the giver euthanasia essay

• My Preferences
• My Reading List
• Literature Notes
• A Note about Infanticide and Euthanasia
• Book Summary
• About The Giver
• Character List
• Summary and Analysis
• Chapters 1-2
• Chapters 3-5
• Chapters 6-8
• Chapters 9-10
• Chapters 11-12
• Chapters 13-15
• Chapters 16-17
• Chapters 18-20
• Chapters 21-23
• Lois Lowry Biography
• Critical Essays
• Major Themes in The Giver
• Style and Language in The Giver
• What Are Utopias and Dystopias?
• Full Glossary for The Giver
• Essay Questions
• Cite this Literature Note

Critical Essays A Note about Infanticide and Euthanasia

When Jonas views the release of an infant on The Giver's video screen, he realizes for the first time that "release" means death, or, in this case, infanticide. Release for elderly people or for people who have broken the rules three times also means death, or euthanasia.

Infanticide is the killing of a newborn child. In the past, the main reason for infanticide was due to food shortages among primitive cultures. In most countries today, infanticide is considered a form of murder.

Euthanasia is the method of ending the life of a person who is suffering from incurable pain or disease. Euthanasia can be voluntary, meaning that the person has requested his or her own death, or involuntary, meaning that the person has not explicitly requested death. Euthanasia can also be active or passive. Active euthanasia involves taking deliberate action, such as giving drugs, to cause death. Passive euthanasia takes place when someone is allowed to die by withdrawing life-sustaining treatment.

The ideas of infanticide and euthanasia are not new. In ancient Greece, Plutarch wrote that infanticide was a common practice in Sparta to rid the city of children who "lacked health and vigor." Aristotle, Socrates, and Plato all favored euthanasia but only under certain conditions. As organized religion flourished, euthanasia became morally and ethically condemned by religions such as Christianity, Judaism, and Islam, all of which consider human life to be sacred.

Euthanasia is an extremely controversial subject, and it is easy to imagine how the power to euthanize can get out of hand. In Jonas' community, such power is abused. Anyone who is different, who does not follow the rules, or who is no longer useful to the community is killed. The people in charge, including Nurturers — like Jonas' father — and the Director of the House of the Old, are simply following rules set forth in the Book of Rules, which was established to maintain the safety and security of the community. Like The Giver says about Jonas' father, who kills an infant in Chapter 19, "It's what he was told to do, and he knows nothing else." The irony of killing people who are different in order to maintain Sameness reinforces Lowry's theme that people must be aware of and care about other people.

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• Euthanasia,
• Medical ethics

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The Giver: Euthanasia and Euphemisim

Euthanasia refers to the intentional act of ending the life of a seriously ill person to alleviate their suffering. It can be categorized into various types, including voluntary, non-voluntary, involuntary, active, and passive euthanasia. Voluntary euthanasia occurs when an individual clearly expresses their wish to die and seeks help from someone else. Non-voluntary euthanasia involves situations where the person is unable to make decisions or communicate their desires.

Involuntary euthanasia is the act of ending someone’s life against their will, even if they want to continue living. Although it can be seen as murder, there are exceptions in certain circumstances. For example, imagine a situation where an individual is trapped on the 8th floor of a burning building. Their clothes are on fire and there is no hope of rescue. In extreme distress, the person cries out for help and a passerby who happens to be carrying a gun decides to shoot them. The shooter understands that the victim’s burns will cause unbearable suffering until death and believes that shooting them will provide relief from this agonizing ordeal.

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Active euthanasia, also known as intentional patient death caused by medical professionals or another individual, differs from passive euthanasia. Passive euthanasia refers to the act of medical professionals ceasing necessary care for a patient or discontinuing interventions that sustain the patient’s life, such as disabling life-support machines or removing a feeding tube. In The Giver, a comparable concept to euthanasia is depicted using alternative terminology.

The society in which Jonas lived referred to euthanasia as “release”. Euthanasia was divided into two categories: voluntary and non-voluntary. Voluntary euthanasia occurred when Rosemary, who was the daughter of The Giver and a trainee Receiver, asked to be released because she could not continue her training as the new Giver. Non-voluntary euthanasia happened when Jonas’s father gave a lethal injection to a baby from the Nurturing Center directly into their forehead. The celebration of “release” played a significant role in Jonas’s community and served as a way to eliminate individuals who were considered non-functional according to community rules. It is important to note that only those involved in carrying out the “release” knew the true nature of this ceremony and its specific procedures.

There is controversy surrounding euthanasia in society, as some believe that terminally ill individuals should have the right to choose when to end their suffering based on bodily autonomy. Additionally, supporters argue that it is ethically acceptable to terminate the life of those who are experiencing extreme pain and are unable to make decisions.

