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Tag Archive: Amelia Rivera

Jan 22 2012

Amelia Rivera’s Story: Deconstructing the Bigotry


****This is the second very special guest post by Rachel Cohen-Rottenberg of Journeys with Autism She is heavily involved in raising awareness about the case of Amelia Rivera. Amelia Rivera is the little girl being refused an organ transplant because of “mental retardation”.

I spoke with Rachel and asked how I could help and she provided this post, which is the second. Please read these posts and help spread the word about this grave injustice.****

 

Over the past few days, the story of Amelia Rivera has made the local, national, and international news. It’s been picked up by such media outlets as the AP, NBC News, ABC News, Good Morning America, Fox, and CNN.

It’s nothing less than a miracle that this story has gotten so much attention, and it’s due to the efforts of thousands of people who are still shouting from the rooftops that what is happening to Amelia is wrong. I’m thrilled to see the story getting so much press.

But the exposure is also bringing the bigots out of the woodwork. In the comments sections, they’ve shown up in force, saying the same things, over and over, and patting one another on the back for how sensible they’re being.

To the unpracticed eye, they may not look like bigots. They’re not sprinkling their comments with racial, ethnic, or anti-Semitic slurs. Most of them aren’t throwing around words like “retard” or “mong.” And some of them are quite well-spoken, talking about “hard choices” and “cost effectiveness” and “quality of life.”

But beneath all of it — all of it — is a pervasive devaluation of the lives of disabled people. This devaluation is so pervasive that it’s like the air these people breathe: invisible and unnoticed. They don’t even question its existence. And with devaluation comes bigotry, just as surely as the sun rises in the morning.

I’ve been advising people not to get caught up in arguing with the commenters. I’ve left a response on a few stories, mainly to speak up for Amelia — and for all of us — for the sake of people who are open to questioning their assumptions. But I will not attempt to argue with a hatred that devalues human life; to do so is to assume that people are being rational when they are not. And I’m not going to read all of the comments, because they’re variations on a theme, and I’ve heard the song more times than I’d like to remember, and I could sing it to you by heart.

But I want to speak to the main tropes, because anyone with an interest in these issues is sure to run across them, and I’d like to help untangle what’s going on. And, truth be told, my interest is also personal: If I don’t deconstruct the mind-numbing bigotry in what I’ve read, I’ll be snarling at the comments inside my head for days to come.

1. Amelia should not get the transplant because the taxpayers will have to pay for her care for the rest of her life.

First, of course, we have a human life valued in dollars and cents. Second, we find the rather stark omission of the fact that able-bodied people reap the benefits of a society built just for them, and that disabled people are begrudged whatever we happen to get for ourselves. And third, we get the familiar trope of a disabled person as a burden — as though it were not an honor and an expression of our highest humanity to help to care for any person, disabled or not, and to provide the most dignified, safe, and fulfilling life possible.

2. Amelia shouldn’t get a kidney. A transplant is a precious gift. The kidney should go to a more deserving person who will have a normal, healthy, productive life.

Note the ellision of “deserving” with “normal.” Note the ellision of “healthy” with “normal” — as though a disabled person cannot also be healthy. Note the ignorance that says that to be disabled is automatically to suffer. Note the utter lack of consciousness that we suffer because of these kinds of statements and the kinds of discrimination they lead to. And, most importantly, note the pernicious idea that “normal” people are more deserving than disabled people because they can be “productive” — as though productivity and human worth were exactly the same thing, and as though human worth were not inherent in every person

3. Amelia’s parents are being selfish. The poor child. They should just let her die.

This is a version of Wouldn’t she be better off dead? Of course, this statement derives from a fear of disability on the part of able-bodied people, who would consider it a tragedy to be anything other than “normal.” It does not derive from any knowledge of Amelia’s present condition, which is wrongly assumed to be miserable. And it implies that the parents should just throw the child away, like a broken car part — an implication that would never be made were Amelia an otherwise able-bodied child who needed a transplant to save her life.

4. Amelia is only three years old. How can you put a cognitively disabled child through a painful procedure she has no way of understanding?

By this logic, you shouldn’t put any child through any painful procedure to preserve life. And make no mistake: If Amelia were a non-disabled child being denied a transplant, these same people would be screaming about medical neglect. The double standard is revealing.

