I think it’s virtually impossible to find a situation where nobody else is pained by the person’s decision to commit suicide, unless maybe it’s someone with no living relatives or friends. Still, just as a person can utilize their money or time as they see fit, I think ultimately the person’s life is for him/her to live or not.
Playing Devil’s Advocate, a few hypotheticals…
Suppose I’m accused of a crime and it sure looks like I’m guilty. Could I commit suicide to avoid going to trial? Remember, I haven’t been proven guilty yet…do the victims or society in general have a veto in the matter?
Suppose I’m tired of living but I want to have one last hurrah. I go out and get several credit cards, run up a huge debt…could I commit suicide to avoid paying it off?
Suppose I want to be like the Buddhist monk who self-immolated in that iconic photo. Is it ok to use the pod for political commentary?
People joke about buying someone a gift certificate but…
Exactly. I understand how someone who as a young child endured the suicide of a parent, especially if they learned about it in a very traumatic way, might naturally feel resentful and reject any tolerance of suicide whatsoever.
Parenthood involves making a commitment to be there to love and support your kid as best you can for as long as you can. And somebody who feels that their parent voluntarily bailed out on that commitment, even if the parent was suffering from incessant mental or physical agony, has a right to feel upset and angry.
But that doesn’t mean that everybody in all circumstances has a moral obligation to eschew suicide (or some form of “terminal care” for the terminally ill), or that their loved ones will necessarily be more traumatized by their seeking death than by their having to endure life in constant pain.
Speaking as someone who lost one parent to illness in early middle age, one parent to terminal illness palliated by medically induced coma in advanced old age, and one sibling to suicide in early middle age, I feel basically the same about all those deaths: I wish all of them could have magically been not ill and not suffering and gone on living.
But given that that wasn’t the reality, I don’t think it would have been better for any of them to go on living in constant suffering just so I wouldn’t have to lose them.
A child who has a parent who committed suicide is 3 times likelier to commit suicide themselves. If you’re an adult when your parent commits suicide, you’re no more likely to do it than the general population.
I haven’t followed this woman’s case, but if the article is accurate, I have nothing but sorrow and admiration for the manner in which she ended her life. Sorrow, because her life was cut short in the prime of her life. Admiration, because she did everything right. She weighed her options. She lived the remainder of her life to the fullest. She took the feelings of her loved ones into account and made her departure as non-traumatic as possible. This article was an emotional read.
Stage 4 glioblastoma is basically a death sentence from which there is no pardon on the horizon. The symptoms are severe, debilitating, and worsen over time. If there is a prime candidate for compassionate assisted suicide, this is it.
Let’s bring a young child into her equation. The child would lose his mother either way, probably by just a few months difference. What is the least traumatic way for the child to endure the inevitable death of his mother? Seeing her degenerate physically and mentally over a period of months, till death from the disease? No. Having her commit suicide by her own hands? No. I cannot imagine the lifelong trauma of, say, seeing your mother’s corpse hanging from a rope in the basement. Or, going through the process of assisted suicide, where you can say goodbye to your loved ones properly, while you are still somewhat vibrant? I think the answer is clear.
I am pro medically assisted suicide, and these Swiss pods look like the best way to go. There do, however, need to be safeguards in place. There should be somewhat different protocols for different pathologies. For example, conditions with severe symptoms, and near-zero chance of reprieve, like stage 4 glioblastoma, should be OKed for assisted suicide after a few months of counseling by a medical doctor (preferably the patient’s PCP, who has a history with the patient), and a psychologist (for both the patient and her family).
For conditions that aren’t a death sentence, nor necessarily profoundly degenerative, but still long-term debilitating, like, for example, general depression, I would mandate a longer waiting period. Not to prolong the agony of the patient, but to give the depression enough time to cycle, making sure the patient remains in the same frame of mind during the highs and lows.
Serious question, because I have no idea. How long does it take to have your depression to be diagnosed as untreatable? Is it years of trying different drug combinations and doses while you are still depressed all the time? To me, that would be a good reason to suicide.
I agree. This just seems like an expensive way to do what is already legal there.
Don’t they? Many seem fully aware, but their life is so overwhelming suicide seems like the only answer.
I sense a new market opening up.
I actually have wondered this. I don’t even know how you could gather the data needed without cooperation of the psychiatrists themselves.
No, no, no. The combo comes with a small drink. You have to Supersize to get the large drink.
Does this happen often with people who weren’t already considering suicide or had some kind of mental health problems?
Make sure that makes it’s way to youtube, I’d hate to miss out on that.
Now I’m going to have to look this up. I don’t remember that at all and I’m usually pretty good at remembering the real whackos.
Well said, especially the last sentence.
I’m always a little bit leery when statistics are reported in this format rather than actual numbers. When stated this way, for all we know only 1 adult committed suicide while 3 children did in the whole US, but the format makes it look worse than it actually is. Better if they would report actual numbers of suicides of children vs. adults.
It’s a bit like when news reports say murders doubled last year. What they don’t say is that they doubled from 1 to 2.