Opinions on euthanasia differ, with some individuals believing that the decision of when someone should die should be left to God. While it is not universally allowed, there are countries and states where euthanasia is legal. The ethical dilemmas surrounding euthanasia highlight the different views on the value of human life. Personally, I support banning euthanasia because it could potentially be used as a disguise for murder.

While I personally agree with the idea, I think it is acceptable for a patient to provide consent to a doctor’s aid in terminating their life. The use of euphemisms involves replacing an expression that may be offensive or convey something unpleasant to the listener with a more pleasant or less offensive expression. Euphemisms can also serve the purpose of creating a lighter tone or deceiving. When used as a euphemism, a phrase often takes on metaphorical meaning, disregarding its literal interpretation.

Euphemisms can be employed to conceal unpalatable or unsettling ideas, even when the literal term is not inherently offensive. This form of euphemism is commonly utilized in public relations and politics, often referred to as doublespeak. Politeness is occasionally associated with the use of euphemisms. Additionally, there exist superstitious euphemisms, which stem from the belief that certain words have the ability to bring about misfortune. Furthermore, religious euphemisms are founded on the notion that certain words hold sacred significance or possess spiritual risks.

The Giver depicts a society characterized by meticulous control, where all aspects are carefully manipulated to uphold order and precision. The citizens’ behavior is strictly governed by regulations, particularly emphasizing the precise use of language. Language plays a pivotal role in this society’s pursuit of perfection. It is important to acknowledge that the term “release” serves as a euphemism for the act of carrying out killings.

Release in Jonas’s community is often associated with concepts of freedom, looseness, being unleashed, and unattached. However, the precise rituals connected to this ceremony were concealed and known only by those responsible for conducting them. The inhabitants of this society remained oblivious to the fact that release represented their own demise; instead, they perceived it as a joyous event and a significant transition in life, particularly for older individuals. This viewpoint was primarily influenced by the deeply ingrained societal beliefs.

Euphemisms play various roles in our society, serving as a source of entertainment, inflicting pain, showing disrespect, conveying hidden meanings, and addressing the topic of death. When it comes to communicating the loss of a loved one, there are challenging situations where individuals often turn to euphemisms to convey this sad news. Instead of directly stating that someone has died, alternative phrases like “passed away,” “been called home,” “departed,” or “returned to the ground” may be used. These expressions aim to soften the impact and reduce the harshness associated with making such an announcement.

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Welcome to the LitCharts study guide on Lois Lowry's The Giver . Created by the original team behind SparkNotes, LitCharts are the world's best literature guides.

The Giver: Introduction

The giver: plot summary, the giver: detailed summary & analysis, the giver: themes, the giver: quotes, the giver: characters, the giver: symbols, the giver: theme wheel, brief biography of lois lowry.

Historical Context of The Giver

Other books related to the giver.

• Full Title: The Giver
• When Written: Early 1990s
• Where Written: Maine
• When Published: April 16, 1993
• Literary Period: Contemporary
• Genre: Dystopian novel
• Setting: A managed community in a futuristic society. The community is cut off from the outside world, which is referred to as "elsewhere."
• Climax: Jonas learns that when his father "releases" newchildren, he actually kills them. Jonas decides to leave the community.
• Antagonist: Jonas's community and its system of Sameness
• Point of View: Third-person limited, through Jonas's eyes

Extra Credit for The Giver

Awards: The Giver won the 1994 Newbery Medal, considered the most prestigious award for children's literature.

Banned Book: Although The Giver tops countless school reading lists, it has also been banned by some schools, which claim that some of the material, like euthanasia and suicide, is inappropriate for children.

One of Three: Lowry has written two more books set in the world of The Giver and including some of the characters from The Giver . The three books together are often described as a "loose trilogy." The second book in the series is Gathering Blue and was published in 2000. The third, The Messenger , was published in 2004.

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The Giver: Euthanasia And Moral Standards

• Category Literature
• Subcategory Book
• Topic The Giver

Euthanasia is it really what Jonas’s community practices. Euthanasia is the practice of ending someone’s life when he/she are very sick, when there is really no foreseeable chance of survival, and they are undergoing excruciating physical or psychological/emotional pain. It is done out of a deep sense of humanity, of empathy for the other’s misery, in order to ease their unbearable suffering. However, is that really what the community Lois Lowry created carries out? I personally think Jonas’ community does not practice euthanasia but a form of very cruel eugenics, which is the practice of ending someone’s life because they have a defect or are just simply different from everybody else or because they are old and have become a burden for society because they are no longer productive. In the community, this “euthanasia” is applied to very old citizens even though they are not at all in a terminal state. It is also carried out on newborn children and, as the novel shows, not necessarily because they are unhealthy or have any type of illness or problem but because they do different things or are different from the rest. Jonas’s father “euthanized” one of two newly born twin babies just because the community had forbid the existence of two people genetically identical (which seems, on the other hand a paradoxical rule in a world shaped by Sameness, that had banned colors and music and emotions for the sake of limiting the negative effects of individuality). The criterion to choose which baby should be put to sleep was that of a very drastic and pseudoscientific eugenics: the baby was 50 ounces lighter than his twin was. The same can be said of the final decision to give Gabriel the killing jab: he was not sleeping well (and it was wrongly assumed that this had something to do with a defective development when in fact the toddler was just missing his new acquired family). Crude, even almost random or whimsical eugenics. Even Rosemary’s voluntary decision to ask for release cannot be compared at all with our concept of euthanasia. Rosemary’s request was accepted by the elders because it was understood that she was psychologically unstable. She was, thus, no longer fully functional to the community and nothing was done to try to help her overcome her distress or to discourage her to ask for her release.

