LIFE PRESERVATIONISM: THE PHILOSOPHY THAT VALUES LIFE OVER PEOPLE

Contrary to popular belief, the #1 priority of doctors in their practice is not to extinguish their patients’ suffering from an illness, but to preserve their life at all cost. Doctors in many parts of the world will turn a deaf ear on patients who request to be euthanized in order to avoid continuing to suffer from a particular illness despite the severe intensity of the pain that their patients may be dealing with because of this illness, and doctors will deem such patients as merely “stubborn,” “silly,” or “lacking in clarity of thought.” This last perceived “trait” is used as an argument by doctors and oppressive pro-life governments of the world to deny anyone with a painful illness (especially those with mental illness) the legal right to be euthanized, assuming that every single instance where a person with mental illness expresses death wishes is an instance where that patient is lacking in clarity of thought that is needed to make rational decisions. However, deeper analysis on this argument tells us that a mere lack of clarity of thought probably isn’t what concerns doctors and pro-life governments in these instances. Otherwise, alcohol consumption would be criminalized in euthanasia-forbidding jurisdictions, considering that consumption of alcohol puts consumers at high risk of doing anything imaginable out of lack of clarity of thought. Therefore, when pro-life doctors and world governments assess situations where someone with a mental illness wishes to be euthanized, they are not nearly as concerned about the patient “lacking any clarity of thought” altogether as they are about what they think the patient is “lacking in clarity of thought” in regards to. In this case scenario, it would be in regards to their life. Their very life would be at stake here. And, sadly, the vast majority of doctors and world governments of euthanasia-forbidding nations simply refuse to come to terms with the idea of extinguishing life in order to end intolerable, recurrent pain and suffering that would hardly dissipate otherwise. Therefore, it becomes clear that the real argument that they use to deny their suffering patients an euthanasia procedure is that “Their life comes before their will,” “Their life comes before their sentience,” and “their life comes before them.” To make matters worse, society at large is no less resistant than doctors and their pro-life governments to endorsing someone with refractory mental illness ever being euthanized or the very idea of extinguishing life to extinguish suffering from a refractory illness and the plethora of problems that it may cause. As stated in previous posts, there is a general trend in society of devaluing people with refractory mental illness, but holding their lives dear; there is a blatantly contradictory behavioral pattern where society disenfranchises and ostracizes those with refractory mental illness, and yet demands them to remain alive. Some members of society may even become entirely submissive to the wishes of someone with mental illness that they once thoroughly rejected if they find that this person is near completing a suicide attempt. And the underlying message that society’s contradictory actions towards the mentally ill who wish to die convey is the exact same that doctors and their pro-life governments worldwide convey to their victims with refractory mental illness that they cause so much torment to: “I care about your life more than I care about your torment,” “Your life is everything, and you are way beneath it,” and, in sum, “Your life alone is more important than you as a person.”  

LIFE PRESERVATIONISM AND RELIGION

Life preservationism in our day is likely to originate from traditionalist views that have (sadly) withstood the test of time, influencing how people have seen life through the ages. Many of these views have spoken in favor of life and against extinguishing it, and they often take root in religious teachings. Christianity (one of the most influential religions in the world for centuries) has been highly influential in forging the pro-life regimes of our day. Many people in our world today who oppose to the euthanization of the mentally ill point to the moral imperative of the sixth of the Ten Commandments, “Thou shall not kill,” often implying that euthanization of the mentally ill is “immoral” and would result in “bloodguilt.” The Bible takes Christianity’s pro-life stance further in 1 Corinthians 3:16-17 by stating the following:

“Do you not know that you are God’s temple and that God’s spirit dwells in you? If anyone destroys God’s temple, God will destroy him. For God’s temple is holy, and you are that temple.”

The Bible takes its views on the human body as god’s “temple” further in 1 Corinthians 6:19-20 by stating the following:

“Or do you not know that your body is a temple of the Holy Spirit within you, whom you have from God? You are not your own, for you were bought with a price. So glorify God in your body.”

Furthermore, the book of Ecclesiastes 7:17 specifically speaks against self-inflicted deaths by stating the following:

“Be not overly wicked, neither be a fool. Why should you die before your time?”

These Bible verses combined gives us a clear idea of how Christianity sees humans in relation to the Judeo-Christian god. According to Christianity, all people and their bodies are sacred “property” of the Judeo-Christian god, an extension of him, and subject to his will; and any extinction of a person’s life can ‘only’ be done at the discretion of the Judeo-Christian god himself. This is very consistent with common pro-life parlance, claiming that “the time hasn’t come yet” for those who wish to be euthanized to pass, or that it is “not within their power” to decide when they pass.

Why Are These Religious Arguments Against Euthanasia a Problem?

The first issue that stands out in these religious arguments against euthanasia for the mentally ill is that they objectify these individuals. For the Bible to state that someone “was bought with a price” implies the idea that people (and the mentally ill, in this case) are “objects” that can be bought or sold. The Bible further objectifies and dehumanizes people by claiming that they (and, most importantly, their life)  are “property” of the Judeo-Christian god. These beliefs are particularly troubling as they dehumanize people, deeming the will of those who wish to die to end a chronic, painful sentient experience and recurrent discomfort as less important than their life, thus making them slaves, or prisoners, of a pro-life regime that hardly (if at all) acknowledges their suffering.

