It is quite paradoxical that euthanasia supporters and opposers, despite being sharply divided in their views on euthanasia for the mentally ill, may still share almost exactly the same life experiences, teachings, influences, upbringings, etc. In other words, they may differ in views on this topic while still sharing very much in common. Two adoptive siblings, for example, may be unfortunate to suffer deeply traumatic abuses from parents or caregivers in their childhood, developing recurrent psychiatric disorders and traumas that severely impair their learning abilities in their schooling and their labor skills in the workforce. Still, it is possible for both adoptive siblings to grow into adulthood being completely divided on this issue despite sharing very similar struggles- while one of the siblings, despite the suffering that he or she may have endured in their own lives, may still become inclined to advocate for the preservation of the lives of those with refractory mentally illness at all cost, the other sibling may have a much more antinatalist stance on the issue that he or she derives for their own traumatic experiences. On the other side of the coin, it is just as possible for two biological siblings who have come from a much more nurturing family in childhood that has enabled them to succeed in their educational and career pursuits, to be divided on the issue.
What is it, then, that causes this sharp divide? From the examples above, it is construable that life experiences alone don’t necessarily guide a person to favor one view or the other. Rather, there are three known factors that influence both inclinations.
DIFFERENCES IN COPING THRESHOLDS
Differences in coping threshold, or resilience, is a key factor that polarizes those who oppose Euthanasia for the mentally ill from those who support it. In many cases, opponents of Euthanasia for the mentally ill tend to be much more resilient individuals than many of their euthanasia-supporting counterparts in this debate, which helps explain their lesser regard for the suffering of the severely mentally ill who wish to be euthanized. Consequently, anti-euthanasia advocates often see the predicaments of death-wishing individuals in the context of their more resilient experience, often dismissing the pain and suffering of those who wish to be euthanized as a reason that is not valid or strong enough to justify euthanasia procedures on these struggling individuals. The same phenomenon can be seen amongst individuals with mental illness, who have varying degrees of resilience. Those who have higher resilience levels (including those who do recover from mental illness) are often the most inclined to oppose euthanasia for the mentally ill, often making the mistaken assumption that, because they have managed to find ways to cope with the challenges of living with mental illness, their less resilient counterparts 'should' and 'must' do the same.
DIFFERENCES IN BELIEF SYSTEMS
The field of psychology teaches us that it is our perception, beliefs, or ideas towards any event, person, or idea (rather than the event, person, or idea themselves) that directly inspire the behaviors with which we react to those things. This phenomenon is especially true in this debate as a wide variety of beliefs direct our leanings on this highly controversial issue. The following is a list of some of these beliefs.
Mental Health System-Imposed Dogma
The mental health system in the United States, for example, is directly responsible for orchestrating a nationwide, anti-euthanasia regime that draws on suicide prevention initiatives, anti-euthanasia laws, and opposition to euthanasia for the mentally ill from the general public, to instill in people’s heads a very simple belief about the mentally ill who wish to die:
"The mentally ill who wish to end their suffering through death are always in a state or condition of being incapable of adequate decision-making, and it is therefore always unethical to allow them to end their suffering through these means."
This dogmatic belief is the key reason why clinicians and caregivers of their death-wishing patients often fail to take into consideration the amount of pain that they may be going through, for how long, or under what circumstances, when imposing their pro-life agenda on death-wishing individuals. They mistakenly assume that the key issue that said individuals face is always a mere “lack of clarity of thought,” rather than a much more profoundly troubling factor, like unbearable and recurrent emotional pain and circumstances outside of their control that exacerbate it. In other words, a circumstance where resilience is lacking, disabling factors are abounding, and protective factors are hardly within reach.
BELIEFS ABOUT LIFE AND DEATH
Differing perceptions of life’s worth and the consequences of Death often cause many to disperse in opinion on the question of whether or not the severely mentally ill should be granted the possibility of euthanasia. However, the vast majority of people involved in this debate generally fall under two categories: those to whom life is sacred and death is a curse (in other words, those who perceive life as being better than death), and those to whom Life is an experience of recurrent torment and Death is an escape from it (that is, those who perceive Death as being better than Life).