5. Amelia’s doctors couldn’t possibly be denying her a transplant on the basis of her cognitive status alone. Amelia’s mother must have misunderstood — either that or she’s just trying to start a media storm.

In other words, Amelia’s mother is misrepresenting what happened. Of course, there is no basis on which to make this assumption. In fact, it bespeaks an extreme level of denial about widely accepted discrimination against intellectually disabled people when it comes to organ transplant, and it reflects a deep desire to rest easy in one’s illusion that doctors are always fair-minded and always exercise good judgment. If anyone says anything to threaten that illusion, as the Riveras have done, the response is that they either have some sort of hidden agenda or simply can’t grasp what’s being said to them. So rather than acknowledging that authority figures are human, and that some of them say unbelievably cruel and messed-up things, they attack the Riveras as being duplicitous or stupid. Or both.

6. I’ve had a transplant and have gone on to live a normal life, so I know the vetting process. It’s very complicated. They don’t just disqualify people based on intellectual ability.

This statement ignores the obvious fact that just because an otherwise able-bodied person wasn’t discriminated against, it doesn’t mean that discrimination doesn’t exist. This is like a white person saying, “I’ve never been discriminated against in a hospital, so it must not happen to people of color.”

What can you say to that except, “Wake up”?

7. We have to make these decisions based on quality of life, and disabled people have less quality of life, so they shouldn’t get the transplants if there are “normal” people waiting.

The assumption here is that disability is inversely correlated with quality of life: the more disabled you are, the less quality of life you have. Of course, there are many disabled people with a very good quality of life, and many non-disabled people with a very poor quality of life. Beneath the assumption that disability means poor quality of life is another: that if we do have a poor quality of life, it’s because of the condition of our bodies, not because we live in a society that discriminates against us at every turn. So rather than question why a disabled person might have a poor quality of life, people locate the problem in the disabled person.

It’s an excellent way to avoid making social change. After all, if the society just lets people like Amelia die, so the logic goes, the problem is solved, and everyone is absolved of responsibility. Except, of course, that no such absolution is possible.

8. There aren’t a lot of organs out there, and people need to make rational, objective, cold, and calculated decisions about who gets them.

The decision to deny an organ transplant only on the basis of intellectual disability may be cold and calculated, but it is certainly neither reasonable nor objective. It’s based on ignorance and prejudice, as are all the arguments for it.

9. God created Amelia’s condition, and we should just let God’s will be done. If her kidneys fail, that’s what God wants.

A person making such a statement would never suggest withholding medical treatment from a young able-bodied boy stricken with cancer, or a young able-bodied mother who comes down with pneumonia. But apparently, in the minds of those who say such things, God has a different standard for disabled people.

You know that God you don’t believe in? I don’t believe in that God either.

10. I don’t mean to sound harsh, but [insert statements 1-9 here].

The only answer I can give is to say, “Harsh doesn’t cover it. You’re being dehumanizing. Keep your mouth shut.”

These kinds of statements should be a wake up call to anyone who hasn’t yet understood that if Amelia Rivera can be denied life-saving treatment, it could happen to any one of us. If you feel moved to wade into the muck and respond to the comments on any of the major news sites, on this issue or others like it, please feel free to pick and choose from my responses. There is no use reinventing the wheel when we have social justice work to do. But mostly, I hope that you will keep your mind and your heart on the thousands upon thousands of people who recognize the worth and the dignity of every life. We are a force to be reckoned with.

© 2012 by Rachel Cohen-Rottenberg

Permanent link to this article: http://lostandtired.com/2012/01/22/amelia-riveras-story-deconstructing-the-bigotry/

Jan 22 2012

A Stunning Injustice: The Case of Amelia Rivera


****This is a very special guest post by Rachel Cohen-Rottenberg of Journeys with Autism.  She is heavily involved in raising awareness about the case of Amelia Rivera. Amelia Rivera is the little girl being refused an organ transplant because of “mental retardation”.

