18 May, 15 | by BMJ
Guest post by Udo Schuklenk
We should not prevent some depressed people from access to assisted dying.
Deborah E Gray, whose depression is (according to her account) successfully managed today, describes vividly on her website the impact depression had on her. She writes:
you don’t feel hopeful or happy about anything in your life. You’re crying a lot for no apparent reason, either at nothing, or something that normally would be insignificant. You feel like you’re moving (and thinking) in slow motion. Getting up in the morning requires a lot of effort. Carrying on a normal conversation is a struggle. You can’t seem to express yourself. You’re having trouble making simple decisions. Your friends and family really irritate you. You’re not sure if you still love your spouse/significant other. Smiling feels stiff and awkward. It’s like your smiling muscles are frozen. It seems like there’s a glass wall between you and the rest of the world. You’re forgetful, and it’s very difficult to concentrate on anything. You’re anxious and worried a lot. Everything seems hopeless. You feel like you can’t do anything right. You have recurring thoughts of death and/or suicidal impulses. Suicide seems like a welcome relief. Even on sunny days, it seems cloudy and gray. You feel as though you’re drowning or suffocating. Your senses seem dulled; food tastes bland and uninteresting, music doesn’t seem to affect you, you don’t bother smelling flowers anymore.
In many jurisdictions where the decriminalisation of assisted dying is debated, proponents of decriminalisation hasten to add that they would, of course, exclude patients that suffer from depression. This may be a political move aimed at increasing the societal acceptability of assisted dying, but it is unjust towards patients suffering from treatment-resistant depression. Many lay-people, and even doctors and nurses, fail to acknowledge the severe suffering that comes with depression. Patients who suffer from long-term treatment resistant depression are not just ‘feeling a bit low’. As the quotation above shows, these people really suffer existentially, and because their depression has proven to be untreatable (often over the course of decades) there is no relief for their suffering. more…