Category: Suicide Prevention/Mental Health

Delawareans: Oppose HB 160 legalizing Physician Assisted Suicide

I sent this to my legislators. Feel free to share:

I strongly oppose the passage of HB 160, the “Death with Dignity” act, which allows terminally ill patients to request physician assistance in ending their lives.

I work for an agency which is heavily focused on suicide prevention and life promotion, particularly among those with mental health disorders.  I feel that supporting this legislation would be counter to my personal values and the mission of my work, and would send a harmful message to those who are already struggling with mental illness and may be contemplating suicide.

In working on suicide prevention, we want everyone to understand that their life has value.  We say that we are being compassionate by extending the right to die to those suffering from terminal illness, but isn’t everyone who is thinking about suicide experiencing great pain and suffering? Isn’t everyone who is considering ending their life moving towards their inevitable demise anyway, as we all are? Isn’t saying that people who are dying faster or sooner have more of a right to kill themselves, implying that their lives are not as much worth living as those who are young and healthy, in other words that they are not as valuable? Isn’t it sending the message that if we are suffering (as most anyone with thoughts of suicide is), life is not worth living?

A 2015 study was published by British scholars David Jones and David Paton demonstrating that states where assisted suicide is legal have seen a rise in overall suicide rates — assisted and unassisted — in those states. The study show that, after controlling for demographic and socioeconomic factors and other state-specific issues, physician-assisted suicide is associated with a 6.3 percent increase in total suicide rates. For individuals older than 65, the effect was even greater, at 14.5 percent.

The legislation uses the term “die with dignity” over and over again. This phrase represents a true shift in values, suggesting that allowing others to care for you at the end of your life is less dignified than taking your own life, which places undue pressure on those who cannot care for themselves to choose death. Many disabilities advocate groups oppose physician assisted suicide because persons living with disabilities or chronic disease are already all too familiar with the implicit and explicit pressures that they face every day.

Most of us hate to see people in pain, and so it is completely understandable why this legislation may be popular. But being compassionate does not mean that we have to sanction suicide. It means caring for people enough to consider their lives precious regardless of illness, age, life expectancy, class, creed or culture.

It is a myth to assume that ending your life early affects only the individual. None of us live in a vacuum. Every action that we make influences others around us, at the very minimum by sending an implicit message. What message are we sending about the value of life for the aged and/or sick when we give them special permission to die?

In all 50 states it is legal for anyone dying in discomfort to receive palliative sedation, wherein the patient is sedated to the point at which the discomfort is relieved while the dying process takes place peacefully. It is also legal to refuse medical care to extend life in many cases. This means that there are legal solutions that already exist and do not raise the very serious risks that this legislation would raise.

Thousands of people make the choice to die by suicide every year. We already have the power to take our own lives if we truly want to. While this type of legislation claims to give more power to the individual, it actually creates a mechanism for the government and medical establishment to enter into decisions as to who lives and who dies, and this is dangerous.

Assisted suicide is the cheapest treatment for a terminal illness. This means that in places where assisted suicide is legal, patients can be steered towards that option simply by being denied the more expensive life-extending treatment that they may desire. There are already multiple examples of insurance companies offering people assisted suicide in lieu of chemotherapy, right here in the United States.

Additionally, while safeguards have been written into the bill to protect those with psychiatric illness (where suicidal thoughts are often a symptom of the illness), these do not actually offer protection, as can be demonstrated by multiple cases. Those who have a history of depression and suicide attempts have already received lethal drugs in the US (for example, Michael Freeland).

In places where physician assisted suicide has been adopted for some time, such as the Netherlands, increasingly permissive laws have cropped up. Currently, patients in the Netherlands may receive physician assisted suicide as children, for psychological distress without physical illness, and for chronic but not terminal illnesses. Dr. Herbert Hendin, who conducted research there, writes in the Psychiatric Times that there have been thousands of cases of involuntary euthanasia (called “termination of the patient without explicit request”).

