[Article] The right to die should not just be limited to the ‘terminally ill’ but for all people!

[TAW122]

This article is partly a vent but also an informative article talking about the current state of the right to die and how it should be expanded to include and cover (ideally) ALL people, not just those who are terminally ill. Before I begin, I will mention some of the problems that advocates for the right to die (or the right to choose death on one's own terms) are currently facing.

It is no surprise and common knowledge that to most people, including the pro-lifers, recognize the right to die and even support medical aid in dying for terminally ill patients. What is really jarring is how this right only extends to those who need it the least (that is not to discount their suffering as all suffering is valid) are recognized as having the right itself to opt out of extreme suffering despite the fact that for terminally ill people, they often are already near death or at least going to die within a certain time-frame (usually less than six months or so, perhaps even sooner). Many people (including pro-lifers, not withstanding some extreme, militant unyielding ones) understand and respect that for people who are in such predicaments. Of course, these people (the terminally ill) deserve to have a more peaceful way out and to curtail the unnecessary suffering, especially when they are near the end of their life (e.g. a terminally ill late stage cancer patient that is dying and will die very painfully). This mercy extended to them helps alleviate them from experiencing unnecessary pain and suffering while waiting on natural death. The point of this is for them to go on their own terms, their choice to skip the days, weeks, or months of unbearable suffering.

Quote by existentialgoof in one of his posts:

Many people without terminal illness are also facing immense pain and suffering. Just because it isn't caused by a tumour, doesn't mean that they shouldn't have the right to a way out of it. People with terminal illness are the ones least of need of the right to die - they are going to be dying shortly anyway. The issue that able-bodied people face at the moment is that the suicide methods available aren't effective enough, and that introduces far too much risk into the process; which is unacceptable when one is simply trying to extricate oneself from a situation that one was entered into without one's consent.

Anyways, so outside of those who are terminally ill (as well as those with very narrow and strict criteria that fit to a 'T'), no other group or individual has the right to die on their own terms, and instead are just subjected to unwanted sentience against their will. So for instance, the people who are not terminally ill, but are chronically ill, severely debilitated (spinal cord injuries), and/or other circumstances, are instead forced to remain alive against their will (with some rare exceptions) to suffer while others keep them out of sight and out of their (the pro-lifers, anti-choicers') mind. Most of us see this as unacceptable as all suffering is valid and suffering is bad overall, regardless of whether one is terminal or not. Furthermore, the right to die on one's own terms is considered a bodily autonomy issue yet it isn't treated as such on mainstream.

What would I propose to be the solution? Throughout the years and previous threads, I have often written about allowing concessions and expanding the right to die for those who are non-terminal or those whose conditions do not improve. Ideally, having the right to die for everyone regardless of their condition, regardless of terminality would be utopic, but of course, that is not reality nor would that be acceptable to most people (whom are pro-lifers and anti-choicers), so therefore, concessions would be the more reasonable ask. It is indeed a complex issue and the fact that even entertaining concessions is often rejected and/or ending up in an impasse, resulting in no change, means that the current reality and consequences of a prohibitive society when it comes to the right to die and bodily autonomy are people who end up DIY'ing and sometimes causing collateral damage (which is a lose-lose situation for all parties involved – unwilling participants are affected by said person's exit and said person had to suffer greatly and take unnecessary risks with brutal means to exit suffering instead of having a reliable, peaceful way out).

In our current day and age, while there are more and more jurisdictions and countries legalizing assisted suicide and medical aid in dying for the terminally ill patients (and hopefully likely to be more in the coming years, decades), there are a few countries that take it a step further to include those who aren't necessarily 'terminally ill' such as Belgium, the Netherlands, Switzerland, and Canada to name a few. However, is still so much work to do, especially due to the narrow criterion as well as red tape and bureaucracy that one has to navigate in order to have a chance (no guarantees!) to access such services. So my solution would be (especially for the jurisdictions and countries who only have assisted suicide, or medical aid in dying for the 'terminally ill') to expand the criterion for right to die to include those who are not necessarily terminally ill, but are severely debilitated and have little to no chance of meaningful improvement (meaning their lives are always full of suffering and hardship, requiring around the clock care, little to no independence, and such). Sadly, in the example I've linked, the person lives in the US and even though his state has assisted suicide or death with dignity, he himself would not qualify since his condition was non-terminal. He suffered for more than a decade and he didn't need to go and suffer for a decade had the laws been more lax and accepting of his predicament as well as those who are in similar situations.

