Suicide Ideation and Life-Threatening Illness

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A post on The Mighty took exception to a "Dear Abby" letter by a person who was diagnosed with cancer and feeling suicidal.

The person who writes the letter to Dear Abby states:

I am inclined to say nothing until it’s too late, but I fear this decision will cause them as much pain as if I had died by my own hand. I don’t want to be here, and I don’t think I should have to be simply because others expect it. I don’t have a close relationship with my family anyway, if that has any bearing. We speak infrequently at best. Your thoughts, please?

Dear Abby's response:

DEAR DONE: I am sorry for your despair. You say your only question is whether to tell your family about your diagnosis because of the pain it may cause them, although you are not close and communicate infrequently. If you have truly made up your mind to refuse treatment, I vote for not informing them, which could be construed as trying to put them on a guilt trip. Everyone has a right to make this highly personal decision for themselves, but I hope you will remain in touch with your doctor, which may lessen any physical or psychological suffering you experience during the course of your disease.

The trouble is, the situation is not cut and dry. As to not telling one's family that one is feeling suicidal, my relationship with most of my family is problematic at best. I'm probably not going to tell them how I'm feeling at all, let alone if I'm feeling suicidal.

Second, I experience a high degree of suicide ideation a fair amount of the time but a low level of planning. If someone tried to shoehorn me into going to the E.R. every time I had a suicidal thought, I'd have to live there. 

As someone who used to work in long-term care, I do happen to agree that a person's decision to receive or not receive treatment for a life-threatening illness is that person's alone in the long run. No-one has the right to force someone to get treatment. As someone who has multiple chronic conditions, if I were ever to end up with cancer or another life-threatening illness, I'm not sure I'd want treatment for it. I'm kind of tired of being a pin cushion as it is.

Since this person was diagnosed with cancer, I feel that the best advice that "Dear Abby" could have given was to advise them to speak to a counselor who works with patients with life-threatening illnesses.  Such a person would be a much better resource for the patient's needs than an advice columnist.

I do agree with the author of The Mighty's post that "guilt trip" is a terrible choice of words.

Myself, I don't tend to put too much stock in Dear Abby's advice.

~Cie~