Thoughts of suicide are sometimes a part of dying, but can be overcome. Like healthy people who become depressed, terminally ill individuals can recover emotionally with the support of antidepressant medications, a good psychologist, a caring spiritual counselor and/or the care of their loved ones. They often find meaning, even in the face of dying, using their final days to reconcile old hurts, tell others how much they mean to them, pass on wisdom that they have acquired in their lives, and appreciate the kindness and compassion of those who care for them.

As a person whose life’s work involves supporting those in psychological distress in the journey toward recovery and psychological wellness, I must oppose legislation that may pressure them towards a decision of despair.

Life Lessons 1-10

I was at a doctor’s appointment the other day, and I filled out all the forms, writing my age as “31.” Then a few hours later, I said, “Wait a minute,” remembered the year of my birth, did some counting on my fingers, and realized I’m 32. I’ve reached the age where I can no longer remember how old I am.

Since I plan on living till I’m 96, I’m really only a third of the way through life, but I have learned a few lessons along the way, so I’ve decided to write one of those “I’m old, so I can give advice about life” lists. Here it is, in no particular order:

1.) Stop trying to gain self-worth from other people’s opinions of you. Promiscuity, perfectionism, and people-pleasing are just different paths that begin at a very desperate place of insecurity and unworthiness, and lead to a place of a whole lot more insecurity and unworthiness. It becomes easier to get off of those paths when you realize that you are already more loved than you can imagine.

2.) Commit yourself to God. You’re never going to solve all the mysteries of the universe, or maintain a constant feeling of joy and peace. That doesn’t mean you shouldn’t explore and accept the tenants of your faith. There is nothing irrational or inauthentic about committing to something bigger than yourself simply because you can’t always feel it, or understand all aspects of it. If you could, it wouldn’t be bigger than you.

3.) Cut back on the drinking. We all struggle with moderation at times. Unfortunately, if you drink heavily enough, often enough, your regular self will start looking more and more like your drunk self, until eventually you become a stranger. When we are drunk, we numb our real feelings. We trade authentic connection and our powers of reasoning for sloppy, artificial sentiments and unnecessary confusion. We trade our treasures for trash.

4.) Don’t do drugs. See above.

5.) Feel your feelings. We don’t like to feel things like disappointment, guilt or anger, but feelings tell us important things. Guilt tells us when we need to change certain behaviors. Anger or fear tells us when we need to protect ourselves from further hurt or turn down our stress levels. Sadness tells us we have lost something we loved, and we need some time to grieve. I’ve done crazy things to ignore reality, and not feel my feelings. It has never led anywhere good, so I’m learning to walk through those valleys, knowing that eventually those things that feel unbearable now, will become bearable, and then become merely uncomfortable, and eventually they will become wisdom.

6.) Understand that love is not a feeling. Falling in love is easy. All it takes is some romantic music, a sexy outfit, and plenty of alcohol – just watch The Bachelor sometime. But actually loving someone is hard. It’s hard when there are little ones running around, and jobs, and so much to do, and it’s hard when someone acts unlovaScreenshot_2016-04-07-13-29-13ble, as we all do from time to time. And it doesn’t always feel worth it, either, despite all our platitudes. But then again, actual love isn’t a feeling, is it? It is actions and service and sacrifices and forgiveness and choices. And sometimes it is in those painstaking, daily decisions to act in love (even when you don’t feel like it) that feelings of love are rekindled.

7.) Practice forgiveness. It’s easier to forgive than to hold on to bitterness, which is incredibly painful. Not forgiving is a way of holding on, of keeping the hurt close, and forgiving is letting go, so that it no longer occupies your mind and your heart. It doesn’t mean that you have to forget, or that your relationship with the person who hurt you has to stay the same. It does mean you have to understand that you are also forgiven.

8.) Savor the moment. Even though we hear it all the time, it’s hard to accept that we can’t change the past, and that the future holds no guarantees. But once we accept that, it’s easier to enjoy the moment. And that sunset won’t last forever. You won’t always be able to enjoy a cup of tea with your grandparents. And some day that child will not want to sleep with his arms in a vice grip around your neck and his face smashed against your ear, so you might as well enjoy it now.