The Human Body: God’s Temple? Or God’s Prison?

The Bible characterizes humans and their body as god’s “temple.” However, when one thinks of a holy temple, one thinks of a sacred establishment where troubled souls go to find peace of heart and mind. The human body, however, is quite different- it is an organic creation that houses the human soul, subjecting it to the vulnerability of the human condition, including the constant urge to satisfy needs like food, water, hygiene, medical care, love, etc., causing significant discomfort when these needs are not met, which is sadly the case for many people in developing nations. In that sense, the human body is nothing like a holy temple. Furthermore, many people all over the world experience chronic suffering within their bodies, such as movement difficulties, chronic physical pain, and refractory mental illness, and many of these unfortunate souls feel entrapped in these bodies like they would in a prison. Why, then, would the Bible compare disease-ridden bodies with sacred establishments where one would not be entrapped in such torment? Is the Bible making a genuine comparison here, or is it merely throwing struggling humans a bone?

The Incongruence Behind God’s “Ownership” of Humans and Their Life

It becomes very apparent that god’s claim in the Bible that the human body is “his holy temple,” is nothing more than meaningless flattery when one considers, for example, the millions of impoverished souls in developing nations which have no access to water, food, medicine, hygiene supplies, etc. which that god does little to serve. His meaningless rhetoric is just as noticeable for what it is when one considers the troubled souls in any part of the world, for that matter, who are troubled by some chronic physical or emotional pain which said god does little, in many cases, to provide any relief for. Why, then, does this god have the gall to claim human bodies and their lives as “his own” despite treating many of them (as troubled as they may be) as though he disowns them, giving them scarce attention and doing little to end their plight? To say the least, if this god does indeed exist, it would be very fair to say that he is not a “good” god like many of his worshipers proclaim, and that he is also a despot and a negligent hypocrite.

Religions’ General Consensus on Life Extinction

Most (if not all) religions of the world frown upon life extinction, whether it be through a self-directed death, or through a person extinguishing the life of another. No known world religion has a text supporting or even mentioning the practice of euthanasia in the first place, and when they do bring up the contemplation of suicide in their respective texts, readers are commanded to simply “have faith” and observe religious practices, thus implying that “euthanasia is not an option” like modern-day oppressive doctors and world governments that oppose euthanasia vehemently proclaim.

CONCLUSION

The unshakable life-preservationist regime that predominates in the world’s nations which forbid euthanasia to the mentally ill is likely to take root in ancient ideas about a person’s life and their spirit, like those found in the Bible, which “sanctify” a person’s life and body and deems it an act of sacrilege for a human to extinguish the life of another (even if it is done with the best of intentions). These views are very consistent with the leanings of oppressive clinicians and world governments of our day which deny euthanasia to the mentally ill, which do so out of the same aversion towards life-extinction that their religious forefathers have professed for thousands of years. There is also a notable correlation between ancient religious texts' lack of regard for those in chronic suffering who wish to die for the sake of religious doctrine on life, and the lack of regard of those who oppose euthanasia for the chronically mentally ill for the sake of modern medical practices prioritizing life preservation over pain extinction. Both religious texts and opponents of euthanasia for the mentally ill hold life alone in much higher regard than the will, sentience, and dignity of individuals with chronic suffering who wish to die, deeming the prospect of honoring the death wishes of people in chronic suffering as inconceivable, and both entities treat the mentally ill as though their lives are not their own, nor the agency to determine the timing of their death their own. Just as the Bible claims that a person’s life is god’s, modern day anti-euthanasia oppressors treat the lives of those who wish to be euthanized as though they practically belong to the state.

The pro-life, anti euthanasia inclinations of modern day doctors and governments which oppose euthanasia for the mentally ill align perfectly with those of ancient religious teachings, and it is very likely that anti-euthanasia attitudes of our day take root in religious doctrine rather than reason, morality, or true understanding of the suffering that the mentally ill who wish to be euthanized go through. It is time for those who oppose euthanasia for the mentally ill to wake up and realize that not everyone lives by any belief stemming from religious doctrine, and that they are no more gracious in their pro-life thumping agenda than their Bible-thumping cousins. Therefore, it is time for these euthanasia-denying oppressors to abandon outdated religious doctrine oppressing struggling individuals who wish to be euthanized and actualize their knowledge to the 21^st century understanding of the world around us- to acknowledge once and for all that the mentally ill who wish to be euthanized have an authentic and unique sentient experience which, in cases of refractory mental illness, see very little recovery and therefore deserve to have a say on when and if their life should be discontinued. If any religious idea applies here, it would be that of Free Will which those with refractory mental illness who wish to be euthanized deserve. Their life and their body are entirely their own (and not a god’s or a government’s) to make life or death decisions on when they see no recovery from their troubling illnesses. Therefore, neither doctors nor their governments have any moral grounds whatsoever impose their life-preservationist agenda on these troubled individuals, much less on “we’ve always done it that way” grounds, or on grounds of religious superstition which force them to live against their will. Such pretexts to force someone to live are in no way morally or logically sound.

