Disability Rights and Bodily Autonomy

Shiva has an intriguing post up about assisted suicide and "mercy" killing --- as a libertarian, he is obviously in favor of the former and opposed to the latter. While most of his post is about recent assisted-suicide cases in the UK, and specific details thereof, it's the general principles I want to respond to:

The thing I really want to get to here, though, is the concept of "mercy killing". I want to say, as emphatically as possible, that there is no such thing. If Lynn Gilderdale's mother was actively involved in her death [link], then it was either murder or assisted suicide - if Lynn did not ask her mother to help her take the overdose, then it was the former, and if she did it was the latter. As, according to the Mail report [link], she had twice attempted suicide already by the same method (although it does not say why she was not successful), in this particular case assisted suicide looks more likely - but that doesn't equate to "mercy killing", which term suggests a person being killed, not at their own request, but based on the decision of the killer, not the killed, that killing them would be more "merciful" than letting them live.

That is killing someone against their will, and that, emphatically and undeniably, is murder. In fact, as far as I'm concerned, it's a worse kind of murder than one motivated by hate, anger or jealousy. Murder with those motives I can understand, but the monstrous twistedness of the mentality of someone who claims to murder someone else out of love utterly terrifies me, so much that I can hardly write coherently about it. A society in which familial love can be twisted into wishing those you love dead, apparently doing so because you love them, is a society there is something deeply, horrifically wrong with.
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It would logically not need to be said, but probably still bears repeating, that in a libertarian worldview this is totally different from assisting with a person's own decision to end their life, even though (as I said in my previous post on the subject) the mainstream media (and seemingly some parts of the disability rights movement) insist on conflating them.

I said in a comment on his post that I could see being against even assisted suicide from a disability-rights perspective: in the ableist, profoundly stratified society we live in, where access to needed supports is often confined to those who can pay for them, more people may choose to end their lives than would in a more accessible, egalitarian society, and many of those people could not be said to have "chosen" their fate so much as to have been pushed into it by myriad external forces. It is not hyperbole to say that this, if it became widely practiced, would constitute genocide.

This conflict between the individual's right to hir own body and the existence of social conditions that make some choices problematic comes up in a few other issues at the intersection of feminism and disability rights: sterilization, genetic testing and selective abortion.

Most feminists believe that women have the right to absolute reproductive freedom --- that they ought to be free to make whatever choice, for whatever reason, irrespective of whether it's a good reason. That includes the freedom to abort a perfectly viable, uncomplicated pregnancy if she discovers the fetus will be born with a disability. Disability-rights activists, even feminist ones, do not much like that possibility. They condemn prenatal testing for such conditions as Down syndrome, autism and whatever else as eugenic, and abortions sought on the basis of positive results to such tests as genocidal.

In the objections to both assisted suicide and selective abortion, in addition to the immediate concern that any individual's rights are being violated, there's an overarching concern about the direction society will take (with respect to disability rights). Since individual solutions to these problems (of severe disability, prolonged illness, or pregnancy with a disabled fetus) cost society nothing, while systemic solutions (greatly improving the quality and availability of healthcare, reworking infrastructures to make them more accessible, changing cultural attitudes toward disability, etc.), though they are often the best solution, and though they solve the problem once and for all rather than one instance at a time, cost a lot in money, time and effort. Especially with selective abortion, there is a fear that people with whatever disability is being talked about (usually Down syndrome) might become such a tiny numerical minority due to selective abortion that social supports for them will atrophy, having become no longer cost-effective. No choice is made in a vacuum, these critics say, and even when they do not wish to bar women from getting selective abortions, they call on women to realize that their choices, in aggregate, will have effects far beyond their own lives, and to factor the likely impact of different courses of action into their choices.

This same question lies at the heart of the endless quarreling within feminism over pornography and prostitution. How can the right of those women who choose to be sex workers to do whatever they want with their own bodies be squared with the rights of other women who were forced into sex work? Furthermore, how can the right to do sex work be reconciled with the endemic cultural stew of woman-hating imagery of which sex work is part and parcel?

In all of these quandaries, I think the right choice lies in preserving the greatest possible level of individual freedom (in other words, yes, you should be free to decide to die, even if you need help performing the life-ending act; yes, you should be free to get an abortion for whatever reason; and yes, you should be free to use your body however you like, and to choose whatever line of work you want, even if most people wouldn't approve of your choices) while simultaneously pursuing a more equal society with the vigor that comes from knowing that, even with the whole panoply of individual solutions open (theoretically) to all, most people will be restricted by economic, personal and social circumstances to a few bad choices.

Systemic solutions don't destroy people's freedom to pursue individual solutions; they just make it less likely that very many, outside the elite, will do so.