Will assisted suicide laws ever allow for mental illness

This is a very cold piece devoid of consideration of the arguments against suicide or compassion for the loved ones left behind. It is primarily a piece of free thinking rather than an argument for or against assisted suicide.

In a handful of countries and states there is legislation that allows for assisted suicide if a person has a terminal physical illness and are in extreme pain. It is seen as both compassionate to let the person die though many opponents argue that it assisted suicide should remain criminalised for a variety of reasons.

Reading Derek Humphry's assisted suicide blog (http://assistedsuicide.org/blog/) has an interesting post that describes what the mainstream assisted suicide movement is campaigning for.

"Only subscribe if you in principle support the right of a competent adult to choose to die when physical suffering is unbearable."

Reading other posts on the blog is elucidating on the shift in euthanasia laws worldwide. A recent post about assisted suicide in the Netherlands is related to mental health. I was quite surprised to see that a group of people were trying to change the already progressive euthanasia laws si that people over the age of 70 who are "tired of life" should be allowed professional help to end their lives.

I assume the phrase "tired of life" has lost something in translation but I think it may be possible to understand the concept better than the words express. 7o years of living may be enough for some people.

There may be reasons why elderly people may want to end their life early, not least because of the problems caused by the proliferation of the 'nuclear family' unit that removed the value of the third generation from most households and left them to spend their last years in homes or looking after themselves.

Those people aren't dying from a physical illness nor is there extreme or untreatable physical pain. I think many a reader may jump to the conclusion that they are depressed and that's not true in my opinion. Their state of mind, their rational decision, their choice is, perhaps, sane.

This would be a challenge for the best psychiatrist to judge what may be rational suicide and what is a mental illness. Assisted suicide for an untreatable, terminal and painful physical illness is not considered a mental illness. I'm sure in practice equivalents of diagnostic tools like the mini-mental state examination are used to weed out signs of depression or other psychiatric illness.

I suppose what I'm perhaps poorly trying to ask is is there such a thing as a rational suicide for mental illness, or could it be possible that in the future a person defined as having an untreatable and deeply painful mental experience could be assisted to take their own life?

I'll end up ruminating over that because I feel it is a complex question that quick judgements would do no justice to. It is a question that needs a precise definition of what is mental illness outside (though not necessarily above) the lay opinion.

Wanting to die clearly isn't a mental illness in itself. Its ok in some countries if physical pain is unbearable. It can be a sign of a mental illness as can many things. I suppose that the arguments that it will never be legal for mental illness is that there are treatments available that can take away the pain. For example a seizure can be induced electrically and this has been found to work for some people with chronic depression. Personally I see ECT as a form of physical reset of personality or emotional state and as a form of death in itself though a death of a state of consciousness rather than physical. Neurosurgery for mental disorder is another option though comes with a higher risk to life.

For some though all the antidepressants, electric shocks and attempts at fixing the problem neurologically don't work. Would society ever evolve to the point where a person with a persistent desire to die that isn't irrational could be assisted in dying with dignity? I doubt I'll see it in my lifetime. My heart says that its not something I'd want to see either but my head says that people have free will.

I thought I'd end it there but there's one more consideration. Personality disorders are very complex and are often defined as difficult to treat, i.e. the people are difficult to change. This may simply be because of lack of research or perhaps lack of resources to pay for long treatment programs. Imagine the scenario where an individual has accepted they have a personality disorder and they want to change because they see their behaviour as destructive to their life but no treatment works. Imagine that this drives them to despair as months and years and decades of treatment are to no avail and their, their life is in tatters and the doctors have given up. They are not depressed per se but decide after deliberation and consultation that it would be better to "catch the bus" (to borrow a term from the suicide underground) but they've never attempted it before (if that's possible with personality disorders. I'm afraid I don't know a huge amount about them but I think that some, e.g. schizotypal, may not have suicide as one of the symptoms.)

In this example there is the possibility of a non-mentally ill suicidal wish but unrelated to the diagnosis. It is possible to see parallels with the reasoning of assisted suicide for mental illness. There is a difference in that the condition is not terminal per se. The pain and the lack of hope are what is in common with the physical illness argument. Compassion for the life of someone who wants to change but can't and can't be helped to change would make me think that assisted suicide for intractable mental health conditions could be a moral thing however the above example is a philosophical or thinking example. I'm not aware if that's based on reality, i.e. I don't know if there people with intractable personality disorders who want to change but can't and whose suffering is so great that suicide is rational.