BY: STEFANIE AWRONSKI

Euthanasia and assisted suicide are practices that have a long history of blurring the lines between being simply issues of legality or morality. As it stands very few countries in the world currently legally employ the uses of euthanasia or assisted suicide. Many will agree that allowing those suffering from physically painful terminal illnesses and diseases deserve the right to die peacefully and dignifiedly if they are of sound mind. But what about if one is suffering from a mental illness? Do they deserve the right to peacefully and dignifiedly end their lives through euthanasia or assisted suicide? A new study in the Netherlands, where euthanasia and assisted suicide have been legal for some time now, is bringing much needed attention to this issue.

Several years ago in my high school English class, I wrote my yearly speech on euthanasia and assisted suicide. The complex legal and moral issues surrounding these practices have long fascinated and confounded me. I cannot say that even now I am completely firm in my beliefs surrounding these important practices.

Euthanasia and assisted suicide are slightly different in practice. They both involve the intervention to help someone end their life. The main difference however, is that euthanasia directly involves someone else ending the suffering party’s life, such as a doctor administrating a lethal injection. Assisted suicide on the other hand could be a doctor prescribing pills to someone that they would then on their own ingest to end their life.

The new study in the Netherlands, published in the JAMA Psychiatry journal, found that in more than half of doctor assisted death cases regarding those suffering from mental illness, those afflicted had refused treatment that could have potentially helped. Loneliness was also touted as a major factor for wanting to die in the study.

It was found in the study that many had not sought assistance through traditional means. Many had sought out a doctor they had not been seeing on a long-term basis and rather had assistance from a “mobile end-of-life clinic”, which are a doctor and nurse funded by a local euthanasia group.

The Netherlands is a country that has one of the longest traditions of allowing euthanasia and assisted suicide in the Western World, but this study shows that even there, with its rich legal history of euthanasia and assisted suicide, the moral debate is still very much going on. The Netherlands, Belgium and Sweden are of the very few countries that do in fact allow assisted suicide for those suffering with mental illness.

The Netherlands study was led by Dr. Scott Y.H. Kim, a psychiatrist and bioethicist at the National Institute of Health. The study looked at numerous cases of doctor-assisted death from mental illness from 2011-2014. In 37 of the 66 cases reviewed, it was found that people had flat out refused recommended treatment. In the Dutch system, consulting doctors review appeals for euthanasia and assisted suicide. The study found that in one quarter of cases, doctors had rejected those appeals.

Dr. Scott Y.H Kim- a psychiatrist and bioethicist conducted a study that looked at numerous cases of doctor assisted death from mental illness from 2011-2014.

Depression has been found to be the most common reason why those sought doctor-assisted death. As aforementioned, simple loneliness was a common reason as well. One account tragically read, “The patient was an utterly lonely man whose life had been a failure.” Another read that a woman in her 70s had decided many years earlier that she and her husband had decided to not live without one another. At the time of her death she had no health problems, but after her husband died, she described her life as a “living hell.”

Dr. Paul S. Applebaum a professor of psychiatry, medicine and law at Columbia University said, “The criteria in the Netherlands essentially require that the person’s disorder be intractable and untreatable, and this study shows that evaluating each of those elements turns out to be problematic.” He further adds, “The idea that people are leaving their treating physician and going to a clinic that exists solely for this purpose, and being evaluated not by a psychiatrist, but by someone else who has to make these very difficult decisions about levels of suffering and disease — it seems to me like the worst possible way of implementing this process.”

Dr Kim pointedly asserts that, “The Dutch system is really the idealized setting in which to try something like this. But still, you can see that there are many cases that make us question whether this is the right practice.”

As it stands very few countries in the world currently legally employ the uses of euthanasia or assisted suicide.

Many will agree that allowing those suffering from physically painful terminal illnesses and diseases deserve the right to die peacefully and dignifiedly if they are of sound mind.

Here in Canada, the issue of doctor-assisted suicide has gained some new legal traction. The Supreme Court of Canada decided last month to legally enforce doctor assisted suicide nationwide under very specific circumstances. This groundbreaking decision, which legalizes physician-assisted suicide in Canada, however will not come into effect for a year. The Government will use that time thusly to produce definitive legislation for the practice. In Quebec, doctor-assisted suicide has been legal since last December and at least one reported suicide has taken place as stated by a spokeswoman for the health and social services center for the Quebec City region in an email.

The Canadian government states that they respect the new judgement and the additional time added on for new legislation to be drafted would help an approach “that protects the most vulnerable among us while respecting the inherent dignity of all Canadians.” It will be very interesting to see what the new assisted suicide legislation will spell for those afflicted with mental illness – hopefully it spells pertinent and dignified consideration.

This grand legal and moral debate regarding letting those afflicted with mental illness use euthanasia and assisted suicide is one that in my opinion will never cease to affect. Whichever side you may fall on, always remember to afford anyone suffering from any mental illness the same dignity and respect you would to someone who is not – even if they are a stranger you encounter walking down the street.

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