Our broken medical system is driven by a profits-before-people structure. People are not getting the care they deserve and choices are often artificially limited by financially motivated players. For example, for-profit insurers and budget-starved bureaucracies mitigate their financial risk by limiting, delaying, or denying care to people with disabilities, some through ableist “quality of life” metrics. Some people die in excruciating pain with too little care, while others pass out of this life in an ICU alone with over-the-top interventions. 94% of hospices in California are owned by publicly traded conglomerates or private equity firms, which companies are lazer-focused on the bottom line, the quality of care be damned. Some are even prowling outside food banks, homeless shelters, and senior centers to drum up business from folks who may nor may not qualify, providing many with a fraudulent 6-month or less prognoses. Some of the best-rated hospitals in California have an unwritten practice of keeping their emergency rooms full so they can send ambulances from poor zip codes to other hospitals while admitting patients into their hospital from wealthier zip codes.  They take Medicaid dollars to fund their programs while rarely, if ever, treating a Medicaid patient.

The pandemic further laid bare and recent studies have confirmed that the lives of people with disabilities are seen as less worth living by society and the house of medicine. Inherently discriminatory Crisis Standards of Care systematically de-prioritized care for people with disabilities and older adults during the pandemic.  People with intellectual and developmental disabilities are iced out of organ transplant lists. There are countless vignettes of people with disabilities experiencing the withholding as well as the non-consensual removal of life-sustaining care. People wait on long lists, sometimes to their deaths, for long term services and supports, durable medical equipment, and home care, if they’re approved for these essentials at all. Recent studies show that many medical professionals view the lives of people with disabilities as having a lesser quality of life, despite the opposite being reported by the people with disabilities themselves. Too often, medical professionals and society on the whole view life with a disability as less worth living, less worthy of care, scarce medical resources, and healthcare dollars – better off dead. 

In the milieu of a fraught system, enter assisted suicide laws, stage left. This public policy is sold as a “compassionate,” last resort option for people with intractable physical suffering at the very end of their lives, but this is far from reality given the many instances that have come to light. The safeguards in these laws are flimsy and unenforced, putting vulnerable people at risk in a world that already devalues their lives.

When a person expresses a desire to harm or kill themselves in California and other states that have legalized assisted suicide, the care received depends heavily on the doctor who receives the request. A patient might be offered suicide prevention, another might be offered suicide assistance. The sole deciding factor: a subjective quality of life that medical professional has placed on the value of this person’s life, whether, given their disability, their life is worth living.  The litmus test to receive a lethal script under the statute is a 6-month or less prognosis, but doctors’ prognoses are often wrong; and that can be with or without access to or the reception of adequate care. People with treatable disabilities like arthritis, anorexia, diabetes, and HIV are receiving prescriptions for lethal drugs in states where assisted suicide is legal.

When a sick or injured person experiencing depression and life-threatening disability has faced barriers to care and an unsympathetic or disability-ignorant medical team who believes them better off dead than alive and when not everyone has equal access to care and they’re left with the untenable ‘choice’ of dying a horrible death, putting their family into debt they cannot pay, or killing themselves – putting killing themselves on the table doesn’t solve any of the actual problems but quickly becomes an attractive option to a demoralized person, and perhaps the only option to which they have equal access.

We should be better than that.  And the law requires more than that, which is why we filed this lawsuit.