The Ethics of Suicide

Great Debates
1

At what point (if any) is suicide justified?

On one hand, it could be argued that a person’s life is his one true possession, and he should have the right to maintain it or destroy it as he sees fit.

OTOH, each person’s life is entwined with others’. The death of a loved one has a profound impact. It then seems obvious that the feelings of others must be considered. The financial impact of suicide may be another factor: is there a moral difference between a suicide that leaves a family destitute, and one that leaves a family with a hefty life-insurance policy?

Death by suicide seems much more traumatic than death by any other cause. “Survivors” of suicide commonly experience anger, guilt, etc. much more than those who lose a loved one through accident or disease. However, depression is a disease, and sometimes it is fatal. So why is suicide considered so much more terrible?

If a person commits suicide, is he responsible for any or all negative reactions of his loved ones? If it’s “selfish” to commit suicide, isn’t it also selfish assume such control of another person’s emotions?

Are there any situations where suicide is preferable or even beneficial?

2

Why does the name “Hitler” come to mind?

3

When the act is a personal choice made through reason and rational thought.

4

A person’s life is their own. Not their spouse’s, not their mother’s, and not their brother’s. I find it extremely selfish to force someone to stay alive just because you can’t bear to let them go (ie-terminal medical cases)

I’ve just never quite understood why suicide is supposed to be a tragedy: if someone doesn’t want to live anymore, for any reason, then that’s their decision. Be happy for them. Hold a wake. If someone talks to me about killing themself, I merrily tell them to go for it.

In essence, who are we to justify someone’s decision to die? Only one person in the world ever knew the true reasons behind it and obviously they won’t be explaining things.

Just don’t leave a mess, is all I ask. Noone wants to see you splattered across 5th & Main.

5

What if it’s artfully done? :smiley:

6

At what point suicide is justified is so individual that I can’t see regulating it. Does only physical pain qualify, or does mental anguish account for anything? How long must one be in pain before you are allowed to end it yourself? In the hospital, I have seen or heard of many suicide attempts that did not work. Some are very half-hearted attempts, others impulsive, some while under the influence and some creative to the extreme.
I recently had a patient with diabetes, Hep.C, no kidneys, osteoporosis and kliebseilla pnuemonia who had fallen at home and broke his neck at C3-4. Had to be intubated and put on a vent. A few days later, he still had sensation, so he wasn’t paralyzed and could still feel pain. They put a halo on him with 20 pounds of traction and decided that surgery would kill him for sure, transfering him to Stanford would kill him. And his family still refused to make him DNR because he was only 50. So he’s still here, down to 10 pounds of traction with the tracheostomy they had to cut him. He wasn’t being moved because of his fracture, so his skin was just breaking down horribly. What quality of life will he have? Suicide doesn’t sound harsh.

7

Cyn:

I would think that mental anguish should account for quite a bit. Mental suffering can be much more intense than physical pain. There’s a fine line (or no line, really) between physical and mental pain, anyway. The mind is a body part, too.

Mekhazzio:

I still think it’s important to consider the impact of your own actions on your loved ones. This goes for any major decision, not just suicide, but I think it’s especially relevant for a parent who is considering suicide. A parent’s suicide will hurt the children.

spoofe:

Some people would argue that a person with major depression is not capable of reason or rational thought. I disagree with this, though; I believe there are people who are quite rational while depressed. If the intense pain of the depression is a factor in their decisions, that seems only reasonable to me.

8

you’ve got to be kidding. shouldn’t the question be:

at what point [if any] is impingement on an individual’s right to self-determination justified??

9

I feel that everyone has the right to commit suicide; it’s the ultimate way of exercising control over your life. I work at a Mental Health Crisis Centre (I man the crisis line, so I take a fair number of suicide calls) - we’re a voluntary service so we rarely get calls from people who are completely decided on a course of action. Since I feel others have a right to choose what they do with their lives, I also feel that if they seek information regarding the choice they are entitled to receive it. Especially if that information is regarding resources they could use to help improve their mental health, living situation, etc.

The risk assessment system we use for suicide uses the CPR model; Current plan, Prior attempts, and Resources. Most people who I’ve interacted with who were at a high risk were lacking resources more than anything else; maybe they had no friends and family (or no supportive family), they might be un/underemployed, etc. Those aren’t things you can easily replace - sometimes I think to myself that if I was in the same place I’d be looking for a way out. I’m legally obligated to phone the police if someone indicates that they are a direct threat to themselves or others, but sometimes that isn’t a comfortable situation… why should someone be taken to jail because their life sucks? That’s not a therapeutic environment at all.

I think that ethically it’s much more questionable to sacrifice quality of life to ensure quantity of life than it is to allow people to terminate their lives if they are in pain. A question I’ve used to assess intent is: “Do you want to die, or do you want the pain to stop?” No prizes for guessing which option most people pick. Problem is, stopping the pain in some cases is damn near impossible without terminating life. So be it - hopefully they’ll find peace that way.

10

Dixiechiq asked:

I think that’s an outstanding question and well-deserving of an honest answer.

My standard would be that it becomes my moral duty, when I become aware of someone’s intent to commit an irreversible act, to assure myself of his or her clearmindedness and emotional stability – that he or she is making the best decision for him/herself, by his/her own standards, not mine, before allowing him or her to proceed with said act, insofar as I have any right or ability to interfere with its commission.

