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This article talks about a man in Belgium who died through Physician Assisted Suicide because of intractable emotional pain resulting from a botched sex change operation. This type of story leads to a whole new set of questions surrounding the euthanasia/physician assisted suicide debate.

This post is not going to be an argument for or against euthanasia in general. That is a whole separate argument with its own haters and supporters. What I want to do is assume physician assisted suicide is legal, and discuss where the line should be drawn.

Euthanasia is a concept that is thought of as “necessary” for the terminally ill — those people with terminal cancer, and degenerative diseases, people who at some point are going to be unable to function and live in the way they desire, people with no chance of ever having a “normal”, pain-free, and happy life again. For the people who are not vehemently opposed to euthanasia, it is these people who we assume should be allowed the option to die when they choose. Let these people, who have suffered the indignities of a terminal illness be given a last chance of dignity and of control. Obviously, there are arguments here about choice and whether a person is wanting to die to not be a burden (financial or emotional) or because they are truly ready to die, but those are separate.

The criteria for euthanasia/physician assisted suicide tend to be intractable pain and suffering. The question that I have always asked has been what type of pain? Does it have to be physical and emotional, or can it be just one? One may start off arguing that intractable, debilitating physical pain is a valid reason to allow a person to end their own life. But then what about emotional pain? The man in this article was not noted to be suffering from physical pain, and he did not have a known terminal physical illness. He was suffering from intractable, debilitating emotional pain, which as many of you may know can be just as bad as physical pain. In a way it may be deemed worse because there is no end point, and there are no answers. With a cancer you are told you have cancer and that there is a treatment and X% chance of the treatment working, and then after a certain amount of time you know if the treatment has worked or not. You are either in remission or you are terminal. With depression and other severe mental illnesses you don’t know. Maybe you fight for a year or even five, but eventually you feel as if there is no treatment that works, and maybe your case is “terminal”. This is shown by the fact that large numbers of people with mental illness attempt suicide every year. Some people with mental illness feel as if there is no cure, as if there is no end to the indignity, and that maybe death is the best choice.

I am not advocating physician assisted suicide for people with mental illness. If we do that then we are sending a message to anyone suffering from mental illness that there is no cure, and that death is the best option. That is a terrible message to send, and people do survive mental illness, and there are many people who suffer or suffered from mental illness who are around today talking about how great it is to be alive, and about how glad they are that their suicide attempt didn’t work.

But I am struggling with the dividing line here. This man suffered from what he believed to be intractable emotional pain due to his botched gender-reassignment surgery and his history of abuse. Was it kinder to let him die than it would have been to force him to live a life he hated in a body he hated?

I think the debate of where to draw the line is an important one to have, and in order for it to actually be productive it should be had outside of the context of the normal pro-euthanasia and anti-euthanasia arguments. This is its own issue, and given the rise in support for physician assisted suicide it is an issue that should be taken seriously so that we know how to tackle problems when they arise.

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