Lara Giddings has reiterated that she will put euthanasia on the Parliamentary programme. I hate to invoke the dreaded Reductio ad Hitlerum but whenever anyone appears on my television endorsing euthanasia I feel an irresistible urge to grab my texta and draw in a floppy fringe and unfashionable mustache.
It is however a fact that Hitler started his terror campaign with the euthanizing of the mentally ill and “feeble minded”; therefore it is probably quite natural that people with mental illness issues might get a little nervous every time euthanasia is promoted.
The general problem as I see it is that many people with mental illness have special qualities which would make legalized euthanasia impact on them differently to the remainder of the population.
Consider for a moment those with serious depression – a common but life-threatening disorder. It is life-threatening because people with serious depression live with thoughts of suicide as a constant companion. It isn’t anything they can help. It just happens as part of the disorder. This is why you never ignore depression in a friend or relative because it is a very dangerous illness. You need to seek medical help straight away.
I am not a very suicidal person even when I have serious depression. I have a great fear of any kind of pain or distress so am not very inclined to any of it. However when I moved for the first time into a flat with a gas stove I felt the kind of remorseless, almost physical tug towards the gas jets that people with vertigo trapped in a multi-storey building have towards the gravitational pull of a plate glass window. Just as they tend to want to lie down flat on the floor, I really felt I needed to be tied up in a chair. Because of this compulsive aspect when you are discussing dealing with the severely depressed it is perhaps more helpful to talk about why people don’t commit suicide rather than why they do.
Surprisingly enough the things that stop you committing suicide under these circumstances are rather trivial, practical things that are based precisely on the inability to select a public day on which to die.
For example the following are likely to run through your brain:
what if someone finds me too early and interrupts my plan?; what if someone finds me too late and I lay here for weeks?; the kids won’t be able to use Cheap Flights and will have to pay full fare to fly over for the funeral; who will take care of the dog?; I haven’t made a will and the kids will fight over my belongings; I don’t want to frighten the cleaner.
The problem with legalizing euthanasia for people with serious mental illness problems is that by allowing people to choose the day on which they die you are doing away with all these natural barriers to suicide. You are saying: Here you are! We are making it really easy for you.
As far as safeguards are concerned the argument is that a psychiatrist can tell whether someone is mentally ill or not and pronounce a person fit for suicide. However I really doubt that. In the very recent case of Arthur Freeman, the Victorian man accused of murdering his daughter, the jury took five days to decide if he was insane or not. Professor Graeme Burrows, who contrary to what the prosecution alleged, is not an ambulance chasing professional witness, but an eminent world-renowned expert on depression, thought the man was psychotic. Six other psychiatrists disagreed. Who is right? Psychiatry is not an exact science and given the strongly desired goal of ending it all many people with a serious depression could fool a psychiatrist, or at least shop around until they found one who would give them the all-clear.
The other problem is that many persons with mental health problems contemplate suicide because their lives are so difficult. They don’t have to be depressed or mentally ill to think this way. Consider how you would be after 30 years of hearing accusing, denigrating voices in your head or 20 years of hearing things coming out of your radio. Victorian author and poet Sandy Jeffs who lives with schizophrenia says she wakes every day with the mantra “Top myself or eat breakfast”. This is not an unusual circumstance among people with serious mental health issues. The answer to it is to provide more services to make the lives of those with mental illness more hopeful and rewarding. For instance Jeffs herself says that her iPod is very effective in blocking out voices and advocates that the Federal Government place them on Medicare.
In 2007 the suicide of Burt Bacharach and Angie Dickenson’s daughter rocked the Asperger’s community mainly because her suicide was announced by this notice:
She quietly and peacefully committed suicide to escape the ravages to her brain brought on by Aspergers.
This sort of comment about Aspergers, which is a developmental disorder and does not “ravage” the brain, is a really good example of what might happen if euthanasia became legal.
People with Aspergers become depressed because their lives become so difficult. Their lives are not necessarily difficult because of the disorder which can be advantageous, but because society in general won’t accept their difference. If euthanasia were easy, rather than trying to make the lives of those with a difference better and less depressing, we could possibly succumb to the kind of doleful acceptance that mental disorder equals “need to escape” which equals euthanasia.
Another rather frightening case in the UK in 2004 was that of 22 year old Sarah Lawson. Lawson self-harmed and her family claimed she was bipolar. This latter diagnosis was later rejected by the medical authorities.
Her father helped her take a drug overdose and then killed her by suffocation. He got off with a two year suspended sentence partly by saying he had killed his daughter because he couldn’t get adequate help from the NHS. The mother said:
‘All of you know that Sarah found life intolerable, she said to me ‘I do not want to be here as life is black, I can see no future’.
Now basically this is common, garden-variety depression and the treatment for it is anti-depressants and not murder. The mother said later that she and her husband thought it was “fitting” that the daughter was at rest and planned a civil suit against the local health authorities who she blamed for the death.
To my mind, the Lawson case shows the lenient approach to people who commit crimes using the “life isn’t worth living” card and how a murder can be dressed up as assisted suicide. While the mother said the daughter was constantly trying to kill herself, at the time she was suffocated she was comatose with a drug overdose so couldn’t possibly harm herself. The mother was later criticized in the report into the tragedy for rejecting possible helpful therapies for her daughter.
While I do feel for individuals who are seriously ill and who do want to go with dignity I think you have to ask whether the introduction of euthanasia is going to affect some groups more negatively than others. That question appears to be “Should individuals have what they want if the impact of the legislation is more damaging to some groups of people in the community than to other groups.”
Sigmund Freud said:
The liberty of the individual is no gift of civilization. It was greatest before there was any civilization.
Being cognizant of the needs of different vulnerable groups is an important aspect of being civilized. The main problem I see with the introduction of euthanasia and the effect on the population of persons with mental illness is the difficulty they have in speaking out. While 80 per cent of Tasmanians are in favor of euthanasia I am absolutely certain that very few people with serious mental health problems answered the EMRS survey on the subject. I know this because I have tried to respond to a phone survey on one of my worse days and it is really very difficult.
The group of persons with serious mental health issues is a group that finds it very difficult to have a say. This group has few leaders or spokespeople. There are few effective ways that they can organize in order to comment or say their piece. This sector of people is without doubt lost in a deep and impenetrable silence. If the safeguards don’t work, you really won’t know about it until it is much too late.
Do we really want this legislation which has the potential to cause unforeseen and perhaps uncontrolled and unreported damage to people in a vulnerable group? Or are we going to agree to meet the freedom of choice needs of vocal and articulate individuals who want the euthanasia option? I say caution is required.
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