9.) Understand that everything is not going to be OK. People get sick, and they don’t get better. People do their very best and still don’t obtain the desires of their heart. People hurt each other in profound ways. People give up. Sometimes life is far more painful than we expected, and at some point, we will all face deep disappointment.

10.) But then again, everything is going to be OK. We see such a tiny fraction of space, and hear just a millisecond of the story. Human beings are tremendously resilient, especially when they harbor a belief that there is always a reason for hope, and I don’t think that is a coincidence. While I will never fully understand the complex interaction between free-will and divine providence, I believe that God can take our biggest hurt, our greatest failures and even our most asinine decisions and still make something beautiful. And if we look for it, sometimes we are fortunate enough to see it.

 

Clinging to a Mustard Seed

The night is hurtling towards the early morning hours but I lie awake with my mind spinning. A sleepless night with no distractions is my enemy. I push away memories like ping pong balls in my head, only to have them return, jolting, distorted, as soon as my body begins to relax.

And so I seek desperately for a solution to an unsolvable problem. My heart aches and my mind turns round and round for a resolution, an answer, relief, but there is none. Time (and work) heals all wounds, but I am impatient. I am tired of feeling.

My husband touches my elbow. I am pulled back, as if from outer space, to the present moment. To a half-asleep caress. To a bed, with soft pillows and warm blankets. We have so much. Our home is quiet and at peace in this moment. For now, the past is blown away in the sound of a stormy wind. I am sheltered in a warm home.

As the wind picks up, a whimper from the little one’s room turns to a wail. After a moment, I go to her. She settles immediately, like she just missed me. We rock a little while in our hand-me-down rocking chair. The stuffed and faded arms are scratchy, and it squeaks softly with each rock.

Soon her weight is limp in my arms, her fat, velvety cheek squished against my chest. I rock slower, then I stop rocking.

Be still and know that I am God.

She smells like milk and cookies, and feels as warm as toast. I breath in the moment. Then I lay her down in her crib and go back to bed. And there they are, still – all my worries. There on the bed, waiting for me, in a heap. Kids, marriage, job, money, home, parents, health, the state of the world, the state of myself.

Is everything going to be OK?

Some questions have no answers. The wind rattles the windows. I can see the tree branches shaking against the hazy moon. The ground will be littered with them in the morning, if they’re not strong enough.

Be still, be still, be still…5bdb5539-b0c8-4bd3-9971-67820b30e383

All things work together for good.

In this moment, the words are lost in translation. They do not make the journey from my head to my heart. But they are true, nonetheless. So I wait. I endure.

I focus on five things I can see, four things I can feel, three things I can hear, two things I can smell, one thing I can taste. I ground myself in the night. I count my breaths. I say another prayer. The same prayers, again and again. Then I listen. I remind myself that the silence does not mean that I am alone. The wind dies down. And before the sun rises, I sleep.

Want to see other stories of faith in the dark or add your own?  Click on the link.

Night-Driving-Synchroblog (1)

 

The Bachelor Hit a New Low Tonight

After watching The Bachelor tonight, I can honestly say that it has reached a new low.

the bachelor

I can’t honestly say that I’ll never watch it again, because we all know it’s about as addictive as crack. But, much like crack, I crave watching it, need to get me some, and then after it’s over I’m left feeling empty and soulless.  At least that’s how it was tonight.

I can handle Ashley L. telling America she’s a virgin followed by a display of very un-virgin-y behavior.

I can handle all the girls being AMAZED that she is a virgin, as though that is a completely foreign concept.

I can handle seeing the Bachelor kiss most of the girls on the same night (even though I kind of hope they all break out in hand, foot and mouth disease in the next episode.)

I can handle seeing women drink to excess and then embarrass themselves on national television. After all, most of these girls weigh about 80 pounds, are too nervous to eat, and then consume liquor for hours upon hours. Frankly, I don’t know how most of them are still standing at the rose ceremony.

