The suicide rate for white men over age 65 is the highest of any group, said Tom Insel, Director of the National Institutes of Mental Health, at Saddleback Church’s second Gathering on Mental Health and the Church October 9. Surely some of those men were dying.
Insel’s words came days after California Governor Jerry Brown issued a statement explaining why he signed an assisted dying bill into law that California legislators had passed on the the 14th anniversary of America’s worst murder-suicide and one day after World Suicide Prevention Day. The New York Times called the bill’s passage a “landmark victory” for supporters.
In his statement, Brown said he was influenced by retired South African Bishop Desmond Tutu, who endorsed euthanasia last year. Tutu had lamented the suicide of 28-year Craig Schonegevel in making his case. Schonegevel was not terminally ill, but had endured a lot of physical pain from neurofibromatosis (NF), a tumor disorder for which there is currently no cure.
“Suicide is considered a premature death often accompanied by mental instability. Craig’s thinking was crystal clear; he wanted autonomy and dignity,” Tutu wrote.
The fury I felt when I read the bishop’s words, and then again when I read about his influence on the governor’s decision, was born of both personal loss (my late son had NF) and of decades-long interactions with other NF parents. Our fears have never before included concern that an internationally recognized religious leader would suggest that our children’s lives might someday not be worth living.
Unlike the young man in Tutu’s story, my son appeared to have a mild case of NF. But after he died by suicide in California, I learned that his body was riddled with benign tumors, and more importantly, that many NF patients experience psychiatric symptoms.
The argument that there is no connection between suicide and assisted dying–as described on the Death With Dignity National Center website–goes like this: “A terminally ill patient making a request under the Oregon or Washington [or California] Death with Dignity law is doing so to hasten an already inevitable and imminent death; therefore, the act cannot properly be equated with ‘suicide.’ None of the moral, existential, or religious connotations of ‘suicide’ apply when the patient’s primary objective is not to end an otherwise open-ended span of life but to find dignity in an already impending exit from this world.”
But as disorders like NF demonstrate, the distinction between body and mind is anything but clear. In its 2014 “Dying in America” report, the National Academies Institute of Medicine listed “management of emotional distress” as a top priority.
A Wired article about the report outlines why the euthanasia debate misses the point that dying in America is a miserable thing. The push for physician assisted suicide speaks to our common fears: dying in pain, without control, without dignity, surrounded by strangers in places we don’t want to be, Stanford Medical School bioethicist David Magnus told the magazine.
“The choice that concerns them is not whether to die, it’s how,” he said.
For those of us who have lost loved ones to suicide, the “how” is what torments us, and puts us–along with people suffering from a variety of mental and physical illnesses–at greater risk for suicide.
“Because Oregon was the first state to legalize suicide as a treatment for medical illness, it would seem to have a special responsibility to protect the significant number of patients who become suicidally depressed in response to serious or terminal illness,” wrote Kathleen Foley, a leading palliative care physician, and Herbert Hendin, a suicide prevention expert, in 2008.
“Although pain and other factors, such as lack of family support, contribute to the wish for death, researchers have found hopelessness, which is strongly correlated with depression, to be the factor that most significantly predicts the wish for death,” said Foley, who won the American Cancer Society medal of honor for her work at Memorial Sloan Kettering Cancer Center, and Hendin, director and CEO of Suicide Prevention Initiatives at New York Medical School.
Suicide is a leading cause of death for both the young and the old. My fear is that wide cultural acceptance of “death with dignity” says to vulnerable Americans that making an early exit is okay. Some of those Americans are the people I love most in this world.
It’s not religious zealotry or a desire to impose my beliefs on anyone else that inspires my concern. It’s love. Pure and simple.
I’m married to a man who has been living in often excruciating chronic pain for more than 15 years. A potentially devastating genetic disorder contributed to my child’s suicide. Other family members battle mental illnesses that put them at high risk for suicide. So please don’t tell me I don’t understand.
While you’re advocating for greater personal autonomy and compassion for your loved ones, I’m raising the red flag for mine.