Trigger Warning: In which I worry about an assisted suicide ruling.

Warning: I have no idea how triggers work, particularly related to depression and contemplation of suicide. I am your typical, undereducated thug in that department. But if any of this entry serves to trigger something, please know it was not intended, I apologise, and you can inform me of it privately if you so choose so I can change it accordingly. I’m not here to traumatise.

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I’m more often than not a fan of any time the Supreme court of Canada wants to take a swipe at our government. The way things tend to come down the pipe now and again, it’s probably deserved more often than it’s not. But on assisted suicide in particular, the supreme court has gone too far.

The court ruled very recently that a law banning doctor-assisted suicide was entirely unconstitutional–and that the right to life, more or less, should include the right to death. On its face a logical ruling, if you can tie anything remotely akin to logic around an issue of when it’s considered legal to kill someone. The ruling allows for the possibility of assisted suicide for any incurable physical–or mental–illness. So, for example, someone determined to be dying of cancer can opt to have it done and over with quickly, as opposed to living out the rest of their however long knowing the disease will eventually kill them. that’s good, in theory. But so can someone dealing with depression. that’s not so much.

Already this happens in certain European countries–Belgium permitted the assisted suicide of two deaf twin brothers who were going blind and couldn’t handle it, for example. And the same procedure for chronic depression is surprisingly not uncommon in jurisdictions that allow it. Unless a bunch of folks are reading the supreme court’s ruling entirely incorrectly, there is ample room for the trend in Canada to follow that path–as, quite aptly, has been explained to death already.

But that is not what the Court has in mind. First, it is clear from the ruling that the “enduring and intolerable suffering” that would confer the right to have someone kill you (with your consent, of course) is not limited to physical pain, but also psychological pain — which, besides being a murkier concept by far, raises the question of how competent the subject really is. Nor is suffering defined further: it is enough that it is intolerable “to the individual.”

Second, nothing in the words “grievous and irremediable medical condition,” the court’s other requirement for the exercise of this right, suggests that death is near, or even likely. It is enough that the condition be incurable; it need not be terminal.

So. You’re on medication for life. It’s keeping you functional, perhaps even something close to healthy, but it’s still there. As a friend told me once, it never goes away–you just get better at ignoring it. You could decide that’s plenty good enough–for all intents and purposes, you’re as cured as you’re going to get. But if you–or your doctor–decide that no, being on medication isn’t good enough–that it doesn’t actually cure you, but just treats the symptoms, assisted suicide could–again, based on this ruling–be an option. In states where it’s already legal, it is an option.

Patients themselves say that the primary motive is not to escape physical pain but psychological distress; the main drivers are depression, hopelessness and fear of loss of autonomy and control. Dutch researchers, for a report published in 2005, followed 138 terminally ill cancer patients and found that depressed patients were four times more likely to request euthanasia or physician-assisted suicide. Nearly half of those who requested euthanasia were depressed.

In this light, physician-assisted suicide looks less like a good death in the face of unremitting pain and more like plain old suicide. Typically, our response to suicidal feelings associated with depression and hopelessness is not to give people the means to end their lives but to offer them counseling and caring.

I know people who suffer from depression. Even completely treated, it’s still there. But because people have been there to offer help, they haven’t decided on their own it’d be better to call it quits. Some of those are friends, family, people I am or was close to. Some of them didn’t speak up about it until they had but two options: get help now, or get out–and they’d already tried that second one. It’s very possible some of them still haven’t spoken up about it–to people, at least, who could potentially have done something about it. I can only guess at exactly how many of those people I’d know now if this were a more widely accepted option. I’d rather not guess at how many people I know would consider taking this path if it becomes a more widely accepted option.

It’s been said to me on more than one occasion. Once a depressive, always a depressive. The best you can hope for is to cope. This is not coping. We can do better than this. The supreme court has it wrong, and I sincerely hope someone in this government or the next puts some effort into correcting it. Even if I will never fully appreciate it, the people who need it most will. That’s what we’re here for.

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