"Yet depression - a treatable condition - is one of the major factors driving the suicide rate."

Yes, it can be treated, but the effectiveness of the treatment varies, and those who suffer depression can still find themselves going through cycles of misery. If a person in that position decides that their down times are not compensated for by their up times, that's a value jugement for them alone to make. It's patronising for other people to suggest that the value judgement is flawed, and that such a person should be denied knowledge of how to terminate their life.

In practice, information on how to do it is readily obtainable over the Internet, and will remain so regardless of anything that the Austrian government does.

Sylvia Else.

Dear Brian (hard not to call you Senator)

Thank you for your article. I am a psychiatric/mental health nurse of some 27 years.

I know despair. I know profound clinical depression. I know what it is like to try and care for people who are profoundly clinically depressed.

I know the difference between the everday "blues" and suicidal ideation. I know how to assess people who have mental health problems. Ugh? Does Sylvia Else have my clinical experience?

I know that there is a difference. I know that I have a Duty of Care. I know that many young and vulnerable people are alive today because of the actions of mental health professionals - such as me. I also know that despite professional care, some people have killed themselves as a result of extreme clinical depresion.

I also know that not all so-called suicidal deaths are as the media and others present. I have nursed many people who have responded to COMMAND HALLUCINATIONS. Intent death in response to "voices" - especially the illness of Schizophrenia and people who have a concommitant drug induced psychosis.

My experience with young people who are intent on killing themselves is profound.

I am not taking away their choice. I am caring. I am certainly NOT PATRONISING (as Else suggests).

And to give further insight on my part. A family member died by suicide. She left a 5 months old and an 18 months old. We are still crying - since 1993.

What a bunch of whimps we are.If you really want to go, the exits are as finite as your own imagination.You don't need drugs to do it.Just a bit of courage to face your finality with the totality of your life's experiences.Yes is was worth it,and the pain of existence beyond this point is not!

Just don't get to the point of being trapped in a nursing home when all your options are diminished by your own physical and mental incompetence.I'm determined to plan my exit and snub my nose at all the anal retentive power hungry bureaucrats.

I think klw's response just emphasises my point. These people with depression are people over there - people we talk about - people we look after - people who are not able to make their own decisions.

But that's not how it is. They are not a separate group from us. They are part of us.

Did it occur to nobody that I'm not speaking as a purported expert, nor as a carer of people who suffer depression, nor as a sort of reverse bleeding heart, but directly from my own experience of suffering periods of severe clinical depression?

I resent any suggestion that people in my position are not competent to make their own decisions about their best course of action. As I said - it's patronising.

Sylvia Else.

"Compassion is not giving someone information on how to commit suicide. Compassion is looking to the reasons they want to take such desperate action. Compassion is addressing people’s pain, depression, loneliness or fear. It is helping them with their mental health, physical illness or substance abuse."

What is disturbing is that this even needs to be said. There was a time when this definition of compassion was obvious. People suffering mental or physical illness deserve better than a suicide kit, they deserve our time, our care, our resources and yes even our money. It may be difficult, time consuming and costly to address the complex problems people face but each and every human being is worth it, no one is a lost cause, we are all valuable.

Would those who advocate suicide as a valid solution to life's problems accept it for members of their own family? Will we send this message to our own children, that suicide is an option we will help them with?

I, like many people have suffered depression and I cringe at the thought of what might have been if I had received such advice.

Thank you Brian for your positive message.

Get a life Sylvia! You seem so angry with the world - and anyone who presents a different view to yourself - refer back to your article about the value of my great mates - men!

For god's sake - I suffer from severe panic attacks and concommitant episodic depression as a result of gang rape. Even so, I assist people who want to help themselves and others. I am not spending my life sending out negative messages.

Thank you to Brian for this intelligent and compassionate piece.

The Nitschke approach doesn't support freedom - it's simply an easy way to end one's autonomy all together.

Brian is spot on when he notes that "dignity comes from knowing that whatever your health and your personal shortcomings, there are people there who will love and support you, no matter what".

Coming from a family with a strong disposition towards depression, I find it offensive that there are some who seriously think part of the solution is to offer depressed patients the option of death.

Having battled it myself, I am glad that a limelight-seeking anti-doctor like Nitschke wasn't offering me advice

Thanks for this compassionate and sensible article. Three students from my high school year have since killed themselves, and last year my friend killed herself and her 3-year-old daughter with a knife. Mental illness, despair, abandonment, and abuse all characterised their lives. I feel a great deal of guilt for not having done more to help them. Imagine my burden of guilt if I had encouraged and even facilitated their deaths, apparently respecting their autonomy.

