Euthasia in cases of severe mental health

[Devon01]

Woman who survived Brussels airport bombing is 'euthanised' in Belgium mol.im/a/11291995 via dailym.ai/android

Yes or no?

I’m pro euthanasia. I think this is an extremely harrowing case, and it’s just so tragic, and I do find it extremely shocking. However, when someone is of sound mind and assessed by others in order to make these decisions then I don’t think it’s up to anyone else to intervene with the process because it’s the individuals life and no matter how much we empathise with them we can never fully understand how an individual is feeling or suffering.

What I do think is that for every single case that is connected to mental health, that there morally and legally should be an obligation for everyone involved within that area, to look into do what they can with every single recourse possible to prevent anyone from getting to that point again. They perhaps already do, but if that’s the case it should be used as a follow up in the public domain.

Prevention and support are what need the most work as it’s the absolute most important aspect of all of this.

I always maintain that with a majority of people when their lives end after a prolonged period of suffering for whatever reason it may be, if that were an animal that had been left to suffer a slow painful and undignified death, the owners would be taken to court and banned from keeping animals. In pretty much every single case.

In this country it’s ok and it’s both accepted and expected for humans (who can make choices) to suffer? I don’t get it. This case doesn’t change my mind.

I think unless you’ve lived with severe and enduring mental illness you can’t possibly understand. Just because treatment exists and you receive it, doesn’t mean everything is roses and happiness afterwards. Treatment can help but complex trauma never goes away. The pain and difficulty of living with it is not something that can easily be described it’s so horrific.
I think most people would agree that a person with a physical illness who suffers constant debilitating pain that completely takes over their life should have the right to die with dignity when they choose. So why is it different for those whose illness is mental?

I am deeply disturbed by the idea of euthanasia. And cases like this highlight why. She was very young, very depressed and suffering from PTSD. People do go on to live 'good' lives with PTSD. She could have been going through a particularly difficult time that would improve.
We need much better care, treatments and more support for people who are in such terrible pain and we need a lot more support for people who have a terminal illness but I can't see euthanasia as the answer.

I don't know about her specific case, but I know (very well) someone who has extremely treatment resistant depression and complex PTSD and has had for 20 years.

They've tried every medication available, they've even had ketamine infusions (legally). They've done pretty much every type of talking therapy and EMDR and inpatient stays and community care and they've gone along with every single attempt to get them better and they still wish they were dead every single day. They might have good moments, but every day of their life they have flashbacks and physical manifestations of PTSD and struggle even with basic self care and simply don't want to be alive. They and we know we are effectively biding our time til our system for keeping them safe and not alone fails and then they'll kill themselves.

It breaks my heart into a million pieces but if they opted for this, I think (I hope) I'd understand. At least they would finally get some choice.

I agree with this - it's easy to be horrified by the idea of this but reality of living with this level of trauma is horrific.

I've got complex trauma and have suffered from very severe depression that's had me hospitalised several times. I've been continuously suicidal for long periods of time (constant for 4-5 years) in the recent past. I spent a lot of time researching this kind of euthanasia as I was so so desperate. I do genuinely think it's has a place but deciding how and what circumstances it can be approved is very tricky ground.
Right now I'm not suicidal in the same way but the pain of that level of mental distress is so fresh in my mind that it's hard to not feel sympathy for this case and know she's being incredibly brave to do this - it's not an easy way out. Surely it's better than her jumping off a building or hanging herself for another person to discover and be also traumatised? In reality that's the likely alternative.

It's complex though and not black and white. I couldn't be a decision maker on this kind of thing.

That’s heart wrenching- poor woman.

She was also sexually assaulted whilst accessing a mh facility, attempting to get herself help… She struggled with her mh for seven years, sounds like she had no quality of life. She had attempted suicide twice….

I don’t have enough experience to say whether further help could’ve meant she would leave her struggles behind. If it was my daughter I’d have done everything and anything for a different outcome, if my daughter chose this way out then I may as well go with her.

I can’t imagine being in a situation where someone is begging to end their life. Tragic.

I would say I’m pro euthanasia but this is actually making me rethink it completely when it comes to mental illness. It’s not because the illnesses are less real - it’s just because the care available is very poor. I doubt it’s great in Belgium either. That article said she was on 11 antidepressants. I can’t know but sounds like shit care.

I’m currently battling with the NHS for the most basic standard of care, but they don’t hesitate to send me away unmonitored and sometimes not even seen with prescriptions for antidepressants and antipsychotics….so I pay money I don’t have for private help which provides actual care and treatment models, not sticking plasters and rationing. The NHS doesn’t treat these mental illnesses like the long term conditions that they are, needing ongoing management, care and support. They provide sticking plasters, gate keeping and general garbage half the time and don’t even follow their own guidance.

In that environment, I don’t want to add killing me off as an alternative for them to consider so they still don’t have to treat me.

I'm very pro although of course I think it's so sad that nothing helped her feel better. At the end of the day it is not fair for other people to want her kept alive because they're not comfortable with it themselves. Many people would be more comfortable with her quietly living in abject misery or taking her own life I'm sure. But this way she gets to have her family around her and for it to be quick and painless. I think it's absolutely the kindest thing for someone so desperately unhappy and has been that way for many years.

Yes but the key thing here is that you don't want it for you. That's wonderful (although you not getting the help you deserve is totally shit). I would assume this is only something that a person could raise themselves, no one would be offering it as an alternative or possible solution to them.

