(Trigger warning) Assisted suicide - Caroline March

[Clumsywithwords]

Name changed for this but regular MN user.

I have read and cannot stop thinking about the event rider Caroline March who sadly had a bad riding accident in 22 which resulted to her breaking two vertebrae in her spine, losing the use of her legs and this week has died by assisted suicide, due to the effects of her injuries.

She left with a very moving letter/post (which is circulating round most newspapers forums and isn’t hard to find) which explains why mentally and emotionally she couldn’t go on.

I can’t really articulate what I feel about this, just that I haven’t stopped thinking about her and how she came to the choice she did and while I support assisted dying and can’t even imagine what a horrific injury this must have been to come to terms with, I was (possibly naively) shocked that someone who wasn’t terminally ill or with a degenerative condition could end their life this way.

I’ve read many say that it was such a frank and brave thing to admit and do and there is an element of braveness to it, certainly her letter definitely encapsulates her fierceness of character but I guess I’m on the fence to where the line is for assisted dying and I’m finding her end choice hard to process…

Has anyone else had mixed feelings on this?

@FindingAPlace I'm very interested in your post and I'm wondering if you would mind trying to explain to me what you mean by "she sounded defeated by ableist perspectives"?

I'm not disabled so I'm maybe looking at it from a different point of view but to me it sounded like she knew what she wanted from life and after the accident she simply felt like she couldn't have those things anymore therefore her life was no longer one she wanted. Do you mean that if she had given it time she would have found things that fulfilled her in the same way?

@FindingAPlace it's really hard to explain but I think if you are not a horse person, it's not imaginable
It's not just a pet, it's a total way of life immersion and was all she knew. The only way I could describe it when I lost my horse was I wanted to go home. When anything went wrong, she was my constant and I would go and ride or see her. Then the worst thing went wrong, I lost her and I couldn't go home

@Newuser75 I don't feel right to quote outright...I don't even like that I read someone's suicide note. She felt that adrenaline was lost, thrill, excitement. And the narrative she followed was that she required "fixing" in her lower half to achieve even remotely the same impact. Her every potential positive was directly obliterated by the percieved indignanty of having to achieve it differently (sometimes a bit disgustingly). And she was absolutely entitled to those feelings. And to express them, which she did.

I really DO believe that she had the tenacity, the drive, the determination to find joy and enthusiasm for the things she reported she used to love from her life prior to disability. I do believe that of everyone. I do have to believe it going forward while knowing, at the same time, something in me will decide that enough is absolutely enough with my motor neuron disease.

@NC03 She insisted she wasn't depressed; and I don't think she was. But she was certainly angry. And it seemed so channeled inwardly and at her loss of physical functioning without any way out. And I don't know for certain if that's ignorance, or complete emotional overwhelm, or lack of support, or all of them. But I can say that, when I lost the ability to run after children, then my ability to sing with them without becoming out of breath, or lift and hold a weeyin after a fall...if I hadn't found examples of alternatives or established alternatives to that joy, I would have probably done the same as she did.

But she didn't want to find other joy. Outdoors was her entire life
And I think we have to respect that if we accept other people find other joy and some don't because the right to choose is important

I could list at least 10 of my friends who are competitive equestrians and would choose exactly the same thing
I've already signed a living will that I don't want treatment if I am diagnosed with Parkinson's, dementia/Alzheimer's or a severe brain injury

It's your entire life. She would get up in the morning and go and ride, muck out, go on a quad bike, compete, exercise, socialise with friends via riding... it's not equivalent to a job, it's 24/7 and consumes you and was all she knew. She didn't want a different life

@NC03 As I said, she was absolutely entitled (as in to her feelings and her choices). And I'm not minimising the lifes passion that is the equestrian era *edit arts as I wouldn't expect others to minimise dedicating ones life to the education and development of children from dawn till dusk as I did prior to disability, by comparing the two.

She made her choices and the post asked about others feelings.

Thank you for sharing yours.

On a personal note, as a person with a neurodegenerative disease that has no treatment at all, I agree that, past a certain point, I would embrace the right to die on my own terms.

@FindingAPlace Thank you for that insight.
@NC03 I agree. Horses aren't a hobby, or indeed a job, it's a lifestyle. And it wasn't just the horses, it was basically everything in her life that made her happy.