Moral standards and qualms about ending a person’s life are completely different in our society. Here even euthanasia in its stricter sense, the way he have defined it above is illegal in most countries, because there is a sort of sacred halo attached to life itself, to the preservation of life at all costs that has its roots in the traditional religious worldviews that have shaped morality so far. Things are changing, because our modern secular world has become to value more the avoiding of unnecessary pain than life itself. That is why some doctors do carry it out even though it is illegal in their country, risking charges for manslaughter or even murder. Euthanasia can be done in many different ways for many reasons, intentional killing, by act or omission.

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If you think about it, what the community practiced was a very cruel form of eugenics, very much like the one the Nazis practiced during their 12 years of totalitarian racist regime in Germany and other parts of Europe. In the name of eugenics (a word that comes from the Greek, meaning better (eu) gens (genics)) they tried to create a genetically improved society by exterminating all kinds of individuals they thought were genetically defective: Jews, Gypsies, Slavs, Blacks, because they belonged to genetically inferior races; retarded people, people born with hereditary diseases, homosexuals (another kind of genetically defective flaw) and, of course, communists and other kinds of political opponents who have shown to be inferior for refusing to acknowledge the righteousness of the eugenic Reich.

In The Giver, just as in the Nazi Reich, eugenics is euphemistically called something else so that nobody thinks of it as what it really is, so that not a chance is given for anyone to develop a sense of guilt. In the Reich, it was the “final solution”, here is “release” and the horrible practice has been made an event to celebrate. As people have their emotions dulled by the daily intake of some sort of pill, they do not have the empathy to feel what they are doing is wrong. Going back on what I said about eugenics being practiced on newborn babies: how can a normal person not naturally feel that being the lightest of two twins or having trouble to sleep at night, but otherwise being perfectly healthy can never be a reason to give a baby a lethal injection. The Giver describes a very unsettling dystopian totalitarian society, a sort of combination of the worst of communist totalitarianism (individual differences merge into a grey mediocre Sameness, the economy is completely controlled by the political authorities, social roles are assigned by the Elders) and the worst Nazi totalitarianism (the state puts itself the service of a carefully designed survival of the fittest policy) with very hard repressive measures, as in both historical cases, for those who break the rules (the Pilot at the beginning of the novel risked being released; for Jonas it would have been his unescapable fate had he been caught).

To conclude, I think we should not be looking at the Giver as an example or an inspiration to reflect about what euthanasia should be in our society but to look at it as a way to understand how far can it go if we do not put strong ethical limits. My personal opinion of euthanasia is that it should not become completely legal, but should be carried out in very extreme situations, when the person is unbearably suffering and can no longer hold the pain. Any doctor or any person that is not the one suffering should not decide it. I think it is very important that the operation should be carried out only if and when the person wants it to be, just like Rosemary did.         

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Home — Essay Samples — Literature — The Giver — The Use of Euphemism in “The Giver”

The Use of Euphemism in "The Giver"

• Categories: Dystopia The Giver

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Published: Mar 20, 2024

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The concept of "release", the suppression of emotions, the illusion of sameness.

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When My Sister Told Me She Wanted to Die

I accepted it as her right. it took me years more to realize something deeper about how we view human euthanasia..

My sister Theda had been bedridden for seven years when she first decided she wanted to die. She was 32 then, and a mysterious chronic illness had diminished her will to live. Though it wasn’t legal in Australia at the time, she wanted to die by euthanasia. Technically, this would classify the death she wished for as a suicide. But ethically—and within the family—we understood it differently.

Theda was 24 when her symptoms began. The fatigue came on first. A few years later, she developed chronic nerve pain, light and sound sensitivity, and multiple food intolerances. Our mother cared for her at home, and Theda only left the house for medical appointments. She lost any semblance of a social life, and eventually, she could no longer read, watch TV, or use a computer without getting migraines. Conversing with her became difficult because she couldn’t concentrate enough to construct sentences. Her suffering was physical, but it was also social—it affected our family and community. Nothing helped. The only change, despite so much effort, was that it got worse.