I’m not a psychiatrist, so I don’t know how long it takes. I do know that:
Sometimes it just cannot be treated, even after you have tried every psychological and medical treatment possible. Everyone’s brain is different, after all, even those of different people with the same condition. I don’t think it’s really a “time issue” but a “number of options attempted” issue. Some people won’t even try one treatment, or invent conspiracy theories about treatment options, or don’t even get a diagnosis.
Sometimes it’s a symptom of a personality disorder, rather than being it’s own condition. Personality disorders are untreatable. Of course, this is not a symptom of all personality disorders.
The current study looked at the entire Swedish population over 30 years, making it the largest one to date to analyze the effects of untimely and/or sudden parental death on childhood development.
U.S. and Swedish investigators compared suicides, psychiatric hospitalizations and violent crime convictions over 30 years in more than 500,000 Swedish children, teens and young adults (under the age of 25) who lost a parent to suicide, illness or an accident, on one hand, and in nearly four million children, teens and young adults with living parents, on the other.
Those who lost a parent to suicide as children or teens were three times more likely to commit suicide than children and teenagers with living parents. However there was no difference in suicide risk when the researchers compared those 18 years and older. Young adults who lost a parent to suicide did not have a higher risk when compared to those with living parents. Children under the age of 13 whose parent died suddenly in an accident were twice as likely to die by suicide as those whose parents were alive but the difference disappeared in the older groups. Children under 13 who lost a parent to illness did not have an increased risk for suicide when compared to same-age children with living parents.
@Kimera757 , sorry, messed up the quote function somehow.
Determining untreatable has got to be difficult.
We have a friend of about 30 years who has been treated for anxiety and depression since she was a teenager. She’s very open talking about it and the sheer number of different meds she’s been treated with over the years is huge. It seems like they all eventually lose their effectiveness, some quite quickly. One she just changed to recently is so new that insurance will cover zero of it’s costs, so she’s paying $600 a month just for the one rx.
From our point of view, she never changes no matter what meds she’s on. If you met her you’d never know she had any problems. The only outwards signs she shows is a tendency towards a bit of agoraphobia when her meds need changing. It just amazes me that she’s been doing this for almost 40 years now. Not sure I could do it.
Thanks, I want to take a read thru that later. That segment you posted is interesting in itself.
I agree. Every brain is different, and as a non-psychiatrist I’m not qualified to determine who is treatable, who is not treatable, or who is … in between?
This may speak to a much larger issue, but in the case of those with intractable psychological/psychiatric/mental health issues, it’s possible that some of them may not have gotten to the right specialists for the right tests:
This is substantively different from somebody with a rare cancer, deemed terminal and untreatable, where the diagnosis can often be made with certainty and precision, and where a PubMed search will confirm the disease course and likely prognosis.
We’re not far enough into mental health. I’ve long believed that some/much of it will turn out to be more organic, and may lend itself to very different treatment modalities than are commonly used today.
I haven’t seen this commercial lately, but I have in the past.
I did read his autobiography, which came out about a year after the crash, and his father committed suicide after he found out his cancer had come back, and this time was untreatable, which is one of the situations where I believe it’s understandable.
I had long heard that the suicide rate was highest in the elderly, and was skeptical about that until I worked at the big hospital, which had a psychiatric unit. Learning about the extent of alcoholism and other substance abuse in the senior population was quite a surprise as well.
Is this what you would tell your spouse if they found out you cheated on them? Or maybe I should when I do?*
But if cheating on your spouse is wrong, why is not suicide and leaving a grieving spouse not wrong or even to be considered as such?
A side note. Suicide might be reasonable when its altruistic, or at least when morally neutral. Would be interesting to see data on how many are, after the problem of accurately classifying altruistic and morally neutral suicides from those that aren’t was determined.
*This is merely a hypothetical thought exercise, I’m not accusing you or admitting/condoning cheating on our, or anyone elses, (hypothetical) spouses.
In this hypothetical, there might be any number of reasons why I cheated on my spouse. Some of them would have no justification at all, and some of the could be entirely justified. My spouse might be equally heartbroken in all these cases, but that is his issue because they are his feelings. I can’t control his feelings, and I shouldn’t try to cater to those feelings against my own best interest. That doesn’t mean that I treat those feelings as meaningless, but it does mean that I have to weigh them against other realities.
As for suicide, if I am truly miserable and my family knows it, then at some point, as difficult as it probably is, they have to accept that I am better off dead. To do otherwise is to be impossibly selfish.
I think a lot of people here are conflating the situation of people with incurable terminal diseases, who should IMO absolutely have the option of making a dignified exit with minimal paperwork burden, with people who are suicidally depressed.
Because the fact is that when people say they are suicidal, typically we lock them up for a week or so. And when they get out, they could kill themselves, but, almost always, they don’t. Even in severely depressed people, suicidal ideation is an impulse that flares up and will fade away given time. And depression is always potentially treatable.
I wouldn’t morally judge anyone for committing suicide, but I’m not comfortable with depressed people having access to the same system that would be appropriate for glioblastoma patients.
I am a psychiatrist, and I don’t feel qualified to make that decision. I’m not going to tell someone they have a moral duty to go on living despite intolerable emotional pain, but I also don’t want to sign the order saying “this person’s case is officially hopeless and we should give up on them”.
