By Melinda Tankard Reist
Genevieve, 33, was sexually abused by men when she was between the ages of 2 and 16 in New South Wales. Bred by her father specifically to be abused, she has suffered Post Traumatic Stress Disorder (PTSD), dissociation, flashbacks, and an eating disorder. Many times she wanted to end her life. Last year she almost succeeded.
Charlotte, 27, has also suffered for years as a result of childhood abuse for more than ten years, beginning when she was 2, at the hands of her father, uncle, family friend and strangers in Queensland. She has endured PTSD, dissociative disorder, eating disorders, anxiety and depression. More than once she has made attempts on her life.
Ally Marie, 44, was sexually abused throughout her childhood by men in her adoptive parent’s church. She has spent years in and out of mental hospitals in New Zealand and Western Australia; she abused drugs and alcohol to numb her pain and also struggled with suicidal thoughts.
What these three women have in common – in addition to histories of sexual abuse – is a deep grief and profound horror that another victim of abuse, a 20-year-old Belgian woman, was killed by lethal injection after medical professionals determined this was a suitable treatment to end her suffering. (Her death took place last year, but the Dutch Euthanasia Commission has only recently released its report.)
The young woman had been sexually abused between the ages of 5 and 15. She suffered PTSD, severe anorexia, chronic depression, hallucinations, suicidal mood swings, self-harming tendencies and obsessive compulsive behaviours. Her psychiatrist declared that there was no prospect of recovery. Doctors believed the woman to be “fully competent with no major depression or mood disorders affecting her thinking” that she wanted death – which makes no sense, given her many diagnoses.
“I’m horrified,” says the mother-of-one Genevieve from Queensland, who I met recently.
“It’s abominable. She was only 20! No 20-year-old with sound mind says ‘I choose euthanasia over living’. Yes, it’s a failure of the medical profession. It’s also a failure of humanity. The decision to kill her says to the rest of us: there is no hope, your life doesn’t matter! You are beyond repair, we have nothing to offer you. It tells us we are leeches who should be eradicated.”
A nursing graduate hoping to work in acute mental health care for young adults, Genevieve has first-hand experience of how difficult it is for survivors to get the specialist trauma care they need. She pays $200 a fortnight to access the specialist medical help she needs through the private health system, which she can’t get through public services. She says survivors are made to feel like burdens:
“Instead of finding alternatives and offering real hope, this decision says ‘let’s just eradicate this person, it will cost less’. Doctors don’t have to deal with what caused this person to become like this in the first place. If society says ‘This is OK’, it becomes acceptable. There is no longer a deterrent to ending your life. Our suffering makes us feel isolated and lonely. It’s taboo to talk about what happened to you. We are made to feel we are too hard. But we need to hear there is hope, keep going, things will get better. We need people who will come alongside and say ‘We can do life together’. We need a community, a network, so we don’t feel like an island.”
Genevieve, Charlotte and Ally Marie feel strongly that the 20-year-old lacked these necessary supports. And like many others on the long journey of recover from abuse, they know that if euthanasia – the medicalised killing of another person – had been legally available, they themselves may not have been with us today to stand as survivors. If their community and the medical profession had offered death as a compassionate resolution to their suffering, they may well have stepped from suicidal ideation into death.
I know Charlotte as a contributor to Prostitution Narratives: Stories of Survival in the Sex Trade – so many child abuse survivors end up in the prostitution industry. She was distressed when reading about the end of life of another abuse victim. While the intensity of suffering echoed her own wounds, she says she has been encouraged to live, not die, helped through regular therapy, the support of loving friends, her teaching studies and her dog. As she writes about overcoming a desire to end it all:
“the knowledge that I came so close to dying fills me with sorrow. I am very lucky and grateful to still be here today. There are so many beautiful and wonderful things in life that I would have missed out on, and it is those moments which make recovery that little bit easier … No one should ever be made to feel as though suicide is an option.”
Ally Marie also recalls a childhood destroyed by sexual, physical and emotional abuse. She has been in and out of psychiatric hospitals much of her life. “Had someone given me a needle back then to end it all I would have gratefully accepted,” says Ally Marie, who now has nine children as well as running her own business helping women reach their goals.
“Thank God they didn’t. Thank God I am alive to share my story. Because now I am grateful as I look at my beautiful family I created, as I look around at the lives I can change with my story … What happened to this girl is murderous. Who are you to anticipate what her future holds? I was this young girl but I found my way and pulled through.”
(Ally Marie first told her story here.)
The Belgian woman is not an isolated case. Among psychiatric patients receiving euthanasia in the Netherlands, most are women. A study published this year showed that PTSD and anxiety were prominent in such cases between 2011 and 2014. Four women were cognitively impaired, some had eating disorders, others prolonged grief. More than half were lonely and isolated. In one case, the report says, “The patient indicated that she had had a life without love and therefore had no right to exist.”
Sydney academic Katrina George has analysed criminological data from around the world to show that euthanasia of women is overwhelmingly at the hands of men. Patterns of assisted death in women reflect that of violence against women. The data simply doesn’t support the tidy theory of autonomy, choice and control put forward by euthanasia advocates.
Two of the most heartbreaking cases reveal how the cause of euthanasia becomes more important than the lives of women. A young Indian woman, Aruna Shanbaug, was brutally sexually assaulted 40 years ago and died last year. She became the inspiration for euthanasia laws, rather than for a campaign to fight violence against women, “a cause much more bitter than passive euthanasia.”
