As debate on the UK’s assisted dying bill nears it is worthwhile considering the unintended consequences of such a change in attitude towards healthcare. Underdiscussed, I think, is the effect this change has on the already suicidal. What follows, to be clear, is not a broad overview but a personal perspective which I hope is illuminating. 

The poet Anne Sexton, no stranger to suicide, wrote “suicides have a special language/Like carpenters they want to know which tools/They never ask why build”. To the suicidal, the why of a suicide is irrelevant — the how is what’s important. That “how” is a question that occupies a good deal of my time. Half intellectual exercise, half genuine desire to die. I think about my future suicide in the same way a little girl plans her eventual wedding. I have a profound desire to die. I’m just frightened of the act itself.

Despite this, I have tried to kill myself on more than one occasion. My self-hatred is such that I enjoy planning my own death even though the violence to the self necessary for suicide disgusts me. I do not have the courage to, like the Roman, fall on my sword. I do not even have a sword. Poetic though my death might be, I do not want my last memories of life to be ones of agony. Simply put, I am afraid of physical pain. 

I’ve been hospitalised twice before for suicide. Neither hospitalisation was particularly helpful or pleasant. Instead of meaningful psychiatric care I was offered something called “occupational therapy” — glorified arts and crafts. Somehow, making a coaster out of ceramic tiles was supposed to cure my suicidal depression. After about two weeks I was released and told to go find a therapist. Some help…

All this was in the far-off time before Covid. Since then, cases of mental ill-health have shot-up and the system, already overloaded before the pandemic, has collapsed. There is a two year wait list to see a psychiatrist and psychologists charge upwards of 300$ a session. Community resources are scarce and in high demand. My experience of them has been mixed. Once, in another moment of crisis, I phoned a suicide hotline. The volunteer who answered the call suggested I look into MAID – Medical assistance in dying. In other words, assisted suicide. It is not currently legal to offer MAID in Canada in cases where the patient is only suffering from mental illness. That said, newly released documents have shown that MAID providers in my province aren’t trifled with little things such as laws and ethics. 

On the night of my 32nd birthday, I had an abortive suicide attempt. It seemed like a good idea at the time.  Evidently, I was unsuccessful. When I went to hospital the next day, I was told that my condition did not merit hospitalisation — this despite evidence of self-harm.

At that moment, I wanted to die more than anything. It was fear that changed my mind. Fear of the pain that comes with an overdose, fear of what my loved ones would think, fear that I would fail. It was an impulsive decision, and I hadn’t prepared or planned for it. I hadn’t even left a note. Very bad form. 

This has been my experience of suicide: too cowardly to do it properly, too melancholic to not do it at all. Sometimes, as happened on the 17th, the melancholy is too powerful. Wherein the appeal of MAiD.

MAiD offers a fascinating opportunity for the genuinely suicidal. It soothes the fears around suicide: the fear of pain, the fear of loss, the inability to explain to friends and loved ones. 

MAiD is suicide. Campaigners for MAiD and assisted dying are adamant that MAiD is not suicide. It serves their interests to portray MAiD as a form of medical care. By that logic, a samurai who committed seppuku would not have been committing suicide because his kaishakunin would deliver the killing stroke. Doubtless these campaigners would also say that Captain Oates did not die by his own hand during the Scott expedition because it was the cold that killed him. These are the sort of Jesuitical arguments that would make Elizabethan propagandists blush. MAiD is doctor sanctioned suicide. By presenting itself as a medical procedure, as a form of “healthcare”, it conceals its very nature as self-slaughter.

This lie, however, is an appealing one and works to assuage the doubts I may have about suicide: that it is a sin, that my loved ones will hate me, that it needs to be a private act. Instead of a housemate or neighbour discovering me dead in a dingy basement, or my even dingier room, I could choose to die in a comfortable setting of my choosing, loved ones nearby, birds singing. I can have a beautiful death. This time, I won’t fail. The Death I could have from MAID is more beautiful than even my most meticulously planned suicide. 

I do not have to go to the bother of killing myself. A doctor will take care of it. Like the old Pullman train cars, all I need do is “Lie back and let (the doctor) take care of it”.

MAiD has created a culture where it is okay for me to want to die

I often imagine what my death by MAiD would look like. I’ll drink a cocktail of barbiturates, and elegantly slump back on my bed like Chatterton in the painting. The perfect end to a life of failure. Finally, I’ve accomplished something. 

MAiD has created a culture where it is okay for me to want to die. On some level, I believe suicide to be a sin, but if MAiD isn’t suicide, then I wouldn’t be sinning. It’s a medical procedure I tell myself, a doctor administers it, there are all kinds of safeguards. Dying by MAiD removes the uncertainties, the inconvenience of suicide. Perhaps my loved ones would even understand? Would they forgive me? My Church, the ACoC, has said that MAiD patients should be “understood” and that the church should not oppose MAiD on religious grounds, even providing prayers to use at a MAiD procedure. What more evidence do I need? My Church says MAiD is alright.

The trouble is the culture around MAiD aggravates the feelings and thoughts that lead me to trying to commit suicide. It confirms all my worst thoughts about myself. Politicians and philosophers like AC Grayling tell me my suicidal desire should be indulged. Is it any wonder I tried to kill myself a week ago? 

While the Eternal may have fixed his canon against self-slaughter, the medical profession, by contrast, has already or is embracing it enthusiastically. This is very bad news for those of us who already wish to die.