Belief That Life is Better Than Death: Through centuries, life has been venerated as a gift and a miracle in most civilizations. Life allows us to come to this world to see the good, live with the good, and enjoy the good in it. The liveliness of friends and loved ones who enrich our lives through their involvement with us adds to our enjoyment of the good in the world, and it is this general “good” that makes our lives on earth worthwhile and at the same time enjoyable. This element of general “goodness” that gives meaning to our lives is what drives many to faithfully believe that “Life is good.” Death, however, robs us of many of these things. It robs us of the opportunity to enjoy the good things that life has to offer when it takes our own life. Death also robs us of the joy we get from the friends and relatives that death takes from us. Death is not only an agent that replaces the people we love with painful voids in our hearts that we must wrestle by undergoing the stages of grief, but it even pushes us into a face-to-face encounter with a factor that most humans repel at all cost: the unknown. We don’t know what there is after life on earth (if anything at all), nor do we know where our deceased loved ones will be or where we will go after we die. Many anti-euthanasia advocates also oppose euthanasia for the severely mentally ill because they view life as something “good,” or even “sacred.” Therefore, the legalization of euthanasia for the mentally ill would mean, from their point of view, that the loved ones of those euthanized would be “worse off” unable to be around to enjoy the “good” in life, thus making the life preservation of those with severe mental illness of far greater importance than firstly ensuring whether or not a life worth living can be sustained by them or for them in the first place.
Belief That Death is Better Than Life: Euthanasia supporters, on the other hand, see the above panorama with the exact opposite lenses. They are mostly concerned with the bad things about life that have made the lives of those with severe mental illness intolerable. Life, after all, makes us susceptible to suffering because of the human condition we are all born with. While some individuals are able to live in this world with ease of access to the good in life and to bring about more good from it to their own lives and the lives of others, other individuals aren’t so lucky. Many individuals with severe mental illness often lack the levels of resilience that are needed to cope with the pain and handicaps instilled by their illnesses to where any enjoyment of or access to the “good” things in life is either impossible or difficult to achieve without enormous amounts of pain and suffering in these processes. Mentally ill individuals who experience a recurrent struggle to gain or maintain relationships, employment, independence, or a general sense of serenity and inner peace because of the marked difficulties they encounter in treating their own mental illnesses and tolerating their distressful symptoms, are examples of this phenomenon. Their lack of resilience in these situations combined with the recurrent nature of their struggles thus makes the “bad” in life become the main theme of their existence. And it is here where death, rather than life, is good and more favorable. Death takes over the role of the rescuing element that kills the “bad,” pain-inducing elements that the more contemptible life brings to the table to make their sentient existence all the more painful. The end result of this dilemma, which the mentally ill are entrapped by, is their stronger preference for death to get rid of the “bad” in life that exacerbates their suffering over living for the “good” in life which they struggle to attain, maintain, or enjoy amid painful circumstances.
DIFFERENCES IN PRIORITIES AND VALUES
When evaluating the possible ways to eradicate the pain of the chronically mentally ill, those who oppose their euthanization have very different priorities from those who favor it. Both sides of this controversy value two different elements of the life of a chronically mentally ill individual, which puts them at odds: euthanasia opponents prioritize life preservation above all else, while euthanasia proponents prioritize pain extinction.
Life Preservation
Those who oppose euthanasia in this debate value the life of the chronically mentally ill above all else, hence their focus on life preservation. From their perspective, neither the intensity nor the duration of the pain of a chronically mentally ill individual match in importance to their very life being intact under any and all circumstances because they believe that life alone, regardless of how burdensome it may be, has infinite value. They revere the aliveness of the individual as the most important of all aspects of that person’s being, and they believe that no amount of their suffering is reason enough to extinguish it, regardless of how intolerable, recurrent, or life-hindering it may be.
Pain Extinction
Those who favor euthanasia in this debate value much more than just the mere aliveness of the chronically mentally ill. They value the sentient experience and the coping ability / coping threshold of those with refractory mental illness, and the quality of life that follows from the combination of those factors. Euthanasia proponents hold the dignity and freedom of choice of the mentally ill at a higher regard than their mere being alive and rebuke the idea that those with refractory mental illness ever have to put up with illnesses that cause them recurrent suffering, and are hardly responsive to treatment, only because legislations force them to do so and because clinicians frown upon them choosing to be euthanized. Euthanasia supporters, unlike their counterparts, do not place value on the life of a person if they want to extinguish it to end intolerable pain. Pursuing the best sentient experience possible is a greater priority for them than life preservation.
CONCLUSION
The key difference between anti-euthanasia, pro-life dogmatists, and their counterparts in this debate is that the previous prioritize life preservation over pain extinction, while the latter value the wellness of the sentient experience of those with refractory mental illness over their mere aliveness. A just society would allow people in each faction to have the right to take part in their preferred side of this debate and to show advocacy for it. However, such a society ceases to be just when it favors and serves the mentally ill in one faction but not those on the other. A society that serves the mentally ill only by euthanizing them (that is, a society that serves the mentally ill who wish to be euthanized while forcing those who wish to live into dying) is just as oppressive as a society that serves the mentally ill only by providing a variety of treatments (that is, by serving the mentally ill who choose, and benefit from, the treatment they have available while imposing life on those who do not want, do not choose, or do not benefit from these treatments into living). Unfortunately, most nations in the world (including the United States) currently fall under the latter category.