Job 3:20-22
Why is light given to those in misery, and life to the bitter of soul, to those who long for death that does not come, who search for it more than for hidden treasure, who are filled with gladness and rejoice when they reach the grave?
I am always (although it doesn't happen often) rather bitterly amused when the conversation (randomly) turns to suicide. It usually starts off with someone saying that they don't understand how anyone could do such a thing. Generally this is followed by some statement about how the people who do commit suicide must be very selfish, since they don't consider the feelings of those left behind.
I generally do not contribute to the discussion. I rather fear that, if I did, my first contribution would be a rude and accusatory comment about the irony of those maundering on about the selfishness of suicide, when those making these comments are, themselves, incredibly self-centred, given that they have never asked about the level and type of pain that would drive someone to try and address it by ending their own existence.
I don't have to ask. I know.
In objective terms, my life is not bad. I do not pretend to know, and do not have particular expertise, in all of the myriad ways that chronic pain and distress can present. However, I have fought depression, and suicidal ideation, since I was in my early teens. Pain is difficult to quantify, and has a large subjective component. Subjectively, depression removes your pleasure in any of the normal pleasures of life, and magnifies the negatives of any negatives. Regardless of what your life is like, objectively, subjectively, your life sucks. (Depression can be seen as an illusion, but please remember that illusion is defined as a real perception which is not borne out by subsequent facts.)
For several years I did not understand why I was unhappier than pretty much everyone around me, and than pretty much everyone around me thought I should be. (Pro tip: telling someone with depression to cheer up is extremely unlikely to help anyone.) It wasn't until I got into university and (more or less accidentally) took psychology that I realized what was going on.
I took additional psychology courses, primarily simply to research depression. Given the cyclical nature of my depression, abnormal psychology (203) taught me that it was manic depression of depressive type. (That was under the old rules: under DSM-V, and the new bipolar model, it doesn't fit anymore. Even my mental disability is wrong.) Before I got married you could set your watch by my cycles. Four months depressed, four months not-quite-depressed. I developed quite a set of metrics to measure the onset, depth, and severity of my depressive cycles. Being married had an interesting effect, somewhat reducing the severity, as well as changing the frequency of the cycles frequency and predictability.
I did a lot of research on Martin Seligman's theory of learned helplessness, which, relevant to the cyclical nature of my depression, provided one of the mainstays of my own treatment of my own depression: just keep going. I sought treatment from doctors, psychiatrists, and psychologists. I learned the various, and disparate, forms of cognitive behavioral therapy, or CBT.
And then Gloria died, and I became a grieving widower. I was rather surprised, given the frequent outcome of grief resulting in depression, that I did not immediately go into a depression when Gloria died. Indeed, I had a period of slightly more than a year, when I did not appear to have any depression whatsoever, although I was definitely within the parameters of both prolonged grief disorder, and prolonged complex bereavement disorder.
For roughly a year after Gloria died, I wasn't depressed. I didn't particularly want to go on living, but I was trying to do grief work, by building a completely new life. It wasn't going particularly well, but I wasn't particularly suicidal during that time. Somewhat, yes, but it wasn't an obsession.
And then the depression returned. With a vengeance. And it hasn't been cyclic this time: I have had over a year and a half of completely unrelieved depression. And, yes, pretty much every day I ask God to kill me. Pretty please.
Up until this most recent depression, I had been tried on three different antidepressants. (The first being lithium, so that's how long ago that was.) During this most recent depressive episode they have tried three more. None of them have done me any good, and one of them was particularly vile. I have just been prescribed a seventh, of a type that is less in favour these days. I am not holding my breath waiting for it to make me better.
So, yes, I know about pain. Chronic, unrelieved, mental pain. And distress. I know about the inability to take pleasure in pretty much any aspect of life. I know that many psychological counseling processes and literature suggest that you take pleasure in the little things in life: a pretty flower in the grass, a sunset, a child's laugh. Well, this is what depression does to you. Things that anybody else would enjoy, you, basically, can't. Depression takes away the pleasure from what would normally be a pleasure. Depression ensures that you are left with nothing but the endless drudgery of what anybody else considers the normal administration of life, but which is monstrously annoying when it is all that you have, and unrelieved by any positive reinforcement at all.
