Euthanasia and Autism

 In The Politics of Autism, I write about the dangers of eugenics and euthanasia. 

\An earlier post described euthanasia in the Netherlands. Some autistic people there have undergone euthanasia because they said they could not lead normal lives.  At NRO, Wesley Smith discusses an AP story on the study:

I never understand why people are surprised by these kinds of horror stories. Once a society decides that killing is an acceptable answer to suffering, what constitutes suffering sufficient to be made dead becomes highly elastic and stretches over time. This can even include loneliness, as I have written about before. The story describes the phenomenon:

Many of the patients cited different combinations of mental problems, physical ailments, diseases or aging-related difficulties as reasons for seeking euthanasia. Thirty included being lonely as one the causes of their unbearable pain. Eight said the only causes of their suffering were factors linked to their intellectual disability or autism — social isolation, a lack of coping strategies or an inability to adjust their thinking.

The unintended cruelty of euthanasia is becoming increasingly clear:

Dr. Bram Sizoo, a Dutch psychiatrist, was disturbed that young people with autism viewed euthanasia as a viable solution.

“Some of them are almost excited at the prospect of death,” Sizoo said. “They think this will be the end of their problems and the end of their family’s problems.” . . .

Tim Stainton, director of the Canadian Institute for Inclusion and Citizenship at the University of British Columbia, wonders if the same thing is happening in Canada, which arguably has the world’s most permissive euthanasia laws and which doesn’t keep the kinds of records that the Netherlands does.

“Helping people with autism and intellectual disabilities to die is essentially eugenics,” Stainton said.

Indeed. Now, add in the prospect of organ harvesting as a benefit to society and the acute danger to the vulnerable who can come — or be made — to think that their deaths will have greater value than their lives comes vividly into focus.

Autism and Euthanasia in the Netherlands

 In The Politics of Autism, I write about the dangers of eugenics and euthanasia. 

Irene Tuffrey-Wijne and colleagues have an article at BJPsych Open:Euthanasia and physician-assisted suicide in people with intellectual disabilities and/or autism spectrum disorders: investigation of 39 Dutch case reports (2012–2021)

Abstract

Background

Euthanasia review committees (Regionale Toetsingscommissies Euthanasie, RTE) scrutinise all Dutch cases of euthanasia and physician-assisted suicide (EAS) to review whether six legal ‘due care’ criteria are met, including ‘unbearable suffering without prospect of improvement’. There are significant complexities and ethical dilemmas if EAS requests are made by people with intellectual disabilities or autism spectrum disorders (ASD).

Aims

To describe the characteristics and circumstances of people with intellectual disabilities and/or ASD who were granted their EAS request; investigate the main causes of suffering that led to the EAS request; and examine physicians’ response to the request.

Method

The online RTE database of 927 EAS case reports (2012–2021) was searched for patients with intellectual disabilities and/or ASD (n = 39). Inductive thematic content analysis was performed on these case reports, using the framework method.

Results

Factors directly associated with intellectual disability and/or ASD were the sole cause of suffering described in 21% of cases and a major contributing factor in a further 42% of cases. Reasons for the EAS request included social isolation and loneliness (77%), lack of resilience or coping strategies (56%), lack of flexibility (rigid thinking or difficulty adapting to change) (44%) and oversensitivity to stimuli (26%). In one-third of cases, physicians noted there was ‘no prospect of improvement’ as ASD and intellectual disability are not treatable.

Conclusions

Examination of societal support for suffering associated with lifelong disability, and debates around the acceptability of these factors as reasons for granting EAS, are of international importance.

Euthanasia and Autism in Europe

In The Politics of Autism, I write about the dangers of eugenics and euthanasia.

At The Washington Post, Charles Lane writes of an autistic Dutch psychiatric patient Dutch psychiatric patient known as 2014-77.  Despite his doctor's qualms, he requested and got a fatal dose of drugs.

Thus did a man in his 30s whose only diagnosis was autism become one of 110 people to be euthanized for mental disorders in the Netherlands between 2011 and 2014. That’s the rough equivalent of 2,000 people in the United States.
...

According to an analysis of 66 of the 110 cases from 2011 to 2014, by psychiatrist Scott Kim of the National Institutes of Health and two colleagues, Dutch psychiatric patients were often euthanized despite disagreement among consulting physicians as to whether they met legal criteria. In 37 cases, patients refused possibly beneficial treatment, and doctors proceeded anyway.
...

Among the obvious risks, Columbia University psychiatrist Paul S. Appelbaum writes in a companion article to Kim’s, is “inducing hopelessness among other individuals with similar conditions and removing pressure for an improvement in psychiatric and social services.”

“Will psychiatrists conclude from the legalization of assisted death that it is acceptable to give up on treating some patients?” Appelbaum asks.

Some doctors already have. In 2009, a 37-year-old Belgian woman became distraught after a romantic breakup and began seeking a doctor to euthanize her, per that country’s law, which is similar to Holland’s.

The woman, Tine Nys, had a history of mental illness, including a teenage suicide attempt, but had more recently been doing well. In February 2010, however, she received a new diagnosis of autism and, two months later, a lethal injection. Her two surviving sisters have recently come forward to denounce the administering physician’s “nonchalant” attitude.