I was backpacking around India when she initially broached the topic of euthanasia. My mom had called to explain the situation, and I talked to Theda the next day from a public phone on a dirt path atop a cliff overlooking the coast. I remember some backpackers haggling with a street vendor nearby, and feeling anxious because I wasn’t sure what I would say. Her voice came wispy and weak over a crackling connection, but it was clear enough. At first, I did most of the talking. I spoke of India and made some jokes about backpacking culture. Then she told me how things were at home. She had almost run out of treatment options. Her doctors were scratching their heads. One had diagnosed her with chronic fatigue syndrome and fibromyalgia. Others argued her problem was a mental illness with psychosomatic symptoms. Theda had chosen to follow the doctor claiming it was chronic fatigue. This doctor’s treatments were slowly bankrupting our family, and we hadn’t seen any improvements. Our father had checked out and moved away, so it was just Theda, Mom, and me.

“Khin,” she said. “I’ve read some chapters of a book about euthanasia, and it suggests asking your loved ones’ permission before you start making plans.”

This was in 2006. The book she was talking about was by Derek Humphry, a controversial figure who advocated for extending medically assisted dying to the chronically—not just terminally—ill. He offers an ethical framework and practical advice to those wishing to pursue a peaceful death, even when doing so may be illegal where they live.

I accepted my sister’s request over the phone that day. I realized as we were speaking that I couldn’t refuse her the right to die. Here I was exploring the world with a backpack and a healthy life while she’d been in bed for seven years. It was deeply troubling: Part of me resisted her wish, but another part knew that she’d proceed regardless without my blessing, which meant she’d potentially face a lonelier and more distressing death.

She assured me she wasn’t ready to give up living yet—she was just setting her ducks in a row. “Enjoy India,” she said. “I’ll see you when you get back.”

Theda didn’t follow through until six years later. In that time, her symptoms worsened. New doctors appeared, and with them came new treatments and cycles of hope and disappointment. Mom suffered two stress-related strokes, and my mental health declined. We tried mainstream medicine, and dipped into the outer reaches of alternative therapies. We got scammed by questionable people promising impossible cures. Mom lost all her retirement savings, and Theda began to experience regular psychotic breaks.

Then, in 2013, Theda found a website that sent euthanasia drugs internationally using a process called “hushmail.” For years she had followed the work of Philip Nitschke, whose organization Exit International helps people seek euthanasia in places where it’s illegal. She worried the drugs she saw online might not be real, but with advice from Nitschke’s website at her fingertips, she felt confident enough to proceed without getting scammed.

The drugs arrived in a nondescript cardboard box postmarked from Mexico. Inside were two vials of sodium pentobarbital—a clear liquid used in animal euthanasia and death row executions. She locked the vials in a petty cash box under her bed. “I’m not going to take it yet,” she told me. “It’s just comforting to know it’s there. I can go on longer knowing an escape hatch exists.” But she would use them soon enough. She took the drugs a few months later.

I had told Theda in no uncertain terms that I didn’t want her to die. My mother was hit hardest, but we both had to accept it. It’s only because of these things—our family’s embrace of Theda’s choice and the medical method she used to die—that our story is about euthanasia, not suicide. Euthanasia involves loved ones, dignity, and a peaceful method. Suicide usually is decided alone. It’s generally performed haphazardly, with uncertain and often traumatic results.

The complex ethics of euthanasia are tackled differently across the globe . Some of the most permissive assisted dying laws can be found in Belgium, the Netherlands, and Switzerland, which offer people with chronic nonterminal conditions—including mental illnesses—the right to die. These conditions can range from severe autoimmune diseases and nonterminal cancers to treatment-resistant forms of depression and schizophrenia. In Belgium and the Netherlands two doctors must deem a person’s suffering as incurable and intolerable, and they must also agree that the patient is mentally equipped to make such a request. In the United States, the debate is complicated by a lack of universal access to health care; experts point out that suffering from a chronic condition may be exacerbated or even caused by an inability to get treatment, making euthanasia a grim option. Currently, euthanasia is allowed in a small number of states , each of which has slightly different laws. In those states, only people with a terminal illness like ALS/Lou Gehrig’s disease or some forms of cancer may access the drugs, and in some cases, the patient must have been given a prognosis of having six months or less to live . This is, perhaps, the option that is easiest for the general public to get on board with: the right to dictate when one’s impending death will happen, and that it will proceed in a predictable manner.

Canada currently offers medically assisted deaths to people with terminal illnesses and chronic illnesses. The debate about whether that should extend to chronic mental illness has caused a stir. The current Canadian government has a plan to offer medically assisted death to mental illness patients on a case-by-case basis, but it hasn’t yet put it into action. A process for assessing these patients was originally slated to begin in March of this year, but it has recently been pushed back to 2027, after Canada’s next federal election.

