There are lots and lots of sound, solid arguments against the implementation of assisted dying. There is the historic fact that everywhere that door has been cracked open, it soon swings wide open. There is the pressure it will inevitably put on the disabled and elderly to terminate their lives. There are the, frankly, deeply troubling arguments that are essentially utilitarian and, quite frankly, neo-liberal market arguments about the value of life being determined by economic usefulness (and if you think I am overstating that for effect, I refer you to this absolute horror article by Matthew Parris from 10 years ago and this similarly unpleasant but more recent one). When we are making arguments about terminating life based on questions of financial viability, I can’t help but think we’ve misunderstood the question.

But there are a few related arguments that cut quite home for me. As many of you will know, I suffer from quite serious depressive illness. I have made more than one serious attempt on my own life and actively planned many more. Fortunately, I am alive today because I was not very effective at killing myself on my own and I now have some helpful medication that keeps me broadly on a level. The threat of assisted dying has some serious and real implications for people like me.

At the more vanilla, though by no means pleasant, end of the matter is simply the fact that the introduction of assisted dying makes it far more likely that depressive suicide will be greeted with a collective shrug. If we are enshrining in law not only the right to terminate your own life but to have help to do so from someone else, the inevitable proliferation of elderly and disabled people killing themselves with help will make it all the more likely that suicide among the mentally ill will have minimal impact. If we are comfortable with people killing themselves we are comfortable with people killing themselves. Those who kill themselves under an assisted dying law – cheered on by a society blind to its own inconsistencies – make anyone else who kills themselves seemingly much less tragic.

Of course, if we are comfortable with people killing themselves, even encouraging some to do so, it will be hard to view as tragic those who do so as they struggle with mental illness. As we consider it less tragic, we may well find ourselves caring less about intervening with mental health services to avert it. If we follow the reasoning of Matthew Parris, the mentally ill are useless to society and, therefore, not worth saving. Not only is the cost of keeping them alive on benefits not worth it on such thinking, the broader cost of mental health interventions will similarly not be worth it. Just as some trumpeted abortion as health care because it is cheaper than paying out benefits and providing high level children’s and family services, so it won’t be long before we twig that the cheapest solution to mental health problems is to not bother intervening and then trumpet assisted dying as a form of health care too.

On a more personal note, I am alive today because I was not very competent in trying to kill myself. I am quite confident that if assisted dying were legalised and someone was willing to help, I would have been much more effective. If that someone is a doctor, it is nigh on guaranteed. If the grounds for assisted dying is the desire of the individual to die, and their willingness to be put out of their misery, it is hard to imagine anything other than a queue of severely ill, mentally tormented people not lining up to take advantage of the provisions. We should be at least a bit troubled by the prospect of doctors being less concerned about how we might treat one’s suicidal ideation so much as proposing how they can help their patients most effectively carry it out!

It can’t escape anybody’s notice that one of the more effective arguments against almost anything at the moment is a potential threat of suicide. It is particularly big in the arguments of trans activists, who insist anything less than full acceptance of one’s self-identification complete with hormone treatments and surgeries to align the body with one’s mind will mean children will kill themselves. It is similarly utilised by those keen on dealing with conversion therapy, arguing anything less than full affirmation and encouragement of one’s beliefs and practices will inevitably end in suicide. It periodically crops up elsewhere. What nobody seems to acknowledge is that these arguments are entirely neutered if we enshrine in law the belief that helping someone to kill themselves is not only acceptable, but actively good. There is an inconsistency in lamenting the potential death of those who will kill themselves because of their bodies whilst encouraging and enabling it for others on the same basis. Suicide is either lamentable or it is not.

My point here is not that the suicide of trans people nor those who have mental anguish from abusive practices performed on them is okay. Quite the opposite. My point is that both the arguments for and against it only hold water if suicide is to be lamented. I question whether there is a necessary correlation between so-called conversion therapy and suicide as well as any given link between refusing to offer hormone blockers and surgery with trans suicide. In the latter case in particular, evidence points to most with gender dysphoria growing out of it in time and there is a growing body of evidence to suggest surgery and hormone blockers induce suicidal ideation in the many who come to regret their choices. However, the point is this: whether trans activities and anti-conversion therapy folk or those who are convinced other interventions would be more beneficial, all agree that suicide is lamentable and we ought to want to help people who might consider it or be pushed toward it. We may disagree over what might cause that and how people ought to be helped, but we all agree suicide is not a desirable outcome but one to be avoided even at great cost. We cannot argue thusly and then, out of the other side of our mouths, argue favourably for assisted suicide.

The point is that suicide is either to be lamented or it is not. If it is not, then assisted dying may well be legitimate but there can be no credit in arguing that trans people will commit suicide if they are not given the medical interventions they seek. Indeed, their death should be welcomed as the Darwinian removal of those who have been dealt a poor but ultimately economically detrimental hand. Of course, if that seems callous (and I should hope it does), and even those unconvinced of trans ideology should find that attitude beyond cold and uncaring, it is because suicide is lamentable and we do not consider a Darwinian approach to society to be particularly kindly or legitimate. But if we object to the case when discussing a trans person, or even someone tormented by abusive conversion practices, why should we not be so moved when it is an elderly, disabled or otherwise mentally ill person?

If we think suicide is to be avoided, assisted dying (for which read, assisted suicide) must be too. It ought not to matter who the person being helped to commit suicide is, nor should their economic output and societal benefit – such as we can meaningfully judge these things ourselves at any rate – if suicide is lamentable, then it is lamentable. Why would we enshrine in law – and open the inevitable floodgates – to something we consider a source of great sadness and something to lament? Why would we want to pile pressure upon those who on a brighter day might think otherwise? If assisted dying comes into force, I fear that many mentally ill people – who might one day come to be grateful that they hadn’t ended their lives – will be all the more likely to do so. If that isn’t lamentable, then I don’t know what is.