Nathan Verhelst was born as Nancy, a Belgian girl unwanted by her mother (“If only you had been a boy”) and sexually abused by her brothers from the age of twelve. Later in life, as a transsexual, Nathan underwent hormone therapy, a mastectomy, and failed surgery to construct a penis. He was euthanised at his own request in 2013. “I did not want to be a monster … I had happy times, but the balance is on the wrong side,” he said in an interview hours before his death. “I was the girl that nobody wanted.” His close friend Marisol later said, “If his family didn’t hurt him so much, he wouldn’t have wanted [euthanasia]. I don’t like the idea that you give your life because other people broke your life.”
If death is sought/offered to escape the pain of sexual abuse, incest, rejection, loneliness, what kind of choice is that?
Reforms to allow euthanasia in Tasmania, South Australia and Victoria are likely to be debated this year, and Senator Leyonhjelm and the Greens want to give the Territories the power to legalise euthanasia. While suicide itself has long been legal throughout Australia – attempted suicide attracts no penalty or consequence – they want medical killing legalised.
Troubled teenagers will not be eligible (though Philip Nitschke continues to promote his suicide bag for them) but patients with “intolerable” psychological conditions might be. Already, Australian teens and young adults are increasingly taking their own lives with the drug recommended by Nitschke’s euthanasia groups.
In the Netherlands and Belgium, the laws were originally very strict and limiting. But over time they have relaxed to include those people without a terminally ill condition: teens; children; babies; abused, lonely, isolated women.
It is no stretch to imagine that a young woman with PTSD, a survivor of sexual abuse, might qualify for euthanasia in Australia in the future especially in an environment of over-stretched and under-funded mental health systems.
Aside from system failures, we need to look more closely at our own attitudes. There is a subtle discrimination in favour of able-bodied people – ableism – so well described by Shakira Hussein. The able-bodied cannot imagine living with a permanent physical or psychological disability.
The response from the online blogs and forums of people recovering from abuse and PTSD challenge these attitudes. Most have condemning the killing of this young woman. Like Genevieve, Charlotte and Ally Marie, they have shared how glad they are not to have been tempted with a death-inducing injection:
“I’m still alive and I can think and feel and love and do all the things I thought I’d never be able to.” (Jenn Selby)
“As someone who suffered severe depression throughout almost two decades (on and off), but who is now free from it through learned insights and changes to core beliefs, and has the tools to prevent myself ever getting to that place of no hope again, I find it very alarming that people are condoning assisted suicide for sufferers of mental illness. I believe it is an illness that is curable, therefore helping someone end their life before they may have found the tools, insight, help they need to help themselves out of the hole, is tragic. While it may have taken me 17 years to get to where I am today, and while I used to believe I would continue to suffer through, and have to manage my depression, for the rest of my life, I am now in a very different place. There were a number of times that I got so low, for so long, that I wanted to end things, but taking the next step to actually do that yourself is a big step. If society’s perception was that it’s normal to end the suffering, and they could assist me in doing so, easily and painlessly, then I probably would have taken that option and wouldn’t be here today. Which would mean I would have missed out on another 50 – 60 years (hopefully) of life, free from that level of debilitating depression. That would be a tragedy.” (Alison – posted privately on Facebook; quoted with permission)
“In my wildest dreams I never imagined that I could recover from a significant PTSD diagnosis. It took years and a chance meeting with a psychiatrist who was able to offer me the therapy I needed but had been unable to access before that time. In my 20s, any option was a good option to break free of the exhausting battle. I remember feeling deflated that I woke up in ICU, a failure even in trying to end my life. In my 40s, I thank God for not having been offered help to end my life and always encouragement that others depended on me to live and live well. Now, I have beautiful children, an incredibly patient and loving husband and LIFE. Once, I never thought I could say that. I have life and am more than my damaged mind. I am terribly sad that this young woman, whose living hell I am not trying to minimise, did not have the opportunity to know that there was more.” (Gabrielle – on the Women’s Bioethics Alliance Facebook page)
“At my worst, I remember feeling an almost ‘logical’ desire to commit suicide … Now I see that thinking as one of the tricks that PTSD plays on you, that you start to think suffering is the only path and death doesn’t seem so bad … For three decades this option would have been a gift to me, not a punishment. I’m immensely grateful that this was not an option because I’m starting to enjoy living.” (“RuthieJujube”)
“PTSD is not a ‘mental illness’ we are born with. You take a perfectly healthy person/child and expose them to unspeakable horror and they develop PTSD. We were each born healthy and we owe it to ourselves to find the way back to our core self – before we were hurt. Call me whatever but I still have hope for each and every one of us. We deserve it. Suicide lets them win … What heals PTSD sufferers is connection, safety, and community.
“The world needs PTSD survivors. Yes, I contend that it needs us. Think about a world where people could be traumatized and then get help to end their lives as a solution to the deep wounds and costs of that trauma. That’s not good for society as a whole … Many movements to end traumatic things on this planet were started, if not led, by people who had survived trauma and were forever changed by it … But by making it legal for doctors to help we would be sanctioning it as a society and saying ‘this is ok’ and we can’t afford the deep cost of sending that message. It’s not just about adults who have been traumatized, but kids too. They need to grow up in a world where we will fight to protect them, not send the unintentional message that their life is not worth living if they are shaken to the core by trauma. We need to send the message that their life matters, period.” (“Justmehere“)
The suffering of women and children is perpetrated in a culture which too often overlooks the violence against them. The State, rather than dealing with the offences, properly punishing abuses, providing every care for survivors, instead may offer them an individual way out of a problem it has helped tacitly to facilitate. It becomes a personal rather than a collective problem. How is it that so many men can continue to abuse so many little girls in a global avalanche of sexual abuse? How is this not everyone’s problem?
Is death the best we can offer? Genevieve, Charlotte and Ally Marie and the many others like them need to hear: Stay here with us. We will help you, not with a needle, but with everything you need to become well.
Reprinted with permission as published on ABC Religion and Ethics, 25 May 2016