Euthanasia & psychiatric conditions - a community response
As an island we are approaching a turning point in the history of our law.
The approval in principle of euthanasia is an expression of our wish to give people choice at the end of their lives. Choice is, in general, a good thing. However, there must always be limits to our choice, particularly when our choices affect other people. We do not make choices in a social vacuum; our choices are inevitably a product of our background, upbringing, belief system and the community that surrounds us.
As a psychiatrist I am ever aware of the influence of family, community, and significant others on the patients that I see. This influence can be for the good, for the bad, or for the inevitable muddle of both that we often are as a human society, and in general, we allow people to make as many free choices as they can, but there are times when we need to restrict those choices.
Choices are restricted by law in part to protect the vulnerable amongst us whose choices may come under undue influence from others.
My major concern about the proposed change in the law to allow euthanasia is the effect that this will have in removing protections from vulnerable people. We must be extremely careful in assessing the capacity of people with mental ill health when they are making decisions, to ensure that those decisions come from a place of stability and self-worth.
By way of demonstration of how euthanasia laws are being played out in other countries, I wish to highlight a case recently brought to the European Court of Human Rights.
Tom Mortier had previously been in favour of euthanasia, being in favour of allowing the choice to those who wanted it. Unfortunately, he did not realise how the law would allow his mother, who had severe mental health issues, to be euthanised without his knowledge, and despite the doubts of her long-term treating psychiatrist.
The Court agreed that Belgium did violate the right to life of Tom’s mother.
The current wording of the proposal for Jersey does not include psychiatric illness alone as a reason for euthanasia. However, as has happened in Canada, it would not take long for a case to be brought which argues that it would be discriminatory to exclude the enduring and unbearable suffering that psychiatric illness can bring.
As an island community, we need to decide how we are going to behave towards those with enduring and unbearable suffering. Are we going to affirm their dignity despite their pain and work with them with compassion to give them hope in their darkness?
We need laws, and we need our families and communities, especially when we are vulnerable.
Dr Rachel Ruddy
Consultant Psychiatrist
Our Duty of Care Jersey