Euthanasia for the Mentally Ill: Not a Good Idea?

 Cole Burston/BBC's photo: 'Dr Madeline Li has helped hundreds of patients die. Now she has doubts about Canada's assisted dying programme.' (January 14, 2022)
“Dr Madeline Li has helped hundreds of patients die. Now she has doubts about Canada’s assisted dying programme.” (BBC News)

Suicide was in the news, briefly, this weekend.

Euthanasia, actually. Or assisted death.

Whatever folks call the process, it’s arranging for someone to die. Or, being impolite in my choice of words, killing someone. For thoroughly nice motives.

Who can die? Canada wrestles with euthanasia for the mentally ill
Holly Honderich, BBC News (January 14, 2023)

As Canada prepares to expand its euthanasia law to include those with mental illness, some Canadians – including many of the country’s doctors – question whether the country’s assisted death programme has already moved too far, too fast.

“Dr Madeline Li can recall the first patient she helped die, about one month after Canada first legalised euthanasia in 2016. ‘I remember just how surreal it was,’ she said.

“A psychiatrist at Toronto’s Princess Margaret Hospital, she recalled checking on her patient that day, asking if she had the right music and final meal, and if she was sure she wanted to go ahead. The patient, in her mid-60s and suffering from ovarian cancer, said she was….”

I don’t doubt that the 60-something woman with ovarian cancer agreed that she was better off dead. At the time, and probably for the five minutes it took for her to stop living.

It Could be Worse

Suicide risk factors. (2015) From Wikipedia, used w/o permission.News from Canada is not, as I see it, all bad.

“…Dr Li stressed repeatedly that a physician’s personal opinions should not influence how they assess a patient for assisted death. But she has significant concerns about the expansion of Canada’s euthanasia and assisted dying programme beyond the terminally ill. She is not alone.

“Since 2016, Canada’s medical assistance in dying programme – known by its acronym ‘Maid’ – has been available for adults with terminal illness. In 2021, the law was changed to include those with serious and chronic physical conditions, even if that condition was non-life threatening.
(Holly Honderich, BBC News (January 14, 2023))

“This year, it is expected to change again to include some Canadians with mental illness….”

Eugenics law historical marker, Indiana.Euthanizing the infirm could have been a decision for qualified experts: who’d set up standards for healthy Canadians, and remove those who don’t qualify for life.

Leaving the ‘die now’ decision in the hands of the person who will be killed seems like a nice idea.

And since the Canadian government “…says that the expanded law protects vulnerable Canadians while respecting patient autonomy…” — like I said, this isn’t entirely bad news. The new rules apparently let folks have a say in whether or not they’ll be killed.

Another ‘it could be worse’ item in the BBC News article is that a fair number of the qualified experts aren’t entirely comfortable about their new responsibilities. Two of them must sign off on a Canadian’s ‘kill me now’ request before the patient’s life is terminated.

And that is the sort-of-good news from Canada.

Decisions, Depression, Death and Me

Illustration of 'icepick' lobotomy, from Dr. Walter Freenan II's 'Psychosurgery in the Treatment of Mental Disorders and Intractable Pain.' (1950)I’m not a Canadian citizen, and I don’t live in Canada, so why do I care about helping distraught Canadians kill themselves?

Partly because if I was a Canadian, I might be eligible for a government-sanction death. I’ve mentioned this before.

I’ve been living with depression and something (probably) on the autism spectrum for most or all my life.

My first suicidal impulse happened in my teens. At the time, I decided to keep living.

A half-century later, I still think that was a good decision. Even though I’ve felt suicidal off and on ever since. Mostly off, now, but I’d be surprised if I don’t get the impulse again.

Now, my situation wasn’t like the woman with ovarian cancer. Being crazy, the way I am, isn’t a terminal condition. And I don’t particularly want to die, even when I feel like it.

But I remember feeling suicidal, know what being mentally ill is like from the inside, and remember when lobotomies were going out of fashion.

Even if I wasn’t a Catholic, I’d be unenthusiastic about an irreversible medical procedure: particularly one that could be marketed to folks like me.

And, since I am a Catholic, I can’t see killing myself — or “helping” someone else die — as a good idea. Even when it feels like a nice thing to do.

I’ve been over how I see life, death and decisions, before; but not recently.

Valuing Life and Health: Within Reason

Pieter Claesz's 'Vanitas Still Life.' (1630)Here’s why I think killing myself is a bad idea: even if I’m not healthy.

Human life, including mine, is precious, sacred; and so is yours. It’s a gift from God. Health is a gift from God, too. Trying to stay alive and healthy, within reason, is a good idea. (Catechism of the Catholic Church, 2288-2289)

Being healthy is okay. But being sick is okay, too. Both are part of being alive. Getting well, and helping others get well, is a good idea. The same goes for scientific research: which is a basically good idea and involves ethics, same as anything else we do. (Catechism, 1410, 1500-1510, 2288-2296)

So, staying or getting healthy is a good idea. But being healthy shouldn’t be my top priority. Putting anything or anyone where God belongs would be idolatry. And a bad idea. (Catechism, 2112-2113)

Another result of seeing human life as precious is thinking that murder is a bad idea. (Catechism, 2268-2269)

Man! That makes it sound like being Catholic is no fun at all! And that’s another topic. Topics, actually.