I wish I were dead.
Canada now has a law about "assisted suicide." In Canada it is referred to as medical assistance in dying, or acronymically, MAiD. (I understand that, in the UK, it is TFMR: Termination For Medical Reasons.)
Suicide is, of course, frowned upon. It used to be illegal. I often thought that it was ironic that suicide was only a legal problem if you failed at it. There is a theological objection to suicide. I suppose that it is felt that suicide is a lack of faith in the God who is supposed to be taking care of you. At the very least, it expresses impatience when you ask God to kill you, and He doesn't say yes, and possibly He doesn't say no, He says wait. And you don't wait it out.
I believe it is still impossible to have a suicide buried in consecrated ground in a Roman Catholic cemetery. And that disapproval of suicide made it all the way into the law book. Now it's been taken out, but, societally, we still frown upon it. We see suicide as a weakness, "the cowards way out." The objection to suicide has now transferred to MAiD. Many people are vociferously, and obsessively, opposed to MAiD. I am also treated to discussions of MAiD, sometimes by people who have some medical background, and should know better, that display a profound ignorance of the actual law and process in Canada. No, you are not allowed to kill somebody just because they feel bad. It is only recently that mental illnesses have made it into the list of permissible chronic and unrelieved illnesses for which you can apply for MAiD. I have, in fact, been offered MAiD because of my treatment resistant, and intractable, depression. Not that they offered me a pill or anything: again, it does not work that way. It's a long process, and it involves multiple people, who all have to sign off on it, and you have to find medical people who are even willing to participate in the process, because nobody in the medical system is forced to participate in the MAiD process if they don't want to.
And the trigger to get me started on writing this particular piece, is yet another article (with slightly less ignorance of the topic than normal) yet again presenting only the problems with MAiD, and not the relief that only it offers to some people.
As I said, I have been offered MAiD. (Or, to be more accurate, the option to be referred to the MAiD process and system.) As I have also said, I do, myself, have religious objections to suicide, for myself. So I didn't take it.
But I'm beginning to wonder if I made the wrong choice. So far, it's the best and most comforting solution anybody, and I mean *any*body, is providing me with.
The article, as I mentioned, is not completely ignorant. But it is rather one-sided. It is looking at the possible problems with MAiD, rather than the benefits of MAiD. And, predictably, it focuses on individual cases. Individual cases can be used to highlight human interest much more readily than statistics. And, of course, the opinions of those who are opposed to MAiD, or who have been left behind by the users of MAiD, are much more readily available than the opinions of those who have successfully accomplished dying with medical assistance.
Even then, the article is not entirely unbalanced, but focuses on some specific cases pointing out the possibility that patients lives could be improved even without recourse to MAiD. In particular, it focuses on situations where there is either financial or residential insecurity, for the person seeking MAiD, or cases where social isolation contribute to the lack of quality of life that would make someone seek MAiD.
Far be it from me to say that the Canadian medical system is perfect. I lived pretty much all of my life in a major metropolitan area, and even there the medical care available was not perfect. I have now moved to a much smaller setting, and it is readily apparent that, overall, the medical system leaves much to be desired, and could definitely provide much greater support to those who need it. Where I am now, it is difficult even to obtain a family doctor, let alone get specialized medical care. Recently it took me over a year to get an MRI, and I am currently on the waiting list for additional specialist care, which is not available in the town where I reside, and, even so, the referral is obviously not going to occur quickly, and I cannot even get information about where I am on the waiting list. So, no, the medical system is not perfect. It badly needs funding, it badly needs personnel, and it is straining at the seams in pretty much every direction. In a recent conversation with one of my care providers, the topic turned to my volunteer work. The care provider pressed me for more and more details, until I realized that what she actually wanted was information on resources that she, as someone within the government supported medical system, could provide to her clients, because the medical system wasn't going to.
Therefore, I am quite willing to entertain the possibility that people involved in the MAiD process and system, overworked and stressed as the rest of the system is, may occasionally err on the side of allowing someone to die, who could possibly be helped in another way.
