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Thursday, 30 October 2014

Nancy Fitzmaurice, Assisted Suicide, and Assumptions

So, a legal first happened in Britain over the summer, the news of which is just coming out now, and it should have all of us concerned. Nancy Fitzmaurice, a 12-year-old disabled girl, was killed in a London hospital in August, and it was all legal. Her parents fought in court for the right to terminate her life, and the judge granted it.

This is the first time a British court has "allowed a child breathing on her own, not on life support and not diagnosed with any terminal illness, to be killed by the medical system." (ASAN Position Statement).

William Peace over at Bad Cripple has been blogging for a long time about the danger of something like this happening, as the struggle to make assisted suicide legal in Canada and the US has intensified. And I've come to agree with him. I do support the idea that people should be able to dictate the terms of their own death, but the legislation that would permit that needs very specific and stringent safeguards to protect disabled people from having other people dictate those terms.

Especially children. Not that we'll ever know ever know how Nancy Fitzmaurice felt about her situation one way of the other.

I realize that opponents will argue that we couldn't have known anyway. Nancy Fitzmaurice couldn't speak, or walk, eat, or drink, for that matter; she was born with hydrocephalus, meningitis and septicemia  (Read more here). But that's the point, really. Nobody truly knew how she felt about dying, or whether she'd have tried to stop the process of death by dehydration at any point if she could have communicated that she wanted to. Everyone assumed that she'd rather die than live, and made killing her legal based on that assumption, and the ASAN Position Statement points out that media coverage hasn't included the voices of those with disabilities similar to Nancy Fitzmaurice's, to give a counterpoint to the narrative that she could never have any quality of life.

That's dangerous to me, and deeply ableist. No responsible judge would rule that assisted suicide is appropriate for a non-disabled child, even one in extreme pain, who didn't have a terminal disease. Even if a 12 year-old who was terminally ill made the request, I would like to think that doctors (and judges) would recognize that:

1) At 12 years old, most children aren't developmentally capable of appreciating all the consequences of that request and

2) Palliative care should be the alternative at that point, not assisted suicide.

If anyone knows of a situation where a non-disabled, terminally ill minor asked for the right to physician-assisted suicide (or the family asked on the minor's behalf) and received it, by all means let me know. Let's tackle whether this would actually happen before we tackle whether a non-disabled minor, non-terminal, but in extreme pain, would receive the right to a physician-assisted suicide.

Actually, no need to tackle it. I guarantee that it wouldn't happen.

Nancy Fitzmaurice was not terminally ill, and assisted suicide cannot replace pain management in disabled people because some non-disabled people think, "I could never tolerate such low quality of life, therefore this person must not be able to either."

This is all about assumptions and what happens when you throw legal clout behind them.

Nancy Fitzmaurice and Assumptions


When I woke up after brain surgery, I was still intubated. I wasn't expecting this, and I initially wasn't expecting the tube to stay in for long. However, the doctors were keeping it in for a reason: They thought that there might need to be more surgery. No one presumed in that (non-emergency) situation, however, that it was okay to go ahead with it without:

1) Ensuring that I knew what was going on

2) Getting my consent

We figured out how communicate through me blinking my eyes, and I let them know that I understood the potential need for more surgery and consented to it.

If someone *ever* makes assumptions about what I must want for my healthcare, based on the fact that I'm disabled, they will rue the day, and I'm not worried about a doctor trying to talk my family into anything if I can't speak for myself - my father and sister get it.

I just wish that every disabled person was so lucky, because Nancy Fitzmaurice's parents would like to see what they've done made legal without having to go court. They'd actually like doctors to be able to make these decisions, to spare the parents. (Read more here)

I know that there are people out there who would accuse me of having no empathy for the parents. I actually do. I have children in my life that I love to pieces, including a 3-year-old niece. If I had to watch her in extreme pain, day after day after day, not being able to do anything about it..well, here's what I wrote about Robert and Tracey Latimer, in my post about Kelli Stapleton:
"Even at that age (15) I could appreciate how difficult it must be to watch your kid in pain and not be able to do anything about it...not even give her pain medication, because it didn't work.  And to know that her body was just going to keep breaking down, requiring surgery after surgery, until keeping her together was going to be more painful than letting her fall apart. It had to be hell. How long could you really keep a father in prison who only wanted to spare his daughter more pain?"

But Robert Latimer (and Kelli Stapleton) went to prison. Nancy Fitzmaurice's parents were legally permitted to do what Robert Latimer did to his daughter.

In order to understand why the legal assisted suicide of Nancy Fitzmaurice is so upsetting for disabled people, their loved ones, and advocates, I think that people need to understand that even though these kinds of decisions haven't been legally made until August, they get made already. Babies with Down Syndrome are sometimes denied life-saving surgery because of concerns over their potential to have a good quality of life. A man with Down Syndrome (in the UK, no less) was issued a DNR during hospitalization for pneumonia that neither he nor his family knew about. I've blogged about two disabled people in the US, one of them a 3-year-old, where disability and was cited as a factor for why they were denied organ transplants (Amelia Rivera, the 3-year-old, did receive one eventually, but only after a battle with the Children's Hospital of Philadelphia). The ASAN position statement talks about the University of Wisconsin Hospital’s "practice of counseling parents to withhold care from children with disabilities for treatable but life-threatening medical conditions", including a young man with treatable pneumonia, who died after his feeding tube was removed - because people decided that he had no quality of life.

These are arbitrary, subjective, ableist decisions based on assumptions about what defines quality of life (and who does and doesn't possess it/might ever posses it), with deadly results.  And now the power for others to make these life-and-death decisions for disabled people is supported by a legal precedent. The judge has opened an enormous can of worms.

And it's not able-bodied people that are going to die because of it. It's us. That's why this is scary, and people need to understand that.

Nancy Fitzmaurice: The Bottom Line


I hate as much as anyone else that Nancy Fitzmaurice was in such pain, and that her parents had to watch it. But my heart also goes out to the 12-year-girl who loved listening to Michael Buble and who laughed when her mother slurped her tea.

This quote from Nancy Fitzmaurice's mother really struck me: "I wanted beautiful memories of Nancy, not soul-crushing ones." I've said before about stories like this that the children pay for what the parents want. I've got no doubt that Nancy's parents loved her. But if I was to make an assumption about her, it would be that she wouldn't want to be remembered as the little girl whose death gave hope to parents who think that it should be legal to kill a disabled child, even if their intentions were simply to end their loved one's pain.

If we're going to make assumptions about Nancy Fitzmaurice, I wish that the court had gone with that one.











2 comments:

  1. This is an excellent piece that raises many disturbing questions. My understanding is that this practice of withdrawing fluids is not uncommon in newborns with significant disability (and even in older children with sig. disability) in North America if the parents request it. I was actually surprised to read that in the British case it was being documented as the first case of its kind there.

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  2. Hi Ikinross

    I think I know from your email address where you're working, and I'd certainly bow to your expertise on this...if there's any information that you can share that talks about this practice legally going on in North America, I'd be very grateful. I've seen a couple of other North American disability bloggers mention this story, and it seems to have caught them as much by surprise as it did me. Please feel free to email me through the Contact page if you'd rather talk privately.

    Thank you for commenting. I appreciate it.

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