Mental Illness and Euthanasia

Critics of euthanasia have always warned that, however tight the initial restrictions, its legalization would inevitably comprise a slippery slope. These critics have always been right. Typically, initial restrictions will specify that the candidate patient must be terminally ill, of sound mind, and suffering greatly. But in all cases these restrictions are slowly but surely loosened up.

Canada was not the first country to legalize medically assisted suicide, but has leapt to the forefront by making plans to legalize euthanizing the mentally ill. Not surprisingly, this development has caused considerable outrage from the disability community but most critics, not knowing much about the inner workings of present-day psychiatry, are unaware of how truly outrageous this plan really is. For we are living at a time when, for a variety of reasons, it may be the treatment of mental patients, rather than their illnesses, that may make them want to die.

Even true believers in the wonders of modern medicine will concede that psychiatry is the least scientific of the medical specialties. Psychiatry has always had a huge shortcoming: unlike other medical specialties, it is unmoored from the biological analysis of illness. There are no biological markers for psychiatry, no blood tests, X-rays, CAT scans, MRIs, or biopsies, that mark the existence of mental illness and points to a particular biological pathogen that has caused it.

Despite this fact, the treatment of mental illness today is manifestly biological. For what could be more biological than putting powerful chemicals into the human organism? Even as late as 1980 the use of medication comprised only about fifty percent of training of psychiatrists, the rest being in psychotherapy. Today, medicating patients comprises almost all psychiatric training. With this chemical emphasis, one might be forgiven for thinking that psychiatrists today know everything there is to know about psychotropic drugs and what they are doing when they prescribe them. Unfortunately, this is far from being the case.

About a year ago a bombshell report dramatically brought home how questionable and harmful the use of the most common type of anti-depressants known as Selective Serotonin Reuptake Inhibitors (SSRI). By now many people have heard about SSRIs because they are associated with a popular theory about what causes depression, that is, “a chemical imbalance in the brain,” specifically an imbalance of serotonin. However, a July 2022 report by Prof. Joanna Moncrieff and a team of scientists at University College, London in Molecular Psychiatry decisively debunked this theory. After reviewing decades of research, these investigators concluded that there is no scientific basis to support it. Moncrieff wrote: “Thousands of people suffer from side effects of antidepressants, including the severe withdrawal effects that can occur when people try to stop them, yet prescription rates continue to rise. We believe this situation has been driven partly by the false belief that depression is due to a chemical imbalance. It is high time to inform the public that this belief is not grounded in science.”

Anti-depressants are not the only psychotropic drugs being marketed that are potentially harmful, especially when taken long term. The first psychotropic drugs were introduced in the 1950s and it was not long before red flags began to appear regarding their safety and effectiveness. A World Health Organization (WHO) study compared outcomes in both rich and poor countries where drugs were used to treat schizophrenia. The finding of this report was that patients in poor countries, where drugs were limited, did better than those in rich countries with abundant resources. Schizophrenia is often said to be incurable but in poorer countries, after five years, 64% of patients with schizophrenia were functioning and normal, whereas in rich countries only 18% were doing as well. On the contrary, in rich countries 61% were being permanently maintained on anti-psychotics because their illness was deemed to be chronic, whereas in poor countries, only 16% used these drugs and then only intermittently because their illnesses turned out to be either one-off events or reappeared only episodically. These findings were ignored in the U.S. and other developed countries. In fact, by 1998 in the U.S. things had only gotten worse. By then a full 92% of schizophrenics were permanently maintained on anti-psychotic drugs.

Notably the WHO reported that patients in rural India did best of all, so you would be better off being diagnosed with schizophrenia there than, say, in Manhattan -- that is, if the diagnosis itself was reliable which is all too often not the case.

Studies have shown that there is limited concurrence among psychiatrists regarding diagnoses with a 30 to 40 percent discrepancy, and that diagnoses differ even depending on the country in which they are made. Different psychiatrist, different country -- different diagnosis. Despite this fact each new edition of the Diagnostic and Statistical Manual adds new illnesses based on the thinnest of clinical evidence. The net widens.

There are innumerable serious side effects from psychotropic drugs. When taken long-term, they can shrink the brain, damage the heart, kidneys, and other vital organs, wreak havoc with the endocrine system and generally shorten a patient’s life. It gets worse. One side effect of antidepressants is suicidal ideation. Another is mania, and because of this side-effect a depressed patient will often be rediagnosed with bipolar disorder and switched to a whole new array of ineffective and harmful drugs.

Perhaps the most interesting and least well-known side-effect to the public is a syndrome called akathisia. Hard to describe but well documented, patients who experience this side-effect often say that it makes them feel as if they want to jump out of their skin, which may lead them to kill themselves and/or others. This is a clinically proven side-effect. Using the method which clinicians call “challenge/rechallenge,” the syndrome will appear when the drug is given, go away when the drug is stopped, and reappear again when the drug is again taken. When you read of shocking and unexpected behavior of patients who have been diagnosed with depression this may very well have been caused by the drugs they were given and not their illness.          

Much of mental illness, especially depression, is situational, triggered by the loss of a loved one, unemployment, or failure in school. Others are episodic and self resolving or the individual learns to compensate and function reasonably well. Still others, such as childhood bipolar or ADHD are arguably not really illnesses at all but developmental problems reflecting an immature central nervous system. Time will heal, but will not do so if all such things are interminably treated with dangerous drugs.

When the Trudeau regime announced its plan to allow the euthanizing of the mentally ill some psychiatrists objected for religious reasons or because of the strictures of the Hippocratic Oath. However, Dr. Derryck Smith at the University of British Colombia, who favors the idea, mouthed the usual platitudes of the need to relieve suffering, respecting human dignity and allowing people to make their own health decisions. Nevertheless, knowing what we know about the adverse effects of drugs, we are entitled to ask him exactly what problem does he think he is solving by counselling this most decisive and irreversible of all interventions, the problem that was brought to him by a hapless patient, or the one that he himself may have created through his treatment?

Whatever his answer, one thing that we know from his own mouth is that he has not taken the Hippocratic Oath because he claims that it is archaic. But archaic has different meanings. There is the neutral meaning which means simply ancient and the pejorative one which means outmoded and irrelevant to our time. It appears that he is referring to the latter meaning but what, one might ask, is outmoded about the Hippocratic stricture to do no harm? In this context, one might feel inclined to offer a bit of archaic wisdom to his prospective patients. Caveat emptor. Let the buyer beware.

Image: Pexels

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