Belgian experts call for euthanasia on psychological grounds to be removed from the law

Euthanasia-Free NZ welcomes the open letter signed by 65 Belgian experts this week, because it is highly relevant to the New Zealand "assisted dying" debate.

The group of psychiatrists, psychologists and others is calling for euthanasia on the grounds of psychological suffering alone to be removed from the Belgian legislation.

They write, “The current law assumes wrongly that there are objective clinical criteria with regard to psychological suffering that could justify euthanasia. It is for this reason that euthanasia on the grounds of psychological suffering alone cannot be regulated by law.”

Simona de Moor recently received a lethal injection for grief over the death of her daughter three months earlier. Emily, a 24-year-old, was granted permission to receive lethal drugs, based on her suicidal thoughts and feeling that her life was pointless. Both Belgian women were physically healthy when assessed for euthanasia.

Similar cases would be possible in New Zealand if the End of Life Choice bill would become law. It proposes that virtually anyone over 18 with an irremediable condition would be eligible, including those experiencing depression or other mental suffering. A condition could easily be declared incurable when a patient has exercised their right to refuse further treatment or when a treatment hasn’t worked as expected.

“The bill poses significant implications for the application of the Mental Health Act. I’m concerned that legal assisted suicide would contradict suicide prevention”, says Renee Joubert, Executive Officer of Euthanasia-Free NZ.

The Belgian experts argue that psychological suffering cannot be declared “irremediable”, because a person’s feelings about their situation can change, and sometimes suddenly.

“We see that some, who are at first declared incurably ill, eventually abandon the notion of euthanasia because new perspectives appeared. In a paradoxical way, this proves that the illness cannot be called incurable,” they write.

The experts reported that it’s often a feeling of hopelessness - a lack of perspective - that makes life unbearable, and that hopelessness is one of the key characteristics of serious depression.

They refer to the World Health Organisation’s estimate that one in seven people experience serious depression at some point in their life. According to the National Depression Initiative the risk is even higher in New Zealand: here it is one in six.

“..When we suffer psychologically, we are often convinced that no other future is possible anymore. It is often precisely this thought that pushes a person into an abyss, because as long as there is perspective, a person can usually tolerate much,” the experts state.

“The Belgian letter's conclusions also apply to people with physical illnesses,” says Ms Joubert. “Surely a person who is suffering from depression is more likely to feel their physical condition is intolerable, and more likely to desire an earlier death.”

“The desire to die is clearly not dependent on a person’s physical diagnosis or symptoms, because only a tiny percentage of dying people choose assisted suicide. For example, only 0.68 % of people with terminal cancer died from assisted suicide in Oregon during 2014. They requested the lethal drugs mainly for psychological and existential reasons. Almost 90 % cited the reason ‘being less able to engage in activities that make life enjoyable’. Isn’t the inability to enjoy life a common symptom of depression?”

“I reckon we sometimes forget that people go through a grief process when faced with a terminal diagnosis or disability. Depression is a common part of the grief process, but can easily be misdiagnosed, hidden and remain untreated.”

“There is essentially no difference between suicide and assisted suicide, apart from the number of people involved in the act. Regardless of whether a person is physically healthy or terminally ill; regardless of whether a person wants to end their life by themselves or with help; the desire to die is mainly a non-physical issue and associated with treatable depression.”

A UK study found that 98-99 % of terminally ill people who wanted to die changed their minds after receiving treatment for depression.

Euthanasia-Free NZ agrees with the Belgian experts that “death as therapy” does not constitute compassionate care.

“There are effective ways to relieve suffering that don’t involve deliberately ending a person’s life”, says Ms Joubert. “We want New Zealand to focus on making excellent care, including psychological care, accessible to everyone who needs it.”

ENDS

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