabilities was horrible and painful, each woman would still
have to make the personal choice. There is no general rule or
procedure because it is a matter of choice. If everything in this
complicated world was perfect and accessible to women with all
disabilities, some women as individuals would still need the
right to make the choice to live or die. It is my life, and my
choice to make.
Barbara
Just as outside parties such as police, lawyers, and judges often
have to enter an abused woman's life situation in order to assess
the appropriate action to protect her against her abuser (such as
issuing a restraint order) which guarantees her right to life, so
too there should be outside parties involved in the process of
facilitating a woman's right to die and to assure that it is in
her own best interests and not someone else's.
Women with disabilities are not supported in their choices to
die, to live or to procreate, because a system of legal and
medical procedures is in place to make decisions for women. But
non disabled women, and to an even greater degree, able-bodied
men, are given better choices because of the lack of restraints
in their lives. If they choose to die, it is a private matter and
their decision. Women with disabilities lack this freedom of
choice in death.
Remember that women with disabilities are not asking only for the
right to die. Women with disabilities want to live, and live
happily and with positive results, but they cannot do that
without control over their bodies. It does come back to the role
of women's bodies in society. Women in general are seen as baby
makers, life givers, and service providers. But women with
disabilities challenge that role and confuse the everyday
assumptions about the role of women. As a result, there are
endless possibilities for debate: Can women with disabilities
reproduce normal healthy babies and do we want these women to be
mothers? Should we allow a fetus with an obvious disability to be
brought to term? Which disabilities are considered severe enough
to terminate pregnancy and which disabilities in adult women
should preclude her from being allowed to have children? Can a
child or woman with a disability experience any quality of life
beyond that of mere existence? If she wants to die should we let
her? Should we help her? Who are we to decide for her, whether
she is to be or not to be? Whose question is it anyway?
Tanis Doe is a deaf advocate (with other disabilities) who works
independently and in collaboration with organizations and other
researchers to effect social change. Tanis has an adopted deaf
daughter who is now eleven years old.
Barb Ladouceur has an MA. in Women's Studies and is a feminist
writer working in the areas of women and poverty and women and
disability. She particularly believes in the educational value of
publishing womens' stories. She has a hearing impairment and has
been a single parent of two children for several years.
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