A right to life and a right to death.
People should have the right to live their life they way they want to.
People should also be able to end their life when and how they whish.
For most cultures in the world including out own suicide is a valid option for many situations and should not been denigrated by religious fanaticism.
What is worse a painless exist and a painful violent exist.

klw,

I've commented to you before about my objection to ad hominem attacks. You apparently didn't recognise the term. It means 'to the man', and describes the practice of playing the man rather than the ball. In the context of this debate, it's a reference to the way you're trying to devalue my responses by suggesting that I'm the sufferring from a distorted world view - "get a life".

You've also managed to construct another strawman, by suggesting that my postings elsewhere (that others here may be unaware of) reflect some sort of valuation of men, presumably one you yourself do not hold.

These are both standard techniques used to stifle debate. By all means disgree with my reasoning, or my views, but leave me out of it. Stick to the subject at hand.

Sylvia.

Sylvia - I still do not have any idea about hom and straw. I have never heard these terms until we met. I don't have a clue what you are talking about - but I sense as strong egocentric academic bit of bulldust.

I think your recent article was extremely useful - created great debate. Well done.

Kalweb,

The 'ad hominem' argument is straightfoward enough. Imagine that I say that two plus two equals five. There are then two possible approaches to arguing with me. You could debate the issue, by pointing out that the axioms of arithmetic lead inescapably to the conclusion that I am mistaken. Or you could debate the man, or in my case, woman, by alleging that I got bad marks for maths at school, and therefore my opinions on arithmetic are worthless. Alternatively, you could try claiming that I beat children for fun, and that as such my morals are so low that no one should even consider listening to my opinions on anything, let alone arithmetic.

The thing about the ad hominem approach is that you might equally well use it if I had said that two plus two equals four. It's particularly well suited where you're more interested in 'winning' the argument, than in getting at the truth.

The 'strawman' arguement is a bit more subtle, and is useful if I'm presenting a view that might lead to some definite action, say a government policy, or legislation, which you don't like. What you do is misrepresent my position - typically by oversimplifying it. Then you can attack me on the basis that this 'strawman' argument is flawed. If people fail to notice that you've misrepresented my views, then they may decide they disagree with me, and never look at my position closely enough to recognise its validity.

You'll see both ad hominem and strawman arguments used frequently in politics.

Sylvia.

Not just in politics Sylvia. In academia, and in just about any debate. Unfortunately the basics of good argument either aren't taught, or more likely are ignored, because they don't suit the conclusions someone wants to make.

Thanks for the explanation Sylvia! Now I finally get what you mean. It sounded like foreign language to me. Obviously I am a slow learner. I have taken on board what you are saying. A lesson well learned.

Cheers
Kay

Gee,I want to meet this "ad hominen" person,she can admonish me from a plethoria of sins,such as logic,reality and accountability.

As someone who has suffered clinical depression I would have thought Sylvia would have had a bit more insight. Depression is a mental illness, people with mental illness are seldom competent to make life and death decisions, I certainly wouldn't want one to make it on my behalf.

To suggest that someone suffering from mental illness should be given advice on how to end their life strikes me as patronizing in the extreme. It's the right of the individual carried to the uncaring absurd.

Sylvia have you ever spoken to anyone who's wanted to kill themselves? Have you listened to their reasons? I spent many years in a job where I had numerous occasions to speak with suicidal persons. The two main reasons I found were either genuine self-loathing or revenge. The overwhelming majority accompanied by extreme depression. The decision to end their life was hardly a result of sound cognitive processes.

During your bouts of depression did you ever SERIOUSLY want to kill yourself? If you did why didn't you? Are you glad now that you didn't? A fit, sane, and healthy person does not kill themselves. The very attempt shows the presence of mental illness and the absence of rational thought.

No wonder our mentally ill cop such a raw deal in our society with attitudes around like this. What a hard, cold world you live in Sylvia. Seeing this thread abounds in ad hominem, let me add my own little bit - Sylvia, I bet you've got razor thin lips.

We stuck with the fact that people go through repeated bouts of depression. This belies the suggestion that depression can be treated successfully. If that were true, then these repeated periods of mysery wouldn't happen.

So the question then becomes, who should decide whether a sufferer should have to put up with this? The sufferer, or someone else.