THE DARK SIDE OF SUICIDE PREVENTION

Note: The target audience of this article are those who are part of the campaign for the legalization of voluntary euthanasia for the mentally ill and are mentally stable to advocate for this cause. Please refrain from reading this post if you are facing a serious struggle with suicidal urges as the post’s content could potentially make them worse. Instead, please go to an medical agency that can help you overcome your burdensome suicidal urges. I, the writer of this blog, am not responsible for your actions as a result of your coming across this post. Your actions are ultimately your responsibility.

In many parts of the world, including the United States, suicide prevention programs are venerated for their seemingly warm and kind-hearted nature of their messages of encouragement to those who have lost hope in their lives. Thru public service announcements with cliché slogans urging their readers to reach out for help and avoid committing suicide, or through Hallmark card-looking pamphlets offering words of hope and resources with picturesque photographs of butterflies, sunrises, or other wonders of nature, suicide prevention programs aim to convey a series of messages- that “Life is beautiful,” that “There’s hope for things to get better for the suicidal,” and that “There is help for that.” These messages are conveyed loudly in suicide prevention walks, which are saturated with people holding signs that read, “You are not alone,” “You matter,” “You are loved,” etc. with an air of cheer and optimism, like Care Bears eagerly shedding their beacons on a mission. These outreach efforts are sometimes effective- they draw in people with mental illness who are suicidal and connect them with medical agencies and resources that provide them with the treatment they need to live life they are happy with despite living with a mental illness. Unfortunately for those with refractory mental illness who wish to be euthanized, suicide prevention programs and incentives are not part of the solution to their troubles, but part of the problem.

OPPRESSION

The suicide prevention incentives from suicide prevention advocates and programs often come across as coming from a place of “goodwill,” “love,” and “care” towards the community at large, especially for those who are suicidal. However, the “warmth and fuzziness” of these incentives is only present when suicidal individuals act according to the will of suicide preventing agents- that is, by getting help and/or making a verbal commitment to life and to not commit suicide. If someone who is suicidal refuses to give in to these expectations, the true colors of suicide prevention incentives and advocates comes about. Their attitudes towards the suicidal shift from being caring and compassionate, to being oppressive and demanding to the suicidal person, forcing them to submission to a pro-life, anti-death agenda; their messages change from the character of “you matter,” “you are loved,” or “we care about you,” to the character of “your thoughts don’t matter,” “you are confined to our will,” and “we will command what you are to do with regards to your life” as soon as anti-suicide public forces step in. As stated in a previous post, suicide preventing agents and incentives like parens patriae in the United States are willing to take their suicide preventing agenda quite far, from forcing a mentally ill person who wishes to be euthanized into going to a hospital on handcuffs in a police car, to persecuting them, to breaking into their homes, to seeking them out at their workplace to embarrass them. This is the true face of suicide prevention in many parts of the world, and it hardly resembles the loving, caring, and warm cosmetic appearance that is given to it by suicide prevention advocates in suicide prevention walks, rallies, and propaganda.

Consequences of Oppression

In oppressive countries where euthanasia is forbidden for the mentally ill, suicide preventing clinicians and government forces vehemently state that “Suicide is not an option,” and the police force, handcuffs, and police trucks that they use on the mentally ill who wish to be euthanized demonstrates that such claim is far from a joke or a light-hearted statement. Consequently, such brutal and forceful measures of oppression and restraint have the potential to cause trauma on those with mental illness who wish to be euthanized, especially in times when they are the most psychologically vulnerable. They create an abusive relationship where the suicide preventing forces are the abusers and the suicidal are the victims of the abuse. After all, what suicidal individual could find recovery from mental illness by facing brutality and oppression from swat teams? Also, because the mentally ill who wish to be euthanized are coerced into living by force, they are often treated as though such force is the “consequence” of not feeling the edge to live, and public force oppressors will take their abuses further by using the “lack of clarity of thought” pretext to justify their oppression, thus manipulating the suicidal person they are capturing into believing that they deserve the treatment they are getting, and that their disdain for it is “invalid” or coming from a place of “lack of clarity of thought,” rather than a genuine discomfort with this compulsory and unwanted intervention. To make matters worse, those with refractory mental illness are always at risk of relapsing into crises of suicidal urges all throughout their life, and it would create more agony and distress for them in the long run if their government forbids euthanasia on them and forces them to either hold their suicidal urges in, or to be subjected to oppressive forces preventing their suicide again and again.  

OSTRACISM AND DISENFRANCHISEMENT

Many individuals who wish to be euthanized are individuals with serious symptoms of mental illness who, in many cases, are ostracized and disenfranchised by the people around them because of the strong way in which they many manifest these symptoms. Often times, friends and family who take it upon themselves to be “caring” guides or supporters of those who are suicidal towards recovery end up losing the edge to do so because they cannot cope with the symptoms of mental illness of the person they once wanted to support, thus deciding that they can no longer help the suicidal individual, abandoning them, and leaving the individual with mental illness to struggle on their own (while maybe giving them a phone number to call or the information of an agency to go to for help), and this is yet another instance where we see the warm and fuzzy messages in the spirit of “you are not alone,” “I care about you,” and “you are loved,” from suicide preventing advocates (including friends or relatives) completely dissipating into thin air, changing into messages conveying that the abandoned individuals are indeed alone, and that they are not loved, tolerated, or even cared about anymore. 

