When I was in elementary school, my pediatrician advised my parents that she thought that I might have an illness that required special expertise beyond her own to treat. I was good enough at masking my symptoms, though, that my need for a specialist didn’t become imperative until I was in high school.
This illness has caused me immense suffering – suffering that for long stretches of my life has felt unbearable. I have a chemical deficiency that, if death certificates were filled out more honestly, would be listed as a secondary cause of death for many. I don’t think it would be going too far to call it a terminal illness for some – and you can very seldom tell who the terminal cases are until it is time for a post-mortem.
A member of my extended family told me that I had this illness because I didn’t have enough faith – that clearly I had not prayed about it, or it would no longer be a problem for me. I don’t suppose she would have said that if I had leukemia. Instead, I suffer from chronic depression. It is indeed “all in my head” (or at least mostly in my head) – “but only if by that you mean that your brain is in your head,” as a doctor of mine once put it. “Your head is still a part of your body, you know.”
There are many ways in which chronic depression contributes to the deaths of individuals – depression makes it very difficult to care adequately for one’s body (which can lead to malnutrition, obesity, substance abuse, and more), and makes some sufferers careless and inattentive (which can lead to otherwise avoidable accidents – some fatal.) But the cause of death most linked with depression in most people’s minds is suicide.
Many people who suffer from depression never make a “serious attempt” at ending their lives, but almost anyone who has suffered from depression has, from time to time, seen suicide’s appeal. You see, depression doesn’t just make a person feel sort of vaguely sad. The emotion goes beyond sad — depending on the person and the stage of the illness, it can range from intense bursts of the deepest sadness and alienation you have ever felt, to the inability to feel any kind of pleasure for weeks on end. It can make a person exhausted. It affects a person’s abilities to imprint memories. It can make ordinary activities seem impossible to achieve. It can even make a person’s body ache, physically. And worst of all, it feels like it will never end.
Some people find the right meds, and get better – some of these people get better forever, and others get better for a little while at least. Other people get better without medication at all. Still others go from medication to medication, and from therapist to therapist, with seemingly no end in sight. I cannot imagine how excruciating that must be.
I have been fortunate, after a fashion. Over the years, I have found treatments that have brought me into remission, sometimes for as much as 2 years at a time. Other treatments have taken away the worst of the symptoms, and left me with a low level pain that has allowed me to function for many years at a stretch. And I have lived with the illness long enough to recognize now when I am starting to slide towards the bottom – to go get help for myself before I am so far gone that I need someone else to get help for me.
But this place I am in now – this ability to recognize and manage my illness – is one that took three decades to reach. And I didn’t reach this place on my own – it took a great deal of willing and competent assistance. If, in the first fifteen years of dealing with this illness, a doctor had suggested that it was perfectly acceptable to opt out of intolerable suffering with their help – if, in other words, euthanasia had been offered by a trusted authority figure – by some expert who decided to share with me that some people never find a successful treatment – on a vulnerable enough day, I wonder if I might not have taken them up on it.
Of course, doctors don’t offer suicide as a solution to people with depression. In fact, in the United States, any kind of suicide is essentially illegal in most states, and any person with a mental illness who is judged to be “a danger to themselves” (who is credibly at risk of killing themselves) will be held against their will in a psychiatric facility. They may even be escorted to said facility by a policeman armed (oh irony!) with a deadly weapon. There they will be rehabilitated to the limits of the law and insurance, and released when they feel merely terrible again. This is not a great solution, but it could be much worse.
The Netherlands has had an assisted suicide law in place since 2002. In that country, an individual can go to their doctor and get their help in order to die quickly, painlessly, and reliably. At first this was only available to a person if they were “suffering unbearable pain with no hope for a cure.” Any kind of unbearable, incurable pain, that is, besides the pain that accompanies mental illness. Until they did start including some mental illnesses, as well as dementia. And now they’re looking to extend it to folks who are simply old and feel that they have “completed life.” How much longer until people like me, chronic depression sufferers, are included in the list of people whom it is acceptable for doctors to kill, with the state’s blessing, in the Netherlands? (UPDATE 10/14/2016: So, apparently it is not a question of “how much longer until…?” A friend on Facebook pointed out to me that it is happening already.)
Of course, as a Christian, euthanasia troubles me. From the very beginning, Christians have asserted that every life is of value – beginning with decrying the Roman practice of abandoning unwanted infants to die, and establishing hospitals, for instance. Killing those who do not fit into our plans for a tidy, shiny happy society is unacceptable. Instead, what is called for is increased support, and improved and attentive pain management when all else fails. (Shout out to Hospice – I will be forever grateful for how they helped to manage my father’s last weeks on earth.)
But it is also true that, as someone who has lived a long time under the cloud of depression, euthanasia troubles me. I am profoundly grateful for all of the many people over the years who told me, in one way or another, “No matter how much you may feel that your life is not worthwhile, your life IS worthwhile. No matter how much you may wish to die, I want you to do your best to LIVE.”
At my lowest points, it has been just as helpful (and sometimes even more so) when a person has said, “I totally get that you want to die. After all, you are in a lot of pain. But I’m asking you to wait until next week, and see if it still makes sense to you then.” And so on, from week to week.
Depression is exhausting for the folks who live around it. From time to time, some folks have had to withdraw – have not had the energy to be cheerleaders for life in the midst of the thunderstorm I was letting loose on them. They did what they needed to do to take good care of themselves.
Once or twice, an exasperated individual did lose patience with me and say, “Go ahead and die then, if you’re so set on it.” But never once has anyone (ANYone! Much less my own trusted doctor) said to me, “Not only do I believe that you are miserable, but I believe that you are right to be thinking about ending your life. Let me help you with that!”
I am not one who believes that a person who commits suicide places themselves outside of God’s providential care. God’s love dwarfs any meager emotion I or any other creature can muster. I myself have so much love, and no condemnation, for those who do end up taking their own lives – who cannot find any hope or reason to go on living. Nevertheless, the loss of life in this way grieves me deeply – it is deeply sad anytime a person is stretched beyond their endurance.
But giving doctors the authority to help someone end their own life is dangerous and unconscionable. The longer a person endures their suffering, the more opportunities they are given to find moments of joy and reconciliation in the days that they gain, the more opportunities their community is given to care for them, the more opportunities God is given to speak through that person’s life.
These days, almost 4% of all deaths in the Netherlands are by means of assisted suicide. Who knows how many of these people would have found that they had not yet reached the limits of their endurance, if there had not been so many people willing to release them from a burden that was not yet more than they could bear?
Many thanks to Rev. Kara Slade, who brought The Telegraph’s article on euthanasia in The Netherlands to my attention.