Giving them reasons to live

Our duty to the mentally ill is brushed aside by the right-to-die lobby.

If she had looked at it closely, my sister wouldn't have passed that old sweater over to me. She had tired of it, though, and I gladly added it to my own wardrobe. One day while wearing it, I happened to glance down at the cuff. There it was – a small bloodstain from one day a year or two prior when she had tried to hurt herself. It had been another of those days that my loving parents, long since over any embarrassment and only wanting to keep their beloved daughter safe, called a police car and an ambulance into their driveway for all the neighbours to see. Again.

I changed from that sweater immediately, and threw it in the trash, only too grateful that my sister was still with us. Thank goodness, she is still with us. She's my hero, and she lives every day with schizo-affective disorder – now well-controlled with the right medicine. Her arduous journey back to reality began one night when she called home, frightened and confused. Mom and Dad dropped everything and drove out to meet her at the university hospital, where they found her pacing in front of the emergency room doors.

From there she moved in and out of psychiatric wards and group homes (when my parents couldn't care for her safely), then back to my parents' house to start again from scratch: first with a part-time job at the 7-Eleven, then with a certificate in flower arranging and a job at a craft store. Next she went back to university to complete her degree (dean's list), and took a job with a self-advocacy group in a psychiatric hospital. Following a diploma in psychosocial rehabilitation, she went to work for a local mental health association. Over the course of years, she got back on her feet. With her full permission, and after she's proof-read it, I've told you the short version of her eventual success.

Had her persistence in trying to take her own life paid off, she would have done none of these things nor would she have married the wonderful fellow she did. And I do mean persistence. At one point she was willing to try whatever was available on the drugstore shelf just to overdose on something – anything. Voices in her head (the auditory hallucinations of her illness) were giving her instructions to kill herself.

Now let's stop a minute, and re-think my sister's story in light of the gradual loosening up of assisted suicide laws worldwide: from the U. S., where right-to-die advocates in Washington are seeking assisted death legislation that mirrors Oregon's, to Germany, where a 79 year-old requested and received assistance to kill herself because she was lonely and feared ending up in a nursing home. Instead of helping the German woman seek treatment for depression, or taking the time to help alleviate her loneliness, a former government official simply waltzed in with a "suicide machine".

In Australia, a woman with four young children who was suffering from post-natal depression was able to get hold of a how-to-commit-suicide book -- while she was in a mental health facility -- and managed to kill herself by following instructions. She borrowed the book from a public library where it was freely available. In Switzerland, a court recently upheld the right of a man suffering from bipolar disorder to kill himself.

You may say that this fellow with bi-polar disorder was in his right mind when he wanted to end it all, and my sister was clearly delusional. But has society stopped seeing the urge to commit suicide as an illness in itself, or at least as a cry for help – help that society has a responsibility to give? Oregon state seems to have: of all 49 Oregon patients who died by assisted suicide last year, none of them were referred for psychiatric evaluation. 

In my sister's case, it wasn't always clear to the casual observer that she was hearing things. To her friends, she often appeared quite rational. She was able, in the earliest stages of her illness, to hide her delusions from them quite well. So well that at first they couldn't understand why my parents kept having her taken to the hospital. Even I didn't grasp how sick she was in the beginning, because I didn't live in the same house. What if she had lived in Zurich, and had the wrong kind of pals or only one family member in the same city who saw her infrequently?

Even worse, what if she were living in the kind of hell that anti-euthanasia activists frequently predict? Think how many health care dollars would have been saved if the hospital had said, "Clearly she wishes to die. What right have we to stop her?" Think about what would have happened in this scenario, if my parents were the type who cared what the neighbours thought.

However, we don't live in some dystopian nightmare yet. My sister's illness has been treated, and she is as productive a citizen as they come. Not only does she directly assist those who suffer like she has suffered, she also advocates for them in the larger community by teaching suicide intervention workshops and giving talks about mental illness. She has even made a presentation to a provincial government committee, and is just one of those who try to make people understand that life is worth living for everyone.

The world would indeed be lacking if she had succeeded in finishing herself off. And it would be lacking if anyone did, whether or not they were successful in their career afterward. It would be lacking simply because we are all human beings with intrinsic worth. Caregivers, professional or not, have an obligation to convince vulnerable individuals of this worth – whether their illness is physical or mental. And we are all morally bound to convince them in word, deed and law that it is not necessary for them to take their own life in order to maintain their dignity. After all, as Jean Vanier, founder of l'Arche International communities for the intellectually handicapped, reminds us, a person's dignity is also a gift we give to them.

It is appropriate to give the last word here to my sister, who puts it quite eloquently: "We have a duty to help others live even when we ourselves can't see why they would want to. That means we have to look very, very hard for reasons for them to hang on. This takes time, respect, sensitivity and resources -- things that are difficult and often hard to come by. Again, whose needs are we meeting through assisted suicide? The system's? Or our own need for convenience?"

Michelle Martin writes from Hamilton, Ontario, where she and her husband have raised their ten children. She is a graduate of the University of Toronto and currently holds down a part-time job caring for intellectually handicapped adults.

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