It is a value judgement. Saying that the sufferers are mentally ill, and not competent to make the call is a convenient way of trying to avoid the ethical issue associated with denying people rights over their own existence, but I don't think it stands up.

Lots of people do commit suicide. We don't get to talk to them after the event. It's a gross assumption to say that their decision was the wrong one.

Sylvia.

Bozzie, in common with yourself I have had professional contact with hundreds upon hundreds of depressed and suicidal people during my psychiatric/mental health nursing career. Depression is surely the "common cold of mental illness" (I forget who aptly said this).

I have prevented many, many people from killing themselves and I am glad that I was their advocate when they were fragile and vulnerable and not capable of rational decision making at the height of their ambivalence. I have never nursed a person who has not been greatful for having their life saved and taught other ways of thinking, feeling and behaving.

The key to understanding a suicidal person is to understand the notion of ambivalence. People can be taught positive ways of handling what they perceive at the time to be an unsolveable and inescapable situation.

I have always worked with and for my clients to assist them in learning better problem solving skills. This is empowering for clients - it is not patronising. I have always treated my clients on an equal footing to myself. I have always treated my clients in a loving and caring way - as I would like myself, a family member, or a friend to be treated.

Thank you
Kay

Sylvia – This is not a question of the rights of the individual. It’s a question of society dealing with their mentally ill members. You say it’s a convenient way of avoiding the issue of individual rights. I say you provide a convenient way of avoiding the issue of mental illness. You say it’s a gross assumption to conclude that someone’s decision to end his or her life is a wrong one. I say it’s a sick and shallow society that allows its mentally ill to kill themselves. I also say that making this decision when one is mentally ill is not a decision at all.

First of all we have all the do-gooders throwing our mentally ill out on the streets using the same logic that Sylvia applies, i.e. they have right to live in society like anyone else. Of course the result of this is that these people have absolutely no help and as a consequence they kill themselves (and others) at an unprecedented rate, and make the lives of their families and the people who love them, hell. The Sylvia solution? Divest more of the responsibility by giving our blessing to them killing themselves. After all, it’s not really a problem if someone comes to the conclusion that his or her life is not worth living and so kills themselves. That’s just someone taking responsibility for his or her own life isn’t it?

Who would you want your mentally ill relative to meet in the depths of their despair – Sylvia or kalweb? No contest I reckon.

Brian,

As a human to human both of us in a way placed in privileged positions to do something effective to change this horrible escalating suicides in our country and the highest increase is fathers after family separation and our teenagers, I write this.

As a medical officer I have had about 5 men (fathers) suicide after forced family separation, and seen these people from single create a family and dearly loved their children, I have seen unsupported happy little ones go to withdrawn blackness or reactive aggression, they feel the fathers' pain. On numerous occasions, concerned about the reasonably foreseeable, I have tried to access government and private agencies for meaningful help, just lip service and referral to some other where same effect of nothing useful in the end.

One parent forcing family breakup, a fully setup well funded government and legal industry, which well oiled effective machine, is that seen to be the claws that grabbed and controlled and supported the brutality that affects about two out of three families participants. My assessment was these people whose duty was to provide effective care to the community acted as if emotionally dead and treated traumatized emotion with such acceptance.

Knowledge about suicide is only relevant for those who want to be dead but fear the process, some go to not caring how either, so car into tree... so officially fell asleep on the wheel (If they dont want to hurt the living left behind) or carbon monoxide leaving evidence of intent so... no blame to anyone living that can be criminally chargeable, but it should be and must be if this reasonably foreseen by acts of others.

The main causes that usually cause suicide and foreseeable to a reasonable common person... the big three factors Family stability= being take control of the family and remove one parent, Financial security = take control of and make income vulnerable to varying attack, and destruction of what was lovingly created = take control of all possessions and remove as and when.

Spectemur Agendo, let us be seen by our deeds

Sam

How about a compromise then?

A person with depression is provided with treatement for a sufficient time to establish whether or not the treatement is effective.

If it is not, then the person, during a period with they're not actually depressed, is given the opportunity to be euthanased, if that's their choice.

This puts on the spot those who claim that depression can be successfully treated. If they really believe this is true, then they should have no objection to the proposal, because no one would ever proceed with euthanasia.

Opposing this option amounts to saying that people, even when not depressed, should not be allowed to form a view about the overall value of their own lives.

