Disability and Health Journal RSS feed: Current Issue. Disability and Health Journal is a scientific, scholarly and multidisciplinary journal for reporting original contributions that advance knowledge in disability and health. Such contributions include reports of empirical research on the characteristics of persons with disabilities, environments, health outcomes, and determinants of health; systematic reviews and tightly conceived theoretical interpretations of research literatures; and evaluative research on new interventions, technologies and programs. The focus will be public health, health promotion, health education, wellness and prevention, reducing the incidence of secondary conditions and medical conditions. http://www.disabilityandhealthjnl.com/?rss=yesElsevier Inc.en © 2010 Elsevier Inc. All rights reserved. Disability and Health Journal1936-657431January 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.disabilityandhealthjnl.com/article/PIIS1936657409001903/abstract?rss=yesThis special edition of the Disability and Health Journal examines the issues related to assisted suicide and disability, the legal considerations, and the Oregon and Washington experiences. We solicited manuscripts from disability advocates and disability scholars, most of whom we knew opposed assisted suicide; however, we believe the varied approaches of the authors broadened the discussion and every article contains a literature review. In total, this issue contains important and thoughtful articles about assisted suicide written by scientists, lawyers, scholars, and disability rights advocates.Assisted suicide: Why this is an important issue for the Disability and Health JournalSuzanne McDermott10.1016/j.dhjo.2009.10.006Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-112http://www.disabilityandhealthjnl.com/article/PIIS193665740900185X/abstract?rss=yesAbstract: The Death with Dignity (DWD) Act, a physician-assisted suicide statute, was initially adopted in Oregon In November, 1994 and became operational in 1998. The purpose of this study is to: 1) determine the nature and form of the empirical literature on the Oregon DWD Act; 2) describe the effects of the DWD Act on Oregonians with disabilities according to the empirical literature; and 3) present opinions held by a group of Oregonians with disabilities about the DWD Act and its effects. A literature review and focus group were conducted for this study. Thirteen empirical studies and 11 state annual DWD reports werw included in the literature review. Review of the empirical literatuer on DWD in Oregon reveals a number of potential concerns, including inadequate demographic profiling of DWD requesting patients, inadequate mental health evaluations, insufficient duration of physician-patient relationships, potential inaccuracy of the six month prognosis, and inadequate exploration of alternative treatment. These concerns suggest that the DWD reporting system may be inadequate and lack sufficient safeguards. The focus group revealed that there are multiple facets to the DWD issue. Within the disability community, there does not seem to be unequivocal support for one viewpoint over another.The Oregon Death with Dignity Act: Results of a literature review and naturalistic inquiryCharles E. Drum, Glen White, Genia Taitano, Willi Horner-Johnson10.1016/j.dhjo.2009.10.001Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-1315http://www.disabilityandhealthjnl.com/article/PIIS1936657409000739/abstract?rss=yesAbstract: This article is an overview of the problems with the legalization of assisted suicide as public policy. The disability community's opposition to assisted suicide stems in part from factors that directly impact the disability community as well as all of society. These factors include the secrecy in which assisted suicide operates today, in states where it is legal; the lack of robust oversight and the absence of investigation of abuse; the reality of who uses it; the dangerous potential of legalization to further erode the quality of the U.S. health care system; and its potential for other significant harms. Legalizing assisted suicide would augment real dangers that negate genuine choice and self-determination. In view of this reality, we explore many of the disability-related effects of assisted suicide, while also addressing the larger social context that inseparably impacts people with disabilities and the broader public. First, after addressing common misunderstandings, we examine fear and bias toward disability, and the deadly interaction of assisted suicide and our profit-driven health care system. Second, we review the practice of assisted suicide in Oregon, the first U.S. state to legalize it, and debunk the merits of the so-called Oregon model. Third and finally, we explore the ways that so-called “narrow” assisted suicide proposals threaten inevitable expansion.Killing us softly: the dangers of legalizing assisted suicideMarilyn Golden, Tyler Zoanni10.1016/j.dhjo.2009.08.006Disability and Health Journal 3, 1 (2010)2009-11-05Disability and Health Journal2009-11-0531S1936-6574(09)X0005-11630http://www.disabilityandhealthjnl.com/article/PIIS1936657409001873/abstract?rss=yesThe arguments that disability rights advocates present in opposition to legalized assisted suicide are frequently misconstrued in public debate. The goal of this paper is to identify and analyze key “straw man” fallacies about the disability rights opposition in order to clarify this position and the factors that contribute to its distortion. The author adopts a first-person perspective as a disability scholar/activist who has participated in “right to die” debates for over two decades. Three possible barriers that potentially impede comprehension of disability rights arguments are discussed. Prominent fallacies that assisted suicide proponents attribute to disability rights opponents are analyzed in relation to the dynamics of the assisted suicide debate, social views of disability and incurable illness, and available evidence. The author's position is that disability rights arguments against legalized assisted suicide contribute a complex intellectual and experience-based perspective to the debate that can illuminate immediate and distal consequences of altering public policy.No, we don't think our doctors are out to get us: Responding to the straw man distortions of disability rights arguments against assisted suicideCarol J. Gill10.1016/j.dhjo.2009.10.003Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-13138http://www.disabilityandhealthjnl.com/article/PIIS1936657409000892/abstract?rss=yesAbstract: Not Dead Yet is a