I was doom-scrolling MAiD proposals — Canada's expanded eligibility debates — when something landed: I am not suicidal anymore. Not a Hallmark epiphany. A flat, quiet huh. And the silence where that low-grade hum used to live was so unfamiliar it took a moment to name.
This essay proceeds from that silence. It is not a recovery narrative. It is a political argument about decisional capacity as the only legitimate gate for Medical Aid in Dying eligibility — argued from a position of stability, not suffering. The claim is simple: if my life is mine when I am happy and choosing, it was mine when I was finished and done. The state's discomfort with that conclusion does not constitute a counterargument. Capacity equals sovereignty. The rest is noise.
· · ·For years — the better part of two decades — there was a sound. Not audible. More like the physical register of a refrigerator compressor: present so constantly that you stop hearing it, and only notice it when it stops. Mine was the low, continuous frequency of done-ness. The background knowledge that exit was on the table. Always. Even during genuinely good stretches: cuddling the dog, watching the farm do what farms do, grinding out another book, running through the standard-issue Reasons to Stick Around. The hum was still there. I'd tuned to it the way you tune to traffic noise.
Then it wasn't.
I noticed because I was reading about Canada's Track 2 MAiD provisions — the non-terminal eligibility pathway, where the numbers climbed to 732 provisions in 2024, where 61.5% of recipients report disability as a primary driver — and I thought, idly and without drama: I actually wouldn't do that. Not "I can't." Not "I shouldn't." Not the guilt-trip reflexes that were installed in a psych ward when I was eighteen. Just: wouldn't. Choice, native and quiet. The option still present. The desire simply gone.
I sat with it for a long time, suspicious of myself. The self-suspicion is trained in too — years of being told that my judgment about my own interior states was not to be trusted, that the fact I thought I was fine was itself evidence I wasn't. Eventually I laughed. Ugly, genuine, a little undignified. Then something that might be called gratitude arrived: not for being saved, not for the intervention, but for the specific unexpected gift of a morning where I wasn't quietly wrestling with existence before the coffee finished brewing.
And then — right on the heels of that warm fuzzy — the political reflex, crisp as ever: this doesn't change anything. My life was mine when I was done. It is mine now that I'm not. The logic doesn't move with the mood.
Arguments for exit rights made from within crisis are epistemically suspect — not because they're wrong, but because they're impossible to cleanly separate from the state that generated them. The person in acute agony advocating for their own death can always be told their judgment is distorted, their preferences are symptoms, their desire for exit is a thing to be treated rather than heard. This is the rhetorical trap the protectionist system relies on: any statement of preference becomes evidence of incapacity.
Arguing from stability closes that trap. I am not rationalizing a plan. I have no plan. I'm in what an assessor would call a non-distorted state. I have a formed, persistent, reflectively endorsed position: competent adults with genuine decisional capacity should be permitted to choose death. I hold that position on a Tuesday when everything's fine, when the farm smells good and the conversations with my sister are gold and the work is meaningful. The argument does not require me to be suffering. It requires me to be honest.
That's the only credential I've ever claimed.
· · ·250 amitriptyline. Two boxes of Benadryl. Some Percocet. Most of a bottle of Stoli. Whatever else was rattling around in the medicine cabinet that looked useful. I dumped it into a mixing bowl and ate it like f***ing Cap'n Crunch, washed it down with the vodka and milk. I love milk. No tears. No ambivalence I can locate in retrospect. Just the flat, quiet sense of arriving at the end of something that had been going on too long.
There was no drama in it. That matters. The popular narrative of suicide requires spectacle — performance of suffering, final communications, a crisis arc with recognizable beats. Mine had none. It was administrative. A task I had decided to complete, and then completed, with the same internal register as doing the dishes.