The legislation discussed by Brian Harradine seeks to sweep the issue of depression under the carpet. It is not trying to reduce the amount of mental illness, and suffering. It is only trying to reduce one politically inconvenient manifestation of that suffering - the suicide rate. In the process is it punishing the victims.

Sylvia.

People who are determined to kill themselves will always find ways to do it. Brian Harradine's proposed legislation is just a finger in the dyke, while the water pours down all around him.
For centuries, suicide was so disapproved of, suicides could not be buried in consecrated ground, I doubt it stopped any of them.
Sometimes life becomes insupportable, for all sorts of reasons. Compassion, it seems to me, has many faces. Of course one of them is to try to help the suicidal to recapture their belief that life is worth living, another may be to understand that sometimes death can be preferable to life, particularly among the terminally ill. The fiesty determination of many of the elderly never to allow themselves to end up a dribbling, incontinent mess is surely completely understandable.
There is too much of a rush to judgement on these issues, Philip Nitschke strikes me as a compassionate man, as does Brian Harradine. Neither is right or wrong, life and death are far more complicated than that.

Unbelievable! Now the state sanctioning suicide is seen as "compassion"? Where do some people get off?! Have a bit of a rethink and follow this stupidity through to its logical conclusion.

Sylvia wants to set society onto a dangerous course. She seems to think that nothing can, or should, happen without the government being involved. So people should be able to go to their doctors for termination? Where does that stop? Your daughter gets dumped by her boyfriend - off she goes for a couple of weeks therapy, still no good, off to the gas chamber. I wonder if the victims family gets any say in this, or even gets notified that their mother, father, child etc is going to end their life? I'd say not - that would be infringing on their rights wouldn't it Sylvia?

"Compassion" - the word becomes an obscenity when used by Sylvia and her ilk.

At present, about 2,000 Australians will commit suicide each year (although that figure is probably underestimated), but of concern is the high rate of youth suicide, particularly amongst male youths, as that rate is in the top 1/3 of other comparable countries.

The Department of Health and Ageing gives an account of youth suicide at http://www.mentalhealth.gov.au/resources/nysps/causes.htm and makes the following conclusion:-

“Modern suicide research has led to the identification of some of the complexities and interrelationships between causes and risk factors for youth suicide. In doing so, it has shown clearly that finding solutions for the problem will not be easy.”

So it will not be easy. Says who? Says the Department of Health and Ageing, but other countries have a lower rate of youth suicide, and such a pessimistic and apathetic attitude shown by a government department may be a part of the problem.

Thankfully Senator Brian Harradine does have concerns regards the rates of suicide in Australia, as there appears to be many other people in government who do not, and eventually a pessimistic and apathetic attitude can have very serious consequences for the young.

Ed Schneidman, psychologist, world expert on suicide.
‘Every person - 100% - who commits suicide is profoundly mentally disturbed at the time. It is not a thing to do when you are not yourself. You should never kill yourself when you are suicidal’

Who owns the life of a person?
Should politicians be able to pass laws that decide how and when a person may be allowed to die?
What about each person having the right to decide for themselves how and when they die?

‘Every person - 100% - who commits suicide is profoundly mentally disturbed at the time. It is not a thing to do when you are not yourself. You should never kill yourself when you are suicidal’

Since people who have committed suicide are dead, they are not available for examination of their mental state.

The quote sounds more like a circular argument, which starts with the premise that people do not kill themselves unless mentally disturbed, and then goes on to reach that as a conclusion.

Killing oneself is a rational thing to do in some situations. Terminal illness with intractable pain is one example.

Sadly, another example is where one has to do it now because if one delays one will be deprived of the opportunity. This occurs with some degenerative disorders, because of our anti-euthanasia laws. People commit suicide because they're unwilling to take the risk of suffering a drawn out, and possibly painful, existence later on when they're no longer physically capable of killing themselves.

I once hesitated about getting medical help for fear that I'd find myself locked away in an accute ward where I would continue to suffer, but no longer have control over my destiny. Had I been aware of how limited the funding is for such wards, I would have realised there was no risk of that. Still, it highlights the dangers with a system that is concerned primarily with preventing suicide, and only to a lesser extent with reducing suffering.

Sylvia.

I think there are two different matters here.

Firstly, is there any such thing as rational suicide?

Secondly, even if rational suicide exists, is it good public policy to allow it? What would the effects be on the wider population, not just on the very very small number of non-depressed and terminally ill patients with intractable pain?

It would be useful to separate these issues for discussion.

