Upon reading Try Harder with Your Mental Illness by Henrietta M Ross of The Triumphant Weed, I remembered a topic that has been on my mind lately—whether we have the right to die.
Though I preach hope and advocate that people try treatment instead of taking their lives, I wonder whether it is reasonable to decide to die when the pain is too great to bear and does not respond to any treatment.
I often feel disingenuous telling people that there is hope, for that is not always true. Some of us living with mental illness respond more effectively to medication, psychotherapy, support, exercise, good nutrition, meditation and so on. Some do not.
No one chooses to have “treatment resistant” mental illness. We cannot will mental illness away. Treatment does not always work. Still, sometimes there are options we have not considered, options supported by science, that just may work.
My friend Dyane Harwood chose ECT when medication failed her. ECT saved her life when she suffered deep bipolar depression. With the help of an astute psychiatrist, she eventually found that adding an “old school” MAOI to her medication mix helped.
I assume I will get some fire, and perhaps some concern, for this post.
Further Thoughts on the Issue…
People With Mental Illness Deserve To Die With Dignity Too, Arthur Gallant, Mental-health advocate
Assisted Suicide for Mental Illness Gaining Ground, Nancy A. Melville
“A first-of-its-kind report offers insights into the characteristics and outcomes of requests for euthanasia on the grounds of suffering related to psychiatric illness in Belgium, where it is legal in that country.”
“We found that when considering patients’ demands seriously, most do find a way to continue with their life,” Dr Thienpont said.
Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study (Thienpont, 2015, BMJ Open 2015;5:e007454 doi:10.1136/bmjopen-2014-007454)
“In Europe, psychological suffering stemming from either a somatic or mental disorder is acknowledged as a valid legal basis for euthanasia only in Belgium, the Netherlands and Luxembourg.”
It’s legally, morally, and ethically complex, without a doubt.
Although the popular term “right to die” has been used as a label to describe the debate over end-of-life decisions, the underlying issues include a variety of legal concepts, some distinct and some overlapping.
When euthanasia and physician assisted suicide are first introduced they always come with guidelines to prevent abuse. Over time, the guidelines are gradually chipped away until you get a situation like the Netherlands, where newborns born with handicaps are euthanized. The elderly and those with disabilities are often in the same predicament even when they are not in pain. It is the slippery slope that many people say doesn’t exist or “It won’t happen here.” The potential for abuse is huge.
You have a very beautiful website. I look forward to coming back and reading more. Please stop by mine and if you like, follow back.
The reason for the photos is to show my face. And it’s part of my therapy. Some of my alternates don’t know what year it is or how old they are chronologically.
So I hope that a portrait of me with my fave walker will clear things up a bit…:)
Please do let us know if you ever share your photographs. I’m fascinated. I used acting to mine my depths, and dissociated for hours while picking my skin. Amazing that my face isn’t pocked (I do have some minor scars).
I’m going to…Thanks for the encouragement, Kitt.
I wish you the best should you try.
I never take pictures because I don’t recognize myself. It’s actually hard to make myself do this.
Doesn’t sound weird at all. Sounds fascinating. I love the idea. Would make a great art project, too.
I am thinking of setting up my camera and taking some self portraits. My therapist and I agree that it will better facilitate communication between my alternates if all of us objectively know what we look like.
I know that sounds weird but–oh well…:)
Thanks, Robert. Amazing what professional makeup artist, photographer, and Photoshop can do.
Yes…it infuriates me–as I’m sure anyone who has read my blog for even five minutes knows…BTW: your new profile pic is great
Deinstitutionalization has resulted in mentally ill now homeless. Without a doubt.
I agree with your premise. I think people must have a way out of a life of relentless pain and suffering.
But the United States is a scary place right now, and the thought of euthanasia in a country that tosses its citizens into the streets is an invitation to even worse brutality than we now have….perhaps my reaction is based on the fact that ‘Assisted Suicide’ is legal in California, a state that was the first to make the mistake of passing a law that was initially designed to prevent healthy people from being institutionalized by unscrupulous relatives and resulted in a blanket refusal to treat even the most obviously sick psychiatric patients simply because they knew which trash can had the lest toxic edibles.
