It Doesn’t Get Better
The mentally ill deserve the right to die with dignity
The mentally ill deserve the right to die with dignity
If you were going to kill yourself, how would you do it? You could jump off a bridge, or leap in front of a subway, or shoot yourself in the head. You could tie a noose round your neck or take an overdose of barbiturates. You could even swim out into the lake, too far to swim back.
I’ve considered many of these methods myself and have even attempted to carry some of them out — as the scars on my left wrist can attest. I was diagnosed with depression, various forms of anxiety, and obsessive-compulsive disorder at seventeen, and, despite nearly a decade of therapy and a dozen medications, have often thought of offing myself, to the extent that I’ve always simply assumed that, when I eventually went, that’s how I’d go. You may understandably wonder why I’ve been unsuccessful in my pursuit of the void.
As Dorothy Parker reminds us, killing yourself is a tricky thing to do. Setting aside the basic human impulse to survive, there are a great many practical complications that any attempt at suicide presents. Guns can misfire, ropes can snap, drugs can induce vomiting and leave you with little more than a sore stomach and adamaged liver. Around 40 percent of subway jumpers survive, mangled into considerably worse shape than before. Just 1 percent of wrist-cutters are successful.
Most suicidal people are aware that whatever attempt they make on their own life is statistically likely to fail, causing them greater pain and humiliation, compounding their sadness and anxiety. (Once, on my lunch hour, I walked down to a frigid Lake Ontario, there taking off my coat and shoes with the intention of taking a terminal swim. I backed out in part because, had I failed, I would’ve had to return to work and tell my colleagues why I was sopping wet.)
There’s also the matter of the body. No one should have to stumble upon the still-swinging rope or the brain matter on the wall, but, inevitably, someone does. That’s because, in Canada, the suicidally depressed still don’t have the right to die.
Razors pain you; Rivers are damp; Acids stain you; And drugs cause cramp. Guns aren’t lawful; Nooses give; Gas smells awful; You might as well live. — Dorothy Parker, “Resumé” (1925)
They still don’t have the right to end their suffering with dignity; they still don’t have the right to spare the people they love the shock of losing them, of knowing that they died alone in terrible pain.
In April, JustinTrudeau’s government unveiled its new right-to-die legislation. It will give those suffering from painful terminal and degenerative physical illnesses — those for whom “natural death has become reasonably foreseeable” — access to doctor-assisted suicide. It will not give those suffering from painful mental illnesses the same access, despite a parliamentary committee’s recommendation to the contrary (the bill proposes only that an independent body be established to explore the issue). But that won’t stop thousands of Canadians from killing themselves this year. Suicide will remain one of the most common causes of death in this country (and the second-most common cause among young people), and it will remain as grisly and undignified as it ever was.
Critics present the suicidally depressed with a Catch-22: if they don’t want to live, then that very fact means they can’t possibly consent to die.
The arguments against legalizing doctor-assisted death for the clinically depressed are mostly specious. Slipperyslope fallacies (“What’s next? Eugenics?”) were popular among newspaper columnists in the lead-up to the release of the legislation, while concerned opposition members of Parliament took to building straw men, suggesting that the government should help people instead of killing them. But countries in which the mentally ill have for years had the right to die — including Belgium and the Netherlands — have not taken to euthanizing undesirables; and, of course, no one is suggesting that doctors stop prescribing therapy and medication and instead advise their patients to take a long drop with a sudden stop.
More disturbing is the notion that the mentally ill are, by definition, incapable of deciding rationally to kill themselves. As the Conservative MP Gérard Deltell (who is not a medical professional) said in a recent interview, “At what point does someone suffering from a mental illness offer his or her full and complete consent? It’s impossible.” Certainly, questions of consent are fraught when it comes to psychotic illnesses, but I have never experienced the breaks with reality that typify them. Deltell’s monochrome thinking, therefore, presents me with a Catch-22: if I don’t want to live, then that very fact means I can’t possibly consent to die.
Obviously, whatever treatments are available — the medications now are numberless, and their efficacy can often be improved through psychotherapy and cognitive behavioural therapy — should be tried before any decision to die is made. And that decision should be made by an adult, in consultation with psychiatric professionals. (Eighteen-year-olds are allowed to purchase cigarettes, so it would be tough for any government to argue that they don’t have the wherewithal to kill themselves by other means.) It needn’t be deemed a moral capitulation or chalked up to an insufficiently stiff upper lip.
In my case, there’s always a chance that the depression and anxiety and OCD will dissolve blissfully away — or at least become manageable — and I will live
longer than I’d ever thought possible. But the government will not, on the basis that a cure might eventually be found, ban ALS patients from assisted suicide. So why should they stop the chronically depressed because they have “good days and bad days”? Even on the good days, I know the bad days are coming.
And so, for those unlucky few who have tried everything and decided that a life mired in oppressive and unremitting sadness is no life at all: rope, razor blades, pills; bridges, subways, skyscrapers; an emissions-happy car and a length of hose. These are the choices that Trudeau has left us with.