I share a lot of your questions about this, but the following parts made me uncomfortable agreeing with you:
People who are seeking death are rarely in the kind of headspace where I think they are able to meaningfully consent to that?
And this feels meaningfully different than the case of a 90yo who’s body is slowly failing them. This is an otherwise healthy young person.
She has the following to say about that: “People think that when you’re mentally ill, you can’t think straight, which is insulting.”
Mental illness is an illness, and can be chronic and progressive. They can cause someone to be unable to carry on living, maintaining a livelihood, afford their own medication, psychiatric visits and therapy that they would need to even want to live in the first place. That’s not even to go into the absolute hell people in such situations can go through everyday.
We can debate on what constitutes “a well-thought-out decision that takes into consideration every available option” and I would actually say that one should give those options a try, but to deny that a mentally ill person can make their own EOL decisions makes me terribly uncomfortable.
In my opinion, sure, there should be a waiting period, to filter out those chronic episodes that lead to spur-of-the moment impulses, or decisions that are strongly linked to temporary conditions. This waiting period can be used to think things through, prove that they’ve tried means available to them, or even give them the chance to try the means they wouldn’t have had access to otherwise (like specialized help, therapy that wouldn’t have been available to them, etc). Now, I think what happens next is up to these medical professionals: do they deem one’s condition to be intractable and no amount of medication and therapy and counseling can make a difference? If they deem the situation to be hopeless, and the patient agrees, then yeah, the patient can make their exit. Otherwise, the medication, therapy, counseling or whatever it is that they’ve been trying should continue. If funds are needed for this to continue, then so be it. Those people who want to be no exits can be counted upon to fund this, right? Those people denying exit should put their money where their mouths are.
If signing up to an EOL waiting list could be the way for people to consider their situation and try out things that might help them, then so be it.
Oh, sorry, I’ve been rambling. My point is, yeah, there should be a waiting period that would double as a chance for people to get the help they need (but don’t have access to or maybe the motivation to). And more importantly, that anyone, and I mean anyone (okay, there’d be a triage system in place, but just allow everyone in, and sort them out once they’re in) can sign up.
The way I imagine things would go is I can just walk into some office, inform the person in the counter that I want to have a passport to neverwhere, and they’d ask me to file some paperwork and after a few days, I’d be in a clinic where someone would perform a psychological check-up on me, and do some interviews. Then after a few more days, some doctor will be informing me of my diagnosis and options—or perhaps just flat out saying I’m completely mentally healthy and my petition is denied (if I’m lucky maybe given a list of people to contact to help with my problems). If I’m continuing the process, then I’d choose which option I want, go with the treatment or other, and like, hopefully continue until I can manage my situation with minimal help!
Do we really need people to sign up for a passport to the great beyond just to get the help they need? No, in an ideal world, there shouldn’t even be a need for this. But in this kind of world we live in, I think allowing people to safely cross the streams with dignity and peace of mind (after giving it a good try, and concluding that it really can’t be helped) is a small kindness society can give to the suffering.
See, I feel like your whole post could be summarized as, “some people’s mental illness makes them unable to work and earn money, so they’re too poor to afford treatment, and therefore the morally correct thing is to just let those people kill themselves.”
And while I don’t think that’s exactly what you meant, it’s how it comes across. Almost all of your points are some variation of who’s gonna pay for their treatment and take care of their physical needs.
And I would strongly argue that the answer is instead to have more robust social safety nets to cover those needs. Allowing people to kill themselves as the solution is hella dystopian.
But, I’m not saying that this is 100% always right. This is a hard issue with no clear answers, and I am absolutely not minimizing the pain of mental illness. My point is that mental illness is much less understood than physical illness, and I wouldn’t trust any diagnosis that said the condition could never be resolved. In the same way that I would be loathe to euthanize someone with a physical illness that has an acceptable chance of being transient, I’m loath to do the same with most if not all cases of mental illness. Especially if the person is otherwise very young/healthy.
And while I don’t think that’s exactly what you meant, it’s how it comes across. Almost all of your points are some variation of who’s gonna pay for their treatment and take care of their physical needs.
Indeed, that’s not what exactly what I meant. Thanks for giving me the benefit of the doubt.
My main point can be summarized in that second to the last paragraph, which I doubt has communicated things adequately.
To reiterate: it won’t be initiated by the medical professionals. They’re simply there to ensure that someone applying for this procedure are indeed “proceeding of their own accord and have made sure options have been considered”. The waiting period is there to make sure that not only they’ve arrived at this decision after careful deliberation, but also to force them to consider and try out the options available to them. The process can be terminated at any point by the patient, and the final step will not proceed without their permission.
My point is that mental illness is much less understood than physical illness, and I wouldn’t trust any diagnosis that said the condition could never be resolved.
I accept this point. This is why I put the emphasis on the decision of the patient. And this is where I think our positions fundamentally differ. Promising treatments may or may not be there, may or may not be there in the immediate or far future, but it’s on the patient to consider. The medical professionals are there to ensure that the patient has considered available options, and have exerted reasonable effort to improve their situation. Whether or not the patient has made “the correct decision” isn’t the point—but rather whether or not the patient has made an informed and well-thought-out decision.
