Many believe in euthanasia for the terminally ill. But why not legalize it for those suffering from an untreatable mental illness?

In the Journal of Medical Ethics, two influential bioethicists argue that we should allow euthanasia for patients suffering from ‘treatment-resistant’ depression. Udo Schuklenk, of Queens University in Canada, and Suzanne van de Vathorst, of the University of Amsterdam, claim it is discriminatory to allow euthanasia or assisted suicide for terminally ill patients but to deny it to those who suffer from incurable mental illness. Professor Schuklenk is co-editor of the journal Bioethics.

The authors see no relevant difference in the quality-of-life of patients in these situations:

“…Those who support acceding to assisted dying requests made by competent adults (and possibly mature minors) for irreversible conditions that render a patient’s life permanently not worth living to them have good reason to support the availability of assisted dying for competent patients suffering from TRD or other psychiatric disease… Incurable disease conditions that are not terminal by most definitions can also render competent people’s lives not worth living in their own well-considered judgement.”

The authors describe the immense suffering endured by those who suffer from incurable depression, and quote a lengthy excerpt from an American psychiatrist and biopolar sufferer: “Suicidal depression involves a kind of pain and hopelessness that is impossible to describe.”

They conclude that legislative bodies should seriously consider revising their restrictions on the availability of euthanasia:

“We recommend that jurisdictions considering the decriminalisation of assisted dying do not limit access to such services to patients suffering from a however defined terminal illness.”

The article poses an interesting question, relevant to euthanasia advocates and opponents alike: Can one rationally advocate for euthanasia while opposing its provision for those suffering from an incurable mental illness?

Many believe the answer is ‘no’, and for this reason refuse to support campaigns to legalize assisted dying.

Canada’s recent Supreme Court ruling may have opened the door for assisted suicide for those suffering from serious mental illness. The Supreme Court judgement stipulates the following conditions for assisted dying:

"(1) the person affected clearly consents to the termination of life; and (2) the person has a grievous and irremediable medical condition (including an illness, disease or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition."



