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As a person with mental illness, here’s why I support medically assisted death

Adam Maier-Clayton was a top athlete and student until his deteriorating mental health left him in extreme, chronic pain.

Catrina Franzoi

This essay original appeared in The Globe and Mail in May 2016. Adam Maier-Clayton died by suicide in April 2017.

The amount of pain I endure on a day-to-day basis, it would break anyone. That's what has brought me to argue for the right to die.

I've done everything that there is to do. I've tried eight or nine medications, I've done traditional Freudian psychotherapy, cognitive behavioural therapy, exposure-response prevention therapy, acceptance and commitment therapy. In a perfect world, I'd get better. But in real life, there's a chance that my progress will continue to be as poor as it has been in the past three years. I'm not going to endure this agony indefinitely.

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My history with mental illness dates back as far as I was able to form memories, so around three or four years old. I had physical tics – chronic blinking, noises I would make, facial movements. I was eventually diagnosed with obsessive compulsive disorder (OCD) and generalized anxiety disorder.

In college, I was doing very well, but my OCD and anxiety started to return and I started developing pain that I didn't understand. I thought it would go away, but this psychosomatic pain got worse and worse. You know when you touch your toes, and you feel that burn at the back of your legs? It's like that in my face, in my back, in my head, and it doesn't stop.

I also acquired something called dissociative depersonalization disorder. It's a dissociative disorder based on anxiety. It takes your connectivity away from this dimension, this plane of existence. You know you exist. You're not erratic, you're not psychotic. But you feel like you're living in a dream. It's obviously very, very distressing when someone who's normal feels like they're stuck in a dream and they can't get out. And it's been going on for about three years.

What I've explained to my psychiatrist, my general practitioner and my family is I'm now in the red zone. My issue is not related to some sort of depressive sentiment. I'm not suicidal in the sense that I hate myself and I want to leave. I think this world is beautiful, but this amount of pain is intolerable.

Physical illness and mental illness can actually induce the same amount of pain. The only difference is the pain in a physical illness has a physical pathology. In a mental illness, the pain is called psychosomatic pain. To the patient, it feels exactly the same.

The harsh reality of life is some people are born and their biology, their biochemistry, inevitably leaves them sick. Some people will get better with treatment. Unfortunately, some will not.

Of course, for everyone who's sick, we have to do everything we can to make them better. It's true that it's incredibly difficult to get really good quality help when you have mental illnesses. Do I think the mental-health system needs major adjustments? Of course. It makes no sense to give people the right to die if they haven't accessed help. But no matter how much funding we put into mental-health programs, there are always going to be issues because we don't have the cures for these ailments. Some people are confined to lives of truly horrifying amounts of suffering that no amount of treatment can stop.

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To people who are so extremely ill that no amount of treatment will make them better, and they want to die, it's nonsensical to not give them access to death. Because first of all, it confines them to a lifetime of pain. And second – and this is an incredibly important point: People who want to die are going to die.

It doesn't make sense for government legislation to corner people and force them to take their own lives in a brutal way.

You're going to hear a lot of people say that legally, it makes no sense to give the mentally ill access to the right to die because they can't possibly give informed consent. But to insinuate anyone who struggles with depression or anxiety or any type of mental disorder is so out of it they can't give informed consent is absolutely inherently wrong.

The basis of informed consent is the ability to think rationally. To me, it means the person is completely aware of what is going on, they understand all the repercussions, they understand their situation. They also have to have pursued treatment.

There's a major difference between someone such as myself and someone who is in a psychotic state. With my depersonalization disorder, it's simply a sensation I experience. It doesn't affect how I make my decisions or how I base my decisions. Simply having a mental illness does not cancel out the ability to give informed consent.

People say, we don't know how you're going to feel tomorrow. And that's true. None of us has a time machine. But if you have someone who has been suffering for 10 straight years, no matter how much effort and genuine treatment they have endured, and they've been confident about this decision for a long time, it's rather nonsensical to say, "Hey, you don't know what's around the corner. Just stick around."

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It's not the sufferers' responsibility to wait for modern medicine to develop to an appropriate level.

When I say giving access to the mentally ill, I'm not talking about someone who has a panic attack once every two years. I'm not talking about someone who has a tendency for melancholy when bad things go on in their life and they have a rough couple months. I'm talking about refractory patients – that's the term I always use, refractory or treatment-resistant patients. The people whom modern science can't help.

The amount of wonderful people I have in my life is quite frankly almost infinite. The reality is as much as I love them, their words and support are, in fact, useless to me. I appreciate the sentiment, but it cannot fix me chemically. So we're talking about giving access to people who are unfortunately neurobiologically doomed.

As told to Wency Leung.

This interview has been condensed and edited.

To read a different take on the issue, click here for Mark Henick's position.

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