“I want to end my life”
That is such a sad cry – an indication of something terribly wrong and a sense of hopelessness about it ever being different. Even for those of us that have suffered from depression, how can we know what tortured processes are present in the mind of the person who feels that suicide is the only option left. And let me say at this point as a medical practitioner of 45 years dealing with depression that it can always be helped and suicide almost always prevented.
Listen to this plaintive cry from the diary of David Brainerd, missionary to the American indigenous people and who eventually died aged 30 of TB in giving himself so completely to the task God had given him:
Lord’s Day, Dec 16 (1744). Was so overwhelmed with dejection that I knew not how to live. I longed for death exceedingly; my soul was sunk into deep waters and the floods were ready to drown me… my soul was in a kind of horror… could not keep my thoughts fixed in prayer for the space of one minute… I would have cheerfully ventured into eternity. While I was going to preach to the Indians, my soul was in anguish.
So even people totally given to God can suffer this deep dejection, this black dog, this beast, this curtain of heaviness. C H Spurgeon describes it well:
This evil will also come upon us we know not why and it is then all the more difficult to drive it away. Causeless depression is not to be reasoned with.
Take courage my friend, seek help. Help is available.
But there are others also who may want to die.
It may be in situations of great physical distress and literal hopelessness. It may be as a captive in a cell of literal torture. It may be due to extreme fatigue – particularly battle fatigue when the soldier may just simply want to lie down and die and is at risk of being killed because of this. It may be as a result of extreme injury e.g. severe burns when the person can see no viable future. Doctors learn to accept such cries of distress but also to push through to healing and to have a grateful patient at the end of that process. And of course it may be due to illness with extreme pain or disability and uselessness as exemplified in terminal illness. This deserves great sympathy and understanding.
Or it may be from a person’s chosen life philosophy. I want to do it my way. I want to be in total control of what happens to me. I will die at a time of my choosing and I insist on my right to do this my way. This philosophy will sometimes complicate the call for euthanasia. Whereas doctors involved in palliative care know that distress in terminal illness can always be helped and unacceptable suffering can be transformed into peaceful acceptance, there are those that will not contemplate or accept such help. No, I will do it my way and I will insist on that. In any cries for euthanasia we need to be clear as to the difference between relief from physical or mental distress (dying people can be depressed too) and life philosophy.
Wanting to do it “my way” is the clear intention of many world leaders of the euthanasia and right to die movement who actually want the right to die at a time of their own choosing by their own convenient doctor assisted method – even for distressed teenagers with “existential” suffering for whom life has become too difficult.
More rarely but important to consider is the person with a deep “scripting” to kill themselves – what may be called a “don’t exist script”. This may be familial or genetic, it may be resulting from deep psychological abuse in childhood, or it may have a spiritual origin particularly in other cultures but also sometimes in our own. This requires, first of all, awareness and recognition by the person so afflicted and then appropriate counselling or even deliverance in a psychological or spiritual sense.
In the instance of the person dying and in terminal distress, pain and suffering can always be relieved given the opportunity of good palliative care. Patients need not die in physical pain. We must never find ourselves in the situation where funding for palliative care is sacrificed and restricted by governments with euthanasia seen as the cheaper option. We must fight against the situation where it is easier to fund death rather than life.
There is a lot more to the euthanasia debate than just simply personal autonomy. I have touched on some of this above but allow me to add:
- Doctors must never be involved in killing.
- Legalising euthanasia and physician assisted suicide works against national suicide prevention strategies, sending a wrong message to people – especially the young – that it is OK to kill yourself if things are too tough.
- History shows us that voluntary euthanasia always moves to involuntary – it has been agreed by enquiries there is no way of stopping this.
It would be very remiss of me not to add that the strongest resource in depression and distress that I know of is committing our way to God – even if He is apparently not listening and has apparently forgotten us. How long, O Lord? Will you forget me forever? How long will you hide your face from me? cried the Psalmist. But even when there is only one set of footprints, they are His and we are being carried. But there’s more, He turns the bad times to growth and the Psalms and other Biblical writers tell of this reality.
Let’s be clear – we must never give legal approval for people to die and doctors must never be involved in killing. To give compassionate and skilled medical care to the very end of a patient’s life, yes, that is our role and duty but never to kill. Killing is not a solution and must never, ever again, be seen as the “final solution”.
Watch out for each other. Get alongside the person in distress. Contact that person you were concerned about again Hi, it’s me, just touching base… Don’t let go, follow through. And having thought that, that’s what I need to do right now.