I share your opinion that in an ideal world, this shouldn’t even be needed. That even though the option would be there for anyone to take, no one will take it in an ideal world. But we are not in such an ideal world. We can strengthen our social safety nets to help people suffering from the debilitating effects of mental illness (among other sources of suffering), and that will do a lot of good, but until we arrive at a society which no longer needs a dignified exit because no one ever wants to exit, I am of the opinion of giving them that option.
I share a lot of your questions about this, but the following parts made me uncomfortable agreeing with you:
She has the following to say about that: “People think that when you’re mentally ill, you can’t think straight, which is insulting.”
Mental illness is an illness, and can be chronic and progressive. They can cause someone to be unable to carry on living, maintaining a livelihood, afford their own medication, psychiatric visits and therapy that they would need to even want to live in the first place. That’s not even to go into the absolute hell people in such situations can go through everyday.
We can debate on what constitutes “a well-thought-out decision that takes into consideration every available option” and I would actually say that one should give those options a try, but to deny that a mentally ill person can make their own EOL decisions makes me terribly uncomfortable.
In my opinion, sure, there should be a waiting period, to filter out those chronic episodes that lead to spur-of-the moment impulses, or decisions that are strongly linked to temporary conditions. This waiting period can be used to think things through, prove that they’ve tried means available to them, or even give them the chance to try the means they wouldn’t have had access to otherwise (like specialized help, therapy that wouldn’t have been available to them, etc). Now, I think what happens next is up to these medical professionals: do they deem one’s condition to be intractable and no amount of medication and therapy and counseling can make a difference? If they deem the situation to be hopeless, and the patient agrees, then yeah, the patient can make their exit. Otherwise, the medication, therapy, counseling or whatever it is that they’ve been trying should continue. If funds are needed for this to continue, then so be it. Those people who want to be no exits can be counted upon to fund this, right? Those people denying exit should put their money where their mouths are.
If signing up to an EOL waiting list could be the way for people to consider their situation and try out things that might help them, then so be it.
Oh, sorry, I’ve been rambling. My point is, yeah, there should be a waiting period that would double as a chance for people to get the help they need (but don’t have access to or maybe the motivation to). And more importantly, that anyone, and I mean anyone (okay, there’d be a triage system in place, but just allow everyone in, and sort them out once they’re in) can sign up.
The way I imagine things would go is I can just walk into some office, inform the person in the counter that I want to have a passport to neverwhere, and they’d ask me to file some paperwork and after a few days, I’d be in a clinic where someone would perform a psychological check-up on me, and do some interviews. Then after a few more days, some doctor will be informing me of my diagnosis and options—or perhaps just flat out saying I’m completely mentally healthy and my petition is denied (if I’m lucky maybe given a list of people to contact to help with my problems). If I’m continuing the process, then I’d choose which option I want, go with the treatment or other, and like, hopefully continue until I can manage my situation with minimal help!
Do we really need people to sign up for a passport to the great beyond just to get the help they need? No, in an ideal world, there shouldn’t even be a need for this. But in this kind of world we live in, I think allowing people to safely cross the streams with dignity and peace of mind (after giving it a good try, and concluding that it really can’t be helped) is a small kindness society can give to the suffering.
EDIT: Some proofreading.
See, I feel like your whole post could be summarized as, “some people’s mental illness makes them unable to work and earn money, so they’re too poor to afford treatment, and therefore the morally correct thing is to just let those people kill themselves.”
And while I don’t think that’s exactly what you meant, it’s how it comes across. Almost all of your points are some variation of who’s gonna pay for their treatment and take care of their physical needs.
And I would strongly argue that the answer is instead to have more robust social safety nets to cover those needs. Allowing people to kill themselves as the solution is hella dystopian.
But, I’m not saying that this is 100% always right. This is a hard issue with no clear answers, and I am absolutely not minimizing the pain of mental illness. My point is that mental illness is much less understood than physical illness, and I wouldn’t trust any diagnosis that said the condition could never be resolved. In the same way that I would be loathe to euthanize someone with a physical illness that has an acceptable chance of being transient, I’m loath to do the same with most if not all cases of mental illness. Especially if the person is otherwise very young/healthy.
Indeed, that’s not what exactly what I meant. Thanks for giving me the benefit of the doubt.
My main point can be summarized in that second to the last paragraph, which I doubt has communicated things adequately.
To reiterate: it won’t be initiated by the medical professionals. They’re simply there to ensure that someone applying for this procedure are indeed “proceeding of their own accord and have made sure options have been considered”. The waiting period is there to make sure that not only they’ve arrived at this decision after careful deliberation, but also to force them to consider and try out the options available to them. The process can be terminated at any point by the patient, and the final step will not proceed without their permission.
I accept this point. This is why I put the emphasis on the decision of the patient. And this is where I think our positions fundamentally differ. Promising treatments may or may not be there, may or may not be there in the immediate or far future, but it’s on the patient to consider. The medical professionals are there to ensure that the patient has considered available options, and have exerted reasonable effort to improve their situation. Whether or not the patient has made “the correct decision” isn’t the point—but rather whether or not the patient has made an informed and well-thought-out decision.
I share your opinion that in an ideal world, this shouldn’t even be needed. That even though the option would be there for anyone to take, no one will take it in an ideal world. But we are not in such an ideal world. We can strengthen our social safety nets to help people suffering from the debilitating effects of mental illness (among other sources of suffering), and that will do a lot of good, but until we arrive at a society which no longer needs a dignified exit because no one ever wants to exit, I am of the opinion of giving them that option.