For me personally as I mentioned previously of those things were taken away from me I may want to make a similar choice, I cannot stand being cooped up in the house. Even when Ill in bed I'm literally going stir crazy. I hate it. I love being out in the countryside doing active things, riding etc. I also would struggle hugely with people having to provide care of any kind. If a similar thing happened to me I know I'd really struggle. But then I have children who I would fight until my last breath to be with for as long as possible so I know I would carry on regardless.

I think my husband on the other hand would cope much better being limited with mobility. He isn't keen on active things, loves his own company and is just a much more laid back, practical person to me.

I guess we are all different and have very different expectations of what we want from life.

Caroline wanted what she wanted and went on her own terms and from the sound of the letter I'm not sure she was interested in fixing joy in other things.

I have life changing conditions after a life of sport and fitness. It too was my solace and my everything. I can understand how she felt she couldn’t continue. It has effected me mentally and everything in my life. What I would say however is that with time you get used to a new life even if it’s not the one you wanted. It took me a very long time to come to acceptance. Maybe 4 years. I do wonder how much support she had to see wat future WAS possible. So incredibly sad.

I can understand how she felt.

I did meet a wonderful lady who was paralysed from the waist down in a car accident mid 20s. After that she met the love of her life and got married and started training for the paralympics and won tons of medals. I was in awe of her!

Caroline's career started before her injury so I guess she felt that she felt that her life had become too restrictive? This is only a slight rambling with no intent to cause offense.

I felt the same as you. I wish I wasn't but I think the language made me uncomfortable. That says more about me and my preconceptions about what to leave.
That said I believe very strongly that people should have a choice. My Dad died of cancer and it was horrific. I hope I have a choice if I needed to.

@Joey1976 I'd like the choice as well.

People always support this kind of decision as the individual's right to choose, but what doesn't get addressed is that these kinds of ideas have a wider effect on what people believe counts as a worthwhile life.

We don't develop our ideas of what a good life is, or what is undignified, in a vacuum. or what it means to be a burden on our spouse, or family, or community.

It's easy to think, "Oh, no one would ever think or feel that way! But then in a generation you have a whole lot of people who have grown up without the cultural references we have now, who will take it wholly for granted that there is a point where life isn't worthwhile and it becomes cruel to have people carry on.

You can see some of this already where countries with assisted suicide begin to ave pushes to more open legislation, and even court challenges to safeguards. TYpically first you get rid of rules saying the person has to have a terminal illness, then one that won't improve. Very quickly you get challenges to rules against the mentally ill or depressed using these services. And then at the far end we already see those who argue that those who do not have the mental capacity to make such decisions themselves - perhaps people with intellectual disabilities, or children - must not be forgotten, we need others to take care of their interests in these matters.

Because once we accept that premise - some people are better off dead - the end point is, society has a duty to help those people whatever their situation. That's not a fevered imagining, it's what advocacy groups push for a soon as assisted suicide laws are passed, you can see it in country after country.

I think it's very sad that someone can think there is no worthwhile life apart from being an adrenaline junkie, and that they could never find meaning or joy in anything else. The first idea is blatantly untrue, and the latter a very sad belief, probably also mistaken.

That's not a fevered imagining, it's what advocacy groups push for a soon as assisted suicide laws are passed, you can see it in country after country.

As a person from one of those countries, can you cite me some sources that show this is happening? While I'm fully aware of difficult cases, and whilst I feel that in the case of dementia, the moment a previous consent is withdrawn it should then stay withdrawn, I don't see a huge conspiracy from advocacy groups to bump off granny. Both my parents were able to withdraw their advance directives and died a natural (horrific) death. My Dsis and I were not in any way pressured to proceed with euthanasia.

What a sad and beautiful post this is.

You are entitled to your views and if this is how you feel then do not have an assisted death. Also - do not try to deny anyone else their choice to have an assisted death.

The only person who should be deciding if life is worthwhile is the person living the life. That means not me, and not you.

Dignitas has been around for 25 years and I haven't heard of assisted suicide being terribly abused in Switzerland. There was the case of Dutch woman Aurelia Bowers who was only 29 and not terminal which made some people feel uncomfortable. But she had suffered from 17 years of psychiatric illness, chronic depression, BPD and attachment disorder. She was chronically suicidal, self harmed, had anxiety, psychoses, would hear voices and had never felt happiness. She had no concept of happiness. Why would anyone continue to make her suffer when nothing in all that time had been found to help her? I can only think it would be for their own selfish reasons, because they didn't feel comfortable with it. It would be more comfortable for them to force her to continue to live in misery to fit in with their religious beliefs. We make people stay alive suffering in ways that we would put an animal to sleep out of kindness for without a second thought. Then it us presented it as 'caring'.

