My co-blogger, ClinkShrink, has very strong opinions on Physician Assisted Suicide. My personal opinions are less strong, though with 40,000 suicides in the US every year, I'm not sure why it's necessary to involve physicians as the agents of death; we went into this field to help people, not to kill them. But I don't believe that every suicide is necessarily either the result of mental illness or a tragedy. We all die, and for myself, if all that remains of my life is suffering, I'd like to go quickly. Clink and I say that she's worried they'll knock her off too soon and I'm worried they'll keep me around too long.
But what about psychic suffering, which by anyone's measure, is just as bad, if not worse than physical pain. I've had a patient tell me that his cancer treatments with all their complications, didn't compare to the pain of his depression. And certainly, many people do decide that their psychic pain is unbearable, or believe they've become a burden to others, and so end their own lives. But should doctors have a role in this? Should we kill people because they have treatment-refractory depression? I'm thinking that's not a good idea and please don't show up at my office looking for your lethal prescription.
In Belgium, psychic torment is an acceptable reason for euthanasia. And they even have a menu: you can drink a potion, or a doctor will administer a lethal injection. That's right, in the land of beer and chocolate, the doctor will actually murder you in the name of medicine.
The YouTube above is haunting. Emily has struggled with depression for a dozen years, and she's been approved for euthanasia. I'm going to tell you that Emily changes her mind at the end because if you don't know that this lovely 24 year old young woman lives, it's unbearable to watch. I find it hard to imagine that there is ever nothing that can be done to alleviate at least some of the pain ...even if it's ECT or ketamine, or TMS, or a few cocktails to temporarily numb the pain (~if you try that one, please don't drive afterwards) and no hope of a new treatment that might make it better. In this case, the events of the two weeks prior to her death date -- time spent meeting with friends to connect and say goodbye, getting ready -- were a period where the pain eased up. Emily felt better knowing there was a way out, she found hope in the prospect of death.