Consequences of Ostracism and Disenfranchisement

Such instances of ostracism and disenfranchisement increase the suicidal thought of the disenfranchised suicidal individuals by inducing three notorious triggers: depression from being abandoned, guilt from having done something to cause the abandonment, and anger and mistrust in society at large. In this case scenario, suicide seems the more logical option for the abandoned suicidal so that they no longer have to deal with a world that has turned its back on them. This is particularly problematic for those with refractory mental illness because even getting help for their illness from an agency can still fail to be enough to bring about relief to a point where they don’t have to be at the mercy of other individuals outside of the doctor’s office whose ability to be the least supportive of them is either limited or nonexistent. Therefore, it is very common for those with refractory mental illness to see people who once wanted to be on their side completely turn away in a time of dire need of support, and this is by far one of the most devastating experiences that those with mental illness in general can go through. This is therefore another situation where suicide prevention falls flat and the suicidal urges of an abandoned individual increase rather than decrease.

SOCIETY’S NONRECIPROCAL DEMANDS ON THE SUICIDAL

The irony in situations where the suicidal are abandoned is the way in which the friends and family who abandoned them would react when the suicidal person begins to talk about intending to commit suicide: the friends and family would be sad, or angry, begging or demanding that the suicidal person not commit suicide; or what about an instance where an suicidal person actually puts a gun to their head and tell the people who once turned their back on them that they will commit suicide? The people who would have abandoned the suicidal individual would then become extremely submissive, frantically giving in to the suicidal person’s demands, in fear that they might commit suicide. This contradictory phenomenon, combined with the brutality that the suicidal are subjected to by suicide-preventing public forces, raises a series of important questions: Why do friends, family, peers, or the people who at one point treat a suicidal individual as though they do not owe them the support they once offered also expect to be entitled to the person they abandoned remaining alive and not committing suicide? Why do the very people who disenfranchise and abandon a suicidal person in need of their support also poke and nab at that that person so they will still remain alive? Why do government forces in countries around the world act as though the suicidal owe them to remain alive, even if it is against their will? What code of ethics dictates that the suicidal are not owed emotional support, supportive friendships, sociocultural privileges, etc. but they are owed brutal interventions from government forces and public powers that push the mentally ill into services even if they do not request them, do not want them, or can’t afford them? Simply put:

Why does society at large bluntly dictate that it does not owe the mentally ill that it disenfranchises any kind of social privilege (like emotional support, relationships, work and other social privileges) and yet shamelessly demand that the mentally ill live, even against their will, as though the mentally ill, in turn, owe it to society to do so?

Or, in a more general sense:

If the world owes nothing to the mentally ill who wish to be euthanized, why does the world treat the mentally ill who wish to be euthanized as though they owe it to the world to live?

This heavily imbalanced societal phenomenon, which gives the mentally ill and suicidal the short end of the stick, proves that suicide prevention measures are not only not entirely rational, but they also fail to make the suicidal individual’s dignity, comfort, and enhancement of their sentient experience the #1 priorities in suicide prevention advances. Instead, we see here that the life preservation of the individual is the ultimate goal and the true #1 priority, and just about every other aspect of that individual is deemed as secondary in importance, if that.

THE MEDIOCRITY OF SUICIDE PREVENTION HOTLINES

Anyone who has contacted suicide prevention hotlines for a prolonged period of time knows that it takes a stroke of luck to be matched with an operator that will be the least helpful in a particular situation. It is no secret that suicide prevention hotline operators are not therapists and that they may or may not have any training in handling suicidal crises. Or they may have, in fact, gotten some training, but may choose to disregard it in a call altogether. An individual we will call Lucas, who has refractory mental illness, will tell us about his experience with having called multiple suicide hotlines:

“Sometimes I’ve gotten connected with operators who are helpful and supportive (who give me follow-up calls) but too often I’ve gotten connected with operators who are just ok conversationalists that mean to be encouraging but don’t necessarily say anything that helps me overcome the obstacle I may be facing. Sometimes I get connected with the very same of those individuals and wind up having yet another conversation with them that is no more helpful than the first phone call with them. And sometimes I get connected with people who are unhelpful and even rude. Once, I got connected to an asshole who said that “we don’t do that anymore” after I asked if I was talking to the suicide hotline. He gave me another number to call and, to the best of my memory, that number he gave me led nowhere. I also got connected to this older woman who was rude. The phone call began with her asking me right off the bat if I needed and ambulance, and when I told her that I didn’t, she asked me why I called in the first place if I didn’t need an ambulance. I told her something to the effect that I just needed to talk. She asked me what was going on, and from her seemingly rude demeanor I grew anxious and struggled to open up about what I was struggling with, and when the woman picked up on that she told me to just come right out and tell her what I was dealing with because she “didn’t want to play the guessing game.” If that had happened today, I would have just told her to go fuck herself and hung up the phone, but imagine how vulnerable I was at the time from being suicidal. So I just gave in, told her what was going on, and we just had a conversation about what I was dealing with from there. Overall that woman was very unpleasant. I remember her telling me that she had “favorite” grandsons that she would write a check to and not expect a dime back from, and other grandsons that she didn’t like at all whom she wouldn’t give the time of day. That woman was downright nasty in the way she talked at me- it's like she was ignoring the fact that I was suicidal that night. She would have been far better as an ambulance dispatcher than an actual suicide hotline operator."