Throwing our sick out like garbage is completely unacceptable. That’s not what I’m addressing. I’m addressing those who have access to care, but whose illness is treatment resistant and who are simply fed up with trying every treatment out there to no avail. Clearly, our country does not serve our most needy. We are in dire need of improved public mental health services, including hospital beds, improved public health services, and housing for those living on the streets.
That I’m good with. If every possible treatment has been tried and has failed then it really is an individual choice. But who wouldn’t ‘choose’ assisted suicide if the only alternative is a slow and degrading death on the street.
True. This option is used in European countries where there is nationalized health care and there ARE options. The choice is the individuals’, not the systems’.
Not before we have full access to every treatment option available which includes long term structured settings. I’m already disturbed by the way the system abuses the right to refuse treatment…the thought that this same corrupt for profit system that discharges people to the streets in the middle of the night will ‘help’ me to choose the ‘merciful’ way out terrifies me.
Honestly, I agree, though with ambivalence. I did intervene when my mom stopped eating and had her psychiatrically hospitalized. Her mood improved, but I know my mother has good reason not to want to live. Her life has drastically changed. Still, I want to see if she can adjust to her new reality before she makes such a decision. Due to her vascular dementia diagnosis, she is not considered “competent” to make such a decision, complicating matters. What makes it even harder, is that I have ambivalent feelings toward my mother due to a life of unacknowledged undiagnosed mental illness that resulted in emotional abuse.
There’s the rub, isn’t it?
People who are against assisted suicide should shut up.
There is this weird idea called ‘consent’. If A doesn’t want to have sex with B, B should respect that and not force it upon him. Then if B wants to kill themselves, A can’t bum-rush with the crap ‘You have so much to live for!”. Sorry dude, but if you don’t want B in your body, don’t force yourself into B.
I know the Beautiful People are delusional and out of touch, but they should understand the basic idea of consent. If you’re not free to die, you’re not free. Assisted suicide should be available to everyone. I don’t care what are someone’s reasons for suicide. They’re valid if they consider it valid.
It’s THEIR body, not mine or yours.
Well no matter how you slice it depression sucks, and I hate using that word 🙁 I know what you are saying. The pain of my depression gives new meaning to the word “long suffering.” There are times when I do give serious thought to ending my life. 🙁 Whether it’s the depression or logic talking I don’t know.
I understand. I realize that religious beliefs and secular ethics make choosing to die difficult, if not impossible, to consider. I get it that it may simply be wrong.
Here I am not talking about suicidal ideation, but a reasonable decision given severe psychiatric illness which does NOT respond to treatment.
Not everyone who wants to die is just suffering from temporary symptoms of depression. For some, there has been no alleviation of their pain. No treatment has been effective.
Yet, a treatment may come about in the near future which would be effective. Even if one does not have an ethical, moral, or religious problem with choosing to die, medical advances may offer relief. It is a permanent decision for something which someday (if not yet) may be temporary.
It’s a tough issue for sure. God says “thou shalt not kill,” but when you are in agony and the chemicals are telling you out is the answer – well that is illness I believe and God forgives. I’m not giving anyone an “out,” just saying that we do the best we can, as I said in the other post (“Good Daughter”)
I like your new photo by the way, very much! You may well have had it up for a while but I am just now noticing it.
New treatments and medications are always being developed, so giving up may not ever make sense. Then again, some people do live with chronic “mental” pain that no treatment yet touches.
This is such a fascinating topic, Kitt, and you were so brave to bring it up. One of the things I love about your blog is that you are fearlessly honest. I think this post might help to enlighten anyone who thinks the pain of mental illness is any less real or potent than physical pain. I have actually never heard anyone mention that treatment resistant mental illness could be legitimate grounds for euthanasia. I like to believe everyone has hope for as long as they are alive, but as you said, that may not always be the case. Excellent post!
I completely understand and support your decision. My parents’ lives have been devastated by alcohol related dementia and vascular dementia. They did not plan for this. They did not plan for my father’s care even as his dementia grew worse over the years. My mother’s stroke was sudden and brutal in the damage to her brain.
I appreciate this post. We all deserve to have options, and deserve the right of choice. Given my individual situation, assisted suicide is my retirement plan. This decision is not made on a whim. I’ve invested a lot of thought in it. I will be leaving no family or friends behind, so no harm will come to others. I exercise my right to choose should my quality of life not be worthwhile
Those are exactly the right questions to ask. Plus, some treatment may come available in the near future that would help.
