When is a mental disorder considered terminal? When is the sufferer a good candidate for physician-assisted suicide? Is it after the first attempt to suicide? The second? The third? Is it when a person who is severely depressed sits in a corner and rocks in mental and emotional pain? Is it when medications don’t seem to work? Is it when a person can’t avail him or herself to electroconvulsive treatment or transcranial magnetic stimulation due to financial or insurance difficulties? Or is it when the person decides he or she can’t face the future prospect of an illness that can cause pain, disability, and a statistically possible early death by heart attack?
Who decides when a person’s prognosis for any illness is just cause for suicide? The person whose mind and body is affected? The family when a person is deemed not sound of mind? Or is it the physician who determines course and life expectancy based on statistics and past observation? We all know persons who “beat the odds” so we all know with certainty that statistics and observations aren’t always correct in real life.
A person usually attempts suicide because of changes in the brain that indicate dysfunction in emotional regulation and the ability to make sound decisions. These changes have been found to occur in association with heart disease, diabetes, Parkinson’s, Alzheimer’s, and some cancers. How does one know if and when the presence of that dysfunction exists? Is it when a person stops smiling? L’Wren Scott, Mick Jagger’s girlfriend gave absolutely no indication she was depressed. No one, not even Jagger saw through her smiles and laughter. Perhaps L’Wren Scott didn’t recognize the illness in her self until it was too late. She hung herself without warning or a suicide note. A physician wouldn’t have provided prescriptions for that of course. She didn’t have a terminal illness, or did she?
We need to be very careful when the media or a person pushes for a cause by capturing our attention through emotional manipulation and touching our common existential fears. We need to study and consider, not jump to conclusions based on what we think, feel, or believe. We need to contemplate what constitutes soundness of mind without divorcing it with the emotions.
I’m not one to hold signs, shout about causes, or yell out loud about things I believe. I do know by experience however that what we think and feel can be a lie and we can create strong beliefs around those lies. Be very careful about mental conditions and suicide. They are still not well understood and therefore are very much still evaluated in the realm of belief. And, the issue of physician-assisted suicide is being put to a vote. You will ultimately decide.
Picture is found on creative commons.