Not only is it important to consider that the quality of service of suicide hotlines is below average, but it is also important to question how therapeutic it is to use them. How is it therapeutic to call a complete stranger to tell them about your problems? How therapeutic is it to call a hotline of complete strangers to talk about your problems, and to get a completely different complete stranger to talk to every time you call? All things considered, contacting a suicide hotline can be a gamble in itself.

CONCLUSION

Suicide prevention programs are very good about using the media to promote their cause with heart-warming messages of hope, healing, and love towards their community like they were lyrics coming out of a Barney the Dinosaur song. However, it is important to keep in mind that these advances have an agenda that does not necessarily intend to favor the suicidal individuals it aims to reach. They are an extension (or perhaps even a puppet) of a larger public force or government dictatorship that uses brute force on the mentally ill who wish to be euthanized if they refuse to act by their pro-life standards. Therefore, their “warm and fuzzy” advances are only an illusion that conceals the iron hand of an oppressive pro-life government force. Furthermore, the suicide preventing individuals who claim that they “love” and “care” or a suicidal person enough to “want to be there” for them cannot fully be trusted. In many cases, suicide prevention advocates find over time that they cannot cope with the symptoms of mental illness of a suicidal person and prefer to selfishly turn them away to their own luck, making their suicide prevention cause and initiatives look like a more selfish than selfless pursuit. This is a commonplace reality that those who struggle with refractory mental illness have to face throughout their life. Therefore, they deserve the option to be euthanized at their request when following any advice they get from suicide prevention propaganda or even from Friend & Lover’s best-known song to “Reach Out in the Darkness” falls flat and they are left with no support and no way to fend for themselves.

THE #1 PRIORITY OF TRADITIONAL MEDICINE

When we think about the role of medical practitioners in our society, the first thought that comes to our minds is the relieving of symptoms of people’s illnesses. And this is true to an extent- doctors give people medicines that bring about relief from symptoms of illness. However, it’s also important to dig deeper and question: what are practitioners priorities when treating illness? These priorities come to light in situations where there’s no cure for a particular illness because these situations put doctors at a crossroads where they have to decide what to prioritize when treating these incurable illnesses. And sadly, doctors around the world hardly give relief from symptoms of illness #1 priority in these cases.

Doctors’ #1 Priority When Treating Illness

Doctors’ priorities when treating illness are quite evident in cases where the illnesses to be treated are refractory mental illnesses. In the majority of cases of refractory mental illnesses, its sufferers have dealt with illnesses severe enough to bring about recurrent torment and difficulty to function in many areas of their lives, bringing about problems that exacerbate the distressing symptoms of their illnesses and often leading to suicidal ideation. Often times, patients with refractory mental illness will tell their doctors that they want to end their life in order to end their pain, and out of desperation may urge their doctors to euthanize them for that very purpose. Sadly, many doctors around the world will be deaf to those requests. Their #1 priority, after all, is not extinguishing pain. It is life preservation. After all, doctors around the world have been indoctrinated by their traditionalist studies to believe that life preservation should always be a greater priority than the will and dignity of the suffering patient with regards to their life. These doctors (and their government’s) sanctification of life and their lower prioritization of the dignity and relief of their patients from illness are the main driving force behind their unshakable pro-life agenda.

Doctor’s #1 Pretext to Oppress Death-Wishing Patients Into Living

Many governments around the world, and the doctors that practice under their mandate, always use the “lack of clarity of thought” argument to justify their oppressive measures when forbidding the mentally ill the option to be euthanized. The lack of clarity of thought argument claims that the mentally ill are always lacking in “good judgment" when they express wishes to be euthanized. This argument is called a pretext here because it isn’t, in fact, the ultimate reason why doctors and governments around the world oppose to euthanization of the mentally ill. If clarity of thought was truly deemed a valid enough reason to validate legally forbidding euthanasia on the mentally ill by euthanasia-forbidding governments, then why do they not criminalize the making and consumption of alcohol in their soil altogether? After all, alcohol is an intoxicating substance that not only makes its consumers much less capable of rational thought than someone who suffers distress from mental illness, but it has great potential to cause death (the outcome that pro-life governments so frantically want to avoid), including fatal crashes that kill drivers or pedestrians from a true lack of clarity of thought and from the truly impaired mental functioning of a drunk driver. Therefore, because alcohol is legal in many euthanasia-forbidding jurisdictions despite its potential to impair mental functioning, the “lack of clarity of thought” argument is less likely to be what leads governments of the world to forbid euthanasia for those with refractory mental illness. It is the long-lived pro-life traditions that are more likely to compel this, most notably the commandment of thou shall not kill, and the standard of bioethics to do no harm.