Death Happens

Gustave Doré's illustration for Poe's 'The Raven.' (1884) via Library of Congress, used w/o permission.Okay. Getting back on track: like it or not, sooner or later each of us deals with death.

Moping around, brooding on the sadness of it all, emulating the student who got upstaged by a bird in Poe’s “The Raven”: that doesn’t make sense, not to me.

Again, human life is precious.

But death happens. (Catechism, 1006-1007)

Death is not, however, permanent — which is good news or bad news, depending on what I’ve done with my life. And whether or not I accept God’s love and mercy at my particular judgment. (Catechism, 991, 997, 1020-1029, 1033-1037, 1042-1050)

That last item is a sort of postmortem performance review.

Consequences and Painkillers

Philippe de Champaigne's 'Still-Life with a Skull', a vanitas painting. (c. 1671) left to right: life, death, and time.Basically, I think suicide is a bad idea because I’d be committing murder: with myself as the victim.

And since I’d be dead immediately after committing a serious offense, I’d have zero time to repent before that final performance review.

My rap sheet is long enough as it is, and I emphatically do not want to be saying “I can explain everything” during my particular judgment.

But let’s say I’m sick, terminally ill, and in pain: lots of pain. Wouldn’t that make it okay for me to kill myself? Or have someone else do the job?

Briefly, no.

Deliberately killing myself, or having someone else kill me, is a bad idea. It’s among the few things I could do that are wrong, no mater what. My intention, sparing myself pain, doesn’t turn a bad idea into a good one. Not even if I’m hurting really, really bad.

It’d be a matter of the object I’m choosing, my intent and circumstances. (Catechism, 1750-1754)

This is a happily-hypothetical situation, but let’s say I’m dying and in pain.

I could use the pain as part of an interior penance, getting a little more work done on my salvation while there’s still time. (Philippians 2:12; Catechism, 1430-1431)

Or I could decide that the pain is getting in my way as I deal with end-of-life actions.

Since I’m a Catholic, the same goes for unreasonably zealous medical procedures. If I know I’m going to die, foregoing treatments that don’t make sense is an option. So is taking painkillers. Again, within reason. (Catechism, 2278-2279)

Remembering Dinsdale Piranha

One of the clearest discussions of suicide as a form of homicide that I’ve run across was in a Monty Python’s Flying Circus skit:

“It’s easy for us to judge Dinsdale Piranha too harshly. After all, he simply did what most of us only dream of doing . . . (tic . . . controls himself) I’m sorry. After all a murderer is only an extroverted suicide. Dinsdale was a loony, but he was a happy loony. Lucky bastard.”
(Criminologist in a Monty Python skit ca. 1969 (“The Complete Monty Python’s Flying Circus: All the Words. Volume one, Volume 1,” edited by Graham Chapman, Monty Python))

The Dinsdale Piranha skit was funny. At least for folks with a taste for dark humor.

Living in a society where relabeled forms of homicide have official approval? Or living just across the border from one of those ‘compassionate’ places? Maybe not so funny.

Hope, Trust and Prayer

Vincent van Gogh's Sorrowing Old Man' or 'At Eternity's Gate.' (1890)This isn’t what I’d planned for this week’s ‘Saturday’ post, so I’d better wrap it up.

Recapping, I’m not a Canadian citizen and don’t live in Canada, so the new-and-improved rules making suicide easier for Canadians don’t directly affect me.

But since a woman who meant a great deal to me killed herself, I’m more than intellectually aware of suicide. Having experienced suicidal impulses has been a factor, too.

My first adolescent suicidal impulse and the “meant a great deal to me” suicide aren’t connected, by the way. Apart from my having experienced both. There was an interval of about a decade between them.

I can’t see killing myself, or someone else, as a good idea. Even if I meant well. And I think there are long-term consequences to homicide. But I also think hope is a good idea.

I’d better explain that.

John Martin's 'Pandemonium'. (1841) Department of Paintings of the Louvre, Room 713I haven’t, happily, experienced some enthusiastic Christian telling me that my friend who killed herself is roasting in Hell.

Maybe you have endured that sort of ‘reassurance’, or whatever the motive is.

Now, remember: suicide is a bad idea and I shouldn’t do it.

But, and this is important: despair is also a bad idea. And hope is an obligation.

“We should not despair of the eternal salvation of persons who have taken their own lives. By ways known to him alone, God can provide the opportunity for salutary repentance. The Church prays for persons who have taken their own lives.”
(Catechism, 2283)

So is prayer. And that’s yet another topic.

An image from Brian H. Gill's brain scans in 2018.I’ve talked about life, death, and making sense before:

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About Brian H. Gill

I was born in 1951. I'm a husband, father and grandfather. One of the kids graduated from college in December, 2008, and is helping her husband run businesses and raise my granddaughter; another is a cartoonist and artist; #3 daughter is a writer; my son is developing a digital game with #3 and #1 daughters. I'm also a writer and artist.
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