I can even handle it when the Bachelor decides not to pick the plus size model, and she goes home in tears, saying that she should just get used to rejection. Because really, that’s the same thing that happens to all the girls that don’t get picked, and there will be plenty of guys waiting to date her after they see her on TV.

What really bothers me though, is when they air a young woman having a psychotic break, and then all of America laughs at her. Because I am about 99% sure that is what happened.

Anyone who has had a loved one suffer from a serious mental illness knows it is not funny. Anyone who has ever worked with patients who suffer from psychotic symptoms knows it should not be entertainment. Anyone who has ever experienced such symptoms knows that it is not a walk in the park. It is painful, and sad, and life-altering, and my heart goes out to Ashley S.

So please hold the snarky tweets and vine videos about how she is “crazy,” because it is likely that she is, in fact, displaying symptoms of a disease she cannot control which will make her life and her family’s lives very, very hard. And all those snarky tweets and vine videos are just our culture agreeing that those people should be the ones sent home, if you will. The ones who make us uncomfortable, and then a little scared, until we make them into a joke.

The thing is, I don’t understand how nobody involved in the production of the show realized that she probably needed to get out of that environment ASAP, and get somewhere where people cared about her health rather than laughing at her misfortune. I mean, when someone gets injured on The Bachelor (like when a staff member jumps off a balcony to avoid being caught with one of the bachelorettes, for example), they get taken to the hospital, right? I’ve seen some tweets suggesting she was drunk, but frankly, we all know what drunk looks like, and that is not what it looks like. So come on, ABC, at least let’s use this as a teachable moment. People who display psychotic behavior need help, not mockery.

I feel like at some point in the future, society is going to be disgusted with our ethical choices in the entertainment industry, particularly with reality television.

And I never thought I would say this, but I’m a little disgusted myself, and I almost don’t want to watch The Bachelor anymore.

Almost…

The Right-To-Die Effect

Brittany Maynard

I didn’t want to write about Brittany Maynard, because it’s hard to disagree with someone who is dying of cancer and not look (and feel) like a big jerk. But here I sit, trying to write about something else, and I just keep coming back to her story.

You’ve probably heard of Brittany. She is the young lady who has a severe brain tumor, was given a prognosis of six months to live, and chose to move to Oregon where she could legally decide to take her own life via prescribed medication, rather than waiting for the cancer to kill her. The day she originally chose when she would most likely end her life is this Saturday, but her latest video suggested that she may wait longer.

My heart aches for Brittany, and I have wept for her.  Granted, I have also wept at country music videos, so the weeping may not be saying a lot, but my point is that I understand and feel that it is an incredibly tragic situation. Although I disagree with her stance on policy regarding assisted suicide, I have absolutely no desire or right to condemn her personal decision, as I have not walked in her shoes or been inside her mind or her heart. Plus I’m not the Judge.

Plus there’s always that teeny weeny little bittiest possibility that I might be wrong.

 

surprised face

 

Yup. But as someone who has worked for the last five years in suicide prevention, I’d be lying if I said I wasn’t very concerned about the messages on this topic that we, as a culture, are circulating. Messages like:

Some lives are more valuable than others.

I often facilitate a training called Applied Suicide Intervention Skills Training, during which we ask participants to examine their own values and attitudes relating to suicide. We ask them to mark on a chart where their feelings lie on a spectrum from Agree to Disagree for a number of statements. One of the statements is “People have a right to suicide.”

When discussing this particular item, someone always brings up the case of a person who is terminally ill and suffering, and says that unlike the general population, such a person has a right to end his or her life.  And the trainer Emily acknowledges the statement by nodding her head and saying, “Other thoughts?” while turning to the rest of the group with her objective robot face.

But the inner Emily really wants to say, “But isn’t everyone who is thinking about suicide experiencing great pain and suffering? Isn’t everyone who is considering ending their life moving towards their inevitable demise anyway, as we all are? Isn’t saying that people who are dying faster or sooner have more of a right to kill themselves, sort of implying that their lives are not as much worth living as those who are young and healthy, in other words that they are not as valuable?” I am convinced that this message is both very prevalent and very concerning. Here’s another:

Ending your life early only affects you.

