Dutch woman, 29, granted euthanasia approval on grounds of mental suffering
theguardian.com
theguardian.com
Assisted dying seems an evil thing to me - all the more so because suicide is feasible without society’s involvement and encouragement. One worries that the state and doctors will at some point go from saying “you may” to saying “you should.”
You can't fix everything. Drugs don't fix everything. Not everything can be treated. Seen too many people slowly detoriating, waiting to die for incurrable diseases.
If I have a right to live, I should have a right to die, otherwise I'm a slave.
Moreover, is not assisted dying treated as a privilege, rather than a right? Like a driver’s license, one must apply. It is alienable.
Who else than state? Random people? You can always off yourself, but that is messy. Might as well have a process for that.
being 'alive' and suffering versus dying and ... being dead and not suffering. pretty easy decision.
ultimately the hippocratic oath is about upholding good ethics and being a just individual. the misconception at the heart of all this is that death is unjust or an invalid solution when in fact it is and the stigma around it should be dropped.
Apart from fries and chocolate this is what we're best at ... granting approval for euthanasia :/
EDIT I'm not at all against euthanasia, it's just a bit macabre that this is what Belgium excels at
Is it thought? If you don't succeed you basically are incarcerated by way of mental institutions (at least in the USA). Obviously they can't hold your un-alived body "accountable" but it sometimes does feel like suicide is illegal.
If only there was another way... We can't fix it now, but if we could put that person in suspended animation or some other kind of stasis, we might revive them once treatment was available...
This all is really sad and I don't wish anyone to suffer. But I also don't want people to die because they thought their situation is hopeless and it might turn out it isn't...
no justification required. you want out? ok, cya bud.
a bird hits a glass window of a skyscraper and falls to the ground. no big deal.
a squirrel is run over by a truck. no big deal.
an individual is sick of living and decides to leave, no big deal.
Why is this such a bad thing? I see no issue here. Forcing another to exist just because they have some kind of untapped value that hasn't manifest yet is antiquated thinking.
Obviously rehabilitation and therapy should be on the table, to try and bring someone back to normalcy - but if that fails we should not falter.
If someone doesn’t want to live, why does the state, or anyone for that matter, get a say? A person didn’t have a say in being born, they should at least be allowed to die on their terms.
BTW, the same states don’t have a problem sending soldiers to their deaths when it suits them.
I hated that they took my agency back then, but looking back it was fair and all of the people involved tried their best to represent my interests, and I'm grateful they did it.
How about, one is allowed to go to some authority or doctor, 3 times at the space of 10 days, and express their desire. They can always change their mind. At the end of their 3 visits they are given a prescription. This is just an example, there can be other ways.
Edit: to clarify, 3 visits, 10 days apart is 30 days. And, the person has to do themselves so obviously need to be healthy and the person receiving the affidavit/declaration can notice if there are any mental health concerns. Make it 6 visits for total of min 60 days. As long as there is a good and relatively easy process I’m good.
I think this is one of those situations where there will never be a good solution. Especially for mental health related issues.
I’m glad to hear it worked out for you though in the end.
If you look at this[1] 2023 report on euthanasia in Belgium, I don't think the numbers are anywhere near a height that it would be something I would say they "excel" at.
I think 'off-ing' one's self is a pretty large consequence in itself.
You can painlessly do it today, by overdosing on opiates or many other drugs.
I've been revived a few times, and I can tell you you don't even notice dying.
A legal process that involves the state and possible years of monitoring, age limits, etc is much more friction than the very quick ways one can do it on their own without the state's involvement.
What worries me is the image of an understaffed public hospital, with a single nurse walking from bed to bed softly asking the patients if they want permanent release.
(a) I have suffered from severe mental health issues in the past and struggle with better-controlled ones to this day,
(b) I was pretty explicitly suicidal for several years (I still have the note I wrote on my desktop as a reminder; it's something I keep close to my heart as a thing that is precious to me),
(c) I very, VERY strongly believe in the idea of mental health as a health problem and not a moral one, largely because of my own experiences, and
(d) I agree with you that the failure to recognize (c) is a far larger problem than even poorly-justified assisted-dying would be.
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All that being said, though, I think there's legitimate reasons for concern here. I absolutely would have said my life was unendurable and that it could never improve, and I would have said that persistently for a long period of time (for around two years, so a substantial chunk of the approval period here). And the claim that my life wasn't going to improve was, in retrospect, a fairly reasonable belief - my life was in bad shape and even if I could talk to myself at the time I'm not sure how I'd ever justify the way it worked itself out.
But it did work itself out. Things did turn around, in a way I could never have predicted. My life improved, and in the years since, I have overcome basically every personal issue I thought I never would. That's not to say my life is perfect, by any means, but it's better than - and I use this phrase in its full literal sense - I could have imagined at the time.
I suffer(ed) from basically the same spectrum of conditions this woman does. I was roughly the same age. I had tried medical treatments that, while transformative in terms of the way I looked at mental health, had not offered sustained relief (and to this day have never found a medication that works effectively for me).
I have no doubt her desire for relief is sincere, because I have no doubt that mine was too. She's quoted in the article as saying:
> People think that when you’re mentally ill, you can’t think straight, which is insulting
I can't speak for her. But I think if someone had told me this during the depths of my own worst battles with it, what that would have sounded like to me is "you're not really in this much pain". In that sense, I agree (and would have agreed at the time) that it would be insulting.
But, again, while I can't speak for her, I was empirically not thinking straight, in the sense that my perceptions of the world and of myself were distorted. I was trapped in a system of mental processes that rounded "my life is really bad and I can't see any way it gets better" to "my life is unbearable and it is impossible that it ever gets better". I was, objectively, wrong in my predictions of the future and my judgements of myself, and that's not someone else talking, it's me, with the benefit of greater experience.