They coded me. I was, by all clinical definitions, dead. What was present in that interval is difficult to report without sounding like a Netflix pitch. It wasn't religious. There was no tunnel, no light, no parade of deceased relatives. There was an overwhelming quality of home — the specific sensation of having returned somewhere, of a long and exhausting trip finally, mercifully over. Peace is too small a word. Peace implies the previous absence of disturbance. This was more total than that. This was the absence of the question.
Then the universe ran in reverse. The specific sickening knowledge — before my eyes opened, before I could name it — that I was being brought back. I hated it immediately and completely. Not the pain. There wasn't much pain. The violation. The unauthorized reversal of a decision I had made.
Psych ward. Three days. Institutional kindness performed in an institutional key — the specific variety of care that is mostly about ensuring the paperwork survives a lawsuit. They convened the people who loved me and made me apologize to each of them, watch them cry, absorb the damage my choice had done to people I cared about. I said the script: life is hard, I was sad, I'm sorry, you're enough.
The last part was even true. They were enough — are enough, still. That's the piece the response never makes room for: the choice wasn't a verdict on them. It wasn't a referendum on whether love is real or whether the people around me had failed. I knew they hadn't. I was simply done. Those can coexist. The system cannot tolerate that coexistence, so it pretends the apology corrects the logic. It doesn't. It just silences it temporarily.
Then they discharged me with a fresh prescription for the exact same amitriptyline that almost did the job.
Read that again. Revive me. Extract a promise. Hand me the reload.
This is not a system oriented toward outcomes. It is a system oriented toward clean paperwork and dischargeable patients. The promise I made was extracted under the specific duress of watching people I love cry — relational coercion, perfectly effective, ethically indistinguishable from leverage. I honored it. Still am. But I never agreed it was right.
· · ·For years after, I was here on someone else's terms. Not because I had converted to the view that my presence was obligatory, not because the psych ward's arguments had landed — they hadn't — but because I had made a promise to specific people I loved and I was not going to break it. This is a distinction the protectionist model cannot accommodate: I was alive not because I had been corrected, but because I had been obligated. These are not the same thing, and conflating them is precisely how the system flatters itself into thinking it works.
Living on borrowed consent is its own particular weather. You inhabit the days. You do the things. You find genuine pockets of interest — the farm, the work, the conversations — while carrying in the background the knowledge that you're here on a pinky-swear and not because you've resolved the underlying question. It's not unlivable. It's not even, most of the time, actively miserable. It's more like being a long-term guest in a house you didn't choose, making the best of the amenities.
I wrote two books during this period, both of which were attempts to get underneath the problem. The Serpent's Sentence was about language — specifically, how the linguistic construction of a narrating self creates an exile from immediate experience. The "I" that speaks is always slightly after the moment, a grammatical artifact that describes experience rather than inhabiting it, and the chronic sensation of being outside one's own life, watching it through glass, may not be a symptom of pathology. It may be a structural consequence of the way language builds consciousness.
The Mathematics of Connection came from somewhere more specific. Sam went to prison. The question it forced — more urgently, more nakedly than anything I'd theorized about — was whether genuine connection persists when all normal channels fail. Whether the link between two people is a function of the medium, or something prior to medium. Either the connection is real and substrate-independent, or it isn't and everything is just medium.
Eight months ago, approximately, the hum stopped. I did not notice in real time. I noticed retroactively, when I went looking for it and found crickets.
· · ·The dominant MAiD frameworks predicate eligibility on suffering: unbearable, irremediable, demonstrable suffering. The intuition behind this is legible. We want to limit exit rights to people who are genuinely in extremis. But the suffering criterion fails in at least three directions.
First: suffering is not the same as impaired capacity. A person in profound pain may retain perfect decisional capacity while a person experiencing minimal subjective suffering may have thoroughly compromised capacity due to acute psychosis. The two dimensions are independent. Using one to gate the other is a category error.
Second: the suffering criterion encodes a paternalistic judgment about which reasons for exit are acceptable. It says: you must be broken enough, in a legible enough way, before we will countenance your decision. A person who has lived eighty years, completed everything they came to complete, and simply does not wish to continue — without unbearable pain, without terminal illness — has an equally valid claim.