According to Sylvia every person who contemplates suicide is not of sound mind at the time?A very simplified generalisation.What about the millions of people on this planet who suffer cancer and other diseases, who realise that the suffering is no longer worth it.These are not the thoughts of mentally deranged people.

In traditional Eskimo culture when the old can no longer support themselves,they simply hop in a canoe and paddle off into oblivian.They would rather sacrifice themselves than be a risk to the survival of their children.This is the harsh reality that we have no concept of.

Arjay,

You have misattributed to me a sentiment that I quoted from someone else's posting, which was in turn a view quoted from some alleged expert. It does not represent a view that I hold.

On the question of rational suicide raised by Ruby, there are at least two major scenarios:

Terminal illness associated with significant intractable pain.

Non terminal illness associated with significant intractable pain.

I cannot see why suicide in the latter case should be considered irrational. The decision to be made by the person is whether they are willing to endure the pain for the sake of continuing to live. It seems to me that this is a value judgement for them alone to make.

My position on that is not altered if the pain is only intermittent.

If we can get past that issue, then next question is whether only physical pain is to be considered a valid basis for suicide. People who've suffered it know how unpleasant depression is. It's a form of mental, or psychological, pain. If one accepts that people who suffer intermittent intractable physical pain should have the right to decide whether or not to continue to live, I can see no reason why someone who suffers intermitted intractable depression should not have the same right.

Sylvia.

As Arjay said, any reasonably determined person can get all the information they want on how to commit suicide from the internet. This is really aimed at Philip Nitschke's seminars, which contain elderly people, not depressed teenagers. Brian Harradine has religious reasons for his position, but many of the people who will support him don't. In New South Wales and possibly in some other states people are not allowed to write a legally binding advance directive (to refuse life prolongong treatment), even though there are no religious objections. We need to "cherchez le loot" as someone wrote on another discussion.

A third to a half of all the money that will ever be spent on an individual's health care is spent on average in the last two years of life. As the health care system becomes increasing privatised more and more of this money will come out of the person's house and other assets after the insurance is exhausted. Your terminal cancer care may mean destitution for your family. One study of terminal patients in the US found that this is what happened a third of the time. If it were made easy for such people to kill themselves or just refuse treatment, then all that lovely money would go to the family, friends and favourite causes of the deceased, rather than the hospitals, medical specialists, pathology labs, pharmaceutical companies, etc.

Yes Sylvia – all very logical, cold-hearted and clinical. But unfortunately, we’re not going to get past that issue. It is never OK for the mentally ill to kill themselves. It is sad and it is a tragedy for society and the families involved. We’re talking about people, not sick pets. You’re treating this subject as an exercise in logic whereas I’d be more inclined to treat it as one in the way we deal with the disadvantaged in our society.

Your argument seems to be that if someone wishes to end their life they should be able to. Hard to argue against from the point of individual rights. But you disregard any factors of love and humanity. You disregard the right to protect your child, the right to a mother and father, sister or brother, and the right to have a future. You may view these things as being beside the point or as being “value judgments” not worthy of consideration. But they are not beside the point – they are the whole point and they should be the primary consideration.

Divergence – why must everything come back to money? Why should the very sick be made to feel very guilty as well? If my kids can’t stand on their own two feet by the time I’m ready to kick off then anything I leave them isn’t going to help much. So what if most of the health money is spent on ones last few years of life? They’ve been paying for those last few years during the well part of their lives.

Do we really want to go down the path of the Netherlands where the elderly walk around with cards in their wallets saying “Do not euthanise” in case they have to go to hospital, where over 60% of all assisted killings are done without the knowledge or consent of the person being killed, or where doctors are given the right of life or death over babies and the elderly with no permission required by parents, family, or the victims themselves? Talk about hell on earth.

I have extreme difficulty in accepting that young people have the "right" to make a "rational" decision with regard to suicide as their only perceived version of problem solving - to escape from what they regard in an unsolveable situation.

It has been my experience that young people (I am speaking of young adolescents, middle adolescents, and young adults) have not adequately thought through issues (not because they are not bright enough - but because they have not lived long enough to have developed sophisticated problem solving skills)before attempting suicide (yes, and repeated self harming behaviours is another issue). It has been my experience that young people who have unsuccesfully attempted suicide have acted upon impulse rather than a calculated plan - and this has often been accompanied by concommitant drug or alcohol use and dysfunctional family relationships (no matter their social "class" or intelligence).

Suicide is not a one person event. Completed suicide usually dramatically effects the lives of at least 12 other people.

