Should the Right to Die Include Mental Health?

 death blog

 

It was 1988 when my mom wrote the first in a series of letters to our Prime Minister at the time, Brian Mulroney, regarding being able to end her terminal illness in a manner in which she had some control. It was in 1989 that she contacted the Right to Die organization based in Oregon and after numerous rounds of correspondence was mailed a book written by the founder about euthanasia. This book was not only a memoir but contained information about certain drugs and the amounts that would be required to overdose. The letters and pleas continued, to no avail, and after battling cancer for six long years and deteriorating to the point of having no quality of life, on September 10th 1990, she took a lethal overdose of pills in the comfort of her home. She had spoken multiple times about this plan over the previous months and made it quite clear she had no intention of dying in hospital.  She already had a DNR (Do Not Resuscitate) order and wanted to have some control over the last moments of her life.

She lay in her bed for hours but had merely slipped into a coma which caused enough concern that she was transported to the hospital. When I arrived at the hospital and saw her lying motionless, she looked so peaceful, like she had fallen into the deepest of sleeps. She remained comatose for almost a week before shocking everyone and waking up, which no one could explain given that they said the number of pills that she had consumed would have killed a horse. She had nothing but painkillers and IV fluids and continued to rapidly decline. There was one more failed attempt in hospital before the last one finally brought her the peace she was so desperately seeking. That was October 5th, 1990. She had written nearly 100 letters.

In February 2015, the Supreme Court of Canada made physician assisted suicide (Euthanasia) fully available to all mentally competent Canadians with terminal illnesses. Prior to the ruling, assisted suicide was illegal in Canada and punishable by up to 14 years in prison. There are strict laws governing the process, such as assisted suicide not being available to minors and only available to those residents eligible for Canadian healthcare. It cannot be used to relieve the suffering of any mental illness or long-term disability and patients are not allowed to arrange to consent in advance to dying, for example in cases of dementia or Alzheimer’s. This protocol has sparked debates in many areas but none as big as when a parliamentary committee recommended that people with mental illness be eligible to seek euthanasia to end their lives in the same manner of those with a terminal illness.

An estimated 90% of suicides in North America are associated with some form of mental illness.

The Netherlands was the first country to legalize euthanasia in cases of terminal illnesses 13 years ago, and in that time, the practice has become legal in Belgium, Luxembourg and Switzerland as well as in five U.S. states…Washington, Oregon, Vermont, Montana and New Mexico. In Germany, doctors are able to provide patients with the necessary drugs for a medicinal suicide, but are not allowed to take any part of the actual suicide, such as guiding the patients or supporting their hand. The feelings are mixed when it comes to people’s beliefs of right and wrong, but if you have ever watched another human being slowly, painfully, rot away with not an ounce of dignity left, it might just open your eyes to the reasoning.

Assisted suicide based on psychological suffering is permitted in the Netherlands, Belgium and Quebec. A 2015 Netherlands euthanasia report stated that there were 5306 assisted deaths that year, with 41 being for psychiatric reasons, and 81 for dementia. In early 2012, a group called the Life-Ending Clinic went into operation for people whose doctors refused to assist in their suicides. The clinic has pushed the moral debate to its highest peak by helping people with chronic depression to die, and allowing some dementia patients to sign a euthanasia declaration in the early stages of their disease. In the past five years the number of assisted suicides has doubled and in Belgium it has increased almost 150%, amongst which has included people who have had autism, anorexia, borderline personality disorder, chronic fatigue syndrome and chronic depression. In two of the more famous cases, the women had suffered from multiple mental illnesses over the years, tried pills, therapy and everything else possible before giving up on the thought of their lives ever improving. Should doctors respect their wishes to die in the same way they would respect the wishes of a patient with stage four cancer?

With regards to mental illnesses, the biggest issues are whether legalized euthanasia can lead to a suicidal frame of mind based on a desire to escape prolonged suffering, and whether a person suffering from chronic mental illness has the capacity to make such a life and death decision. Given that mental illness can distort thinking and impair judgment, perhaps on the finality of the consequences, we have to question is it the rational mind speaking or the voice of the illness. “Right to Die” advocates point out that doctor assisted suicide would be less traumatic than a hanging or gunshot, for everyone involved. The protesters say that accepting euthanasia as an option for the mentally ill would create a presumption of sanity for those who attempt suicide or request assisted suicide as candidates are supposed to be mentally competent to make an informed and voluntary decision. Statistics say almost all people who die by suicide have mental health problems and there lies the conundrum.

Having had three failed suicide attempts myself, I question if I would even be here if euthanasia was available here in Canada for chronic depression. I wonder where this debate will take us in the future, but for now, I continue to fight.

