Monday, June 22, 2015

Assisted-suicide shouldn’t be for those in the fog of depression.

This article was written by columnist Rosie DiManno and published June 22 in the Toronto Star.

Rosie DiManno
By Rosie DiManno

The attempted suicide came onto the ward in the middle of the night direct from emergency.

For several days she remained in a private room, on 24-hour watch by an attendant privately engaged by her family. One morning, she appeared in the patient's lounge, bandaged wrists protruding from the sleeves of her silk kimono.

She was the most beautiful woman I'd ever seen.

And she wanted to die.

It was a declaration she made repeatedly — impossible not to overhear — to her visitor, a man who placed her stocking feet in his lap and rubbed them continuously, as if trying to restore feeling, not to the feet but to the woman's spirit.

"I'll do it again," she stated flatly. "I will. You can't always be there to save me."
By the end of the week she was gone, presumably transferred to some other facility for the mentally fragile.

Many years later, at a cocktail party, I saw her again. She was laughing, a glass of wine in her hand, like in the Rolling Stones song. Her green eyes sparkled with amusement. Another man, not her hospital visitor, had his arm wrapped around her slim waist. This, I would learn, was her husband. They had three young children.

When I drifted towards the group with whom she was conversing, the woman turned in my direction. There wasn't a flicker of recognition in her face. That was for the best.

We often don't recognize even ourselves, the people we once were, when we were broken and despairing. That's how you get beyond the pain, not being able to remember what's faded away. If it returns – as is frequently the case for people with mood disorders, the "black dog" clinical depression that locks on with pit bull jaws – it always feels like the first time. And you forget that it will pass or at least abate. In the moment, it feels unendurable.

Sometimes, you want to die.

I once had a heated debate with a psychiatrist esteemed as Canada's leading expert on suicide. He's spent a lifetime trying to prevent it. "Why do you think people don't know their own minds?" I argued.

I was wrong. Descending into that dark place where hopelessness – and psychical fatigue, really, just so damn tired of misery – renders rational thought impossible.

Yet the irrational, what has long been viewed as moral anathema, is starting to take hold in the medical and ethical establishments. That can be traced directly to momentum of the "right to die" movement. Canada's Supreme Court unanimously struck down the law against assisted suicide in February, although the ban won't be lifted until next year.

And this is where such thinking leads: In Belgium, second country in the world (after the Netherlands) to decriminalize euthanasia – and the first (in 2014) to legalize euthanasia of children by lethal injection—the law allows physician-assisted suicide in non-terminal cases of "lasting and unbearable suffering'' that "cannot be alleviated''.

As in the Netherlands, it permits doctor-assisted suicide for patients suffering from severe and incurable distress, including psychological disorders.

These are people where death is not inevitable, which is the core requisite for countries (and in some American states) where euthanasia is permitted. Not death with dignity but death with a push.

In Belgium, euthanasia and assisted-suicide deaths has increased by more than 150 per cent in the last five years. Among those "approved'' for death have been people with autism, anorexia, borderline personality disorder, chronic fatigue syndrome, partial paralysis, manic depression, Alzheimer's and a 24-year-old transgender man devastated by the failure of his sex-change surgery.

None of these patients was dying. They just feel real bad and don't want to take it anymore.

They were — as explored in a profoundly disturbing article in the current edition of The New Yorker — morbidly disconsolate and frail of mind. Which is a far sight from terminally ill and dying.

We're getting dangerously close to erasing those distinctions, those boundaries.

In Belgium, a nation that has the second highest suicide rate in Western Europe (excluding euthanasia), five people a day now breathe their last in doctor-assisted suicide. Some ethicists, at least, are alarmed by both the flourishing culture of death and a loose interpretation of the law which, in cases of non-terminal illness, requires agreement from three doctors. As Rachel Aviv, author of The New Yorker article writes: 

"The laws seem to have created a new conception of suicide as a medical treatment, stripped of its tragic dimensions."
It seems a contradiction that the right-to-die ascendancy globally is promoted primarily not by an aging population contemplating unpleasant end-of-life issues; rather by, as Aviv notes, "the concerns of a younger generation, whose members derive comfort from the knowledge that they can control the end of their lives." A professor of geriatrics at Mount Sinai School of Medicine in New York — a leading palliative-care physician — tells Aviv that 
"the movement to legalize assisted suicide is driven by the 'worried well', by people who are terrified of the unknown and want to take back control."
This is the slippery slope that so many, including Canada's top justices, have discounted as a consequence of assisted suicide, with its purportedly rigid guidelines.

Knocking off the depressed, because that's what they want, as if the deeply disconsolate can possibly make an informed decision.

In the unfair lot of life, some people contend with depression on almost a daily basis. The curtain lifts only occasionally and only briefly. Anti-depressants are not a one-size-fits-all magic cure. But for most the suffering can be alleviated, the misfiring synapses stilled for long stretches of time. Others learn to cope with chronic melancholy. It's just how we roll.

I know quite a few people who have survived suicide attempts in their bleakest of moments. Not one regrets being pulled back from the abyss. But if they did? How can any sane society countenance ushering the mentally shattered, the morosely sad, towards oblivion by assisted suicide? That's madness.

I think of the tormented souls who yet managed to leave behind a great legacy of art and literature and music and philosophical dissertation. It's a fine line, sometimes, between derangement and genius. I think as well of those countless ordinary men and women who quietly triumph by stilling the demons in their head, one day at a time.

And I think of a beautiful young woman, cracked through the soul, who wanted so fiercely to die — a wish now fainter than the scars on her wrists.


Stacy Patterson said...

This is totally nuts! The Government protects me from myself in many ways that are not necessary. Our food is totally FDA regulated and I cannot buy a lot of very good things I have only heard about, but yet, they want to pass a law that makes it totally accessible for me to find professional to assist me with killing myself?

The Constitution gives Americans the right to Life, and a lot of other things, but not the right to kill myself.

Susan said...

A great article.