Thursday, November 11, 2004

In Defense of Suicide

Yes, it's Regina's "anything goes" blog, where anything on her mind ends up in print for the whole world to see. Even I feel self-conscious about how different today's post is from the previous one, but here it is anyway: what I've been thinking about today. This is the article that prompted me to publish today's post: "Author Iris Chang Found Dead from Self-Inflicted Gunshot Along California Highway.".

There are plenty of people who believe that no life should ever be terminated, whether it's an embryo, the aged and infirm or those "at death's door." This piece of writing does not address them. It addresses those who see euthanasia as a viable alternative for those who live in great physical pain from a life-threatening disease. I agree that a person should have control over her own life and be allowed to make all major decisions regarding that life. If someone is in unbearable pain for which there is no remedy, and knows she'll be in that pain until death, she should have every right to decide whether the rest of her terminally ill life should be suffered or cut short. But if helping to facilitate the death of someone in that situation is merciful, this consideration should also allowed to those who suffer from mental and emotional pain.

Our culture has a strong prejudice against the very idea of mental illness as we can see in our health care system that only recently has begun accepting mental illness as a condition covered by their policies. Mental illness affects almost all of us, whether as part of our family secrets or because many that we see each day, including many of the street people we try to ignore, are people who don't have the money or health care to stay on their medication. Mental illnesses are often seen as character flaws that should be overcome with discipline and a strong will. Too many people still don't know that mental disorders are genetically influenced, biologically determined and can be helped when drugs balance out the body chemistry.

Maybe when mental disorders are seen as legitimate, treatable illnesses our opinions will stretch to include them in our list of diseases that can make life unbearable. And when that happens maybe we'll look with more sympathy at the mentally diseased who just can't take the emotional pain that drugs can't help. If we accept the euthanasia decision of someone in unbearable physical pain, we should be able to accept a similar decision by someone who suffers from unbearable emotional pain and mental torment.

Some would probably say that if suicidal tendencies are part of the symptoms of a mental disorder, then that symptom should be treated rather than accommodated. This view nullifies the person's right to decide her own treatment. Many can accept the decision of a cancer patient who chooses not to undergo treatment, but instead live out her life "naturally" and die earlier than she would have with treatment. If that's acceptable, why can't a person with mental illness likewise choose not to accept treatment and die earlier than she would have with treatment? It's wrong that a disease that attacks the cells of the body is seen as a legitimate reason for euthanasia but a disease that destroys the chemical balance of the brain is not. Just as a person with a terminal disease might have a strong will to live that the pain eventually overpowers, so a person with a major mental disorder might have a strong will to live that the pain eventually overpowers. Why isn't that seen as legitimate?

Some would argue that the difference between a physical disease like cancer and a mental disease like depression is that cancer doesn't affect the very organ with which decisions are made, and thus a cancer patient's decision to die is more of a reasoned choice. They might further argue that since the nature of depression distorts one's perception of reality, a depressive is fundamentally unable to make major life-or-death decisions. But to deny a depressive the option of suicide is like denying a person in extreme, terminal pain the option of painkillers. Let's say the cancer patient has always been a reasonable person who would never do anything illegal or that might cause long-term addiction or harm to herself. Consider that while in unbearable pain, that person might demand painkillers, even if she knows the drugs are illegal or addicting or harmful in the long-term. In the moment of extreme and unrelenting physical pain, a person's reasoned judgment can certainly be clouded or absent, but that's no reason to deny them the relief they are unable to objectively consider. Likewise, a depressive's desire for suicide should not be ruled out just because the depressive isn't "in her right mind." Who's to say a depressive wanting to die is any less in her right mind than a cancer patient in a delirium of physical agony? I believe a person in extreme and unbearable mental and emotional pain should be given the same access to relief as a cancer patient. Judging a mentally disordered person as unfit to decide her own fate is the ultimate unfair dehumanization.

I know suicidal tendencies are an aberration of human nature in which the desire to die must overcome the much more basic instinct to survive. But chronic, unbearable pain sometimes does overcome the survival instinct. If we accept that a patient with nothing to live for but prolonged physical agony is capable of deciding her treatment and death, then we must accept that a patient with nothing to live for but prolonged mental agony is also capable of deciding her treatment and death. The right to life must include each individual having the right to live or die as she chooses.


Anonymous said...

This has been on the blogosphere for quite sometime, so I may be late, but I want to say that I wholeheartedly agree. I've wanted to kill myself for some time and haven't, in part out of hope for the future and because I know it would devastate a few people in my life. However, I wish that our society could look at such decisions as reasoned and people could have some sort of rationality about them. That way, people wouldn't have to resort to throwing themselves off buildings or slitting their wrists and making suicide far more dramatic than it has to be (another reason I haven't killed myself yet). Well-reasoned, I don't think anybody will agree with us though.

Regina said...

I am so, so sorry to hear about your pain. I forgot about this post, but I still agree with most of it (I no longer think suicide is equivalent to painkillers, but the rest of the argument stands). I used to use an independent commenting website that's now gone, and that's why it looks like there were no responses to this. Believe me, the were.

Sometimes treatment works and sometimes it doesn't. I was in a huge amount of pain for years, until therapy and meds finally began to work well for me. I hope you find peace in a way that results in the least amount of pain to you and others.

Anonymous said...

Hi Regina,

Depending on the point of view, I have successfully or unsuccessfully fought off the urge to leave this mortal coil for most of my 50 plus years. The urge to leave has been greater lately and today I found myself looking around the internet on the subject. What prompted me to write a comment was this line in your post...
" They might further argue that since the nature of depression distorts one's perception of reality, a depressive is fundamentally unable to make major life-or-death decisions. "
It reminded me of the studies that have been done in the last few years that show, fairly conclusively, that many depressed people actually have the most "true" world views. I would tend to agree with that and think that most of the people who feel so strongly against suicide and come out with their typical comments when someone (whether they know them or whether it someone famous like Robin Williams) does commit suicide, are the ones who have a distorted sense of reality. But as Mark Twain said (paraphrasing a bit here) It is much easier to fool someone than to convince them they have been fooled.