Assisted Suicide

Why assisted suicide for the mentally troubled is so problematic

An Essay By Derek Humphry
18 August 2006

For the 25 years that I have been campaigning for the right to choose to die, and get help with it, I have kept my arguments confined to the terminally ill and the hopelessly ill competent adult. People are always asking me why don't I include the mentally ill in the struggle. Here are nine reasons:

1. Poor mental health can be treated -- medications, psychotherapy etc -- whereas terminal illness followed by death is inevitable.

2. With all due respect to psychiatry profession, I don't think understanding the working of the human mind has yet got very far. It certainly hasn’t found the answer to suicide.

3. A mentally ill person has the physical ability to bring their life to an end in some way, whereas the dying person is usually very sick, bed-ridden or in a wheelchair.

4. Many people have great emotional and ethical difficulties in helping a person dying in great pain to a dignified end, thus it follows (I think) that helping a mentally ill person with assisted suicide is enormously problematic. This applies to both physicians and family and friends. Who amongst us would help a severely depressed person to die?

5. The right-to-die movement meets enormous opposition from the medical and nursing professions, church leaders and politicians, in our democratic efforts to legalize doctor-assisted suicide for the terminally ill. Only in Oregon have we succeeded in the US and this law is under constant legal and political attack for the past eight years. So if we added mental illness to our agenda we would have to climb an even higher mountain.

6. The number of people who commit suicide for mental health reasons bears no comparison to the numbers of people who die of natural causes. For example, some 30,000 suicides are recorded yearly in the USA compared to some 2,250,000 who reach the end of their natural lifespan.

7. Because I am well-known in the right-to-die field by virtue of starting the original Hemlock Society – now ‘passed on’ -- and writing five books on the subject, people with mental health problems and wishing to escape them approach me for help in suicide several times a week.

8. I talk things over with them, always decline actually to help, urge them to seek further treatments (they've usually had lots already), but mention that my paperback book "Final Exit" has been in bookstores and libraries worldwide for 15 years. Is mentioning the ‘how-to’ book breaking my own rules? Perhaps, but a non-violent, peaceful end is preferable to bloody gunshots, knives and jumping. Plus, expecting others to clear up the mess is unforgivable.

9. I gently tell such troubled people that I don't think anybody is going to help them to die -- it's just too much to ask -- and if they are still determined to leave this world they must handle it themselves. Some do, most don't so far as I can tell, at least, not until later on.

All that said, I do sincerely acknowledge that a good deal of mental suffering is terribly painful, as severe as the worst cancer. As I have written in "The Good Euthanasia Guide," I believe that assisted suicide for the mentally troubled will eventually be available in perhaps 50 years when we know more about the human mind, and when society has a more enlightened view on choices in dying in general.
Derek Humphry
August 18, 2006

Derek Humphry, aged 76, is a veteran writer with no background in medicine, psychiatry or law. Currently he is president of the Euthanasia Research and Guidance Organization (ERGO) in Oregon, USA.

The books mentioned above, and others, can be obtained at

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