If a chronically suicidal person is shown no mercy then man and god are evil: assisted suicide is right and this mercy must be legalised.

If you suffer I would end it

Can you say the same about yourself?

Angel of the Abyss: an email to David Crepaz-Kaey at the Mental Health Foundation

I’d like to write to you about two issues but I’ll start with suicide because I saw you’re doing a project to create a suicide prevention pathway. The science isn’t good enough nor are the principles which are applied to psychiatric suicide practice.

I’ve written a document stating my position on the issue. It’s in two parts: the first talks about compassion and mercy especially in legalising assisted suicide and the other talks about the flaws and how suicide treatment could be improved.

I’ll sum up my thoughts here:
– if you want 100% of suicidal people to engage in the suicide system then there has to be legal assisted suicide available. Otherwise people who are certain they want to die will do so any way or attempt to without engaging with treatment. Assisted suicide is humane and incentivises suicidal people to engage who otherwise wouldn’t.
– people need the best scientific answer. The problem is there’s a lack of scientific suicide research. Psychiatric research is about syndromes so treatment effects are measured on multi-variable measures. Suicidal ideation is a common sub-measure in measures like the Beck Depression Inventory but significant effects on this one single symptom can be masked by effects on other symptoms. What’s needed is a retrospective meta-analysis looking solely at the effect of treatments on suicide both within syndrome research and across all syndromes to create suitable evidence based guidelines for suicide.
– there also needs to be scientific evidence and clinical guidelines for treatment resistant suicidal ideation. Basically this is necessary when the first attempt at suicide treatment fails. There’s nothing like this at the moment but it’s obviously necessary because standard treatments don’t work for everyone. Treatment resistant schizophrenia has guidance for treatment – alas it’s clozapine – so it’s logical that there should be something like this for suicidal ideation.
– I believe suicidal ideation is the worst state a conscious being can experience: when it wants to cease its life prematurely because it has become too awful to bear. Bearing this in mind any suicide treatments must be fast acting as well as effective. The aim should always be to minimise the duration of the personal torture of wanting to die. Psychiatric medication and psychological therapies take too long to work in my opinion. It is imperative that any suicide treatment is available quickly and works quickly.

These comments are drawn from substantial experience of unfulfilled, almost constant suicidal ideation over many years. The science is rubbish and the treatments aren’t good enough. Of all symptoms suicidal ideation is the most important but (as far as I am aware) there’s no suitable meta-analysis of old trial data. This is comparatively cheap and I’ve seen a review of 500 trials of job satisfaction on physical and mental health as well as a meta-analysis and funnel plot of publication bias using 1,000 trials so large reviews aren’t impossible. Psychiatric researchers have really failed in their remit to use the best science to tackle the suicidal ideation epidemic.

“The right to die is not the antithesis of the right to life but the corollary of it, and the State has a positive obligation to protect both.”

This quote is taken from the interpretation of the Human Rights Act and article 1 of the Convention on Human Rights in the Pretty 2002 case.

If you’re suicidal isn’t that harm enough?

Don’t Exterminate Us: why do I carry the weight of the world?

Because everyone in science and social change should think of the risks and the cost.

Though I believe suicide is okay and assisted suicide should be legal that doesn’t take away the loss and deaths caused. Though I strongly believe that disabled people will exist in utopia or heaven on Earth I fear protecting this future could have a terrible cost to disabled people now.

I think of Nobel and his invention of dynamite that he hoped would revolutionise mining and his guilt when it was used by the military to kill people more effectively.

I wonder if some of the people on the project to build the first atom bomb were conscientious objectors but were drafted irrespective of their moral objections.

Scientists prioritise discovery and truth seeking above consideration of their uses. They usually leave that to engineers. Neither profession has a moral code. It is left up to individuals and I’m afraid they fail to comprehend the consequences of their advances.

A theoretical physicist should consider that their work could contribute to a new generation of power generation but also that more advanced particle physics could also be turned into uncontrolled reactions which would dwarf current nuclear bomb technology.

As a social scientist, mental health rebel or whatever you, the reader, label me as I have to weigh my actions against the potential consequences. Too often I fail to do this enough.

For example, the other prongs of Angel of the Abyss could have negative impacts I’ve not yet explored. Equality First is riddled with problems and a lack of rigorous criticism.

But the genetics problem at the core of Don’t Exterminate Us is something I’m afraid of. I see big problems and evils whatever position I take. My intellect and experience have thus far failed to find a solution I’m comfortable either. Any decision I can make thus far makes me an evil man. My heart errs one way but protecting my soul make me err the opposite way.

Ugh.