A few weeks ago, the story of the 28-year-old Dutch girl Zoraya Terpik appeared in several social media platforms due to her decision to end her life through euthanasia or assisted suicide.
She has been diagnosed with multiple mental health problems such as depression, autism, and borderline personality disorder. Despite living a comfortable lifestyle with her loving partner and a pet she feels she is a “failure” and believes her condition is untreatable. Therefore, her doctors should help her end her life. The court’s decision to grant a person with mental health problems their wish to die sparked controversy and questions as it contradicts the main ethical principle “doctors should do no harm”.
It was no surprise that members of the public took to social media platforms to express their surprise that a doctor who is supposed to be treating a person would help him end his life through assisted suicide. Although assisted suicide is considered legal in a few countries it is mainly offered to people suffering from physical pain caused by complicated and untreatable conditions.
In Belgium and the Netherlands, assisted suicide has been provided to people with different mental health problems such as chronic schizophrenia,
post traumatic stress disorder, severe eating disorders, autism, personality disorders, and even prolonged grief. In such situations, the court would request evidence that the patient has exhausted a long period of different treatment options before approving their request for assisted suicide. This would not apply to Zoraya Terpak since she is only 28 years of age and is unlikely to have received all possible treatment options.
The question many people are asking is, would assisting suicide be an easy way out for people living with severe depression? and what if depression is affecting the person’s judgment when she or he signs up for it?
The second question is, since many people with depression and other psychological problems take their own lives by committing suicide and doctors who fail to detect a suicidal patient and intervene to stop them would be charged with negligence.
In my opinion, assisted suicide is unacceptable and doctors are supposed to save lives and not help in ending it. Life is gifted to us by God and should not be taken away. In countries legalising assisted suicide, healthcare professionals believe it should not be offered for people with mental illness for several reasons.
First, mental illness is often associated with feelings of hopelessness and helplessness which makes the person believe they will never get better, so they give up easily. Second, who gets to decide that the condition is untreatable and have we explored all possible treatment options before saying so? As psychiatrists, we sometimes come across patients who have treatment-resistant conditions and there are international protocols to treat such patients. Yet not all treatment options are available to everyone. So does that mean countries with limited resources should legalise assisted suicide? Third, mental illness often affects the individual thinking and reasoning which is known as decision-making capacity. Therefore, doctors need to be competent in assessing mental capacity before granting his/ her wish to choose assisted suicide. Such competency is unlikely to be equally available to all doctors.
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