I spoke with Rachel and asked how I could help and she provided this post, which is the first of two. Please read these posts and help spread the word about this grave injustice.****

 

Of all the forms of inequality, injustice in healthcare is the most shocking and inhumane. — Martin Luther King, Jr., March 25, 1966

By now, many of you are familiar with the story of Amelia Rivera, a three-year-old child with Wolf-Hirschhorn Syndrome who has been denied a life-saving kidney transplant at the Children’s Hospital of Philadelphia on the basis of her intellectual disability.

Amelia’s mother Chrissy has described the circumstances of the denial in her post Brick Walls. At a meeting with Amelia’s doctor, Chrissy and her husband were given two pieces of paper on which the words “Mental Retardation” and “Brain Damage” were highlighted in pink. Here is part of the interchange that ensued between Amelia’s mother and the doctor:

I point to the paper and he lets me rant a minute. I can’t stop pointing to the paper. “This phrase. This word. This is why she can’t have the transplant done.”

“Yes.”

I begin to shake. My whole body trembles and he begins to tell me how she will never be able to get on the waiting list because she is mentally retarded.

A bit of hope. I sit up and get excited.

“Oh, that’s ok! We plan on donating. If we aren’t a match, we come from a large family and someone will donate. We don’t want to be on the list. We will find our own donor.”

“Noooo. She—is—not—eligible –because—of—her—quality– of –life—Because—of—her—mental—delays” He says each word very slowly as if I am hard of hearing.

“STOP IT NOW!” The anger is taking over. Thank God. Why did it take so long to get here?

When I first read these words, I felt so outraged by the injustice, so heartbroken for Amelia and her family, and so disgusted by the doctor, that I was at a loss for how to respond.

Not anymore. This case is not just about one precious child. It’s about the ways in which the devaluing of disabled lives has found its way into a discussion of whether to let this precious child live.

The sheer weight of ignorance about the lives of disabled people couldn’t be any more clear than in the doctor’s presumptions about Amelia’s quality of life. As the late Harriet McBryde Johnson wrote in her brilliant article Unspeakable Conversations, the judgments of medical professionals about the quality of life of disabled people tend to be greatly at odds with the judgments of disabled people themselves: “The social-science literature suggests that the public in general, and physicians in particular, tend to underestimate the quality of life of disabled people, compared with our own assessments of our lives.” This disparity begs the obvious question: On what basis can a doctor — or anyone else, for that matter — possibly assess the future quality of another person’s life? Unfortunately, there is an answer to this question, and it’s not pretty: The basis for such a judgment is that the person will not live the life of a so-called “normal” person, and that therefore, the person’s life is diminished in worth.

The Nazis had a term for such a life: Lebensunwertes Leben. Life unworthy of life.

And because Amelia has been deemed unworthy of life, she has been given a death sentence by her doctor. As though that weren’t enough of an outrage, enter the social worker, who said to Amelia’s mother:

Well, you know a transplant is not forever. She will need another one in twelve years. And then what? And do you have any idea of the medications she will need to take to keep her healthy?”

[W]hat happens when she is thirty and neither of you are around to take care of her. What happens to her then? Who will make sure she takes her medications then?

For anyone who is unsure whether these words mean what you think they mean, let me translate: According to the social worker and her crystal ball, Amelia will not be capable of keeping track of her medications when she is thirty, so she should die in the next six to twelve months.

Never mind that Amelia may be fully capable of keeping track of her medications at thirty. Never mind that if she can’t keep track of her medications when she is thirty, society has an obligation to provide her with assistance to ensure her quality of life. Never mind that every human being is owed pure respect and limitless love. Never mind that we actually live in society with other people who have the choice to either help us or leave us to die. By the social worker’s reasoning, people who cannot remember to take their medications, people who cannot lift their hands to reach their medications, people who cannot put their hands to their mouths to take their medications, people who cannot afford medications in the first place, have lives unworthy of life.

I wish I could believe that the danger facing this one little girl stops with her. I wish I could believe that this case is an aberration. But I know better. Consider the following:

A 2006 article called Dispute Over Mental Competency Blocks Transplant describes the case of Misty Cargill, who was denied a kidney transplant because of her intellectual disability, and contains the following statement:

When Mary Ellen Olbrisch, a clinical psychologist at Virginia Commonwealth University Medical Center in Richmond, surveyed nearly 100 transplant centers, about 60 percent said they’d have serious reservations about giving a kidney to someone with mild to moderate mental retardation.

