October 24, 2016

What Does The “Death with Dignity” Debate Mean To D.C.’s African American Community?

By Ingalisa Schrobsdorff

The D.C. Council is currently debating a “Death With Dignity Act” modeled on similar laws in Oregon and California, which would allow mentally-fit patients with fewer than six months to live access to medical aid in dying. Some in D.C.’s African American community fear laws like the “Death With Dignity Act” could target poor people of color who rely on government health care when end-of-life care becomes too expensive. On The Kojo Nnamdi Show, Carmack Waterhouse Professor of Law, Medicine, Ethics, and Public Policy Patricia King of Georgetown University and Pastor Joyce Scott of Inspired By God Fellowship Ministries explored the following reasons why some members of D.C.’s African American community oppose the legislation.

1. African American distrust of the medical establishment goes back a long way.

For black Americans, there is a long legacy of distrust of the medical establishment –from slavery through the Tuskegee experiments, when researchers overlooked potentially life-saving treatments for Black men with syphilis. King notes those concerns aren’t necessarily relegated to the past, given the ways racism and unconscious bias continue to affect society today. A relatively recent example includes an ethically-suspect study of the effects of lead paint on black children in Baltimore in the 1990s.

“We’ve been ignored, experimented on, but most importantly, not listened to.”
-Patricia King

2. “Death With Dignity” won’t hold anyone accountable if misused.

On air, Scott, of the Inspired By God Fellowship Ministries in Ward 8, voiced concern over who would monitor insurance companies to ensure they would not withhold or withdraw expensive care from elderly and poor black patients.

3. If autonomy matters in the “Death With Dignity” debate, then put health care access first.

Access to care matters in these cases, said King. It helps, especially, to address this with the understanding of African Americans’ history with the medical community.

“If you can’t get healthcare, if you don’t have a primary care physician, if you’re economically disadvantaged, then we have to be careful about talking about autonomy.”
–Patricia King

4. What works for Oregon might not work for D.C.

Oregon has had a “Death with Dignity” law in place for nearly two decades, but it’s difficult to draw conclusions or compare it to a place like the District, in part because Oregon has a 2 percent African American population compared to D.C., which is 49 percent black. Some suggest lawmakers look at California instead, a much more diverse state which recently implemented a “Death with Dignity” law.

5. Death With Dignity debates often don’t start with African Americans.

Ward 8 Councilmember LaRuby May called in during the show and said during her community outreach on the “Death with Dignity Act,” which she supports, she heard from people in favor, people in opposition and others who needed more education on the legislation. But she made a larger point to press people in her community to think more about end of life decisions. “We know that in the African American community, those end of life things —wills and health directives— are things we have not traditionally done well,” said May. She then urged pastors to go to the pulpit —even if they don’t support the legation— to encourage their congregations to begin to think about these difficult issues.

“In vulnerable communities we have to talk about death and dying more. We have to think about who we want to speak for us, we have to have to talk about what frightens us, and what things we would like at the end of life. Death is a subject we just don’t want to talk about, but we must talk about.”
-Patricia King


Listen to the full conversation with Prof. Patricia King and Pastor Joyce Scott online, and revisit our conversation featuring D.C.’s “Death With Dignity” supporters. Do you think medical aid in dying is seen differently by different communities? What about those in religious communities, people with disabilities and African Americans? Leave us a message at 202-885-1450 or weigh in with your thoughts in the comments below.