Regular readers may remember that I worked on George Peters' FacTapes during the 1990s, and although we never actually produced such a document, one of the topics on which George Peters wanted to gather facts was the then-current trial of Dr. Jack Kevorkian for "assisting suicide."
Thus rendering one popular quickie test of mental health absurd for several mentally healthy people he knew. "Have you ever thought about suicide?" Well, not as something we personally wanted to do just then, but definitely as a topic for an audio-book. Mostly we thought it was a bummer of a topic, and the fact that Mr. Peters was using Tegretol probably had something to do with his interest in the topic. And he said, yes, it did; he was using Tegretol for intense chronic pain, and if the pain reached the point where Tegretol didn't block it, he didn't want to "graduate" to morphine, he wanted to end the misery right then. And at least two of us said, rather forcefully, or shrilly (if you don't like the idea that women can and should say things forcefully), "Don't talk about that kind of thing in public! People will say your grandchildren have inherited 'depression' from you."
The question remains. In principle, in an abstract way, do we think people who are conscious and in pain have a right to euthanize themselves? If so, how far does that right extend?
I say it stops with the conscious patient. If someone feels suicidal under the influence of drugs s/he has recently used, we have a responsibility to tell them to wait and see how they feel when they're completely sober. (If they've used a class of drugs that includes street drugs the junkies have mostly abandoned because they were so fatal, of which LSD is the most infamous, and also certain popular prescription medications, I think these patients should wait a year before making any life and death decisions.) If someone still feels suicidal when s/he is stone cold sober, I think we have no right to force that person to keep breathing.
Argue with them, yes. Tell old people who've diagnosed themselves as terminal that their grandchildren need them, yes. But should we tell old people that their grandchildren somehow "need" to watch them lose the ability to think or speak, and keep the ability to feel unbearable pain, for months or years of howling agony? I don't think grandchildren need that, at all.
Does that imply that, if people are alive but not in their right minds, others have any right even to suggest suicide? (We're talking about senior citizens with Alzheimer's Disease here.) I say no. If they're not in unbearable pain, if they're still enjoying moments of joy, then the law should require health care providers to continue to supply those moments of joy. Who knows, a cure may be discovered...
Actually, I'm not sure that Alzheimer's Disease will ever be curable, but I have seen firsthand that fear of this disease makes people think seniors have it when they don't. You have to observe a patient carefully, under different conditions, to have any idea whether what looks like senile brainfog is actually a temporary reaction, either to a different disease or to medication used to treat that disease. Anyone who has been anesthetized or sedated, as it might be for a coloscopy or childbirth, is going to seem foggy for a few hours. What I see far too much of is an assumption that, although an eighteen-year-old would be equally foggy after a certain medical procedure, when an eighty-year-old is the one who's had the procedure people assume her or his foggy condition is permanent. Most of the time that's not true.
I've seen greedy relatives bring in psychiatrists to "examine" someone who's been freshly sedated, eager to pronounce the person incompetent. Erma Bombeck's bestselling books often referred to her mixing up her own children's names, but if a rich great-uncle mixes up the names of young relatives he's not seen in five years, he's incompetent! I have stood beside hospital beds and argued with these people. "She's not answering a question like that because she's too weak to say a whole sentence. If you'll ask her a few yes-or-no questions you'll see that she's fully aware of what's going on." So then the greedy relative tries to arrange for me not to be with the patient on the day the relative produces the psychiatric quack to certify the patient incompetent and take over full rights to "manage" the patient's property, transfer all his bank accounts to the relative's, start driving her car, whatever.
People like this are occasionally checked by fear that if their rich relative survives, s/he may be able to prove that s/he has recovered competence. Imagine how much easier life would be for greedy, evil people if they could not only claim the right to manage Uncle Richie's property, but also claim the right to terminate his life.
I say we can't allow this kind of thing. If you, in your current state of consciousness, seriously think you'd rather die than live through five or ten foggy years of "moments of joy" with Alzheimer's Disease, that is your prerogative, but please make your own arrangements for your own unassisted suicide. There are a variety of quick and reliable methods; this web site won't discuss them, but support groups like the Hemlock Society do.
Sane people have euthanized themselves...sometimes as ludicrously early as Sara Teasdale, whose horror of disability caused her to end her life when doctors agreed there was little chance of even a serious illness. More recently Carolyn Heilbrun promised to end her life when she reached retirement age, put off doing it for a few years, and then finally did euthanize herself rather than depend on Social Security.
One thing I said to George Peters, while he was praying for the quick natural end his life got in 2001, applies to others who want to make sure they don't live too long. You have a right to euthanize yourself when you believe your life is over anyway, and God may judge your motives and say "Well done thou good and faithful servant" for all I know, but you have no right to demand that anyone else participate in ending your life. That's cruelty to doctors.