Implications of Medicine’s #1 Priority

As doctors’ radically pro-life agenda comes to the surface in countries where euthanasia for the mentally ill is illegal, it becomes evident that doctors in these jurisdictions prioritize life-preservation over pain extinction, and therefore prioritize life imposition over pain relief. This is especially the case when these doctors deny euthanasia to the mentally ill out of wholehearted conviction. However, looking at this oppression from a larger scale reveals that these doctors themselves are also oppressed in their countries. The laws that forbid the mentally ill from being euthanized also forbid these doctors from performing euthanasia on their psychiatric patients. If the doctors were to oblige to the wishes of the mentally ill, they would be subjected to imprisonment and to revocation of their licenses by order of the law of their oppressive nations. Consequently, their hands are tied, whether or not they support euthanasia for the mentally ill. Therefore, world governments are ultimately the agents to blame for the oppressive measures that the mentally ill who wish to be euthanized are subjected to. World governments are directly responsible for orchestrating dictatorships which deny the mentally ill who wish to be euthanized the right to euthanasia, and which decree that life-preservation is more important than pain extinction. It is therefore imperative for those of us who support euthanasia for the mentally ill to raise our voices, stand up to our governments, and proclaim that we do not want to be forced to remain alive by any clinician or government authority, especially if our being alive means enduring intolerable pain from mental illness. Most importantly, we must make it clear to the governments of the world that we want everyone with mental illness to have the freedom to live by choice, and not by a government decree that does not necessarily have their best interest in mind.

THE “LACK OF CLARITY OF THOUGHT” ARGUMENT

The basis of all opposition to euthanasia for the mentally ill in the field of medicine is the misguided assumption that the mentally ill who wish to be euthanized are “lacking in clarity of thought” needed to be able to make informed, rational decisions when they express wishes to be euthanized to end the recurrent, intolerable pain that they endure because of their mental illnesses. The world’s clinicians and world governments which forbid euthanasia to the mentally ill argue that it is never appropriate to euthanize the mentally ill because the state of emotional duress that they may be in when experiencing death wishes makes them “mentally incompetent” to make rational, informed decisions about their life. However, those of us who favor euthanasia for the mentally ill are not swayed by this argument. After all, we take into account the level of suffering of those who wish to be euthanized, rather than their mere “thinking ability.” Therefore, this leads us to question the following: 

  

Are the death wishes that an individual experiences from emotional suffering a justifiable reason to force that individual into compulsory treatment and intervention?  

  

Those who oppose euthanasia for the mentally ill would likely answer this question with a resounding “yes.” After all, they believe that an individual in that situation is “mentally handicapped” in their decision-making process, and they would claim that their condition is treatable- pointing at all the treatment methods that have been developed to date to treat mental health issues. Those of us who favor euthanasia for the mentally ill, however, have other considerations. For example, we take into account that there are many individuals who have a treatment-resistant mental illness, while also acknowledging that no treatment method available for mental illness is 100% effective for 100% of consumers. This leaves us with a significant population of individuals with mental illness who do not benefit from these treatment methods who therefore experience death wishes because they suffer from chronic and intolerable pain due to their unbearable struggle with mental illness, thus diminishing the validity of the argument against euthanasia that such conditions are “treatable.” This raises another important question: 

  

Can the experience of chronic and intolerable suffering of a mentally ill individual be a justification to favor euthanasia to end this suffering? 

  

Those who oppose to euthanasia for the mentally ill would likely answer this question with a resounding “no.” After all, they ultimately favor and prioritize life-preservation over pain-extinction, and therefore favor life-imposition over freedom of choice between life or death. Those of us who favor euthanasia for the mentally ill, however, find this agenda to be deeply troubling. At its core, it is life-centered rather than patient-centered. This mentality in turn neglects important aspects of the suffering that those with refractory mental illness experience and raises important concerns about current medical practices worldwide which deny euthanasia to the mentally ill, and the validity and ethics of the “lack of clarity of thought” argument as the standard pretext to encourage these practices.  

  

“Lack of Clarity of Thought”: Scientifically Sound Argument, or Gaslighting Strategy? 

  

In order to evaluate the validity of the “Lack of Clarity of Thought” argument against euthanasia for the mentally ill, we decided to use evidence against it, straight from the horse’s mouth, to see how that argument would hold out. To do this, we will use the testimony of an individual with refractory mental illness who wishes to be euthanized. They will use the name “Marie,” tell their story, and explain why they want to be euthanized.  

  

