Many years ago Carl Reiner and Mel Brooks made us all laugh with their take on the 2000 year old man. On bit involved Carl Reiner, during the interview, asking Mel Brooks how he had managed to live to such a ripe old age. The the 2000 year old man replied it was his "Will to live." Carl Reiner misunderstood and was deeply impressed until Mel Brooks remarked that it wasn't his will to live, it was his Doctor, Dr. Will To Live.
Sigmund Freud, not noted for his sense of humor, believed that within all of us there was a dynamic struggle between the will to live (Libido) and the death instinct (Thanatos). Many have wondered, including me, whether in the West, especially in Europe and among the American elites, the tension between the two instincts have become unbalanced.
While aggression is fueled by both Libido and Thanatos, for the liberal West, the connections are often successfully repressed and suppressed. Because of this success, the roots of aggression, even the existence of aggression, are often denied.
The admirable liberal desire to minimize aggression is overt in the international arena, where almost any use of American or Israeli force is a cause for consternation. However, such desire to minimize aggression shows up in many other areas of life, as well. For example, the desire to minimize income disparities, using the legal system and the tax system if necessary, includes the desire to minimize envy, a source of a great deal of aggression in humans. The desire to protect young people from the powerfully disruptive effects of irresponsibility or to protect women and their families from the pain and damage of a seriously defective baby has led to institutionalizing aggression toward the unborn infant.
Unfortunately, denying and minimizing aggression is not the same as resolving it, and just as the repressed tends to return, suppressed aggression also has a habit of reasserting itself in often surprising ways, especially if it has its roots in Thanatos. Assisted suicide is a cause which has been identified primarily with liberals and the left, who have moved from the position of compassion for th terminally ill whose pain and discomfort cannot be alleviated to the position that if someone's life is not worth living, they should be allowed to terminate it in comfort. In March, 2005, in Libido & Thanatos: Part IV, I wrote about the Groningen Protocols, a frightening set of guidelines for use by Physicians to decide when, in their opinion, a patient's life should be terminated without the patient's or their parent's consent:
This should alarm you; it alarms me. If Doctors, with the understanding of the patient and their family, decide to assist a patient to hasten their end, or allow a hopelessly brain damaged person to slip away, they will have to come to terms with their own conscience and morality. If a society decides that starving a brain damaged person to death, or euthanizing hopeless cases, will become the law of the land, we are in a terrible fix. If the right to die is legislated, the right to kill, only for the best of reasons, will inevitably follow. Consider that the right to kill those whose quality of life falls below our thresholds will be much easier to exercise than the right of society to exact capital punishment from those who have murdered innocents; this would be a triumph for Thanatos.
The Swiss have gone the next step. On Friday, in a news item that has been largely ignored, appeared a very disturbing article, describing how the Swiss may expand assisted suicide law":
LAUSANNE, Switzerland - A ruling by Switzerland's highest court released Friday has opened up the possibility that people with serious mental illnesses could be helped by doctors to take their own lives.
Switzerland already allows physician-assisted suicide for terminally ill patients under certain circumstances. The Federal Tribunal's decision puts mental illnesses on the same level as physical ones.
"It must be recognized that an incurable, permanent, serious mental disorder can cause similar suffering as a physical (disorder), making life appear unbearable to the patient in the long term," the ruling said.
"If the death wish is based on an autonomous decision which takes all circumstances into account, then a mentally ill person can be prescribed sodium-pentobarbital and thereby assisted in suicide," it added.
For the perspective of a Lumberjack, who seems to have more sense than the Swiss judiciary, consider his take, Swiss Go Kevorkian on the Mentally Ill, which includes some useful details on the particular case involved.
The overt paradox is striking. Perhaps the Swiss Court can explain how a person who is so disordered by their mental illness that their life is not worth living can make an autonomous decision to commit suicide? It seems to me that, by definition, a serious mental illness impairs one's autonomy.
On another level, this decision shows a remarkable disconnect from current reality. When I was in training, there were large groups of patients who were considered untreatable. There were chronically depressed patients who could not tolerate the types of medicines available in the 1970s; there were Narcissistic characters who were considered unamenable to any kinds of Psychotherapy; there were Borderline Personality Disorders who could never be reached; there were drug addicts and alcoholics who were beyond the reach of any Medical or Psychiatric intervention. Yet, in the last 30 years we have had entire classes of medications become available to treat hitherto untreatable Psychiatric disorders; we have drugs in the pipeline which may well revolutionize the treatment of Cocaine and Heroin addiction; we are closing in on cures for alcoholism; severely disturbed Schizophrenics and Manic-Depressives can often be stabilized well enough to live satisfying and productive lives; medical science, including neuroscience, is proceeding at such a rapid pace that anyone who claims they can predict the state of the art in treatment five years from now is lying. With all that, the Swiss have now decided that if a person feels sufficiently hopeless and helpless (ie, depressed) that they want to kill themselves, we should agree they are hopeless and helpless and help them do so.
I will leave it to others to marvel at the ability of intellectuals to convince themselves of nonsense. My curiosity is piqued by the awareness that rationalizing assisting people to kill themselves must have powerful unconscious determinants. Western elites are exhausted, perhaps their day is past. Europe fought two conflicts which were unabashed expressions of Thanatos; many Europeans eagerly embraced the murder of the other while a much larger number passively acquiescenced in the same; all Europeans were marked by the experience. Further, following the second world war Europe lived in the shadow of death for 45 years in a way that Americans may have difficulty appreciating. They seem now to be trying to bury their aggressive instincts, but instincts can never be successfully repressed; they always find a way toward expression.
In Libido & Thanatos: Part IV I concluded:
Libido always falls before Thanatos; the strength of the Libido wanes throughout the life cycle, and while the passion that arises from Thanatos may weaken (rage is an emotion for the young and begins to diminish by middle age), its expression is certain in the end. We would be wise to do everything we can to delay its expression in our society, lest we prematurely fall victim to it ourselves. Death has a habit of increasing its sway. It is further speculation, but tempting speculation, to wonder if the left, which has done so much to interfere with our ability to protect ourselves (in war, we express Thanatos in the service of Libido), which is at the forefront of the right to die movement, and which has glamorized revolutionary violence for so long (Che, Castro, Michael Moore's "Minutemen", et al) is now unconsciously pushing an agenda contaminated by Thanatos.
The Swiss have now moved the discussion further into suicidal territory for those who look to the Europeans for guidance. This is not a life affirming outcome.
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