My family tackled euthanasia from an especially troubling angle, one that falls far outside firm categories of illness. The question of whether Theda’s condition was mental or physical was constantly debated, and it initially weighed heavily on me when thinking about her right to die. Doctors who believed mental illness was at the core of her problem argued that her physical symptoms were psychosomatic. This is known as conversion disorder , where people experience physical and sensory problems because of psychological distress. Others who diagnosed her with physical conditions like chronic fatigue syndrome, fibromyalgia, and Lyme disease eschewed psychiatric explanations and treatments altogether. The tension between these two camps was never resolved. Even after her death and an autopsy, the nature of her illness remains uncertain.

That uncertainty highlights the way our culture ranks suffering in conversations about who “deserves” the right to die. We’re socialized to see some types of suffering with less sympathy. Wellcome Prize–winning neurologist Suzanne O’Sullivan discusses this prejudice in her 2016 book It’s All In Your Head, which focuses on psychosomatic illnesses. “I have come to realize that not all suffering is the same,” she writes. “It is not necessarily the greater suffering that receives the greatest consideration and sympathy. Illness is not scored in that way. Deadly disease obviously scores higher than others. After that there is an unofficial ranking system for illness in which psychiatric disorders are the out-and-out losers. Psychiatric disorders manifesting as physical disease are at the very bottom of that pile.”

This distinction between physical, psychological, and hybrid suffering didn’t matter much to Theda in the end. After 13 years of being unable to get out of bed, suffering was suffering. What we called it—or what her diagnosis was—was beside the point.

All of the diagnoses she was given, whether mental or physical, relied on clinical assessments. No blood tests or scan-based technologies were capable of definitively proving what was causing her sickness. For each possible diagnosis, a doctor would interview her about her symptoms, and she could only describe them. The symptoms she described were on lists for multiple diseases. Definitively proving any diagnosis was impossible, so she had to choose among those on offer, and then commit to a treatment plan.

Over the years, I tended to believe the doctors who attributed my sister’s condition to mental illness. I felt this way for a number of reasons, but I learned to keep my mouth shut about it because I soon realized that evoking mental illness upset her immensely. I started to think about why we stigmatize some diseases, especially those linked to mental health. Stigma affects a sick person’s life profoundly. It adds to their suffering. And it affects their family. Importantly, it can perpetuate their resistance to a diagnosis that involves the mind, keeping them from trying treatments that might help.

Part of the reason I believed Theda’s physical symptoms were connected to a deeper psychological issue was that she started to have regular psychotic breaks at the age of 26. Looking back, I see that these psychotic breaks could have been caused by her ongoing physical pain and social isolation—but psychiatrists often told us that it was the reverse. They believed her physical symptoms were “hallucinations” caused by an underlying psychiatric issue. I privately agreed with them, though I didn’t judge my sister for it as she feared some people might. “I’m not crazy!” she told me when mental illness causing physical symptoms came up once. She needn’t have worried, because I never saw her as crazy. I loved her and only wanted her to get better.

When she was psychotic, she talked to me a lot. I would be her confidant in the locked psychiatric wards in which she was sometimes committed. In these wards, she was stripped of her rights and unable to leave, so I would visit her daily. Her personality was completely transformed. Usually mild-mannered, polite, and cautious, she became melodramatic, forthright, and charismatic when a psychosis hit. She could be violent and irrational, too. We usually had to call the police to get her from my mother’s house to the hospital.

These breaks with reality came about once every nine months. She would barely recognize me as her brother during those times. She preferred to categorize people according to archetypes. I was often “the brother” or sometimes “Neo”; Mom and our father were “the mother” and “the father.” She even spoke about herself in the third person, as if commenting on a troubled twin with whom she occasionally shared a body. She’d also talk to people who weren’t there, babbling about gods and demons. It was during these times that I first heard her talk about our childhood traumas.

Theda and I grew up in a broken household with ethnic tensions. Dad was a Burmese refugee, and Mom was a working-class Englishwoman who couldn’t afford to get back to the Northern Hemisphere. Cut off from any extended family, one parent wanted us to identify as Asian, and the other as Western. Throughout adolescence, we were bullied for being dark-skinned in a predominantly white neighborhood. We lived in a suburb adjacent to where the Australian Nationalist Movement —Perth’s active white supremacy group—had set up its headquarters. We went through adolescence in a backwater part of the “ world’s most isolated city ” in the 1980s, and when I was 12, nearly half a million posters appeared around town stating that our “kind” were not welcome. Anti-Asian immigration had been the government policy in my country until just before Theda was born, so the bigotry in our city was still strong. Racism came at us from teachers, peers, and adults. It was implied in stories we read and the television we watched. That made for a tough and confusing childhood, leaving both Theda and me with a sense that something was intrinsically wrong with us. We internalized racism because we weren’t empowered with a language to describe what we were experiencing. We blamed ourselves. For me, that manifested as major depression from the ages of 13 to 24. For Theda, I believe it contributed to her getting sick. I later discovered research that links poor adult health to the particular kinds of developmental stress minorities often face as children.