This is a radically individualistic point of view, but then, America is a radically individualistic country. Sure, it’s your life, but none of us live in a vacuum. Every action that we make influences others around us, at the very minimum by sending an implicit message. What message are we sending about the value of life for the aged and/or sick when we give them special permission to die?

There is value in comfort, but no value in suffering.

Suffering can bring us closer to God and to one another. It can give us a stronger understanding and voice to help others. It can refine our character. It can cause us to seek, and to find meaning in life. But sometimes we can’t see the value. When we are in pain, our bodies are crumbling and our life is running out, I’m sure it can seem pretty meaningless. But just because it looks meaningless to us, does that mean that it must, indeed, be meaningless? We see our small part of the world, but we are not omniscient. And as we lean more and more towards the idea that suffering is meaningless and without value, suicide becomes a more and more logical option, even for the physically healthy. Why bother with it?

It is brave to die on your own terms, but undignified to spend the end of your life living.

I understand that having a forecast of just six months to live can surely cause a person to want to gain some bit of control over their situation. But can we not make a difference in the world in just six months? Can we not do something meaningful, touch someone’s life, give our loved ones the sweetness of our presence, in one day? Can we not glorify God in even one moment? Isn’t it brave and dignified to try?

Protecting liberty is more important than protecting life.

I don’t actually believe that sanctioning the right-to-die protects liberty (See Reason #23). But I do value protecting life more than protecting liberty in most cases. I do so for several reasons. One is that if someone is dead, they aren’t free to make any choices, and if we are giving liberty to one set of humans at the expense of another set of humans, we are not supporting liberty or life, and we are definitely not supporting justice. I also value human life because I’m religious.

 

 

surprised face

I know – you’ve likely picked that up by now. But what I mean is that I do actually think that life is ordained by God, and as such is precious, and worth protecting, even if that means not sanctioning by law something that over 100 Americans do every day anyway, without the direct assistance of a physician. So that brings me to the next message that I hear frequently:

Religious perspectives have no place in policy decisions.

Let’s just say, for argument’s sake, that our system is meant to have a clear wall of separation between church and state. So let’s say that arguments need to be secular in order to be valid for policy making.

Let’s look at one example of an argument that is widely considered secular, which is that if we allow assisted death in our profit-driven healthcare system, then people, particularly the elderly or those with disabilities, will be targeted for assisted suicide, which is much cheaper than treatment. Here’s an example of such an argument. But how do we determine that it would be wrong to pressure vulnerable people to choose assisted suicide over treatment? We determine it would be wrong because we value the lives and choices of people above the cost of healthcare. It is a moral decision based on a belief system that values life, even though the argument itself doesn’t refer directly to a deity, church or text.

Similarly, the very name of the agency advocating for assisted death (Compassion & Choices), evokes moral values that are also, believe it or not, Christian. They may also be part of other ethical codes of course, but my point is that they are based on our philosophical beliefs, not scientific study, not theory about what makes society function. Values. Right and wrong.

We can take out direct references to religion from our arguments, but that doesn’t change the foundation of the arguments, which are firmly rooted in our belief systems. So as hard as we try to relegate religion to the private sphere, we cannot remove our values from our policy arguments, and to say that an argument isn’t valid because it is based in a particular worldview is to say that no argument is valid.

And at this point I’m probably in way over my head, so let’s move on to the final message that concerns me:

Being unwavering in regards to religious values means that we are not compassionate.

Most of us hate to see people in pain, and so I completely understand why a lot of people support the right-to-die. And while suffering has meaning, we should still strive to alleviate it. That is often part of the meaning – we find in our suffering the kindness of strangers, the tenderness of loved ones, the goodness that exists when we are in our darkest moments. We try to meet each other’s needs, and show one another the love of God that way. And when suffering cannot be alleviated, we weep with those who weep.

But I don’t think that being compassionate means we have to sanction suicide. I think that it means loving people enough to consider their lives precious regardless of illness, age, life expectancy, class, creed or culture.