Several months before reading this, I ran across Harriet McBryde Johnson's piece 'Unspeakable Conversations' in the New York Times [1]. It's a disability-rights criticism of Peter Singer that I found interesting. The author had a congenital condition that was very disabling, requiring her to use a wheelchair. I was interested by her claim that disabled people self-report significantly higher quality of life than abled people (including doctors) would report on their behalf; this led me to recons

Several months before reading this, I ran across Harriet McBryde Johnson's piece 'Unspeakable Conversations' in the New York Times [1]. It's a disability-rights criticism of Peter Singer that I found interesting. The author had a congenital condition that was very disabling, requiring her to use a wheelchair. I was interested by her claim that disabled people self-report significantly higher quality of life than abled people (including doctors) would report on their behalf; this led me to reconsider how I think about becoming disabled and the life satisfaction for the disabled.This book is about as close to the opposite of Harriet's piece as I could imagine. Clayton strongly criticizes Not Dead Yet, the organization Harriet is affiliated with, and their beliefs. The fact that Clayton was paralyzed as an adult versus Harriet's congenital condition surely play as much a role in his position as Clayton's individual personality and circumstances. I found this book particularly interesting to consider in light of reading Harriet's piece. Seeing NDY essentially partner with Christian pro-life groups doesn't endear me to them, but strange bedfellows I guess.I think assisted suicide should be fully legal for anyone, so I agree with Clayton that assisted suicide should be available to the disabled. Among the benefits of this approach would be having a process that could force people to attempt different types of therapy and counseling to see if their minds can be changed with dedicated work, and allowing them a dignified, painless exit with support from friends or family otherwise.I disagree with several claims Clayton makes about resources spent on disabled care (e.g. about the 'head gardens'). They are very zero-sum and don't reflect that such resources are comparatively tiny in the world. It's hard to disentangle how much those statements are products of his depression and frustration with parts of the disability community or an intrinsic belief that 'head quads' could not lead internally meaningful lives (which I would disagree with.)I also think Clayton's machismo, as seen across the book (his self-assuredness, "When I look at my lower body it looks meek, almost feminine in its passivity", comments about fighting), could very well have contributed to his depression and inability to see a meaningful life as a disabled man.Though Clayton brings up the higher rate of suicide among people who experience a severe spinal cold injury, from trying to find information online I believe the overall number is still below 10%. That is not to discount Clayton's position or what I perceive as his human right to allow him to end his life with dignity, but to Harriet's point it may indicate that many become accustomed to their limitations and find ways to live their lives despite it. I suppose in the case of high quadriplegics they may not have such an option--I'd be interested to learn more about comparative suicide rates. I was surprised, but understood, when I found that numerous papers that try to estimate disability weights for calculating disability-adjusted life years treated severe spinal cord injury as more severe than blindness.The book deals with physical disability, though I think navigating assisted suicide with mental impairment (persistent vegetative states, dementia, Alzheimer's, etc.) is even more difficult to comprehend, especially as no state allows living wills/advance medical directives to make that decision on behalf of your future self. When I read Harriet's article I could understand her argument in the context of physical disability, but I identify 'myself' with 'my mind' and would not want to continue to be kept alive if that had gone. I'd run across disability-rights criticism of discounting the living value of the severe mentally impaired, but at least in my own case I would not want to be kept alive.These were my thoughts as I read this book, I have no idea how to honestly review it beyond that.[1] https://www.nytimes.com/2003/02/16/ma...