“There’s nothing more we can do for you. It’s never gonna get any better…“
— Some Idiot Dutch psychiatrist
States considering legalizing Medical Aid in Dying for terminal illnesses do not exclude mental health illnesses from those very same laws. Further, the 10 states and District of Columbia which have approved MAiD have not excluded mental health illnesses.
As such, we are now getting a clearer picture of the ramifications for this lack of vision.
Protestant Theological University healthcare ethics professor Theo Boerin served on a euthanasia review board in the Netherlands from 2005 until 2014. During this time, he told The Free Press, he observed Dutch euthanasia “evolve from death being a last resort to death being a default option.”
We see that observation playing out in the media. Following are just three stories involving physician assisted suicide in which the patient’s mental health is the primary health issue.
https://www.bbc.com/news/stories-45117163
https://www.bbc.com/news/world-europe-48541233
Some observations from those articles include:
“How could I know – how could anybody know – that her death wish was not a sign of her psychiatric disease? The fact that one can rationalise about it, does not mean it’s not a sign of the disease,” says psychiatrist Dr Frank Koerselman, one of the Netherlands’ most outspoken critics of euthanasia in cases of mental illness.
“My whole career I worked with suicidal patients – none of them was terminal. Of course I had patients who committed suicide, but as a matter of fact these were always cases when you didn’t expect it.”
But people can and do live for decades with psychiatric disorders. “They’re not treatable like an infection, they’re like diabetes – you’ve got the disease, you will have it the rest of your life, but we, as doctors, are going to make it possible for you to live with it,” argues Frank Koerselman.
Ter Beek decided she wanted to die after a psychiatrist told her ‘there’s nothing more we can do for you’ and that ‘it’s never gonna get any better’, The Free Press reported. [emphasis added] [As an aside, perhaps another definition of “grooming” should be, “A process used by a mental health predator to make a child or vulnerable adult an easier victim.”]
“Now, after doctors have reportedly said they cannot do anything else to help improve her mental health, she has decided she is tired of living.”
‘I see the phenomenon especially in people with psychiatric diseases, and especially young people with psychiatric disorders, where the healthcare professional seems to give up on them more easily than before,’ Groenewoud said. [emphasis added]
Debates surrounding MAiD and mental health focus on the rights of the individual versus the rights of a compassionate society. Or the cognitive capacity of an individual to make the most important decision he/she will ever make. In the United States, debate on this topic inevitably includes our insipid politicians, their room temperature IQs and their tribal mentality.
However, regarding MAiD laws, we do not discuss evolving new technologies which are meant to address the brain and its capacity to heal itself. Or how the upcoming snowflake generation seemingly characterizes every slight as an aggression or traumatic event which paralyzes them and contributes to their lack of development.
Another great concern is that the debate on Medical Aid in Dying rarely focuses on calling into question the competency of those medical and mental health professionals. Look at just a few quotes from the articles posted …
“… especially young people with psychiatric disorders, where the healthcare professional seems to give up on them more easily than before…”
“… Ter Beek decided she wanted to die after a psychiatrist told her ‘there’s nothing more we can do for you’ and that ‘it’s never gonna get any better’…”
“Now, after doctors have reportedly said they cannot do anything else to help improve her mental health, she has decided she is tired of living.”
Patients deciding they are tired of living after being told there is nothing more to be done. That their condition is not going to get any better.
We must start to address the competency of mental health providers who are involved in physician assisted suicide. Especially regarding eating disorders. Because that is the elephant in the room and the potential for an appalling rise in mental health “grooming” is very real.
In June 2023, a dissertation entitled, “A Systematic Review of Training Programs for Mental Health Professionals Who are Treating Eating Disorders” was submitted by a PsyD candidate, Shir Zion. The statistics, resource material, findings and notations included in this dissertation are alarming. The dissertation can be found here:
This dissertation found:
“Previous researchers have noted that psychologists historically have not used treatments that have been empirically validated due to having received minimal training and because those treatments did not address ways to mitigate concerns and comorbid conditions that people with EDs typically display (Haas & Clopton, 2003).”
