Recently, Dr. Jennifer Gaudiani, a Colorado doctor of internal medicine, published a paper in which she advocates that physician-assisted suicide should be extended to patients struggling with anorexia. “Anyone who wishes to keep striving for recovery despite exhaustion and depletion should wholeheartedly be supported in doing so,” Gaudiani wrote. Others “simply cannot continue to fight.”
Her advocacy is not theoretical. Jennifer Brown with the Colorado Sun reported on some of Gaudiani’s practices:
One 36-year-old woman died after ingesting the lethal doses prescribed by another doctor, with Gaudiani serving as consulting physician. Another 36-year-old woman died of severe malnutrition on the same day she planned to take aid-in-dying medication prescribed by Gaudiani.
Some in the medical community have responded to these accounts with outrage. Johns Hopkins behavioral scientist Dr. Angela Guarda stated, “It is in direct contradiction to treating mental illness, promoting hope for recovery and improving quality of life for our patients. … Anorexia is treatable, not terminal, [and] ambivalence about treatment is a characteristic of the psychiatric disorder.” In other words, seeing a mental health issue as “untreatable” is one of the main barriers to effective treatment in the first place. The primary role of psychologists is to combat that assumption, not enable it.
Gaudiani defends her position by arguing that only a tiny minority of anorexia patients should be considered for assisted death, particularly those patients who have already experienced the long-term effects of malnutrition and who simply lack the will to continue. But Denver-based psychiatrist Dr. Patricia Westmoreland argues, “Patients suffering from extreme anorexia are not mentally healthy enough to make a decision with such dire consequences.” University of Maryland psychiatrist Dr. Annette Hanson adds, “Historically, we do not declare people futile when it comes to psychiatric illnesses,” because “suggestion is a form of coercion.”
History also does not support the theory that assisted death can be kept to only a handful of “exceptions.” After just a few years of legalized doctor-assisted death, Canada has become the new global case-in-point of how the so-called “right to die” devolves into a kind of “duty to die,” with patients being pressured in various ways toward that so-called “choice.” One way is by a subtle shift in language; for example, from the justifying of the intentional ending of a life due to a terminal diagnosis to the more subjective “hopeless” diagnosis.
Canadian policymakers are already considering expanding the parameters of so-called “Medical Assistance in Dying” to include mature minors. Suicide is the second leading cause of death for Canadians aged 15-34, and numerous youth suicide prevention efforts have been launched by both government and non-governmental entities. The irony here is that Canadian youth are now being told that suicide should never be an option, unless it is encouraged by the state or a medical professional.
To say, as Guadiani does, that some mental health problems are “too far gone” not only compromises the agency of patients and their loved ones, but it also compromises the responsibility of medical professionals to provide care. The value of every human life is inherent, not determined by what we can do or how we feel. This is why, with obvious compassion for those suffering, Christians have always viewed self-harm as wrong and human life as a gift.
Assisted suicide, especially when extended to those most in need of compassion and care, subverts our collective understanding of human value. It subjects this value to feelings, both our own and (increasingly) that of medical professionals and government officials. When made available to cases of mental illness, assisted suicide undermines the battle a patient wages on their inner demons and thwarts efforts to recovery. In other words, it is the exact opposite of “care.”
This is yet another way that physician-assisted suicide or “medical aid in dying” corrupts medicine. Vulnerable people in most need of help will be the victims of these bad practices. For their sake, and for future generations who will inherit the world that we are unmaking, we must find a better way.
This Breakpoint was co-authored by Kasey Leander. For more resources to live like a Christian in this cultural moment, go to colsoncenter.org.
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