 

 

 

Swallow My Pride

Sometimes life throws so much at us at once, we can no longer stand up without the assistance of others. We have to drop our guard, allow ourselves to be vulnerable and reach out for help regardless of our pride or shame. I had made it my whole life keeping both a roof over my head and employment until my breakdown over a year ago. The trauma of severe sexual abuse as an infant through to my early teens resurfaced and led me to a hospital trip where I was diagnosed with Borderline Personality Disorder, Major Depression with suicidal ideations and self-harm, and severe anxiety. I have since been in therapy and on medication and am trying my best to heal, but life keeps piling it on and I no longer can see a way out without any assistance, which means dropping my pride, which for me, is the ultimate sacrifice. I am on insurance disability who is now threatening to kick me off in 8 weeks, as that is the time frame they have deemed that I will be better enough to go back to work. I wish that was the case as I truly don’t want to stay in the system forever, but the truth is I am simply not well enough yet. I had to move which increased my rent and I am now facing the possibility of having no income. I will need to get a disability lawyer to help me get the rest of the time off that I need to heal, but because disability is already limited funds and with having to move, I simply cannot do this on my own, and unfortunately I do not have family to turn to for help. I am asking with all sincerity and humility for any financial help anyone could provide to help me get a lawyer. Anyone who knows me knows I would never reach out in this manner unless I was desperate, and right now I am. My time off will not be in vain as I am going to be working towards a being a certified Trauma Recovery Coach so I can give back, and help others. I would be humbled with any assistance anyone could provide to give me a helping hand. I promise to return the favor tenfold. Thank you so much and please be well.

https://www.gofundme.com/disabilitylawyer

 

Lost In the Darkness of the Jungle

 

dark jungle

 

They say that without darkness there is no light, yet I see not even a glimmer of light right now, like it has dissipated into tiny particles and scattered into obscurity, leaving me surrounded in a blanket of gloom.  I feel like I have been dropped off in to the depths of the jungle with no flashlight or compass, nor the light of the stars to guide me, with a deadline to somehow make my way out and back to a place where the light shines again. It feels like every step I take is through the thickest bush lined with vines of thorns and branches of spikes. I glance up hoping for even a glimmer of light to help light my trail but the density of the leaves form an umbrella of shade. I start a climb uphill only to have the earth give away under my feet. I have no sense of direction and feel like I have been wandering the same path in circles, or perhaps just always heading the wrong way, yet I keep walking.

I feel lost. Lost in every possible way; lost to the point that even if I was handed a map, I am not sure I could find my way out. Maybe I have been lost in this darkness for so long it has become my comfort. Perhaps a part of me doesn’t want to find a way out, not because it is easier to stay but because it is what is familiar to me and the unknown is frightening. Maybe there is an invisible string that pulls me back every time I follow that flash of light because I have unfinished business here. It might even be that I have convinced myself that without light I will finally succumb to the darkness, in which somewhere lays the only peace I can see. Why do the answers come so much easier in the shadows than in the light?

I am grasping for hope. Grasping on to anyone or anything that can help to fuel the reserve in my empty tank; probing for any reason, any purpose to continue this trek. I have looked and pulled from within for so long there is very little self-reliance left.  There is no unlimited stockpile of strength hidden somewhere deep within. There are not enough learned behavioral techniques in my mind to overcome the ingrained negativities that keep drawing me back into the darkness. I clutch on to anything I can…words, pictures, memories…anything that can provide a hint of this elusive thing called hope. I rely on my empathy for others to encourage myself to continue on this journey, after all, I may want out of the jungle but I certainly am not willing to drag someone in there with me to accomplish that.

I am afraid. Afraid that perhaps this jungle is actually my home; that there is no beaten path for me to follow or make to find my way home, and that the darkness is actually where I belong. I am afraid that no matter how hard I try or how far I travel that I may never find that glimpse of light, that smidgen of hope that is bright enough or strong enough to guide my way. I am scared of looking up to the jungle always covering the night skies, fearful to look forward because I can’t see far enough through the thick brush to see my hand in front of my face, and looking behind me all I see are the trails of cuts and bruises that have gotten me to this point. I am afraid that my thoughts are far too at home in this place and that the darkness has always felt comfortable for me and perhaps the needle on my compass is just pointed here.

I can’t at this point even say why I continue to walk this unlit, beaten track, or why I continue to plod through the mud and stumble over the uneven ground. I don’t know why I insist in looking up in the hopes that there is a crack in the canopy where just enough light will peek through to at least point me in the right direction when time and again, the blackness is all encompassing. I stumble forward, unguided, trip over broken branches and fall right back to the place where I started, yet despite the mud weighing me down, regardless of the cuts and bruises incurred with each fall, I continue to rise. I somehow manage to stand back up time and again, after losing my bearings, and keep searching for this seemingly elusive path of light.