When Theda was sane, she never talked about our childhood. Only psychotic Theda did that. During a psychosis, it was like she became another person. Her speech patterns changed—she had what psychiatrists call pressured speech , which is the constant need to talk (somewhat incoherently). She also clanged , which is a tendency to fill silence with simple rhyming speech patterns. She trusted me during these times in a way she didn’t seem to trust anyone else. She tried to communicate with me, and there were narratives in the content of her speech that I recognized. She talked a lot about her physical condition, calling it “the sickness Theda has.” She believed that her illness existed because our family was in the “wrong realm.” She mythologized our migration and ethnic experience when speaking like this, saying our parents had migrated from more agreeable realms in their “past lives.” She also commonly linked her physical illness to trauma from “a past life” in which she’d been raped and buried alive for attempting to move freely in a single-ethnicity culture while being a half-caste.

It was my sister’s personality to repress painful childhood memories, but they came tumbling out when her sanity was compromised. Most importantly, all her physical symptoms would temporarily vanish as that occurred. This is one reason I always felt her illness had psychological roots—her physical symptoms seemed capable of transforming into mythic narratives about trauma. It was remarkable to witness. Her food intolerances would stop, light and sound would no longer give her migraines, she didn’t experience any fatigue or pain, and her short-sightedness improved, quite dramatically. The abatement of symptoms would last for the duration of each psychosis, usually around 10 days. After that, her symptoms would return. This tracks with theories about how repressed trauma can drive psychosomatic illnesses. These theories, which began with Freud in the late 1800s, revolve around the idea that when people cannot consciously process trauma, their brains manifest perceptions of physical symptoms instead. When they find a way to face the trauma consciously, those physical symptoms tend to abate.

The world of psychogenic research is fascinating, sometimes counterintuitive, and often deeply resonant. Functional neurologic disorder—another name for conversion disorder—appears in the current Diagnostic and Statistical Manual of Mental Disorders and it can include symptoms like blindness, paralysis, allergies, seizures, fatigue, and pain. Once known as “hysteria” and attributed mostly to women, it still gets some bad press. Many people, including some doctors , equate it with faking or hypochondria, whereas others imagine that it simply doesn’t exist, citing sexist ignorance in past eras as the only reason such things were ever diagnosed. But psychogenic diseases do exist, and much research confirms that they aren’t the same as faking. These conditions have been recorded since ancient Egypt , and they happen to both men and women. They have been cured in some people, and they remain incurable in others. Diagnosing them is difficult, but proof often appears when a psychological treatment eliminates otherwise inexplicable physical symptoms. Research estimates that 20 percent of all neurology consultations include patients with some conversion disorder symptoms.

For many years I believed that my sister had severe conversion disorder. But as I learned more about medically inexplicable conditions, I also began to consider other possibilities. Emotional distress can change our cells, which is quite different from conversion disorder and explains why my sister’s hormone levels were often out of whack when tested. Chronic teen bullying victims, for example, can have higher levels of disease-indicating C-reactive proteins that can last a lifetime . Women who have been physically or psychologically abused by a partner show altered neurological and gastrointestinal function. Takotsubo cardiomyopathy is a strikingly illustrative example of how emotional and social distress can potentially alter our physical health through our hormones. It is a heart disease that shows up on echocardiograms as a deformation in a patient’s left ventricle, caused by spikes in their stress hormone levels. It can kill, and it occurs in in people who are struggling with grief, financial stress, or social isolation. Crohn’s disease and endometriosis are two more well-known physical conditions that have also been partially linked to psychological trauma.

Like many people, I once classified mental and physical diseases as quite distinct from each other. In my mind, a key difference involved their cause and cure. My perception was that mental illnesses were generally caused by social and familial distress, and that they could be cured with medication and/or therapy. The reality is that mental illnesses can be, for some, a lifelong burden . They have genetic factors too. And social and familial distress can cause physical illnesses just as they can cause mental illness.

When we recognize that mental and physical illnesses are not so cleanly divided, we can also question the usefulness of that “divide” for deciding on someone’s right to die. Should a person experiencing a temporary mental health episode be considered a euthanasia candidate? Everyone would agree the answer is no. Just like someone experiencing a bad case of mononucleosis shouldn’t be given the right to a medically assisted death, nor should someone experiencing an episode of depression.

But should someone’s right to die be explicitly about their diagnosis? When someone’s suffering is intolerable and without an end in sight, that should be enough of a reason to consider their right to a peaceful death, on a case-by-case basis. We should listen to people in that situation when they ask for more rights, no matter the cause of their illness, as a cause may not be able to be neatly untangled.

