Barriers to Physician Aid in Dying for People with Disabilities

Terminally ill people with disabilities face multiple barriers when seeking physician aid in dying (PAD) in the United States. The first is legality. Efforts to legalize the practice have been thwarted in dozens of states in part due to vocal opposition by advocates for people with disabilities who contend that legalized aid in dying discriminates against and harms people with disabilities by leading to their premature and unnecessary deaths. Some disability rights advocates disagree with their colleagues, however, and support legalization on the ground that it promotes autonomy and independence at the end of life. For proponents, legalization in six states is proving to be an illusive victory. Emerging reports from the states where PAD is legal suggest that people with disabilities may face special and impenetrable barriers when seeking legal aid in dying. This article identifies four such barriers: procedural protections embedded in PAD statutes; physician objection; cost; and a rule pertaining to California veterans. The article calls for additional study to determine the extent to which these barriers have a disparate impact on care options available to terminally-ill people with disabilities.