national disability rights organization formed in 1996 to articulate and organize the disability rights opposition to legalization of assisted suicide. In the first half of 2009, Not Dead Yet and four other national disability organizations joined in an amicus brief filed in Baxter v. State of Montana, an assisted suicide case on appeal to the state Supreme Court. Autonomy, Inc., another disability organization, filed an amicus brief in favor of a constitutional right to assisted suicide. The author reviews the lower court opinion and the key arguments in these amicus briefs from the perspective of Not Dead Yet. The Montana District Court concluded that the privacy and dignity provisions of the Montana Constitution establish a constitutional right to physician assisted suicide for terminally ill people, and that potential abuses of that right could be regulated by state statute. The author addresses the question, “What does disability have to do with it?” The author uses a combination of clinical research, legal analysis and the Oregon Reports on assisted suicide to examine the claim that abuses can be prevented by restricting assisted suicide to competent people who are terminally ill and choose it voluntarily. Autonomy, Inc.'s arguments explicitly depend on the medical profession's ability to reliably predict terminal status, and the capacity of society and the law to implement a double standard of suicide prevention and suicide assistance based on terminal status. Not Dead Yet's central argument is that such a double standard based on health status constitutes unlawful discrimination under the Americans With Disabilities Act. The author highlights data from the Oregon Reports demonstrating that lethal prescriptions were issued to people who were not terminally ill under the law's definition, and examines various problems of implementation and enforcement under the Oregon and Washington assisted suicide statutes. Particular attention is given to the problems associated with the role of physicians as gatekeepers under the statutes, providing examples of physicians pressuring people to forego life-sustaining treatment and involuntarily withholding life-sustaining treatment.Assisted suicide laws create discriminatory double standard for who gets suicide prevention and who gets suicide assistance: Not Dead Yet Responds to Autonomy, Inc.Diane Coleman10.1016/j.dhjo.2009.09.004Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-13950http://www.disabilityandhealthjnl.com/article/PIIS1936657409001861/abstract?rss=yesAbstract: Background: A policy resolution supporting physician aid in dying was proposed to the American Public Health Association (APHA) in 2007 that prompted a debate with the Disability Section on its meaning for people with disabilities.Objective: The present paper reflects on the issues revealed and lessons learned.Methods: The debate included subcommittee discussion; review of research, polls, administrative reports; discussion with disability rights organizations; and floor-debate and vote by the APHA Governing Council.Results: Reflections on the process are summarized under the themes: we all have our own views; it's highly personal; confusion among key concepts; I might want it for myself; it's about control and not about pain; the slippery slope and other arguments; and undue burden on people with disabilities.Conclusions: The APHA resolution supporting aid in dying was passed in 2008 with some improvements in the language and a recommendation to measure pre-existing disability. Valuable lessons were learned through the debate process.Reflections on the debate on disability and aid in dyingGloria L. Krahn10.1016/j.dhjo.2009.10.002Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-15155http://www.disabilityandhealthjnl.com/article/PIIS1936657409001514/abstract?rss=yesAbstract: Background: In 2008 the American Public Health Association endorsed lethal ingestion as a public health policy as part of “Patients' Rights to Self-Determination at the End of Life.” Although rhetoric framing physician-assisted suicide (PAS) invokes individual autonomy, public health's focus is populations. Even regarding treatment refusal, its logic and coercive power (e.g., quarantine) subordinate autonomy to population interests. Research indicates health practitioners and disciplines that are closer to persons with terminal conditions oppose more PAS than those having little contact: specifically, public health associations are more willing to authorize life-ending means than disciplines directly caring for the dying. Why is that the case and with what consequences for populations and public health?Methods: Contextual analysis of semantics; policy submissions; standards; statutory and regulatory documents; related economic, equity, and demographic discourses is employed; and, finally, scenarios offered of the future.Results: Notwithstanding rhetoric invoking autonomy, public health's population orientation is reflected in population health measures (e.g., aggregated DALYs, QALYs) that intimate why public health might endorse availing life-ending means. Current associated statutes, regulations, terminology, and data practices compromise public health and semantic integrity (e.g., the falsification of death certificates) and inadequately address population vulnerabilities. In recent policy processes, evidence of patient and system vulnerabilities has not been given due weight while future-oriented scenarios suggest autonomy-based rationales will increasingly yield to population-driven rationales, increasing risk of private and public forms of domination and vulnerabilities at life's end.Conclusion: Public health should address institutionalized violations of data integrity and patient vulnerabilities, while rescinding policy supporting the institutionalization of lethal means.Public health, populations, and lethal ingestionKirk C. Allison10.1016/j.dhjo.2009.09.005Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-15670http://www.disabilityandhealthjnl.com/article/PIIS1936657409002003/abstract?rss=yesEditorial Board10.1016/S1936-6574(09)00200-3Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-1FrontmatterA1A1http://www.disabilityandhealthjnl.com/article/PIIS1936657409002027/abstract?rss=yesTable of Contents10.1016/S1936-6574(09)00202-7Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-1FrontmatterA3A3http://www.disabilityandhealthjnl.com/article/PIIS1936657409002039/abstract?rss=yesAuthor Information10.1016/S1936-6574(09)00203-9Disability and Health Journal 3, 1 (2010)2010-01-01Disability and Health Journal2010-01-0131S1936-6574(09)X0005-1FrontmatterA4A5