Stigmatizing some types of diagnoses—and seeing some terrible chronic conditions as worthy of the right to die and not others—is a form of collective victim-blaming. Social psychologist Melvin Lerner can give us insight there. He hypothesized in the 1970s that victim-blaming is driven by the “blamer’s” desire for an illusion of safety. When we imagine that someone’s misfortune is caused by their own folly, we can strike that misfortune from our own list of personal concerns. Consider how that plays into the ways we stigmatize some illnesses. Blaming the patient alleviates our anxiety about that particular sickness. Hence, mental illnesses get stigmatized because many people wish to imagine themselves immune. As noted by O’Sullivan, psychosomatic conditions attract the intense victim-blaming because they challenge the very framework separating mental and physical illnesses. This challenges our illusion of invulnerability in a significant way.

I learned to see beyond that as I went through this story with my family. My big sister’s illness was not her fault. It was an illness as real as any other, and beyond her control regardless of whether it was mental or physical in origin. It was likely caused by social trauma, but it proved untreatable. And her suffering was terrible.

In a 2023 essay for the Atlantic, David Brooks argues that the right to die should be afforded narrowly, only for people with terminal physical conditions. “You don’t have the right to make a choice you will never be able to revisit,” he writes. “Banish the question from your mind, because the answer is a simple no.” He believes sick people owe it to their ancestors and society to continue living despite their suffering. He blames modern liberal culture for prioritizing individual well-being over our responsibility to others. “Our individual choices take place within the framework of the gifts we have received, and the responsibilities to others that those gifts entail,” he continues.

I agree with Brooks that tackling the rights of chronically ill patients involves thinking about responsibility. But instead of putting the emphasis on the individual, as he does, we must think about responsibility more broadly. We need to examine how we rank illness-related suffering as a culture. That’s our responsibility. We also need to consider how social injustice plays a role in causing chronic and mental illnesses.

In the final month of my sister’s life, I traveled to America because of pressing concerns in New York. Meanwhile, Theda was back in Australia with pentobarbital under her bed. She had promised me she wouldn’t end her life without first calling me back to Australia. I knew it was a risk leaving, but I took it.

The night I arrived in New York, George Zimmerman’s trial was on a TV in the reception area of my accommodation.* It was mainstream news, and two anchors were orchestrating a conversation between talking heads in live feeds. The topic turned to growing up Black in America and how it could affect the long-term psychological well-being of people like Trayvon Martin. They argued about the impact of racial inferiority complexes. I remember watching that debate with awe. Theda and I hadn’t grown up in a society debating such ideas. We never encountered those thoughts in our social circles or on national news. Some of our ignorance came from growing up working class, and the rest was colonial Australia’s tendency to sweep discomfort under the rug rather than discussing it on TV. I’d never heard the term “racial inferiority complex” until that year, but it resonated. I remember being affected by how my sister would perceive and react to what I was seeing. Witnessing a nation discuss such things makes thinking about them possible. A robust public discourse on racism would have helped her to shine a light on the childhood experiences that she seemed to understand in her head when psychotic, and in her body when she was sane. I realized that night in New York that I was witnessing one of the ways a society can speak to the sick.

A month later, Theda euthanized herself while I was still abroad. It happened after she’d attended a medical appointment with a neurologist who implied her suffering was her fault because—that neurologist believed—it had a mental health component at its core. I was staying at an Airbnb in Ithaca at the time. I hadn’t truly imagined Theda ending her life without calling me home. That day, Mum phoned while I was at a café getting ready to catch a bus to Albany. After the call, I remember walking down the main street toward the bus station on autopilot, unsure where I was going. Mum’s voice was playing over in my head, telling me that my sister was gone. It felt like I was watching myself from outside my own flesh.

I wasn’t mad at Theda for ending her life. She had chosen euthanasia after reaching the end of what she could tolerate. I knew that it no longer mattered whether her illness had been in her body or mind. All I knew is that she was no longer suffering.

​​ If you need to talk, or if you or someone you know is experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call or text 988 to reach the Suicide & Crisis Lifeline .

Correction, March 21, 2024: This article originally misidentified Robert Zimmerman as having been on trial for killing Trayvon Martin. It was George Zimmerman.

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U.K. Conservative Party Under Fire Over Donor’s Alleged Racist Remarks

Frank Hester, the leading supporter of Britain’s Conservative Party, is accused of making the comments about Diane Abbott, a well-known lawmaker.

By Stephen Castle

Reporting from London

Britain’s governing Conservative Party was under pressure Tuesday to return more than 10 million pounds to a donor who reportedly said that Diane Abbott, a prominent lawmaker, “should be shot,” and that looking at her made him “want to hate all Black women.”

