Trigger Warning: discussion of suicide (philosophy and legality)
1,500 words
The first thing I want to emphasize is: I am not suicidal. I don’t want to die, I don’t see death as a way out, and I’m not currently spiraling. It’s taking everything I have not to spiral, but “everything I have” is working for now, even tho the spiral is right there and threatening to swallow me up every moment of every day (this is why it’s taking me so long to respond to texts, btw - I’m doing my best not to spiral, and external communication takes from the same energy pool). Sometimes the spiral pulls me in a little, but my coping strats have improved enough that I’m actually able to pull myself out after a little bit. These are all good things.
This is also not about making a demand, but it absolutely is about making a statement of my values. We’re talking about life and death here, so this is serious, and accordingly I want to seriously state: I am not demanding that anyone do what I want. I am accepting the reality that maybe nobody will, and choosing accordingly. In therapy, we say there are at least two healthy responses to any situtation: accept it totally, or walk away. I get to walk away from any deal I don’t like, so what I’m doing here is attempting to state clearly what I’ll walk away from.
Of course, isn’t “walking away” illegal? Yes and no. Here is a medical resource on a recent conceptual innovation in Dying With Dignity: Voluntarily Stopping Eating and Drinking (VSED). And here is an academic paper on the legal and ethical issues underlying VSED.
In short: those who do not have access to Physician Assisted Suicide (PAS) have a loophole in VSED, because it is ethically and legally distinct from Conventional Suicide (CS). CS, for example by blade or poison, is an impulsive decision that is both violent and sudden. VSED, by contrast, is a considered decision rooted in Quality of Life restrictions due to some chronic condition (in my case, chronic emotional pain). Forgive the rickety analogy to the famous Trolley Problem, but this activates the exact same “killing vs. letting die” distinction: while this is a course of action fully intended to result in death, there is no singular or violent “killing blow.” Instead, the patient simply refuses all nutrition and hydration for seven to fourteen days, during which time dehydration triggers endorphins to offset hunger pangs and then organ failure begins. The patient does not kill themself; they simply let themself die.
Moreover, CS can legally be stopped, while VSED cannot. You can interfere with CS by taking an object or forcing someone away from an immediate threat to their life, and the law will be on your side. But you cannot interfere with VSED, because force-feeding someone against their will is battery at law. Money Quote: “...there is no right to commit CS. However, competent individuals have a right to undertake VSED, which is grounded in bodily integrity. There is no legal basis for overruling a competent person’s decision to die by VSED, as this would involve forced administration of artificial nutrition and hydration, which a competent person can refuse.” And while VSED was designed to route around PAS restrictions in jurisdictions without Dying With Dignity supports (since the physician is merely providing end-of-life palliative care and not actively hastening the patient’s death), VSED does not require physician approval - only patient competence, which has operationalized definitions I know how to meet. Don’t panic, be calm, don’t overexplain, be resolute and demonstrate unwavering commitment, etc.
I know this is getting long, but I’m trying to explain this concept so that it doesn’t blindside people if it becomes my Plan A. Right now, it’s Plan B - Plan A is working with Trilogy Inc to meet my unmet developmental needs. I’ve told them straight-up that I’ve been trying for forty years to meet these unmet needs, and I’m done doing it the world’s way - where I just keep working and hope that Maybe One Day some kind soul will take pity, see my need, and fill my need. Maybe One Day hasn’t paid off enough, and I’m tired of being pumped for productivity while my needs continue to go unmet. I’ve had my needs deprioritized and sidelined for so long, and I’m saying no more: Developmental Needs Now, or VSED.
If the world won’t work the way I want, then that’s fine: I simply won’t work the way the world wants, so nobody gets what they want, The End. This outcome is both possible and acceptable. If the world wants to get anything out of me from this point forward, then my needs need to be met first. If that doesn’t happen, then fine: no terrorism, no lashing out, no behavioral outburst of any kind. I’ll just say my goodbyes and walk away slowly.
We are working on Developmental Needs Now. But this may break down, it may be too little too late, there may be a roadblock I can’t tolerate or an obstacle I can’t route around. In that case, I’m simply falling back on VSED, because my developmental needs are just so important to me that I would honestly rather fold than continue to throw chips I don’t have into this shit pot. I’m not starting another 3-5yr crash & burn cycle, that feels undignified to me and I’m not willing to do it. I’m also not willing to pursue mood-altering medication, because I’ve been burned by them before with nothing to show for it (when I was a kid, one med permanently disabled an important component of my already-hobbled mental health maintenance strategy - I’m not taking that risk again, and nobody can make me). Any stubborn doofuses who try to say, “Well you’re not gonna get those needs met, so you need to find another way, now try some drugs and get back to work,” is only going to be answered with, “No, I don’t need to, and I’m not going to. We tried it that way, it didn’t work, so now we do it my way or I leave.”
That’s the Bottom Line in all this: Developmental Needs Now, or VSED. The world has had me for forty-two years on freeware trial, and if the world wants continued access to my skills then the world simply must meet my unmet needs, or the world just doesn’t get to have me around. No blame, no shame, I’m just asserting that I am neither a prisoner nor a slave, so I cannot be kept here against my will and I cannot be forced to work under conditions I find unacceptable (like a hunger strike). That may mean I don’t get to stick around either, but again, I’m fine with that. I have a price and the world can refuse to pay it; but I get to walk away if my price is not paid. Simple stuff. I’m at the point where I accept the possibility that I may die soon without ever having met my unmet needs. That is more acceptable to me, than continuing to work for the benefit of a world that refuses to meet my needs in turn. I’m not even angry any more, just disappointed. The End.
Final Note: You can say whatever you want, but I’m not arguing with anyone about whether my life is worth living or not, because I’m the only one who’s ever lived it and nobody else is qualified to make that call. I’ve said my piece and I don’t need to convince anyone of my rights in order to exercise them. Nobody gets veto power over this decision, and nobody can take POA while I’m able to demonstrate competence (which is under my control). I’ve also notified local law enforcement that I am in the middle of an end-of-life decision and I anticipate “vexatious and unnecessary wellness calls.” Of course, I also know they have to do their jobs, which I’ll make easy for them by sticking to my script: I’m calm, there’s no emergency, this is a private medical decision and I’m sorry you’re being involved in this family dispute but I’m good. This is not about making demands, this is about giving folks advance warning of what may be coming, so they have some time to get used to the idea before any hypothetical goodbyes are upon us. I’ve been thinking about this for weeks, I mentioned it last week at my Trilogy intake, it’s on the books and everything; but it’s new info to lots of folks (even the Trilogy staff didn’t know about it, I had to explain), so I’m letting people think about it while the pressure’s still off and I still have a Plan A (i.e. Developmental Needs Now with Trilogy). Hopefully this is all just one big false alarm, an unnecessary precaution, but it’s up to Plan B now so I’m doing my due diligence. Again, no demands; just trying to communicate how serious I am about this. Thanks for reading.