I didn't have the options on the table that she does. But if I had, and things had continued for more years the way they were? I might have taken them. I'm not sure. I know I had a plan for how I would end my life painlessly. I never got to the point of quite executing it, but that was as much a statement about how hard it was for me to do anything at the time than it was a statement about how much pain I was in. And my life came within hours and a lucky roll of the dice of going further down into despair.
When I think I might have made that choice, and I think I would have been incorrect to make it, it's hard for me to feel entirely comfortable with her choice as the correct one. Perhaps it's a choice she nevertheless should have the right to make (I think you can make pretty good arguments for that), but the choice you have the right to make, and the choice you should make, and the choice that deserves social endorsement, are different matters.
Making the request itself is grounds for significant psychological involvement. Doctors are opening themselves up for lawsuits for manslaughter if the conditions are not met (see the Tine Nys case[1]).
All this to say: it's not just a matter of making the request twice and wham bam thank you ma'am.
I am sure that everyone involved here thinks they're doing the right thing, and that they're approaching it with the seriousness and gravity the topic deserves. And I think this is a topic on which reasonable compassionate people could disagree. I'm just not sure if the solution here is the correct one.
Just because a suffering isn’t visible, or doesn’t prevent someone from walking or getting up from a couch doesn’t mean it’s not every little bit as painful as a physical affliction.
- electroshock therapy (wtf)
- throw a bunch of mood stabilizers, SSRIs (Selective serotonin reuptake inhibitor) and see what sticks
- therapy/talking
- lock em up in prison or psychiatric “hospital”
- in some cases people resort to self medication with various mind altering substances (LSD, microdosing MDMA) and see what sticks
At least we aren’t doing lobotomy procedures anymore.
Medical science has failed her. Society has failed her.
Mental health care is hard because people are complicated. It's been almost seven years since the woman who saved my life sat with me in her office for no less than four hours telling me that yes, I should really take these pills, and I am still sorting things out to some extent.
SSRIs don't work for me. But one of them worked for a short time, and that short time was enough to completely change my understanding of myself. It changed me from thinking of myself as a terrible person who deserved all the considerable suffering I was enduring at the time, to thinking of myself as someone who was very very very sick and needed help to survive. If you've never been severely depressed, it's hard to explain what a revelation that is. I broke down sobbing for hours at the feeling of understanding for the first time that my suffering wasn't my fault. It was (in part) due to my actions, but my actions were due to my mental state, and my mental state was not something I had gotten to choose. So when I say that I strongly, strongly, with all my heart, recommend that you try them if you're depressed even though they only worked for me for a couple of days - well, that should tell you just how important that was to me.
Therapy didn't fix me. But it did give me the tools to work on myself, in fits and starts, for what is now half my adult life. Having someone I spoke to every week, who understood the patterns of mental illness, helping me to see the feedback loops for what they were, was critical in understanding the nature of how I was sick. That didn't make those loops go away. But it did train me to listen to them less, and helped me know where to find them when I had the mental energy to work on them.
Without mental health care, I would be dead. With mental health care, I've shed my constant fear of the smallest changes, I no longer scream at myself for the smallest mistakes, I've had healthy romantic relationships, I have a career most people would envy, I take care of my personal environment, I'm in the best physical health of my life and have shed 40% of my body weight to be not-obese for the first time since childhood, and I smile. I smile a lot.
Has society failed many people? Yes. Environmental factors are relevant to mental health. In fact, it's part of why mental health is so dangerous: once your health deteriorates and you lose control and maintenance of your environment, you create a feedback loop that worsens mental illness. I am by no means arguing that we could not take care of people far better than we are. But I, at least, believe in the importance of mental health care as strongly as I believe in anything else on this Earth, because of what it did for me.
How many people are so mentally ill that death is the only conceivable escape, but at the same time so mentally well that they can make an informed medical decision about the end of their life. Certainly I believe that number to be very low, potentially it might just be zero.
People suffering from non-suicidal mental illnesses could fit this description. For example, consider a patient who has undergone various therapies and medical examinations but remains irrationally terrified of fluids and can only receive them via injection. They'll be mentally sound enough to make an informed decision, and the patient concludes that life is not worth living.
But even if such a person existed and the phobia wasn't persistent without a doubt the person would suffer from related anxieties. I don't believe that you could suffer from such a condition and be mentally well for any amount of time, although I certainly see your point that during certain periods the person might be able to make an informed decision.
Most would opt for it when they have mental illnesses like Alzheimers or dementia in general but most often they would too ill to be able to make required informed decision. I am glad it's offered because why would someone need to wait until they die? Especially, when the person can't be treated further like when having cancer.
Many medical decisions are put into the hands of relatives when people become mentally unfit to make those decisions. Certainly in this case it shouldn't be allowed.
The law in my country is that the final decision has to be made by the patient itself, shortly before the euthanasia (no advance directives), and while mentally fit.
The mental fitness has to be confirmed by the personal physician, and in reality, they will also take into account whether the decision has been maintained consistently, over a longer period of time before the onset of serious dementia, and if so, they might relax mental fitness criteria somewhat.
Relatives don't enter the picture (as opposed to withdrawing of life support).
But their doctor does? That is just bizarre.
Here in Germany, if you aren't fit to make your own medical or legal decisions, the state will try to appoint a family member as your formal caretaker in those matters.
Honestly hearing this made me significantly more apprehensive about the whole thing. This seems like an awful idea.