The Real Crazies
While I was watching some DVDs about the Holocaust I got an idea about how the Nazis euthanized people with mental illnesses. It made me wonder if physician assisted suicide could lead to people who can’t take care of themselves being euthanized as an official policy like it happened in Nazi Germany. In 2006, the Swiss Supreme Court ruled that mentally ill people can have access to physician assisted suicide. I found a lot on this online from many sides of the issue. The logic goes that since mental illnesses are accepted as biologically based mentally ill people should have the same options available as terminally ill people. If the mentally ill person is deemed in temporary remission from a chronic, debilitating mental disorder then they should be considered rational enough to be assisted in killing themselves. A lot of physicians, especially psychiatrists, see this as anathema. For psychiatrists, suicide is failure. What happened to “First, do no harm.”? Moreover, some people with terminal illnesses are depressed. Some articles were alarmed – including an editorial on MindFreedom International’s website. Many consider all physician assisted suicides a “slippery slope.” Will it lead to patients being encouraged to die so they are no longer a burden to society? In Nazi Germany, mentally and physically disabled people were exterminated for this reason. Many psychiatrists report that one consultation with a person who wants physician assisted suicide is not enough to determine if someone is rational enough to go through with a permanent solution for their suffering. Oregon has a law permitting physician assisted suicide for terminal illnesses, but now that intractable mental illnesses are viewed as biologically based, will the mentally ill have the same “rights” as the terminally ill? According to a Medscape article, “we are entering an era during which psychiatric patients do not need to be protected, but empowered. Our goal should be to maximize the options available to the mentally ill.” From a civil liberties perspective this seems logical, but mental illnesses distort reasoning. Should someone with impaired judgment be “empowered” or should they be helped to overcome their condition? Even MindFreedom International sees access to physician assisted suicide for mentally ill people as having potential to lead to coerced or forced euthanasia of those labeled mentally ill. MindFreedom usually supports civil liberties for persons with a mental illness.
If someone with a mental illness wants to kill himself, he will find a way without the help of a physician. There’s a libertarian type reasoning to some of these articles – a cold appraisal similar to the Nazi’s reasoning that those who can’t work and care for their survival shouldn’t be allowed to be a “burden to society.”
According to a 2002 article in the British Journal of Psychiatry, there are no clinical criteria to guide such an assessment for determining the rationality of the right to physician assisted suicide. It seems crazy that physician assisted suicide be available to the mentally ill – especially if there is no standard for a “rational” decision. Mental illnesses may be biologically based, but it affects your brain, where you need to think rationally enough to make an informed decision.