A PP asked …. Would I call an ambulance if I found a friend dying of an overdose?

It depends. If I knew that the friend had exhausted (in their mind) every avenue to improve their mental health to a acceptable level and it had failed. If I knew that qualified mental
health professionals had undertaken lengthy assessments with them and had come to the conclusion they were capable of the decision. If I knew that it was truly their wish to die and had been over time (not a reaction to a difficult but likely temporary period in their life) then No I wouldn’t call an ambulance/try to stop someone jumping. Because as a much more knowledgeable PP said there is a difference between ‘cry for help’ or ‘crisis’ suicide attempt and a carefully agreed process with multiple controlled parameters which it appears this was.

it’s still desperately sad though but I guess so is a 23 year old with a terminal physical illness.

Maybe there needs to be some kind of agreement on what constitutes “terminal” mental illness

Its absolutely tragic.
I feel extremely uncomfortable about it so it would be a no from me.
I do not underplay the significance of her trauma or how awful it must be to live severe mental illness for what would have been almost a third of her life but I do believe change is possible with the right support and meditation and there is always hope.
At 23 your brain is only just fully developed or is still developing. People with severe MH won't be able to accept that they can and will get better.
It's heartbreaking.
I saw a similar story few years ago about a young woman who had anorexia and choose euthanisa. My DD had was recovering from anorexia at the time and I can completely see how in the grips of her illness DD would have absolutely opted for this but she is now well and happy and at uni. So I really don't agree with euthanasia for this reason.

@Runnerduck34 but the fact it was happily curable in your daughters case doesn't mean every case is. You would refuse an adult who had suffered 20yrs and exhausted every treatment available? 30yrs?

23 is too young. She can't have tried everything to get better. I don't know what information the psychiatrists had so that both agreed she could be euthanised. Who knows what the reality of her quality of life was. Still, I feel she should have got more help. She was so young.

I guess I'll just walk on by next time I see someone distressed on the edge of a cliff..

@BigFatLiar how many people have attempted suicide and come out the other side only to be glad that they didn't die? This wouldn't happen if euthanasia was an option.

There is a massive difference between deliberate self harm "suicide attempts" and actual suicide attempts. Experienced health professionals will be trained in distinguishing between them and in the assessment and decision making around these complex cases.

I'm pretty sure this poor young women wasn't fatally injected on a whim.

Everyone should have the right to end their lives at any time, and for any reason, in a safe manner. Apologies if this upsets some people, but it's something I strongly believe in.

It's hugely difficult but in the UK in the here and now, people with mental illness take matters into their own hands due to the inadequacy of MH provision in the UK. I can't see the UK introducing this when to reach a clinical decision would require the involvement of suitably qualified psychiatrists and evidence that the provision of optimal care had been exhausted.

I think those in charge of MH trusts would prefer to keep this as a DIY option rather than ensure care is optimal. We hear clinical staff whinge about the impact of resources on them; we rarely hear them tell us about the impact on the patients.

I think we should all have the right to choose whether we want to be alive or not.
If euthanasia was an option, I would take it right now.

I do too.

Quite.

But the problem comes when doing that requires other people's involvement. Then questions of ethics arise and, ethically, they have to be gone into in depth. So it's not as simple as "everybody has the right to end their own life" unless it's in a way that does not involve anybody else.

I have an older friend and he and his wife have both signed living wills to say that at a certain point of certain conditions they would like euthanasia.

The ethical problem is that if my friend gets dementia and can no longer consent - or says he doesn't want to die (as has happened here before) then the doctors involved in euthanasia have an ethical issue. There was something in local radio about this recently. My friend thinks he's found a way around this, but there's no way of knowing without the situation happening. Thankfully he's in round health, so I hope it never does.

Yes but the key thing here is that you don't want it for you. That's wonderful (although you not getting the help you deserve is totally shit). I would assume this is only something that a person could raise themselves, no one would be offering it as an alternative or possible solution to them.

This is naive I think. Psychiatry isn’t a very caring profession some of the time. I can’t imagine the suggestion or implication wouldn’t ever arise. I’m expressing it through my own experience but I’m not only saying it for me because there are many more vulnerable people out there.

@FloorWipes Yes, the slippery slope argument. Once it becomes an option, how do you stop it becoming a 'suggestion'? It simply isn't a black and white issue. Which is why I think I can't ultimately say how I feel about this case. Was it the 'right' (or least wrong) thing to do? I don't know. There are too many unknown factors. I do think euthanasia needs to be an option for humans, quite urgently, due to having witnessed end-stage dementia in my family. But that's all I'm sure about.

The slippery slope issue doesn’t bother me so much in the case of terminal illnesses though.

It’s specifically to do with mental illnesses and the fact that a lot of mental illnesses are treatable and you quite possibly could go on to live a full life or a worth it life but the treatment is just too difficult for them to bother with, and the patient is too vulnerable to know or advocate what’s best. I know for example someone who took matters into their own hands due to BPD. He was never offered evidence based treatment for it over years so I feel like in effect the NHS gave him no options but to end it.

In the case of dementia, the capacity issue still applies for sure, but then there is no recovery or treatment. My DH had cancer recently and luckily recovered, fingers crossed, but if he wouldn’t have he wanted to be able to end it and since has started supporting the Dignity in Dying campaign and I totally get that and I agree it’s mad that the option isn’t there.