So in conclusion, this thread is made partly to vent and lament at the fact that while the right to die exists in several jurisdictions (and more to come throughout the years, hopefully!), it only extends to those in very narrow circumstances. Those in these 'narrow circumstances' would certainly benefit from it and while it would be nice and necessary, they need it the least when compared to those who are perpetually suffering, yet non-terminal and being forced to endure many years of unnecessary suffering. Make no mistake, I fully and absolutely support the right to die for those with terminal illnesses and in no way am I implying that they shouldn't get it. I am merely stating the fact that they need it the least yet most people would allow them to have a peaceful, more dignified exit, yet refuse to allow it for anyone else. That is the main difference and I am arguing that the right to die SHOULD be extended to all (ideally), but at least more than what it is currently.

 

[Rational man]

Very interesting thoughts about the subject. An update from the UK: The new Labour government is to hold a free vote on assistance in dying but no timetable is given. Of course, the devil is in the detail but the outcome could change the law here and maybe elsewhere over time. Meanwhile, I continue to read stories of people ctb in the most brutal of endings.

 

[sometimesoon]

I have always thought we should have complete control over our lives - and the choice and timing of our deaths

 

[TAW122]

Very interesting thoughts about the subject. An update from the UK: The new Labour government is to hold a free vote on assistance in dying but no timetable is given. Of course, the devil is in the detail but the outcome could change the law here and maybe elsewhere over time. Meanwhile, I continue to read stories of people ctb in the most brutal of endings.

Yes, I have heard about the new PM in the UK, Keir Starmer, and it seems he is at least on board with allowing the right to die for the terminally ill (previous when it was considered illegal in the UK to aid another person in dying, even those who are traveling abroad, with some stories of people being legally prosecuted for doing so). I do hope as well that with small steps then over time, be it years or so that there will be significant change that benefits those who are not only terminally ill, but those who are chronically ill and suffering with no reprieve until natural causes. I think once we reach that reality (whether in our lifetimes or beyond our lifetimes), it will certainly result in fewer impulsive or DIY CTBs, especially the really brutal ones.

I have always thought we should have complete control over our lives - and the choice and timing of our deaths

Absolutely, and I agree.

 

[Cress]

I actually had a pretty long form conversation about right to die for the non terminally ill with a therapist And he actually agreed with me that It should be opened up to more people. Maybe at some point the times will change if you have enough people in mental health and medical professions that advocate for it. However at the moment truth be told people just have too much difficulty assisting with someone's suicide.

I think if we had a official system for CTB it would actually save more people than we lose. That might sound crazy but hear me out. Offering people a official channel for taking themselves out is a great comfort but it's also a good way To get people around the system of mental health treatment and making absolutely sure that they won't benefit from a small amount of treatment. At present there's a lot of people there never seek any help at all for mental health treatment Because of how abrasive the whole system is. The number one cause of death for Males under 35 is suicide I think it's pretty safe to say that the current system has failed.

Even I can barely talk with mental health professionals about anything that I have going on because they're literally always threatening confinement and isolation in the form of hospitalization. I can't tell them that I have sn they would consider it their duty to remove it from my possession. Unfortunately mental health kind of operates off of a handoff system the therapist/social workers and Psychiatrist's Hand you off to the hospital to be confined where no one talks to you and they just lock you in a room and bring a psychiatrist in once a week. After your discharge from the hospital your handed off to the therapist/social workers and Psychiatrist's yet again. Everyone just passes the buck off to someone else assuming the next person is more qualified to handle the situation.

Mental health Reform is such an immense need but everyone likes to pretend like it doesn't exist. Like if we just ignore it it won't be the biggest problem. Maybe if a politician gets elected and makes it their campaign Focus you might see something significant but at the moment we're a long way off.