Third: "unbearable" is not a clinical measurement. It's a self-report. We accept the self-report in terminal cases because the physical substrate corroborates it. For psychiatric or existential cases, we treat the self-report with suspicion because the substrate is interior and invisible. This asymmetry is not principled. It is a bias toward the legible.
Suffering is a proxy for something we actually care about: genuine autonomous preference. Capacity is the direct measure. Prefer the direct measure.
· · ·The most substantive objection to capacity-based exit rights is the external pressures concern. If we permit MAiD for anyone with intact capacity, we will effectively permit it for people who are choosing death because of poverty, isolation, inadequate housing, or the internalized sense that they are a burden. We will call it autonomy while executing people for being poor.
This is not a stupid argument. It deserves a straight answer.
The correct response to a capacitated person choosing death because poverty makes their life intolerable is not to deny them the choice. It is to stop making people poor. The external pressure objection is most powerful not as a reason to restrict exit rights but as a reason to deliver what we've been promising: housing, income, care, the basic material infrastructure of a livable life.
Here is the political argument that paternalists are trying not to see: a genuine right to exit creates an obligation to make staying worth it.
Canada's numbers already show this mechanism in early form. Track 2 recipients cite housing instability, inadequate disability supports, and social isolation as primary drivers. If the state must record, on official death documentation, that a citizen chose MAiD because they had no housing and no supports — that is a different kind of public record than a death certificate reading "complications of chronic illness." The specificity is politically actionable. It names the failure. It creates a constituency with standing.
The door must open, or the room must improve. This framework insists on both. Dignity in staying, or dignity in leaving. You don't get to deliver neither and call it compassion.· · ·
The objection I find most emotionally resonant, even when I think it's philosophically weak, is the regret argument: what if I had been permitted to exit at eighteen, and I would have been happy at thirty-eight? Doesn't that possibility justify forced continuation?
My answer: yes. And?
I might have made a mistake. The decision, made at eighteen with genuine capacity, might have foreclosed a future that was worth having. This is also true of every irreversible decision any person makes under any framework of autonomy. The person who declines a medical treatment and dies from a treatable condition might have been happy if they'd complied. We do not, as a general principle, use the possibility of regret-that-cannot-be-experienced as grounds for overriding present autonomous choice.
The regret argument is a special pleading reserved for exit decisions because we find them morally and aesthetically disturbing. The disturbance is real. It is not a principle. My mistake to make — if it would have been a mistake — is mine. That's what ownership means.
I stayed for years because people I love asked me to. I'm glad I did. That gladness does not retroactively make the coercion correct. It just means the outcome was good. Good outcomes don't justify any method of achieving them. We know this. We believe it about everything else.
· · ·I don't want to die. That is genuinely, weirdly, wonderfully new. I am here by choice. I am choosing to keep being here. Every day that I do is a voluntary act, and that voluntariness is the only thing that gives it any moral weight whatsoever.
The world does not own my exit because it is uncomfortable watching me leave. Some people get done. If they are lucid — if they have demonstrated stable, informed, persistent preference, if they understand the stakes and have weighed the alternatives and arrived at their answer with clear eyes — let them go.
Not because death is better than life. Not because pain automatically qualifies anyone. Not because suffering is sufficient. Because capacity equals sovereignty. Because the only condition under which presence means anything is the condition under which it is genuinely chosen. And the only condition under which it can be genuinely chosen is the condition under which not-choosing it was also available.
Bar the exit and you don't save a life. You take ownership of one.
Unlock it, and everyone who stays does so as an act of will. That's the only version of a life that has moral weight. That's the only version worth anything.
Replace sanctity-of-life dogma with the sovereignty of the living. Make the room worth staying in. And if you won't — if the room is genuinely uninhabitable and you won't fix it — then at minimum have the decency to unlock the door.
My argument does not need me to be miserable to be true. It just needs to be honest.
It is.