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Dutch woman, 29, granted euthanasia approval on grounds of mental suffering

www.theguardian.com Dutch woman, 29, granted euthanasia approval on grounds of mental suffering

Zoraya ter Beek, who has chronic depression, anxiety, trauma and unspecified personality disorder, expected to end her life soon

Dutch woman, 29, granted euthanasia approval on grounds of mental suffering
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  • Don't really agree with this. If you look at it on an individual level, there's a case for it, but on a social level, it's dangerous. Individualist societies look for individual solutions even if the problem is social. There are problems that can't be solved with any sort of medication, therapy, etc, because the cause of the problem isn't with the individual. It's impossible to know for sure if any kind of social change would fix her problems, but if suicide is simply the go-to answer when such a problem is encountered, then we will never know. And once this becomes normalized and people start accepting it as a viable solution, then it's going to be a lot harder to materially improve things for people in these situations. Often it's only when people see that there is no individualist solution that they start thinking in terms of systemic changes, and if there's any kind of "solution," no matter how horrid it is, they'll turn to that first. I don't want to create a future where, "I've tried everything I can to fix myself and I still feel like shit," is met with a polite and friendly, "Oh, well have you considered killing yourself?"

    Suicide is violence. Self-harm is harm. It's nonsense to describe a process that kills you as "safe." I understand that many people view it terms of rights or personal wills because those are prevailing ways to look at things, in individualist cultures. But life is inherently valuable and if someone thinks otherwise about their own, then they are wrong. I would make an exception for someone with severe, incurable physical pain, but while mental pain is just as real and valid as physical pain, the way it functions is more complex, and so I'm skeptical that it could be declared "incurable" to a sufficient standard, especially if solutions aren't limited to the individual level.

    The fact is that we ought to be striving to accommodate as widely diverse minds as possible. Both because it's the right thing to do, and because diversity is valuable, and people who see things differently may notice or understand things that others don't. If the diversity of minds starts to narrow, I'm concerned that it will continue to narrow until neurodiverse people are effectively eliminated from society, or be isolated without community, as more and more pressure builds against anyone who doesn't fit the mold of a productive worker.

    • Suicide is violence

      sorry that's simply your opinion. for most who seek it for medical reasons, it's the final escape. I don't have enough familiarity with this case to judge but would want the option open should I need it. You have no idea what kind of physical pain people have to live with - shit that can't be touched by opioids or other painkillers, like bone cancer. The only out for some of these folks is to be gorked to unconsciousness. I'd prefer to pass on that and go straight to the end myself.

      • I would make an exception for someone with severe, incurable physical pain

        • the problem with exceptions is that they're often nebulous and lead to cover-your-ass decision making that disregards the best outcome for the patient. SEE: Texas birth control laws that supposedly have exceptions for the mother's health, but in fact result in them waiting for their once-fetus to send them into sepsis.

          • Texas birth control laws

            I would simply not be a fascist pretending to care about people's rights and not design laws as if I were one.

            • And that's great, but I have more faith in you - rando from the internet who's expressed clearly well meaning desires - than I do in the system, whether that's us's crappy healthcare, NHS in the uk or whatever - I do not have faith in governments and with healthcare providers impressed into the task of deciding who gets to claim their pain is unbearable.

              And for the remainder: people will suicide. If you take away their options, they'll step in front of busses or jump off bridges, potentially traumatizing and putting others at risk. They'll suicide by cop, they'll drive their cars into the opposing lane. There's something to be said for giving people the dignity of choice.

              Good luck.

              • I likewise don't have faith in governments or healthcare providers, but that's where I don't want to just place this in their hands and trust them to handle it in a responsible way.

    • But it is it a greater harm to decline her request and force her to endure suffering (or risk more drastic methods)?

      I hear where you're coming from (I think), and agree this is tragic, but part of me is jealous of her.

      How much that part of me equates to changes each day with my tension headaches

    • What makes you think that severe chronic depression is more curable than severe chronic pain? maybe within a year someone will come up with a new drug or therapy that cures certain types of severe chronic pain? Should we force people to endure the pain in the basis of this possibility?

      Or what makes you think this woman's problem is social? What if she has some genetic or neural predisposition to having such problems? Should we deny her request on the basis that normally mental health issues are social?

      You are talking about accommodating neurodiversity but your view of life and mental health conditions is extremely black and white.

      • Mental health is socially defined to a very large extent. One of the ways that we evaluate a person's mental health is whether their issues interfere with an ability to live a "normal" life, which includes providing for themselves. Well, a person's ability to provide for themselves can vary drastically based on external circumstances, like how rich they are or what social services they have access to.

        It's my belief that it's rare for evolution to screw up. Of course, sometimes it does, but I'd argue that many mental illnesses are the result of one's mind being equipped for a different set of circumstances than the one they're in. In some cases, there's clear evidence that this is the case, but in other cases it's more difficult to prove.

        I just don't believe we should give up on a person just because they ask us to. If a friend came up to me and asked me to help them kill themselves because of a mental illness, I would do everything I could to find an alternative solution and talk them down from it. I feel like that's the normal response anyone would have, and people are treating it differently just because a state said that it's ok.

        • It's my belief that it's rare for evolution to screw up.

          That's not how it works, I'm pretty sure... Mutations will have random effects and the species evolves based on characteristics being selected for based on better survivability, reproductive effectiveness, etc.