 

[Forever Sleep]

Even with the acceptance of more people, I kind of suspect the choice to die via VAD will ultimately, always be controlled by someone else. Likely doctors of some description.

That's not to say I don't think it would need regulating. I certainly think it needs to be ascertained that a person can rationally think about the decision, that they have fully considered all their options, that they're not being coerced etc.

But- what I'm referreing to is- likely a group of people will need to agree that someone's life is shit enough and irredeemable enough to warrant them being given a way out. And these are likely doctors- who very likely believe in modern medicine and their own abilities to cure most problems.

I just think it's set up to fail really. Doctors- who have taken an oath to try to save life are likely going to be reluctant to allow people to die. Especially relatively healthy people.

I've always felt like the assessment process should be done by an independant group of people who are specialists in ascertaining competency first and foremost. Beyond that though, I think they ought to know what services are available to offer people. According to their problems in life- health, wealth, quality of life- whatever. Not to say these things should be forced on people but, I think they should know all their available options and be given support if they want it.

Some people likely are still capable of recovery. Ironically- by allowing them to be open about just how bad things have gotten for them, they could actually receive the help they need. I wonder if it could actually save lives! How many people here suffer in silence because the subject is so taboo? For years, decades sometimes and with no help. Their situation may well not improve and only get worse that way- till they suicide on their own.

By legalising assisted suicide, it would bring the subject into the light to be discussed. Perhaps the more aware people are of people's wishes to die in the first place and the more realistic prospect that they now could reliably will make them more keen to actually try and help solve their problems before it gets to that stage.

I agree with you that assisted suicide ought to be available to all adults of sound mind (and to minors with debilitating health issues.) I think a process that includes a 6 month waiting term and assessments with people to sort through their reasoning would cut out impulsive attempts. I just can't see it happening though!

I actually find it so depressing that- even if we do see assisted suicide legalised worldwide, it will likely be for utterly dire circumstances. Sorry but- I don't want to have to wait for a bunch of doctors to agree that my situation is dire! I don't even want to get to that point. Imagine having to even go through all that paperwork, all those assessments when you're in that much pain. Imagine if you have to try and do all that on your own. Some of us don't have supportive families and again- care providers aren't exactly wired to help someone die.

I certainly hope assisted suicide is legalised for the terminally/ chronically ill. I think it's barbaric that it isn't already. I doubt it will help the rest of us though. Unless we fancy sticking around for however many years we have left at a level of suffering already (we wouldn't be wanting to suicide if we weren't already suffering in some way.) Just waiting for things to get worse- to a level where doctors agree! What a delightful prospect! (Sarcasm intended.)

 

[TAW122]

@Cress Yeah, it seems to be very risky to have a conversation like that, because IF the professional/therapist believes (whether they were right or not) that there is a threat, then they would certain take action against the patient because of "can't take any chances, better safe than sorry" kind of approach. While I never did mention those topics back when I did see one (many many years ago), I certainly always viewed any interaction with the mental health system, whether voluntarily or not is something that is akin to like talking to the authorities and there indeed is a power imbalance. Even workarounds or whatnot is just risky and doesn't really solve the problem of the ever looming threat of saying the wrong thing and/or having them to incorrectly (or falsely) believe there to be a danger and then taking action based on that alone.

Also, yeah I agree with you that the MHS is indeed in need of reform and perhaps once they abolish involuntary hospitalization or even a temporary hold (up to 72 hours), then maybe, there might be more people who are receptive to 'help' because it wouldn't be mandated, or forced on them, but instead "offered". That would make a world of difference for those who WANT help but otherwise wouldn't have done so. Personally, I've already made my decision many many years ago so that wouldn't really pertain to me, but I figured I'd mention it because it is an important topic (albeit for another thread).

