New Scientist reports on assisted suicide for psychiatric cases

New Scientist 23 July 2016 published an article discussing assisted suicide for psychiatric patients – which is legal in some countries such as the Netherlands and Belgium. The article gives an interesting account of the issues around providing medically assisted suicide to people with only psychiatric problems, such as a Dutch woman in her ‘30s.

Unfortunately, in referring to assisted suicide for people who are “not terminally ill”, the article does not distinguish between these very difficult, purely psychiatric cases of younger people, and the far more common case of people who are elderly and are suffering from a number of incurable “non-terminal” conditions, which permanently and incurably reduce their quality of life below the level they can tolerate. This latter category includes people suffering from dementia and other degenerative diseases. The article does not clarify that the term “terminally ill” is usually defined as having a life expectancy of less than 6 months. MDMD strongly reject the idea of restricting medically assisted dying to the terminally ill in this sense, as it would be denied to many people who quite rationally request it, and instead would have to suffer for a long time.

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Man shot wife with dementia in care home ‘to end suffering’ – BBC News

An elderly man told care home staff his dementia patient wife “had suffered enough” after shooting her at point blank range, a court hears.

Source: Man shot wife with dementia in care home ‘to end suffering’ – BBC News

This story is a challenge to the DPP guidelines. From the details available it appears that the man was acting out of compassion. Did his wife previously ask him to help end her life? Unless she left a written statement there may be no evidence. The moral is surely that if you want someone to help end your life in the future when you feel your quality of life is permanently below the level you wish to accept you should leave a written statement to that effect. It may help a compassionate relative who helps you to die, defend themselves against laws which may otherwise punish them for their compassion.

A more humane legal system, as available in some European countries, would permit someone with dementia to request assisted suicide or euthanasia in the earlier stages of dementia, before mental competence has been lost. That way there is no doubt of the person’s intentions, and they are not dependent on someone else carrying out their instructions to end their life to relieve their suffering.

An assisted dying law which is restricted to those who are terminally ill with a prognosis of 6 months or less (as proposed by Dignity in Dying and rejected by MPs) would not help in situations like this. That’s one reason why it is the wrong approach for this country.

Update: The Hereford Times reports that at the trial it transpired that Mr King was himself suffering from dementia. He was sentenced to 6 years for manslaughter to be served in a psychiatric hospital. The judge said “As you will know, there’s no evidence that she was in pain or suffering any more than anyone else who has succumbed to dementia. This was not a mercy killing. Rather, it was a killing that occurred at a time when the experts agree that you were suffering from dementia causing an abnormality of your mental functions.”

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Couple in joint suicide pact to avoid going into care

The Daily Telegraph reports the case of a Devon couple in their ’80s who successfully carried out a joint suicide. From the article it appears that this was a rational, well thought out, end of life choice. However, it is unfortunate that this couple needed to end their lives in this way. Perhaps, with more compassionate and flexible legislation they might have been able to have a better death. In particular:

  • Saying goodbye to their relatives and friends.
  • Avoiding the secrecy and risk of failure of their plans.
  • Delaying their death in the knowledge that there would be medical help to assist in safely and painlessly ending their lives when they felt their quality of life was permanently below the level they wished to accept.
  • Avoiding the shock and distress they undoubtedly caused to their cleaner who discovered their dead bodies, and their family who were unprepared for their action.
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