ABSTRACT
Disability issues in bioethics are highly contested because they bring up powerful emotional issues: questions about the permissibility of technological intervention; the vulnerability of disabled people; the widespread non-disabled perception that impairment is a fate worse than death; the historical backdrop of abuse, oppression and murder. These factors are common to debates at both the beginning of life, and the end of life. Fears about eugenics and about euthanasia form the substrate of the disability rights response to bioethical arguments about autonomy and the value of life (Asch, 2001). End-of-life questions are poignant, first, because they seem to threaten
the very existence of disabled people, even more personally and directly than questions about prenatal diagnosis. Second, if individuals are permitted to end their life on the grounds of suffering and restriction, this potentially sends a message that impairment is so awful that no one would want to go on living in such a state. Third, a narrow focus on impairment and suffering again risks obscuring the social contexts which often determine the quality of disabled people’s lives, in particular, the availability of independent living and civil rights protections from exclusion and discrimination. In recent years, the end-of-life debate has assumed a high profile in
manyWestern countries. The US state of Oregon legalised assisted dying for terminally ill mentally competent adults in 1997 and the neighbouring state of Washington followed; the Netherlands legalised voluntary euthanasia in 2002, after a thirty-year period of non-prosecution of such cases; Belgium legalised voluntary euthanasia in 2002 (Finlay et al., 2005); assisted suicide for chronically ill and disabled people is permitted in Switzerland.
