States' rights versus civil rights.

How Gonzales v. Oregon impacts people with disabilities.

By: DIANE COLEMAN

The U.S. Supreme Court will hear oral arguments next Wednesday in Gonzales v. Oregon, the federal government's challenge to that state's assisted suicide law. Eleven national disability organizations, including such respected groups as the National Spinal Cord Injury Association and the National Council on Independent Living, have filed a friend of the court brief arguing that the Oregon law discriminates against people with disabilities.

The Oregon law is not the first time states' rights have been states' wrongs. But in this case, neither the political right nor the left recognize disability discrimination when they see it.

Assisted suicide is supposedly about terminal illness, not disability, so many question the legitimacy of disability groups "meddling" and trying to "take away" what they see as the general public's right to choose assisted suicide.

The disability experience is that people who are labeled "terminal," based on a medical prediction that they will die within six months, are -- or will become -- disabled.

In fact, although intractable pain has been sold as the primary reason for enacting assisted suicide laws, the reasons doctors actually report for issuing lethal prescriptions are the patient's "loss of autonomy," "loss of dignity" and "feelings of being a burden."

Those feelings often arise when a person acquires physical impairments that necessitate relying on other people for help in tasks and activities formerly carried out alone. Those are quintessential disability issues. In a society that prizes physical ability and stigmatizes impairments, it's no surprise that previously able-bodied people equate disability with loss of dignity.

Disability groups, however, loudly object to the implicit claim that any of us need to die to have dignity. Needing help in dressing, bathing and other intimate daily tasks does not rob a person of autonomy and dignity. Unfortunately, popular culture has done virtually nothing to educate the public about how people with severe disabilities actually live autonomous and dignified lives. Our lives are portrayed as tragedies or sensationalized as heroism, but the real life issues and coping styles that most people will need if they live long enough are left out of the picture. No wonder people who acquire disabilities so often see death as the only viable solution.

The disability rights movement has a long history of healthy skepticism toward medical professionals, and there's an established body of research demonstrating that physicians underrate the quality of life of people with disabilities compared with our own assessments. Our skepticism has grown into outright distrust in our profit- driven health care system.

This is the same system that controls eligibility for assisted suicide under the Oregon law. Anyone could ask for assisted suicide. After all, with 16 of 17 suicide attempts failing, everyone could use help to guarantee a "successful" suicide. But physicians decide who's terminal and who isn't, despite well-known problems with prediction.

Physicians decide what "feasible alternatives" to disclose to the individual. Physicians decide if the individual's judgment is impaired, if the desire to die seems rational to them. The Oregon law immunizes physicians from being accountable for those decisions.

Oregon has the highest elder suicide rate in the country. Not surprising in the face of constant social messages over nearly two decades that needing help in everyday living robs one of dignity and autonomy, makes one a burden and justifies state sponsored suicide. What looks to some like a choice to die begins to look more like a duty to die to many disability activists.

If the values of liberty dictate that society legalizes assisted suicide, then legalize it for everyone who asks for it, not just the devalued old, ill and disabled. Otherwise, what looks like freedom is really only discrimination.

- Diane Coleman

Diane Coleman is a lawyer and is president of Not Dead Yet, a group of people with disabilities opposed to the assisted suicide and euthanasia movement.