According to an investigation by The Guardian newspaper , Frank Hester, a health care technology entrepreneur, made the comments in 2019, at a meeting held at the offices of his company, The Phoenix Partnership. He has apologized but has not confirmed the Guardian’s account of what he said.

Mr. Hester said on Monday that he “accepts that he was rude about Diane Abbot in a private meeting several years ago but his criticism had nothing to do with her gender nor color of skin,” in a statement released by his firm that misspelled her last name.

The statement added that he had called Ms. Abbott twice “to try to apologize directly for the hurt he has caused her, and is deeply sorry for his remarks,” and that he wished “to make it clear that he regards racism as a poison which has no place in public life.”

According to the Guardian, Mr. Hester said in the meeting: “It’s like trying not to be racist but you see Diane Abbott on the TV and you’re just like, I hate, you just want to hate all Black women because she’s there, and I don’t hate all Black women at all, but I think she should be shot.”

The first Black woman to be elected to Parliament, Ms. Abbott, 70, is a prominent figure in British politics and spoke on home affairs issues for the opposition Labour Party under its previous leader, Jeremy Corbyn.

She was suspended from the Labour Party in Parliament last year pending an investigation into a letter she wrote to a newspape r calling to distinguish racism against Black people from prejudice against other groups.

In a statement issued on Tuesday , Ms. Abbott described Mr. Hester’s reported comments about her as “frightening.”

“I am a single woman and that makes me vulnerable anyway. But to hear someone talking like this is worrying,” she said, adding that the fact that two members of Parliament “have been murdered in recent years makes talk like this all the more alarming.”

A Labour lawmaker, Jo Cox, was murdered in 2016 by a right-wing extremist, and David Amess, a Conservative lawmaker, was murdered in 2021 by a radical Islamist who opposed British airstrikes against the Islamic State.

Mr. Hester is the Conservative Party’s biggest donor and recently gave £5 million to the party, taking his total donations to £10 million in a year. With a general election expected later this year, the party on Tuesday was resisting pressure to return the cash.

On Tuesday afternoon, Kemi Badenoch, the Conservative business and trade secretary, said that Mr. Hester’s comments, “as reported, were racist,” and, by the evening, Downing Street had echoed that verdict.

Earlier, another senior Conservative Party lawmaker and minister, Mel Stride, had told broadcasters that Mr. Hester’s alleged comments “were clearly wrong” but people should “move on.”

That did little to allay the criticism from opposition politicians. Keir Starmer, the leader of the Labour Party, described the reported comments as “abhorrent,” and told the broadcaster ITV that Ms. Abbott had been a “trailblazer” who has “probably faced more abuse than any other politician over the years on a sustained basis.”

Mr. Hester appeared to be “pretending that what was said wasn’t racist or anything to do with the fact she’s a woman,” Mr. Starmer said, adding: “I don’t buy that, I’m afraid, and I think that it’s time the Tory Party called it out and returned the money.”

Earlier, speaking in Parliament , Wes Streeting, a senior Labour lawmaker, said that the reported comments had used “utterly revolting, racist and inciteful language, which has no place in our politics and public life.” Calling on the Conservatives to return donations from Mr. Hester, Mr. Streeting said that “if they have any integrity whatsoever, they will give every single penny piece back.”

Some Conservative lawmakers were also critical, including Kwasi Kwarteng, who served briefly as chancellor of the Exchequer in the short-lived government of the former prime minister, Liz Truss. Mr. Kwarteng told the BBC that the comments were “clearly racist and they are clearly sexist.”

Recent Conservative governments have featured some strikingly diverse cabinets and the party is led by Rishi Sunak, Britain’s first nonwhite prime minister.

But the party recently suspended one of its former lawmakers, Lee Anderson, after he claimed that “Islamists” had gained control of the mayor of London, Sadiq Khan, a Labour politician. On Monday Mr. Anderson formally quit the Conservative Party and joined Reform U.K., the small right-wing successor to the Brexit Party, which was once led by Nigel Farage who campaigned for Britain to leave the European Union.

Critics have accused the Conservatives of tolerating anti-Muslim hatred. In a letter sent last month to the Conservatives, Zara Mohammed, secretary general of the Muslim Council of Britain, said that “the Islamophobia in the party is institutional, tolerated by the leadership and seen as acceptable by great swathes of the party membership.”

Ms. Badenoch, in her comments released on social media, said that she and Ms. Abbott “disagree on a lot. But the idea of linking criticism of her, to being a Black woman is appalling.”

It was, she added, “never acceptable to conflate someone’s views with the color of their skin.”

However, Ms. Badenoch, who is the equalities minister as well as business and trade secretary, welcomed Mr. Hester’s apology and said there “ needs to be space for forgiveness ” when there was contrition over flippant remarks.

Stephen Castle is a London correspondent of The Times, writing widely about Britain, its politics and the country’s relationship with Europe. More about Stephen Castle