No, all pain is not equal but adding to the issues at hand is that we have no objective measure of pain, either.
Upon reflection (I have been absent from this thread for a bit) I think I really dislike blanket statements or absolute statements. The real world is complicated and there are always edge cases.
I do think some people kill themselves for reason I personally consider stupid, or to get out of problems I see as solvable though clearly they don’t. That said, I would not offer those opinions to people in distress, or to their friends and relatives after they kill themselves, because doing so would just add to the general distress and I have no reason or justification for sharing that opinion where it would cause further pain.
If you have a terminal illness such as you describe and you’ve “explored all other reasonable options” that’s an area where I’d defend your choice as the possible lesser of two evils given that no matter what there is going to be pain and suffering. But that’s an instance where other options have been considered/tried and it sounds like you’d do something to minimize any resulting damage from your actions. Which is a lot different than eating a shotgun in your bathroom while your six year old child is at home (guess who found the largely headless body) because you have financial difficulties and have to make a career change, which is one instance of which I’m aware.
In no small part my views on suicide have been shaped by life experience and the terrible damage suicide can do to those left behind.
See copycat suicide. Once suicide can trigger others, so yes, it’s entirely possible that using the measure you give one suicide can cause that level of pain in others, leading to multiple deaths.
Again, we don’t have an objective measure of pain. We do know that some people have a greater tolerance for pain than other people. Some people choose, even actively want to continue living despite chronic, daily, untreatable pain. We have others who would rather die than endure it. There are people who declare they would rather die than need to use a wheelchair, or be blind or deaf, yet there are millions of people who deal with those limitations every day and very much want to continue living.
I think a lot of people with sort of situation are so much eager to kill themselves as wanting an option for the worst-case scenario.
One thing I think would be better than a suicide pod for deteriorating conditions is a delayed activation, implantable suicide device. For illnesses like dementia, ALS, Alzheimer’s, and so on, there is a long time between the initial minor symptoms and when the disease has fully degraded the person. If a person wants to control their destiny, they would have to take that final action while they still have their full faculties. But often there is a significant amount of time where the person can still have a good life and not be a burden to their relatives. If there was a suicide device someone could have implanted which would activate only after the person is no longer able to manage their condition, it would allow the person to enjoy whatever time they had without worrying about being an excessive burden. For example, something like the opposite of a pace maker. If the person does not do something to regularly interact with the device, it will take that as an indication that the illness has progressed fully and stop the person’s heart after some amount of time. I think something like that would be easier on all involved than the person having to take their own life while they still had the capability to do so.
That’s why I say, IF this was legal in a society, I’d want safeguards. Does the person have a treatable ailment? Have treatments been tried? If the condition is debilitating, chronically painful, or terminal is the issue “I don’t want to live” or “I can’t see a way to live with this?” If the latter, are the ways to alleviate the problems so the person would want to continue living? IF assisted suicide was legal then absolutely there should be some assistance with putting affairs in order and not leaving the surviving family worse off than before.
I still don’t like the idea of assisted suicide, but I do understand that society doesn’t have to agree with me.
For damn sure I don’t want someone else murdering me because their opinions of about what is and isn’t tolerable doesn’t match my own. Because if that happens it really IS murder and not suicide, assisted or not.
It might reduce it, but I doubt it would eliminate it. Some of the people performing those actions are not thinking in either a rational or orderly manner.
Nope. Not OK or moral to deliberately cause suffering to another human being. I understand wanting to cause pain, but actually doing that is not OK.
That’s an example where having an out for the worst case scenario makes a person less likely to actually opt for it. I’m sorry you suffer from that sort of mental dysfunction.
I know that I can’t stop you if you do, finally, opt for one of your exit strategies but I would hope you’d do so in the least damaging manner possible.
I am not convinced that each and every suicide considers the feelings of others when opting to kill themselves. People facing terminal illness and a short time until death? Yes. A young adult going through their first episode of mental illness? Maybe not.
It’s also not just “any degree of discomfort”, it’s a great deal of pain left for the survivors. We’re not talking about a trivial hurt that will be forgotten in a week. It’s well established that there are circumstances when one suicide can trigger others - that’s one person’s reaction to intolerable pain generating intolerable pain in others.
I can see a problem with that in that there might be situations where, even if such sessions were available and money not obstacle, the person might be in a terminal situation that could subject them to agony before a lengthy process could be completed.
In which case I’d like to see some sort of medical ethics counsel involved and perhaps and emergency court session to ensure the rights of the person involved are protected and there is no coercion involved.
I’d hope such situations were EXTREMELY rare, though.
So, you have compassion for a “fuck you, world” suicide but not for the child that finds the mutilated body of a parent? Are you sure that’s the position you want to take?
Sounds like she is also better for not having left it.
It also sounds like helping her overcome the problems leading her to suicide was much more productive than helping her kill herself. This is why I keep beating the drum that alternatives need to be tried. Often, it’s not that people want to die, it’s that they want the pain to end - and if they can do that without dying life might turn out to be good.