Except that those other ways are not available either.
Before I moved here, I was involved, as one of the designers, of a pilot project looking at social isolation, and the risks of social isolation, and the steps that could be taken to reduce social isolation and therefore the risks, with particularly regard to the elderly. At the same time as I was involved in this project, I was also in a position to observe similar programs in a different medical region. So, yes, I know that social isolation, particularly for those with additional medical problems, mobility issues, or age-related issues, may contribute to demands on the medical system itself. I know that the resources available to those facing such social isolation are minimal to nonexistent. I do not have the same level of experience and research with regard to financial and residential insecurity, but residential insecurity, under the rubric of the "housing crisis," is hard to avoid in our news media. Once again, I am quite willing to accept that these are real problems, and that addressing these problems could help with the demand on the medical system, and possibly even reduce the calls upon the MAiD system.
But, is anyone doing anything about it? Well, other than the fact that politicians constantly mention it in their campaign speeches, or in their speeches attacking the party currently in power, the answer seems to be, not much.
Our society is growing increasingly complex, but also increasingly fragmented, and many of the supports that used to be available no longer are. I have mentioned religion. The church used to be a mainstay of social support in Western society. (Sometimes too much so.) However, the church is no longer a major factor in that regard. The church is now a fraction of its previous size. Whereas a hundred years ago church attendance or adherence would be on the order of a half or a third of the population, nowadays it is likely to be three percent or less. That three percent definitely cannot be expected to address the shortcomings of society overall.
The church is, itself, under stress. The church must be aware of its very much dwindling population, and that the bulk of any revenues achieved by the church must be devoted to maintaining the church itself, rather than being addressed to the larger needs of the community. In this situation it is no wonder that, during a two year stint of church shopping, I have failed to find any support in any of the churches here in town. I am well aware of the fact that my existence is not only unwelcome at the churches, but is, for most, a positive threat. The church seems to have wandered from the central themes of its theology, and most people now believe in a variant of the prosperity gospel. The prosperity gospel basically says that if you do what God wants, then God will take care of you. So, pursuant to the prosperity gospel, if you are in pain, or distress, or grief, or any other trouble, the problem is actually a lack of faith, or an unacknowledged sin, or something of that nature. In other words, the problem is your fault, and nobody within the church needs to take any steps to address it.
So, it is no wonder that the members of the churches in this area avoid me like plague. (Except for the fact that, primarily being on the right end of the political spectrum, most of them don't take too many steps to avoid the plague.)
To return to religious objections in regard to religious objections to suicide, there are those who would say that life is a gift from God, and should not be casually discarded. However, an awful lot of things, including the natural environment in which we live, are, in fact, gifts from God, and we seem to casually discard many of them without much thought. So, why should this one, particular, gift be the exception?
In regard to this particular religious objection to suicide, I have, several times in the past few days, being bombarded by online ads for a t-shirt that reads "God is not finished writing your story. Please stop trying to grab the pen." This is an interesting perspective, and, yes, does speak to the idea that God is in control of our lives, and all the situations around us, and we are not. However, in situations of great distress, most people feel that they have lost all control. The one possible thing that they can control is continuing to live, or not. It is, actually, all too easy to think of ways to kill yourself, if you are willing to put up with a little pain in the process.
(In regard to that t-shirt, I note that the ad is from Temu, an online fast fashion hypermarketer, somewhat in the style of Amazon. It is interesting that Temu would be advertising a particularly Christian themed t-shirt, since Temu is a Chinese company. However, when you think about it, it is not all that strange. China has been very active in promoting discord attacks against the West. Discord attacks are frequently targeted at the conservative or right of the political spectrum, since that end of the spectrum seems to be much more willing to participate in discord attacks by repeating falsified information that is sent to them, without too much analysis as to whether or not the claims or stories are true. Therefore, given the close connection between China's government, military, intelligence, business, and information warfare, a predilection for themes aimed at the religious right in the United States seems much more reasonable.)
"Life is a gift," as an argument, also only works if there is some reward for continuing to live, not if life is only punishment.
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