“My mental illness has made it extremely difficult for me to have a tolerable life, and for me to be able to advance through it smoothly. I struggle with developmental disorders that make me inept in social situations and make it hard for me to make friends or even land a committed relationship with someone. People think I’m stupid or that I’m creepy and petty, so they push me away without even thinking about it. I get rejected like this on a regular basis, and every instance of this rejection feels bad, especially when I see other people getting together as friends, or when I see two people holding hands, staring passionately at each other, and making out. My developmental disorders also make it hard for me to do well in high-demanding classes or jobs, which means that I’m prone to be stuck in low-end jobs as I have been for a decade after I was supposed to graduate from college. I’m 33 years old right now and I’m STILL dependent on my aging parents for financial support. I also struggle with a personality disorder, which makes me feel overly attached to people who (I think) show an ounce of interest in me, only for them to lose that interest when I cling to them. People push me away in those instances, and I cannot begin to tell you how much pain I feel when that happens. It’s a stabbing pain I would not wish for my worst enemy. This personality disorder makes it a painful struggle for me to tolerate being rejected as it makes it a painful struggle for me to tolerate being alone, thus making me very prone to becoming very emotionally dependent on the approval, acknowledgment, and support from people of interest, none of whom are interested in me, to begin with. I’ve taken it upon myself to get help for these issues by having gone to talk therapy and by having taken prescribed medications for well over a decade, and the issues I’m facing from my mental health issues persist. There are neither pills nor is there a cure for personality disorders like BPD or CPTSD-There is DBT, but the problem with it, first of all, is that it’s expensive and I simply can’t afford a single session with what little I earn. Psychologytoday.com is full of practitioners who don’t take insurance and whose session fees are exorbitant, and no facility in my city that offers DBT takes my Medicaid (or any insurance, for that matter). And even if I could afford DBT, it would take very hard work and months (if not years) to yield results. I’m having the exact same problem with my treatment of Developmental Trauma. All of this makes matters all the worse, considering that my pain-coping threshold has been far surpassed for years. Also, no skills that I’ve learned in therapy (like grounding, counting to fucking 10, deep breathing, etc.) have helped me to make the issues I get from my developmental and personality disorders be the least tolerable. Like this was not enough, I also struggle with bipolar disorder, which makes me feel like my skull is cracking open when I'm off my Latuda for too long, or like I’m in a suffocating daze when it’s kicking in, or like I have no energy to do anything at all and like my body is petrified by an overwhelming depression into an ocean of despair even when I’m on the pill while gaining enormous amounts of weight from it. And this begs the question- why can’t medication developers make medications so that they don’t cause all these problems? Why do they have to make shitty medications that supposedly treat mental illness but cause a bunch of other problems to your body?! 

 

Most of the serious problems I’m faced with right now come from some disfunction or distressful signal from my brain that causes me some kind of suffering that has the potential to ripple into more suffering if I don’t have the edge or the know-how to cope with these mental health issues in ways that don’t cause more problems in my life. Like I said before, I’ve gone to therapy and have taken medications for over a decade to resolve these issues, but those approaches to treatment haven’t really been enough to keep me from having serious problems that are related to the issues I’m seeking treatment for to begin with.  

 

All these things are a shit-ton of issues to deal with- the social ineptitude, the compulsive clinginess, the rejection and ostracism from mainstream society, the painful biochemical imbalances and the nauseating trial and error of medicating are all heavy layers of pain that have sat on a vulnerable psyche that lives in agony by not being able to hold their weight but having to do so anyway. 

 

That shit is just too much. And it has been way too fucking much for way too fucking long. So, I’m done. I want to be euthanized. And I know, that it would take a toll on my family if that were to happen. They’d fall into torment and despair, and they would struggle to come to terms with the fact that I’d be gone for good, and they would go through anger, sadness, and other painful emotions as they struggle to process my death. They would be angry that I left them, and they would be sad that all the good things that could have happened in my life never did. So yes, I acknowledge that it would have a negative impact on some people if I were to be euthanized. But what about me? And what about my dignity? This mental illness has caused me to experience more pain and suffering than I can cope with, and it’s been that way for years. I’ve been very disenfranchised by many people as it is because of my mental illness and the behavioral issues that surge from it for years, so why should any of those people have a say on whether or not I should live? Should I remain alive because other people think I should or because other people want me to despite the suffering I endure because of my mental illnesses? These people don't necessarily understand the suffering I'm going through, and they're not the ones having to deal with what I have to deal with! Living a life of torment that I do not want to live because other people want me to and because they only want to focus on the good in my life and diminish the bad that has made it so unbearable, does not sound like a very reasonable gamble to me. It does not sound very considerate of me or my dignity, and it is old-fashioned thinking altogether- like the times when a person had a career path, or a spouse chosen for them by their parents or someone of "higher" authority. This is the 21st century now- an age of self-determination! So, if I am to be alive, it should be because I want to and because I feel glad and comfortable in doing so.” 

 

Most clinicians would draw the conclusion that Marie, in this particular instance, is lacking in clarity of thought because she is expressing death wishes. However, it is an obvious fact that a person who is truly incapable of thinking clearly cannot put two and two together. They wouldn’t be able to make sense of complex situations or to explain them in the way that Marie does here. She does this with profound clarity of thought and clarity of understanding of her situation, her role in it, the roles of others, and she demonstrates a clear understanding of what she would need to do to recover and the roadblocks she has endured for this recovery to take place. She also has a clear understanding of the implications of her actions on other people. This instance of clarity of thought in the midst of profound psychological distress gives way to an often-overlooked fact in the treatment of mental illness: 

 

Not everyone with mental illness who expresses death wishes is lacking in clarity of thought.  

