Comment: Further Consideration on the Relationship Between the Americans with Disabilities Act, Supported Decision-Making, and Medical Aid in Dying

• Published in: Washington and Lee law review Vol. 80; no. 1; pp. 617 - 624
• Main Author: Heller, Amitai
• Format: Journal Article
• Language: English
• Published: Lexington Washington & Lee University, School of Law 01.01.2023
• Subjects: Americans with Disabilities Act 1990-US; Assisted suicide; Communication; Decision making; Disability; Health care; Palliative care; Participation; People with disabilities; Physicians; Oregon; United States > US
• ISSN: 0043-0463; 1942-6658

While the extension of supported decision-making to end-of-life medical decisions may seem logical to people with disabilities and their network of supporters, the inclusion of the model in end-of-life decision-making has the potential to challenge healthcare professionals' pre-existing notions of competency and autonomy, as a communal approach to decision making may be at odds with a more individualized doctor-to-patient form of decision-making. As such, the lack of familiarity with supported decision-making in the healthcare setting could lead healthcare providers to feel discomfort in participating in the end-of-life care of individuals who make use of the model. Such discomfort could result in both substandard care and incorrect determinations of eligibility for end-of-life options on the basis of a misunderstanding of the supported decision-making process. Further, some doctors may erroneously determine that an outright refusal to treat such patients is preferable to having to wrestle with unfamiliar frameworks for determining competency. Here, Heller suggests that the acceptance of the use of the supported decision-making model for end-of-life care by healthcare providers is one that is likely required by the Americans with Disabilities Act.