I recently asked some friends and followers what they thought about the concept of physician-assisted suicide when it came to the terminally ill and those suffering from incurable, severe pain. Most of the results were in favor of it, which reflects the growing support across the United States.
But when I asked whether it should also be the case for certain instances of mental illness, like depression, the answers changed a little. Suddenly people weren’t so sure. There were too many grey areas and things to consider. It’s harder to diagnose these invisible illnesses than it is something like cancer. Some rightly pointed out that in many instances, suicidal tendencies are fleeting and often regretted later. At least one other pointed out that depression doesn’t cause actual pain, so it was unclear if mental suffering alone was enough to justify such a thing. There’s also the question of whether mental illness in itself disqualifies someone from being mentally sound enough to make a decision that involves ending their own life.
It was partly due to the difficulty of the question that led people to be hesitant, but some of it also came from a fundamental misunderstanding of mental illness, especially depression. A common misunderstanding is that depression can always be cured if you find the right doctor or medication, or at least treated to a point where life is manageable. Many of those with mental illnesses will say medication doesn’t cure anything, it just makes life possible to deal with.
As you might expect, I didn’t ask this question because I enjoy subjecting my friends to random moral and ethical exercises. I had originally planned on making a speech of the subject and wanted to garner feedback, but the only reason I had thought of that was because I suffer from depression myself, and noticed that my resulting bias leads me to a point of view that differs from many others. If I was going to talk at length about this, I wanted to see what arguments I was up against.
During this short life of mine I’ve attempted suicide twice, and as a result, I realized two things. One, I’m pretty bad at suicide. Two, the experience got me to thinking that it was downright silly that people who feel so miserable aren’t allowed to end their lives with dignity. It’s my life, is it not? Why do I have such little say in it?
This often overlapped with the argument that “suicide is selfish,” the idea that someone taking their own life isn’t concerned with the feelings of their loved ones. How could someone just kill themselves like that, knowing how it would make their loved ones feel? My rebuttal has always been that it’s selfish to ask someone to stay alive in a state of suffering so that you personally don’t have to feel the pain of loss. It’s an awful thing to guilt someone into continued suffering, the insinuation being that they don’t care about anyone else otherwise. I can say from experience that the only reason I didn’t make any more attempts, or why I waited so long before making the two I did, is because I couldn’t stop thinking about how others might feel.
This argument came up again in the physician-assisted suicide discussion, but only when it came to depression. You never hear people accusing those with terminal illness or suffering from cancer of being selfish for wanting to put an end to their suffering. My guess is this stems from the same misunderstanding of depression, almost to a point where people deny its validity and the pain people endure from it.
(Which is often real pain, by the way; I could go on about how the anterior cingulate cortex stimulates the vagus nerves going through your chest and abdomen during points of mourning, depression, etc. and how this explains why people feel as though their heart hurts when they’re very sad. But I don’t want to have to justify this in such a way; my argument is that, physical [i.e., “real”] pain or not, PAS should still be a valid option.)
It’s worth noting how differently people suffer mental illness. It differs in severity and symptom, and I would go so far as to say that no two people suffer a mental illness in the same way. Even if they did, their capacity to handle it would vary as well.
But I think that only strengthens the argument for PAS, not weakens it. You’ll find people who suffer from depression who say PAS should not be legal because they got better, so, you see? Just keep trying, hang in there, it’ll work the same way for me too. I just need to find the right doctor, the right medication. And besides, medical science might improve, I can never know.
Again I point out how I never seem to see this argument for other patients. We don’t want to force them to stay alive in hopes that eventually there might be a fix. Maybe.
But that’s all I can remember people telling me when I confided in them that I wanted to die before. “Just wait. Hang in there. It’ll get better.” When? How? These were questions that they couldn’t seem to answer, and so I never found it very convincing. Besides, that’s what I’ve been told for over 15 years now, from friends, psychiatrists, therapists, doctors, random intellectuals online, etc. Yet, I’m still waiting with no real end in sight. I’ve had ups and downs and times where things improved so that not every minute of my day was taken up by this desire to no longer exist, but it’s still there.
It’s arguable that I’m living without pain (I would contest that, but I digress), but that’s not living to me, that’s just being alive, and in a miserable state as well. I may not be considered terminal, and I could live to a ripe old age, but I would do so miserably. Which loving, caring people out there who are so interested in my health and happiness would deny me the right to put an end to that?
There are those who would, and to those of you who fit in that category, I posit that it’s now your responsibility to provide the terms. How long should I wait? I’ve been at this over 15 years now. When would be an acceptable cutoff time? 20? 30? How many more years should I put myself through this for your sake, to be miserable so you don’t have to be?
For whatever it’s worth, I don’t see this as happening in my life any time soon. Depression presents its innumerable problems, but I still have some things worth living for that help push against my constant desire to stop existing. I don’t know if the latter will ever go away, but it makes life extremely challenging. But because I’ve gone on this long, it’s no longer a frantic desire to end things right this moment — it’s more like an acceptance of something that may inevitably happen, something that I think about with as much urgency as I might tomorrow’s weather. For now, at least in my case, I have more reason to live than to not. Would that everyone were so lucky, and that it stays this way for me.
My argument isn’t to make anyone like the idea. My idea is to request that the option be there at all. Sure, we could talk about a process and protocol so that we could screen out people who are going through a temporary ordeal. We could request signoffs from multiple healthcare professionals and a mandatory wait time, whatever you like.
But until that point, my life and my control over it is in your hands. All I’m asking is that you put it back in mine.