Ok. I guess I’m just thinking how long was the therapy offered for, how many meds were tried, etc. I’m just worried it isn’t really treatment resistant it’s just the right treatment has not been found. Maybe I’m being cynical. I do know people who have had years of meds and therapy to no avail.
In those countries where people with mental illnesses can legally obtain physician-assisted suicide, there is a process which people must undertake. The study whose link I listed goes into more detail.
But, I totally get your point. When I experienced severe depression, I saw no way out. I believed that suicide was my only option to end the pain. I was wrong.
Without doubt it goes against many, if not most, religions’ beliefs and values, and presents secular ethical dilemmas.
Treatment resistant means that psychotherapy, medication and other interventions such as ECT have not helped alleviate or lessen extreme pain and suffering. Not talking about common unhappiness here, but harrowing pain which does not abate and which the individual finds unbearable.
I think this is an important topic particularly because other parts of the world find the Right to Die acceptable. My personal view is that other diseases are treatment resistant and so the question could be ask in those cases as well. I am more of a proponent of let nature take its course. Its very difficult to support the Right to Die for people with mental illness because the very nature of depression as a disease is to want to die. Thank God I never had that option I might not be here today.
I disagree with euthanasia. The “right to die” is like playing God…and so only God has that right. We are not the Author of Life, like God is, so it is prideful to assume that role. What’s more, because of Jesus’s agony on the Cross, suffering now has so much more meaning. Before the Crucifixion, it was virtually meaningless; but now all suffering can be united with Jesus’s. It’s a share in His suffering, and a way to grow close to Him. I know it’s hard for me to judge those that feel like they should be euthanized, but from an objective point of view, it is immoral.
I’m not sure what treatment resistant means… It’s so sad. I have asthma, it is controlled, but it’s not curable, does that make it treatment resistant?
Yes. Perhaps we try to impose our will when it is not our place to do so.
This is a touchy topic for sure. I think ultimately it comes down to having the right to decide how I live my life and asking others to respect my desires.
Karma is a complicated business. Who are we to judge? Yet I try to maintain, right action. Even if not always successful. I happen to believe, it is a power of the universe and that humans are always quick to test it. Cheers Jamie
I can totally understand that one. 💘
That it does. Not sure how that would affect the karma of our actions. Compassionate, perhaps, in certain circumstances. Must be decided by individual with medical/psychiatric support for the decision. Not decided by medical professional, but supported by medical professionals.
Honestly, I’ve been thinking of it because of my parents’ health issues (dementia, stroke, severe aphasia), but didn’t include that here. For another post.
Personally? I’m a believer in karma. So, whatever that means? It behoves us to always consider the karma of our actions … Cheers Jamie
In so many cases, it just seems humane. I’m looking at it from a geriatric point of view lately, but the sentiment has always seemed valid to me. An important post, Kitt.
Thank you. I feared writing and sharing this post. I shared similar thoughts in an Alzheimer’s/dementia caregiver’s support group fearing reactions, and turns out I was not alone in my thoughts.
Thanks for the link. Luckily advances in medicine continue.
Yes. I think we have the right to die. Nobody has the right to judge an individuals’ situation, until they have been there and been them. If pain is unbearable and somebody opts for peace by ending their life, far be it from me to criticize them.
Sometimes….you just can’t go on.
Thank you for posting this, Kitt.
Hi Kitt, I can totally relate to this. Why oh why do we have to continuously suffer the horror that nobody understands, cares about, or can even begin to get a grip on. Sometimes, an assisted suicide is the kindest way out of the hell of madness that cannot be contained, and every single day, the pain and horror gets worse. Great article.
I hope you don’t get any fire about this post, Kitt. This is your blog, your “living room”, and you have the right to express whatever you wish. If people disagree, they should do it with the utmost respect.
Thank you for mentioning my experience & link to my Huffington Post article & blog.
I read an intriguing article last night in the acclaimed Santa Cruz weekly “Good Times”, the paper that was edited by our friend Greg Archer for 14 years. The article is about a new form of brain therapy using a magnetic helmet. You and some of your readers might find it interesting.
Here’s the link:
Kids just woke up. Gotta dash!