I am glad that I have nursed so many young people who have been suicidal and who are alive and well today to tell their story of recovery - because they had appropriate intervention which was given in a loving and caring way. People can get better - and people do get better.

Sure, some people do not get better and they do successfully kill themselves. That does not mean that we should stop trying to offer others a helping hand along life's often very difficult pathway.

Bozzie

You comments misrepresent my attitude towards value judgements.

"You may view these things as being beside the point or as being “value judgments” not worthy of consideration."

This issue is almost entirely about value judgements. Without them we can form no conclusions at all on the subject of suicide. The question is how do we deal with the fact that different people form different value judgements. In particular, how do we handle the difference between the value judgement formed by the individual who may decide to commit suicide, and the value judgements *about the same life* formed by others.

To say that it is never acceptable to allow a mentally ill person to kill themselves is simply prejudging the issue. If you start with that as a premise, you will inevitably have it, possibly expressed in a different form, as a conclusion. It's really just another value judgement.

It is a personal rights issue. Just because a person suffers from a mental illness does not necessarily mean they're no longer competent to make decisions. The decision to commit suicide on the part of a person suffering periodic depression will only become irrational on the day that medical science offers a cure for that person - at least at the level of symptomatic relief. As yet, medicine doesn't always do that.

By disallowing suicide as an option, we're saying that the person with chronic periodic depression must simply endure it. History is full of examples of practices that were thought proper by the societies of the time, but which from our more enlightened times seem abhorent. Our descendants may look back at our attitudes to euthanasia, and shake their heads in disbelief that we could be so cruel.

Sylvia.

Sylvia – Someone forming a value judgment that their life is worthless when that judgment is arrived at from a position of mental illness is hardly a true value judgment. You say that people suffering from depression, to the extent that they are prepared to take their own life, are still capable of rationality. True – but the very act of suicide is an act of irrationality. Today’s value judgment is tomorrows “what was I thinking?”

The question as to whether one has the right to suicide has long been answered. There is no law against suicide. Nor should there be. The question is whether laws should be enacted that allow others to actively participate in this death. This is the slippery slope that I’m worried about. Where does it end? The very act of offering a person the option of suicide would tend to confirm their opinion that life is not worth living. Government has no business offering this option to their citizens. The very presence of death fetishists like Nitschke show the real dangers that would be faced by depressed persons thrown to the mercy of our money starved medical professionals. Oh well – at least the crisis in mental health in this country would be over pretty quickly.

It is perfectly feasible to have protections in place. It would clearly be inappropriate for someone to be able to go to a 24 hour bulk billing surgery, and be euthanased on the spot.

But where a person is afflicted by an illness that is causing them prolonged suffering, and the person does not want to continue to live, then it's time for society either to put up, or shut up. In this context, "put up" means to provide a solution, either in terms of a cure, or symptomatic relief. Once society has failed to do that, it has lost any moral right to have a say over the person's conduct in respect of their own life.

One should beware of people acting out of good intentions, because they can cause considerable harm. It's true that in practice the government will not be able to prevent access to information on suicide over the Internet. This is just as well. If people are denied access to reliable methods, they will use unreliable ones. Throwing oneself off a tall building, or wrapping one's car around a tree is all very well, if it works. Not so good if one ends up having quadraplegia to contend with as well as one's other problems. Particuarly in a society that considers that life as a quadriplegic is better than death, even if the person themselves considers otherwise.

Sylvia.

Sylvia, I agree that one should beware of persons acting out of good intentions. You can’t cause more harm than death!

It is not an obligation of government or society to facilitate the death of its citizens. The obligation is to help its citizens to lead a satisfactory life. Being dead is not that.

Your last statement perfectly illustrates the dangers of legislated suicide. You’ve already extended the debate to the disabled! 30 years ago the idea of a doctor assisting in a suicide was shocking. Now you’re talking about helping paraplegics top themselves! How do we legislate for this Sylvia? Do we have a waiting period like for a sex-change operation? How long? Can we have a choice as to our method of death? I want to be hung, shot, stabbed. Where will the goal posts be then? Will the debate centre on whether or not consent is required? You probably scoff but you need to look no further than the Netherlands.

Unfortunately Sylvia not every doctor or family member can be trusted to act in the best interests of the person in question. Monetary constraints, monetary gain, stress and any number of other issues will influence whether someone lives or dies. No mentally ill person should ever be told that suicide is an option.