Physician Assisted Suicide and Mental Health
Julia Roberts, LCMHC
As a mental health counselor, I encounter many individuals in their most hopeless and vulnerable moments. There is rarely a week that goes by that one of my clients does not talk to me about contemplating suicide. It causes great concern for me to consider how physician-assisted suicide (PAS) will affect both the mentally ill and those who experience periodic suicidal ideation due to difficult circumstances.
Countries such as Holland, Belgium, Switzerland, and the Netherlands where physician assisted suicide and euthanasia have been legal for many years are proving how difficult it is to control euthanasia and PAS once they are introduced. The legalization of euthanasia and PAS started with specific groups such as terminally ill cancer patients and has now expanded to include the elderly, disabled, incapacitated, mentally ill, and children and newborns with disabilities. PAS seems to call into question the legitimacy of a person’s very existence if his or her quality of life seems objectively poor. Our most vulnerable in society then become at even greater risk of carrying the unnecessary burden of a “duty to die” or to even be killed without their consent or against their will as studies in the Netherlands have shown.
A more subtle threat to the mentally ill and those suffering from emotional stress is the shift in societal attitudes toward suffering, illness, disability, death and suicide. Because laws serve to inform the conscience, legalization of PAS then suggests that suicide is a morally permissible and at times even heroic choice or duty. Removing deterrents to suicide can only lead to an increase in suicide. Those who work with suicidal clients know that in the midst of hopelessness and despair, clients often cling to one thing to stop them from suicide, whether that is a child, grandchild, significant other, friend, religious belief, or moral conviction. Legally sanctioning suicide may remove for some the one thing that would have prevented them from following through with their suicidal thoughts and plans.
Of great concern is how PAS will affect the already rising teen suicide rates. Imagine the sense of confusion distressed teens may have as their parent, psychiatrist, or counselor tell them over and over that suicide is not an option; yet the teen observes that for some people, it is an option. Teens are often not fully developed in their ability to reason and make moral choices, such that they may lack the ability to understand the difference between the choice a terminally ill person makes to commit suicide and their own seemingly hopeless situation leading them to consider suicide. Because teens can easily idealize individuals of high status, the involvement of a physician in this act also further reinforces the acceptability of suicide.
The legalization of PAS will not only affect the elderly and terminally ill, it will have an effect on every layer of society: from the infant born with a disability to the emotionally distraught teen, and from to the severely mentally ill patient to the family members of individuals suffering. PAS challenges the traditional doctor-patient relationship and the unique relationship a psychiatrist has with the patient. Though superficially compassionate, PAS actually places at risk many vulnerable populations, including the mentally ill and disabled. Through gradually shifting societal perspectives on death and suffering, it conveys a subtle yet destructive message to teens and those suffering from emotional distress that suicide is a legitimate choice. Those who want to minimize suicide in our culture should give serious consideration to how this legislation could affect those who are most at risk for attempting suicide.