A television documentary “Tod nach Plan” (Death by Plan) aired on Swiss-German television in early February, followed the path to assisted suicide taken by a man suffering from bipolar disorder. This has focused debate on the practice of euthanasia / assisted suicide / medical killing for the mentally ill.
While there is little question that mental illnesses such as bipolar disorder (formerly known as manic depression) and schizophrenia can be debilitating in the extreme and lead to great suffering, the obvious difference between such illnesses and terminal diseases like cancer is that they do not carry with them the certainty of death.
“The fact that it is a chronic illness is one thing, the fact that it is an incurable illness is another,” Panteleimon Giannakopoulos, head of mental health and psychiatry at the University Hospital of Geneva, told swissinfo.ch.
Giannakopoulos notes that psychiatric illnesses often manifest themselves over many years, during which the patient may suffer periods when they can have suicidal thoughts and periods of improvement when they are able to live a relatively normal life.
“It is clear that for these people we can treat them, we can improve their situation,” he said.
But such people can often become marginalised from society through factors such as loss of employment and friends as a result of their illness, said Giannakopoulos. He warns that a lack of regulation for such cases could lead to a “certain type of modern engineering”.
“These people are often in very good [physical] health but often they have few friends and are very solitary,” he said. “Do we take the point of view that we allow them, during a phase of resignation to say ‘well that’s it, I’ll finish it’? In an indirect way, it’s a risk, if we let the flood gates open, it’s a way of getting rid of these people.”
My former Ethics Advisor, the late Revd Dr Christopher Newell wrote a submission to the Tasmanian Parliament on this issue in 1997. It is pertinent today, Ethical Social Policy? Euthanasia and People at the Margins of Society, with Particular Attention to People with Disabilities.