WASHINGTON, D.C.—With signs and banners and much shouted advice, people with disabilities told the Supreme Court Jan. 6 that “We're not dead yet!” and “We want to live!”

While the court heard oral arguments in two cases that could lead to approval of physician-assisted suicide, protesters outside the court said people with disabilities are already dying from neglect, despair, and pressures to sign “do not resuscitate” orders. “You can't get into a hospital without signing those damn things,” Lucy Gwin told scores of demonstrators in wheelchairs and on crutches. “That ain't right. People are dyin'of this right now. There's a rage for death on the land, and we are the targets.”

Gwin, editor of a disability community magazine called Mouth, suggested that assisted suicide, if legalized, will be used to solve cost problems in health care. “We're too expensive to [keep alive],” she said, but then added, “everybody is too expensive to live.… We got five corporate CEOs who are not too expensive to live, eh? And the rest of us are all gonna die?”

“This is not gonna happen,” she continued. “We're not gonna let them do this to us.” Referring to doctors who have already helped disabled or dying people commit suicide, she added, “I'm mad as hell, and I'm not gonna die for Jack Kevorkian or Tim Quill.… We will not go quietly.… You're not gonna herd us off one at a time quietly in little rooms. We're gonna be loud about this, because we want to live!”

The demonstration outside the court was organized by Not Dead Yet, a new disability-rights group. Bundled up against the winter cold, the protesters held signs proclaiming “Endangered Species,” “We Are the Target,” “Quiero Vivir” and “Hitler Would Be Proud.”

Supporters of assisted suicide said the “Not Dead Yet” protesters didn't understand the cases the Supreme Court was hearing. “I think they are very sadly misinformed and misguided,” said Roy Torcaso of Wheaton, Md., who had joined a band of Hemlock Society counter-demonstrators. They carried a large Hemlock banner and signs declaring: “We Support Physician Aid-in-Dying.”

The cases before the court, from New York and Washington State, deal with assisted suicide for the terminally ill. Torcaso said mentally-competent persons with “incurable disease”—and great pain that a doctor can't relieve—should have a right to medically-assisted suicide so they won't “botch a do-it-yourself job.”

Pat Belcher of Washington, D.C., a spokesman for the Hemlock demonstrators, said Not Dead Yet protesters had “been manipulated by the Catholic Church” and “filled with propaganda that allegedly doctors will now start killing them willy-nilly.”

Mary Jane Owen, executive director of the National Catholic Office for Persons With Disabilities, said the idea that Catholics controlled the demonstration was “absolutely ludicrous.” But Owen, who is blind and a wheelchair-user, spoke at the “Not Dead Yet” rally and recruited other Catholics to attend it. She remarked that “I am a convert—and in large part because of the Church's stand on life. I wanted to be part of a community that wanted me to live.”

Belcher told the Register: “We seniors, particularly, would like to die with dignity at a time of our choosing when life has become insupportable. If we are terminally ill and in a very undignified state, we do not wish to be in an alien hospital with tubes and so forth coming at us.” He said he believes that “legislation can be so framed that the doctors cannot abuse their privileges and arbitrarily kill people.”

Former Surgeon General C. Everett Koop, addressing the “Not Dead Yet” rally, said that approving doctor-assisted suicide, would “put us on a very slippery slope—which, indeed, to me looks like a precipice.” He said that assisted suicide would lead “to involuntary euthanasia—just as it has in the Netherlands.” Koop called assisted suicide “the most important and dangerous issue on the American agenda” and “a very real threat to disabled Americans.”

Meanwhile, Harvard Professor Laurence Tribe tried to convince the nine justices inside the court that there's a constitutional “liberty interest … when facing imminent and inevitable death, not to be forced by the government to endure a degree of pain and suffering that one can relieve only by being completely unconscious.”

Tribe and attorney Kathryn Tucker, who also argued for doctor-assisted suicide, had rough sledding inside the court, according to a hearing transcript published in The Washington Post. Even justices thought likely to be sympathetic to their cause asked tough questions.

Lawyers warn against reading too much into such questions, since justices often play the devil's advocate. Still, many foes of assisted suicide were optimistic after the court hearing. “I was somewhat encouraged by the drift of questioning,” Cardinal Bernard Law of Boston told the Register. The cardinal, who heads the Catholic bishops'pro-life committee, stressed the need for better pain control for the dying. He said it's “a particular task for Catholic health care … to show, indeed, how do you die with dignity.We are for that—not for murdering people, but for letting people die with dignity, compassion and love surrounding them.”

Addressing assisted-suicide supporters after the hearing Professor Tribe said the issue “is not a foregone conclusion for a good many of the justices,” but didn't look or sound confident about his side's chances.

Andrew Batavia, a Miami lawyer who wrote a pro-assisted suicide brief, told the group not to be “misled” by the “Not Dead Yet” demonstration. Speaking from his wheelchair, Batavia said there's a “very loud, vocal minority of people with disabilities who are very scared.” While conceding that they “have some legitimate concerns,” he said most people with disabilities support “the right to assisted suicide.”

Whichever way the court goes, the debate over assisted suicide may last a long time. While the court could say that states may ban assisted suicide, that's not the same as saying that they must.

In 1994, Oregon voters approved a law allowing assisted suicide for the dying; but that law is on hold while under court challenge. Since the Oregon vote, said Richard Doerflinger of the National Conference of Catholic Bishops, efforts to legalize assisted suicide have failed in every state where proposed. Doerflinger called the “Not Dead Yet” rally “a real watershed” showing that “many, many disability-rights activists have come to see this issue as their own.”

Mary Meehan is based in Rockville, Md.

Should Congress Step in?

WASHINGTON, D.C.—Could Congress step in and ban physician-assisted suicide? “Yes, they could,” said National Right to Life Committee general counsel James Bopp Jr. That “should be considered,” he insisted in a Jan. 7 interview, if there's a serious prospect of states legitimizing the practice. (Oregon did legalize it in a 1994 referendum, but a federal judge found the Oregon law unconstitutional. His decision is on appeal.)

Conservative Republicans in Congress tend to resist further expansion of federal power. Bopp said, however, that “many conservatives recognize that, while they want a limited government, there are legitimate roles for government”—and “the principal role is protecting life.”

But Rep. Charles Canady (R-Fla.), chairman of the House Judiciary subcommittee on the constitution, said last September that he doubted a federal ban would “move forward” in Congress because of “complicated constitutional issues.” Canady, an opponent of assisted suicide, suggested that he and others should instead “continue fighting in the courts” and try to ban the use of federal funds for assisted suicide or euthanasia.

On Jan. 8, the day the Supreme Court heard two cases on physician-assisted suicide, Sen. John Ashcroft (R-Mo.) and Sen. Byron Dorgan (D-N.D.) announced they'll introduce an anti-funding bill.

According to a description of the bill provided by Sen. Ashcroft's office, however, the bill will not limit withholding or withdrawal “of nutrition or hydration.” Evangelium Vitae states “… when death is clearly imminent and inevitable, one can in conscience ‘refuse forms of treatment that would only secure a precarious and burdensome prolongation of life, so long as the normal care due to the sick person in similar cases is not interrupted’” (65.2). Normal care includes at least nutrition and hydration.

—Mary Meehan