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.

 

 

 

I Speak Because I Can

blog i will not be silent

 

I leave my social media private messaging open for anyone who may need a friendly ear or some advice and have received countless kind emails and messages from people of all ages, in all types of situations. It is humbling that random strangers can muster enough trust in me, also a random stranger, to not only reach out, but to express their deepest fears and emotions. I am by no means a counselor, just a survivor who may be able to offer a different perspective based on my knowledge and experiences. I want to thank those of you that have reached out for having the courage to do so. As the saying goes, the first step is the hardest.

I started a blog last year to not only help heal myself but with the hopes that maybe some aspect of the traumas I have endured will make at least one person feel less alone, or perhaps a bit more understood. I am completely open about my experiences and almost always have gotten positive feedback and encouragement. The people who have been ignorant have been few and far between and generally their comments just roll off my back. However, for the first time this got under my skin to the point where I am now going to respond with the hope that a little education, ignorance does not have to be.

I won’t bother copying and pasting the entire message as you should get the idea with the following few quotes…

Why do people like you insist on reliving your past in a public forum for everyone to see? It’s the past for a reason, get over it. Everyone had their own childhood issues but do you see most people whining about it online? You had plenty of time to tell someone when you were being abused or sometime shortly after, but after thirty years, it’s time to move on. Complaining will get you nowhere…”

“…are you not embarrassed enough that you were abused and now decades later you think anyone is going to believe you…”

“…and anyone who has attempted suicide three times and not succeeded is simply seeking attention. There are enough resources online that you shouldn’t need three attempts to end your life. You are obviously sick in the head and should seek professional help.”

The message continued for another few hundred words but I am guessing you get the point. So, Mr. Ignorant, allow me to reply.

The fact that you say people “like me” screams the type of mindset that you hold. We are not a stereotype, we are warriors. We are survivors of atrocities and horrors that you could not comprehend. We went through more trauma in our early and formative years than you will likely suffer in your lifetime. As a child I was afraid to speak for a multitude of reasons, and that carried on through a large part of my life, until one day I found my voice and so now, I speak because I can. I am no longer bound in fear and silence as I am no longer a victim. I use my words to in an attempt to educate people like you who are bound in stigma. I write on behalf of those who have not yet found their voices and to let others know they are not alone. The fact that you asked if I am not embarrassed enough about my abuse already says a lot about your mentality. The last time I checked I did not molest myself, so what do I have to be embarrassed about? I was merely a child who was preyed upon by some very sick people and was unable to defend herself, and whether or not anyone believes me or not does not sway me from my purpose. Those who don’t believe me simply don’t have the privilege of being in my life.

Your comments about suicide actually left me stunned for words, which is not easy to do… so shame on you for not only saying that, but for thinking that. People like yourself who’s views are based on stigmatisms believe that you are untouchable, and that nothing like that could ever happen to anyone you love, and just based on statistics alone, if you know more than four people you likely know someone affected by a mental illness, which in some cases leads to suicide attempts. I won’t even begin to try and explain to you the complexities of suicide as you are too close minded to learn. Just know that anyone who has sunken low enough to make an attempt to take their own lives is suffering a sense of hurt you could not comprehend, and in most cases, for them, at the time, it seems the only way to truly end the pain is to end your life. 99% of the time it is not a cry for attention like you have insinuated.

So, to sum it up, thank you for reminding me why I speak and write and advocate for mental health…it is people like you that keep me motivated.

I speak because I can.

 

 

 

Love, Me and BPD

 

Borderline Personality Disorder basically feels like all your emotions are attached to your nerve endings, which are all protruding from your skin. They are constantly tingling and even the slightest breeze initiates a sense of pain that would be almost incomprehensible to someone who has never felt it. They fire off at even the smallest of triggers with the ferocity of an electric shock, no matter the time or place, for undetermined periods of time. It’s like being sunburnt to the point of blisters and the pain of having to put the cream on, then the gauze and top it off with the constant irritation of clothing; or like having open sores after having ripped the scabs off, only these sores are affected by words and actions instead of touch. Being around people can in itself be a challenge, but it seems for me that the closer you are to me, the more reactive my emotions are.

It’s been just over seven months since I decided to deconstruct the wall that was guarding my heart and allow someone close enough to not only invite them in, but actually allow them to cross the threshold and shut the door behind them. It is a constant daily struggle to not to rebuild my walls while slowly pushing them out the door, or to just run out the door myself. The vulnerability that is involved in a relationship is a constant trigger to my deepest fears of abandonment and being un-loveable, and regardless of the constant reassurances I require and receive, the terror continues to surface. I question things that are said or not said, done or not done, and always seem to read between lines that are not even there, creating unnecessary negative scenarios that trigger me even further, causing me to either internalize the pain or lash out, neither of which are particularly healthy. With BPD, vulnerability is far more than the feeling of being susceptible. It is more like walking down a dark alley, naked and defenseless while trying to keep an eye out in every direction knowing that nothing can protect us, from others or from ourselves.

Almost all of my relationships have had a sense of instability. Distant friends seem to be the easiest relationships to maintain because there is limited contact or communication, but the closer I am to someone the rockier the road becomes. My closest friends and my relationships often face the brunt of my BPD episodes, and despite my trying to control the impulsiveness of my words and reactions, I always seem to fail and for this reason, very few stick around. Despite my explaining my illness thoroughly it is just too much for them to understand and it is overwhelming. In fact, unless you have BPD you can sympathize but not truly empathize. The outbursts are so impetuous and the words so often hurtful that when I am rational, I can fully understand why no one would want to stay. If someone said those things to me, I wouldn’t stick around either, yet a few have chosen to stay, chosen to overlook and see past the emotional eruption I throw their way, and for the life of me I don’t know why.

So to those who have stayed in my life despite having to put up a shield from my words and my BPD driven actions, from the bottom of my heart, I thank you. You have chosen to peel back the layers of my illness and look for the good beneath. You elect to not only see the positive qualities in me but point and try to bring them out. You put up with my erratic moods and my pushing you away with one hand while reaching out for you with the other. You remain loyal through the hardest times of my life and not turned your back, proving to me that there are people in my life who won’t abandon me, there are people who can love me, undeterred by my illness. I don’t test you on purpose, nor do I mean any malice with my words and I am working on learning to try and control both a little bit better, but in the meantime I want you to know your love, trust , loyalty and patience mean the world to me as I travel along this healing path. I truly love you and you are my family now.