Why would we not allow anyone with 'unbearable suffering' to die gently and peacefully? There are only selfish reasons IMO.

The only person who should be deciding if life is worthwhile is the person living the life. That means not me, and not you.

Agree with this but what about when other people are making that decision on your behalf because of your incapacity?

In the event of incapacity it would become a “best interests” decision and a persons condition and their chances of surviving would be the main consideration. These decisions, when necessary, are made by a multidisciplinary team, not a single person, and usually involve family and the patients views if expressed prior to them becoming incapacitated. The healthcare profession does not make these decisions lightly and legalising assisted dying would not change that.

Withdrawal of consent is not the issue, it's a matter of the conditions under which people understand the value of their own life.

Look at the way laws have expanded in the Netherlands or Canada over time - in the case of Canada, as soon as the laws were passed, they were being legally challenged in order to broaden their scope.

There is a very naive view that many people have that there is a level of common accepted truths that mean good people would never take the law or social conventions to problematic places. There have been many societies which had very different ideas about the value of human life.

These things don't just affect individuals, they affect the shape of society.

Who are we to say it's wrong? None of us really know what she wanted has been through. She had a life where she was active, doing an activity she loved that was her life & now that has been taken away. I've become severely disabled over the last 5 years & can understand where she is coming from, she has tried to make a go at life as a disabled person & she knew that she didn't want to live that way. Walk a mile in her shoes & then think about why she did it.

None of asked to be born.

All we can do is make the most of our lives in whatever way we can.

Her life had become so far removed from the one she had made for herself.

I think it's very sad, but entirely right that she was able to take control of her situation.

I'm actually from the Netherlands and I do not recognise the picture of doom that you are describing. I get that some people think those suffering from mental ill health should not be eligible for assisted suicide, but I would ask the question (once again) that those opposed never seem able to answer: How long do you think a person with sustained mental ill health should have to suffer before they are allowed to choose not to live? Aurelia Brouwers did 17 years - people get lesser prison sentences for murder. At what point are we beating people to death with the carrot of hope for a better treatment, just to appease our own uncomfortable feelings? Why don't you give me a duration you think is long enough - is it 'never'?

I would argue that valuing life properly also means recognising when it is no longer of value to an individual, and at that point there should be choice. My grandmother had an assisted suicide. She was 100% capable of making that decision. And no, there wasn't a massive inheritance in it.

So very well said.

Assisted suicide for those with mental illness will ALWAYS be a contested issue…..in the uk at one time those with anorexia were “ allowed “ to die because it was deemed that they had free choice in their illness…we are now more insightful that it is a treatable mental health condition that people can and do recover from . So to introduce assisted dying will not be an easy ask of our mental health system because we spend a lot of time trying to actively prevent people from making their own choice of killing themselves. I think we have to reverse your question …what is it (apart from nhs interventions as most people are not 24/7 supported)that stops people with enduring ,lifelong mental health conditions from actually killing themselves by suicide? Human beings have a surprising capacity to choose life even if others deem that life to be horrendous and full of suffering, I am a full supporter of right to die even though I worked in hospice care but there is a vast difference between those who are making that choice in a clear minded way compared to those people with active severe mental illness making that choice.

@123anotherday no, that's just you refusing to address the question. I work in mental health, by the way - not frontline clinical, but I've seen enough over the past 23 years to know that it isn't as simple as presuming people 'aren't in their right mind' and don't have capacity to make that choice. Mental health law also doesn't support that contention.

So back to Aurelia Brouwer: is 17 years enough for you, or do you think she should have been left to suffer for longer? How long do you think is long enough? Do you genuinely think that someone with mental ill health and a long held and sustained wish to die should be forced to live? Because I would call that evil. Of course every case should be assessed individually, but a blanket 'no' isn't acceptable. Even people on a section in the UK have the right to consent (or not) to certain things.

@pointythings i have also been frontline clinical in mental health. To give assisted dying for mental illness opens up an ethical minefield that isn’t manageable or able to be boundaries in the same way that assisted dying for those with physical conditions can be. I re-iterate, people have the option through suicide to take their own lives but many choose not to. Whatever we may believe on a personal level is not trumped by what are moral /ethical choices for society. The Nazis went after those with physical and mental disabilities first using “ euthanasia” programs …..any civilised society has to be extremely careful of setting precedents that we may later regret……it’s a hell of a lot cheaper to allow severely mentally ill individuals to choose to end their lives rather than adequately fund mental health services.