A 2010 article called Transplantation and Mental Retardation: What is the Meaning of Discrimination?, contains information on international organ transplant guidelines, some of which note that intellectual disability should contraindicate organ transplant:

A consensus report from the Pulmonary Scientific Council of the International Society for Heart and Lung Transplantation states that the presence of MR represents a contraindication for transplantation. The report states that transplantations should not be provided on the basis of ‘the documented non-adherence or inability to follow through with medical therapy or office follow-up or both, untreatable psychiatric or psychological conditions associated with the inability to cooperate or comply with medical therapy, absence of a consistent or reliable social support system’. (728)

Please note the rather chilling idea that the lack of a “social support system” should amount to a death sentence

Another 2010 article, called What do you expect? She is mentally retarded!, contains an excellent discussion about the depth of the problem, with the testimonies of parents who have seen their children denied organ transplants:

[P]arents have reported that it has not been unusual for their sons or daughters to be disallowed recipient status for organ transplant surgery, with disability given as the reason for exclusion:

“I was told by her cardiologist that she is not eligible for a transplant because of her Down syndrome.”

“We were told that if he was ‘normal’ like us he would be a great candidate for a corneal transplant.”

“The first doctor we saw told us that no transplant could be done because our son was ‘retarded’”.

“I was told that at the university hospital they will transplant a kidney but not even consider a heart transplant for someone with Down syndrome”.

If anyone believes that the devaluing of the lives of disabled people is simply a question of architectural barriers, job discrimination, and social exclusion, think again. Sometimes, it turns lethal.

But we can act to save the life of Amelia Rivera, and all the other Amelia Riveras out there. Please do the following:

Leave a message on the Facebook page of the Children’s Hospital of Philadelphia:

http://www.facebook.com/ChildrensHospitalofPhiladelphia

Contact the Children’s Hospital of Philadelphia’s Family Relations Office by phone at 267-426-6983 or by e-mail at FamilyRelations@email.chop.edu.

Sign the petition at Change.org:

http://www.change.org/petitions/executive-vice-president-and-chief-development-officer-allow-the-kidney-transplant-amelia-rivera-needs-to-survive

Consider contacting the following media outlets so that Amelia’s story reaches a wider audience:

http://www.facebook.com/WBRETV?sk=wall
http://www.facebook.com/PhillyDailyNews
http://www.facebook.com/pages/Philadelphia-News/129580433764477
http://www.facebook.com/phillyinquirer
http://www.facebook.com/6abc.ActionNews

And please, post to the Facebook page set up to support Amelia and her family:

http://www.facebook.com/miastransplant

Together, we can help this child live.

Sources

Johnson, Harriet McBryde. 2003. “Unspeakable Conversations.” The New York Times, February 16. Accessed January 15, 2012. http://www.nytimes.com/2003/02/16/magazine/unspeakable-conversations.html?pagewanted=all&src=pm.

Panocchiaa, N., M. Bossolaa, and G. Vivantib. “Transplantation and Mental Retardation: What is the Meaning of Discrimination?” American Journal of Transplantation 10 (2010): 727–730. doi: 10.1111/j.1600-6143.2010.03052.x.

Shapiro, Joseph. 2006Dispute over Mental Competency Blocks Transplant.” NPR, December 22. Accessed January 15, 2012. http://www.npr.org/templates/story/story.php?storyId=6665577.

Simpson, J.H. “’What do you expect? She is mentally retarded!’: On Meeting the Health Challenges of Individuals with Intellectual Disability.” The Internet Journal of Health11, no. 1 (2010). http://www.ispub.com/journal/the-internet-journal-of-health/volume-11-number-1/what-do-you-expect-she-is-mentally-retarded-on-meeting-the-health-challenges-of-individuals-with-intellectual-disability.html.

Wolfhirschhorn.org“Brick Walls.” http://www.wolfhirschhorn.org/2012/01/amelia/brick-walls/. January 10, 2012. Accessed January 15, 2012.

© 2012 by Rachel Cohen-Rottenberg

Permanent link to this article: http://lostandtired.com/2012/01/22/a-stunning-injustice-the-case-of-amelia-rivera/

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