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.

 

 

 

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4 thoughts on “Should the Right to Die Include Mental Health?

  1. What a thought provoking article. Just the other day I was thinking about this topic in a matter-of-fact way.

    Imagine if you could die if you wanted to legally & in a dignified manner at your own hands? No drama. Basically a walk in euthanasia clinic that does all the clean up & maybe even provides an admin service to tie things up for you like bank accounts, insurances, obituary notice etc.

    The result? Lower population. Less strain on resources. It’s like Darwin’s Theory of Natural Selection. Only we’re doing the self-selecting to weed ourselves out. Win win… For humanity. For those non-sufferers, you no longer have to put up with our moods & being a strain on company productivity because we’re maxing out our sick leave. Family – no more having to worry or care.

    Many of us who are so sick are alone anyway without much contact with the rest of the world that no one would miss us.

    Like

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