          I would do everything I could to find an alternative solution and talk them down from it.

          I've read your other messages and it seems that you're thoroughly convinced that this wasn't the case here. I suggest that you get a bit more context about this whole situation, as it has been a long path of trying multiple treatments and approaches, without any success. So it's not even remotely close to what you suggest here. No Futurama suicide chambers here.

          • That’s not how it works, I’m pretty sure… Mutations will have random effects and the species evolves based on characteristics being selected for based on better survivability, reproductive effectiveness, etc.

            That's why I said that it's rare for evolution to screw up, not that it's impossible.

            I’ve read your other messages and it seems that you’re thoroughly convinced that this wasn’t the case here.

            I've made a lot of comments but few of them have been about the details of this specific case, I'm not sure which ones you're referring to.

    • If someone wants to end their own life, that isn't your choice to make.

      • No, but as a voter, it is my choice (to a degree) how the state responds to the situation.

        • Ah yes, you’re one of those people. “We should legislate what people do with their own bodies because I don’t like their decisions”

          You people are already ruining the US, so now let’s do it to the world. Except that it was mentioned in the article that this was legislated and settled over 20 years ago where she lives.

          • “We should legislate what people do with their own bodies because I don’t like their decisions”

            I mean, yes. That's the vast majority of people, regardless of political affiliation, or where you live. I don't think meth should be completely deregulated, for example. If someone goes to a hospital and asks a doctor to inject them with bleach to cure COVID, I don't think the doctor should do it.

            That doesn't mean that I don't support bodily autonomy, however. Just not as an absolute right, because I don't consider any right as absolute. Rights have to be balanced against each other and considered in the context of their material consequences.

            I don't see how this is comparable to something like abortion, where only a fetus is being terminated, not a human being. Nor is it comparable to, for example, trans rights, where a person is aiming to live a happy and fulfilling life. Just because crazies want to restrict bodily autonomy in cases where there's no valid reason to doesn't mean that cases with valid reasons don't exist, and discouraging suicide is one of them.

    • I don't want to create a future where, "I've tried everything I can to fix myself and I still feel like shit," is met with a polite and friendly, "Oh, well have you considered killing yourself?"

      Are you for real? This kind of thing is a last resort that nobody is going to just outright suggest unprompted to a suffering person, unless that person asks for it themselves. No matter how "normalized" suicide might become, it's never gonna be something doctors will want to recommend. That's just... Why would you even think that's what's gonna happen

        • ...and did you notice how everyone was outraged by that? That incident was not an issue with assisted suicide being available, that was an issue with fucked up systems withholding existing alternatives and a tone-deaf case worker (who is not a doctor) handling impersonal communications. Maybe it's also an issue with this kind of thing being able to be decided by a government worker instead of medical and psychological professionals. But definitely nothing about this would have been made better by assisted suicide not being generally available for people who legitimately want it, except the actual problem wouldn't have been put into the spotlight like this.

          • You're the one that specified doctors, not me. I just said I don't want to create a future where anyone thinks it's ok or normal to recommend suicide to people. You dismissed my fears as unrealistic, and then I presented evidence that it's not just a far off possibility, but something that's actually happened. Many people may find that story outrageous now, but it's clearly pushing things in a direction such that in 20 years, who's to say how people will react.

            But definitely nothing about this would have been made better by assisted suicide not being generally available for people who legitimately want it, except the actual problem wouldn’t have been put into the spotlight like this.

            Literally the whole thing would not have happened without the policy.

    • I don't really see why you say you'd make an "exception" for strong and lasting physical pain (which by the way are of course the vast majority of assisted suicide cases), but not for mental health reasons. In this case multiple doctors concluded that the patient is unlikely to improve, and no progress has been made in over 10 years of therapy.

      especially if solutions aren't limited to the individual level.

      What do you mean by "not limited to the individual level"?

      • What I mean by that is that there are some problems that affect individuals which are not caused by anything wrong with the individual, but by the world at large. For example, climate change. It can't be solved at the individual level, and it may be possible to shut out and ignore it, but that's not really a proper way of handling it. No amount of therapy or drugs will make climate change go away.

        I'm not saying that the woman in question is killing herself for that reason. But I am saying that how much things like that can affect people's mental health is something that is difficult to study and prove. One example that does have evidence though is social support for gender transition - trans people with social support generally have much better mental health than those without, but addressing this issue can require changes to society as a whole and not just the individual trans person's behavior or mentality.

        My concern is that people will overlook potential social changes to accommodate people, if they view the issue as solved by means of assisted suicide.

    • The slippery slope falacy is so passé my dude, get on with it.

    • Self-harm is harm. It's nonsense to describe a process that kills you as "safe."

      Safe to her? No. Neither option can boast that.

      Euthanasia is safer to everyone else around her. And tidier.

      Get it?

      • And tidier.

        Those two words are why I find this thread so terrifying and so alienating. I'll never "get" the perspective that tidiness is a significant factor when discussing matters of life and death, and to be perfectly frank, it makes me feel like a lot of this is coming from a mentality towards suicidal people of "Get them out of my sight so I don't have to deal with them and their negative vibes bring me down" rather than genuine empathy and concern for wellbeing. And that sort of mentality surrounding this, about how neat and tidy and clean it all is, how it avoids disruption to society, is exactly what makes the policy so concerning to me.

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