@Forever Sleep Once again, thank you for a very thorough response and taking the time to read my thread. I really appreciate it. To address the points, I absolutely agree that there should be some independent group of people whose primary goal is to adjudicate these cases (maybe they may receive special training and not necessarily have to be doctors or medical professionals per se). This alone would create more jobs and also allow people to make money (which goes in accordance with capitalism and such), and whether that is good or bad is a different point altogether and not going off too far on that tangent. Next, yes, I also believe there should be further "real" efforts to destigmatize the talk of the 'taboo' subjects in order to help those who otherwise are currently suffering in silence and afraid to speak out for fear of repercussions (involuntary hospitalizations, alienation, poor treatment and bullying by their peers and people around them, etc.). Once that is addressed adequately, and people can do so without having to walk on eggshells or circumvent and reframe their delivery, presentation of the topic, then there would be real tolerance that is needed to have a constructive, civil, and level-headed dialogue (which is where a lot of current social issues are where they are in present day - women's rights, LGBTQ, civil rights, minorities' rights, etc.). The talk of the right to die has yet to reach there and in some places are regressing which is really sad. So in essence, yes, while there are a majority of people (barring some extremists) who agree that terminally ill (late stage cancer patients, late stage ALS, and/or other terminal conditions) deserve to have a peaceful, dignified exit, especially those who are already near death, there is still much progress to be made for those who aren't near death (non-terminal) but still have chronic and severely debilitating conditions that make their existence far worse than death itself. There is also so much red tape with all the anti-choice and DRA's (disability rights activists/advocates) who oppose the right to die for people who also could benefit greatly from them (non-terminal, chronically ill and/or debilitated people).

 

[Cress]

@Cress Yeah, it seems to be very risky to have a conversation like that, because IF the professional/therapist believes (whether they were right or not) that there is a threat, then they would certain take action against the patient because of "can't take any chances, better safe than sorry" kind of approach. While I never did mention those topics back when I did see one (many many years ago), I certainly always viewed any interaction with the mental health system, whether voluntarily or not is something that is akin to like talking to the authorities and there indeed is a power imbalance. Even workarounds or whatnot is just risky and doesn't really solve the problem of the ever looming threat of saying the wrong thing and/or having them to incorrectly (or falsely) believe there to be a danger and then taking action based on that alone.

Also, yeah I agree with you that the MHS is indeed in need of reform and perhaps once they abolish involuntary hospitalization or even a temporary hold (up to 72 hours), then maybe, there might be more people who are receptive to 'help' because it wouldn't be mandated, or forced on them, but instead "offered". That would make a world of difference for those who WANT help but otherwise wouldn't have done so. Personally, I've already made my decision many many years ago so that wouldn't really pertain to me, but I figured I'd mention it because it is an important topic (albeit for another thread).

@Forever Sleep Once again, thank you for a very thorough response and taking the time to read my thread. I really appreciate it. To address the points, I absolutely agree that there should be some independent group of people whose primary goal is to adjudicate these cases (maybe they may receive special training and not necessarily have to be doctors or medical professionals per se). This alone would create more jobs and also allow people to make money (which goes in accordance with capitalism and such), and whether that is good or bad is a different point altogether and not going off too far on that tangent. Next, yes, I also believe there should be further "real" efforts to destigmatize the talk of the 'taboo' subjects in order to help those who otherwise are currently suffering in silence and afraid to speak out for fear of repercussions (involuntary hospitalizations, alienation, poor treatment and bullying by their peers and people around them, etc.). Once that is addressed adequately, and people can do so without having to walk on eggshells or circumvent and reframe their delivery, presentation of the topic, then there would be real tolerance that is needed to have a constructive, civil, and level-headed dialogue (which is where a lot of current social issues are where they are in present day - women's rights, LGBTQ, civil rights, minorities' rights, etc.). The talk of the right to die has yet to reach there and in some places are regressing which is really sad. So in essence, yes, while there are a majority of people (barring some extremists) who agree that terminally ill (late stage cancer patients, late stage ALS, and/or other terminal conditions) deserve to have a peaceful, dignified exit, especially those who are already near death, there is still much progress to be made for those who aren't near death (non-terminal) but still have chronic and severely debilitating conditions that make their existence far worse than death itself. There is also so much red tape with all the anti-choice and DRA's (disability rights activists/advocates) who oppose the right to die for people who also could benefit greatly from them (non-terminal, chronically ill and/or debilitated people).