“Only 6%-35% of clinicians who treat EDs report utilizing evidence-based guidelines (Waller, 2016). In fact, practicing psychologists tend to not use treatments that have been empirically validated due to having received minimal training and because these treatments do not address effective ways to mitigate general concerns and comorbid conditions that individuals with EDs frequently report having (Haas & Clopton, 2003).”
“Despite reviewing 665 articles, 14 were included in this review, suggesting that there is a dearth of quantitative research in this area. This is important, particularly for the mental health field, to note because there is a general lack of training opportunities available across settings (universities, practicum sites, and internships) for those who wish to treat one of the most enduring, complicated, and debilitating psychiatric illnesses in the field.”
“According to Kazdin et al. (2016), therapist competence may be linked to treatment outcome, and given the seriousness of EDs and the exceptionally vulnerable client groups who seek treatment, the need for increased professional competence in this area is greater than ever (Williams & Haverkamp, 2010).”
“According to Williams and Haverkamp (2010), despite having the knowledge that there is a lack of competence related to the management of EDs (e.g., Gurney & Halmi, 2001; Rosenvinge et al., 2003), there remains insufficient training as well as a lack of competency and overall confidence for professionals who are working with individuals who have EDs (Jones & Larner, 2004). For example, graduate school training opportunities for those interested in treating EDs are likely “insufficient and inadequate” (Wilson et al., 2007, p. 207).”
This dissertation, with its cited resources, confirms what many in the eating disorder industry already know and have been whispering about for quite some time. And that for some eating disorder professionals, their characteristics include:
Insufficient training.
Lack of overall competency.
Lack of training opportunities.
Lack of confidence.
Grad school training which is sporadic and inadequate.
Only 6%-35% of clinicians who treat EDs report utilizing evidence-based guidelines.
The inescapable conclusion is that many medical and mental health professionals are incompetent because they do not have adequate training nor experience treating the unique challenges presented by eating disorders. Let alone to participate in life and death decisions regarding eating disorders and end of life options.
Make no mistake. I have met some incredibly intelligent, insightful, involved clinicians and research professionals. Persons whose wisdom, experience and compassion far exceed anything I would ever hope to accomplish. Those people inspire me and give some hope for the future. But there are many, many others who do not.
To participate in the ending of another sentient being’s life, a medical or mental health provider must epitomize the absolute best in not just their chosen profession but, as a human being.
Intellectually, they must be elite. They must have experience gained only through years of exposure to and treating persons suffering from mental health conditions. They must be at the very forefront of understanding human anatomy and the brain. They must be inquisitive and seek to understand evolving treatments and state of the art biological interventions.
They must have a limitless supply of compassion which is honed by setting aside their own ego, listening and absorbing the subtle messaging which exists in the manner in which humans communicate. They must be spiritually evolved and have a vast understanding of the manner in which different religious beliefs, or the lack of any beliefs, impact the body, the mind and the soul. They must be transparent and open to talking/collaborating with all persons with a stake in the topic.
Only after mastering all of these qualities should a medical/mental health professional think about participating in the end of another human being. And they absolutely cannot be a passive witness enslaved to the demands of their patient who wishes to take their own life.
Our medical schools are not providing a working, rudimentary training and understanding of eating disorders. We know there are no generally accepted standards of care for treating eating disorders. Treatment centers and providers bandy around the term “gold standard” such that it has lost all meaning. Health insurance companies are utilizing their own treatment guidelines, guidelines they ran through their finance and accounting departments. Charlatans are peddling new therapy milieu devoid of any scientific or medical background or support.
And yet we expect our medical/mental health professionals to have the insight, intuition, intelligence and integrity to discern whether a person has the cognitive ability to make the decision to take their own life?
To rise above all controversies as well as the flaws, mistakes, inadequacies and incompetence in the eating disorders field? And then to administer or supply the very substances by which a person will take their own life?
What a mad, mad, mad, mad world in which we live.
A DAD'S JOURNEY WITH EATING DISORDERS 