 

To assume that Marie is “lacking in clarity of thought” for expressing death wishes in the circumstances that she is in and to deny her a euthanasia procedure on those grounds denotes an inadequate understanding and poor insight into the issues at play in people with mental illness who express death wishes in general, often ignoring the fact that instense pain, rather than an inability to think clearly, is the driving force behind many instances where the mentally ill express death wishes. Furthermore, because the #1 priority of many anti-euthanasia clinicians and world governments is to preserve the lives of the mentally ill who wish to be euthanized (even if it is against their will), it is fair to say that their use of the “Lack of Clarity of Thought” argument to discourage the death wishes that someone with mental illness expresses (in instances where emotional pain is the cause of said wishes) is a gaslighting strategy to coax them (and sometimes coerce them) into living- especially when one considers the zealous nature of their life-preservationist agenda, which deems “life” the only valid choice for the death-wishing mentally ill individuals that they oppress. This, in turn, involves a variety of ethical issues, as listed below. 

 

Why is the “Lack of Clarity of Thought” Argument Against Euthanasia a Problem? 

• It fails to address one of the most common factors that cause many with mental illness to experience suicidal ideation and leanings towards euthanasia in the first place. Pain, rather than mere “inability to think clearly,” is at the forefront of their death wishes in some instances. The way that those with mental illness in these instances “think” doesn’t always influence their death wishes as do their coping/pain tolerance thresholds being surpassed in a given situation, and sometimes for prolonged periods of time. People with refractory mental illness sometimes become suicidal because they are in pain, not necessarily because they “cannot think clearly.” 
  

• It heavily discredits the ability of those with refractory mental illness who wish to be euthanized to make informed decisions. Many of these individuals have already done their part by seeing therapists and psychiatrists, picking up coping skills and medications along the way, and using every resource within their reach to achieve recovery, over a very long time span, before determining that none of these resources have been helpful to help them achieve a life where their life-long mental illnesses are manageable and tolerable. Therefore, many of those with refractory mental illness lean towards euthanasia because the treatments they chose to undergo in the past were not helpful, not because they’re incapable of making good decisions about how to deal with their mental health problems in the first place.

• It insults the intelligence and rationale of those with refractory mental illness who wish to be euthanized, implying that their urge to end their pain through death is always because of “faulty thinking” rather than a genuine struggle to live through pain-inducing circumstances. It has overall negative connotations on the intelligence and thinking capacity of the mentally ill who wish to be euthanized, practically deeming them to be "stupid," "crazy," or "insane" just because they want to end their life through euthanasia.

• It dehumanizes the mentally ill who wish to be euthanized and invalidates their plight, neglecting and ignoring the recurrent pain they endure which leads them to suicidal thought and deeming it practically “meaningless,” and “less important” than their own life being preserved, and therefore not a valid enough factor to legitimize euthanasia to end the intolerable suffering caused by their mental illness. It also implies that the life preservation agenda of mental health regimes worldwide is more important than the will of the individual in a situation when the pain in their lives is intolerable.
• It neglects those with mental illness whose conditions are treatment-resistant, leaving them out of options to end their intolerable pain and suffering and thus prolonging their suffering.

• It overlooks the relatively insightful understanding that many of those with refractory mental illness who wish to die may have about their mental illnesses, the myriad of ways in which these illnesses cause their suffering (usually for prolonged periods of time), and the plethora of issues that these illnesses pose in their lives as a whole to a point where euthanasia is the only reasonable means to end their suffering once and for all. Contrary to popular belief, those with refractory mental illness who wish to be euthanized are not necessarily as lacking in awareness of the consequences and implications of their actions as a baby who is eager to touch a red, hot burning coil on a stove top without knowing they will get burned. In fact, those with refractory mental illness can be just as capable of understanding the impact of their euthanasia on those around them in the same way they understand the impact of their illnesses on their own lives. 

 

Conclusion 

 

The “Lack of Clarity of Thought” Argument that clinicians and world governments use to deny euthanasia to the mentally ill is a tool for oppression that practically forces the mentally ill who wish to be euthanized into continuing to live in pain-inducing circumstances that they have already expressed to have a marked difficulty in coping with, and an inability to cope with further. This oppression from anti-euthanasia clinicians and world governments is always carried out under the misguided cookie-cutter assumption that people with a mental illness in these circumstances are always lacking in clarity of thought simply because they express death wishes. In reality, this isn’t always true, as illustrated with Marie’s story. Furthermore, the “Lack of Clarity of Thought” argument fails in that it places too much focus on the “thinking ability” of those with refractory mental illness who wish to be euthanized and neglects the intolerable pain which leads them to experience death wishes in the first place. It also discredits their thinking ability when making decisions about their situation with intolerable suffering, even in instances when they have already made the choice to get help in the face of mental and emotional duress. This argument also diminishes the validity of said duress as an understandable reason to justify the use of euthanasia to eliminate a life that is mired with this kind of suffering. This argument places the life of the individual in higher regard than their dignity and comfort and imposes the idea that this must be the right order of things and that any thought that deviates from this idea is scientifically and ethically incorrect. The "Lack of Clarity of Thought" argument, therefore, has a hindering effect on the euthanasia-wishing individuals that it oppresses because it dehumanizes them by placing their pain extinction as second order of business (thus exacerbating their pain in the long run), and by degrading their rationale in times of great distress- that is, in times when they need the most understanding, validation, and compassion.