I don't know if you would want to abolish involuntarily hospitalizing people completely As there's some people that are so disturbed that they have no idea where they are in time and space And the only reasonable thing you can do is to involuntarily confine them. The issue is the system acts like a 1 size fits all hammer. Whether you're someone that's feeling a little bit down and thought about suicide one time this week, you can be confined in the same environment as someone that is in a complete state of confusion.

I realize it's mostly due to the bureaucracies and funding of how these places come together That they end up the way they are. However I think until We have a system that is Sensitive enough to be able to address the minute differences in mental health people experience in figuring out ways to address Those issues, Mental health is going to remain in a total state of Chaos for the patients and the providers of treatment.

I think the first step for mental health reform is early identification the main issue is no one realizes there's an issue until the patient is long past the point of no return or the issues are incredibly traumatic and severe. You need a system that is capable of identifying when people are in distress much earlier as well as a system that can encourage people to voluntarily come forward And allow themselves to be treated. Which of course requires That people actually trust mental health services enough to come forward. At the current time I don't think they deserve that Trust so I don't blame people for hiding their mental health struggles

 

[TAW122]

I would think that the bar and criterion for involuntarily hospitalizing people (both those who are court-ordered or temporary holds) must dramatically change as the current criterion is too invasive and rife for abuse. One major change I would propose is only to involuntarily hospitalize those who are really out of touch with reality (like you mentioned, completely unaware of time and space, really out of touch with reality - through objective means, like not knowing it's day time versus night time, hearing voices or heavily under the influence of substances and may be dangerous to others, violent, etc.) Even in those cases, it would have to be minimal and certainly better than what we have now. You are correct that in our current system, there is little to no differentiation between those who are passively thinking about CTB (though for the fact, I don't agree that the thought of CTB alone including actively planning should constitute irrationality or lack of ability to make sound decisions - clearly people who do CTB have some level of cognizance of their actions and are aware of them, thus for people to dismiss that fact and immediately rule them to be mentally incompetent is an grave insult towards their mental capacity and ability to reason). With that said, I do think that it would be a fair compromise if the people who really want to CTB are given some waiting period, and if they still don't change their mind, then after some point (after they gone through all the checks and balances, verification, etc. similar to what @Forever Sleep mentioned about indepdent groups), they should be allowed the green light to go peacefully and with dignity. This saves unwilling participants for being part of collateral damage, saves the person from choosing brutal DIY methods that have no guarantee of success (with some that have probable failure rates), and more.

I do agree that the reason compromise would be where there is a system that is gentle and sensitive enough to encourage people to want to try help NOT forced nor mandated for the person, and also certain lines in which the patient is ALLOWED to go with their wishes. For example, a person was really depressed about their predicament, whether it'll be a loss or something that they cannot fix and they were offered ways to cope, alternative solutions, but of course after trying and exhausting those options (within a reasonable timeframe, like a year, maybe two at most - just throwing some numbers out there), then after that should the patient still find their conditions unacceptable (link to Canada's MAID criterion), they should be given the green light to go. In such a system, someone would be given ample opportunities to change their mind while also still respecting their ultimate bodily autonomy. Also, I do think the term 'mental illness' is still too broadly applied and often done so with the pretext of depriving one's civil rights and liberties, but that's another point altogether and for a different topic.

Although in the end, and especially in present day, anti-choicers and pro-lifers are simply not interested in concessions and/or reaching a compromise where they can allow some give and take from their side as well as their opposition (us, pro-choicers and right to die advocates). They just want to impose their beliefs and will and are afraid that any deviation or allowance would undermine that. Thus, it is very disappointing and as long as the present day status quo stands, people who may have otherwise not acted upon CTB would still continue to take unnecessary risks, going through brutal means, and inadvertently involve unwilling participants as part of collateral damage. I do not endorse these brutal means or the collateral damage caused, but I merely see it as a consequence of a prohibitive, taboo society when it comes to the right to die.