For example, and tying the question to the OP, suppose a 55-year-old man with paid-up life insurance without a suicide waiver and a moderate amount of life savings, with a family for whom he is the principal means of support, discovers that he has contracted an incurable fatal disease, which will reduce him to a pain-ridden invalid, and which will eat up the majority of the life savings in prolonging his life. If this man gets over the depression he is likely to have over this discovery, and determines that suicide is the proper course for him to ensure his loved ones are provided for, I am likely to grant that he is making a sound decision on his own standards. But it would be incumbent on me, if I were able to interfere, to assure myself that he is not doing this out of depression or sufficient under the influence of painkillers to warp his judgment. This would be less my duty towards him and his than towards myself, my own need to act morally.

In your own case as a transgendered person, if I were in any position where I had any influence over you, I would need to assure myself that you were making the decision to have gender correction surgery after due consideration of the definite and possible consequences, and were “counting the cost,” so to speak – that it came from true gender dysphoria and was not a spur-of-the-moment decision which you might regret afterwards.

And, of course, all this presumes my being in a position where I have some judgment or influence over the situation. But that, of course, is implicit in the question as it stands – one who has no right to judge or to exert influence should not attempt to do so.

Does this sound like a fair stance to you? I ask seriously, because I can see that the question is important to you, and I’ve tried to give a balanced and honest answer to it.

11

polycarp

wow, i didn’t really expect a direct answer…

though i posed the question [it was rhetorical to me] as a response to the op, you’ve made a reasonable and far reaching reply.

in your example of the 55 yo man, you sound like a reasonable and caring person. my personal ethics would preclude me from making strong attempts to persuade the person to change their mind regardless of depression or state of mind. perhaps i am just weak, suicide is irreversable after all. [i did have such an opportunity. i did my best to soothe and tend to the person during the attempt. the suicide was unsuccessful to my happiness.]

don’t like to be known as the transgendered person. oh well. when i first came here i meant not to let that out for that reason. what will be will be. i don’t ever expect to seek srs because i don’t believe that i am shaped by my genitals. society does, but to hell with them, i’m not going to change my body to suit their tastes. but someone seeks srs, i believe it is/should be, their right to have it upon request. i have never heard of someone that had srs on the spur of the moment. are there really a bunch of people that want to trade their genitals on a whim?? [if there are, i think they should have that right.]

back to the 55 yo. it would be nice if every suicide-minded person had someone to help them make their own best choice [as you outlined]. or at least someone to ease them through it. so yes, it sounds like a fair stance to me.

suzanne

12

I would commit suicide if I believed I no longer had anything to look forward to.

And I’d do it in a hotel room; I wouldn’t step in front of a subway train, thus closing the station for three hours and bollocking up the whole Metro system for the rest of the day.

13

Poly:

Would you please clarify what you mean by “out of depression”? In other words, do you think that depression, in and of itself, is a reasonable justification for suicide? Do you think that a person who is depressed is unable to think clearly or to make a wise decision on this issue? (I’m asking not to be argumentative, but because I respect your opinion.)

I’m very surprised by the responses here. Usually, in my experience, the topic of suicide is met with comments like, “Oh, that’s so selfish!”, “That shouldn’t even be an option!”, and the like. It’s nice to be able to discuss this.

14

Poly, I don’t get it. If you’re going to apply his standards anyway, why must you interfere? You seem to be saying that, given the identical set of circumstances, you would let him kill himself if he were rationalizing it one way but not another. How is his rationale relevant if the circumstances are exactly the same?

[brief hijack]
Your input in the Born Of Water thread would be greatly appreciated.
[/brief hijack]

15

Don’t, Neidhart. The stuff chambermaids expect to have to put up with as part of their jobs is bad enough. To make them walk in on that would be too much.

I suggest doing it in a hospital, assuming you’re going to do it right and there won’t be any way for them to stage a miraculous rescue. Go to the ER with some complaint at a time guaranteed to be busy (full moon Saturday nights work well), then after you’ve waited around a while, ask for the bathroom. In the bathroom, do what you’ve gotta do.

The advantage here is that the people who will have to clean up the mess are used to cleaning up that particularl type of mess.

16

I’m going to follow Knead around today and disagree with everything he posts! <g>

You want to give them a suicide in the middle of a hectic night? They won’t be able to clean it up, you know – they’ll have to call the police, they’ll have to process the crime scene, and nobody will be able to use that bathroom for a while.

The only time suicide is ethical is if you’ve murdered somebody. Then it’s self-execution, and saves the State a lot of time, trouble and money.

17

I mispoke – suicide is also justified if your quality of life is unbearable, your physicians agree that it cannot be improved, your affairs are in order, your physicians agree to assist you, AND there is no chance your physicians will get into legal or professional trouble for assisting you.

18

Lib. and Holly:

The answers to your disparate questions are pretty much the same.

I respect his right to do what he thinks best. (Please read “or her” into all my masculine pronouns here.) But I wish to assure myself that he is making a rational decision for himself – because in my experience, people do have emotional reactions and act irrationally from time to time. And often go to extremes at such times. Besides which, clinical, somatopsychic depression is a legitimate bodily illness which needs to be treated, and which often masks itself as a state which people avoid realizing they need treatment for.

In essence, if Joe has determined levelheadedly that his moral choice is to take his own life for the sake of others, I ought not interfere. If, on the other hand, Joe is despondent because the manipulative bitch he was dating dropped him, my duty is to prevent him from jumping off the bridge and point out that she was indeed heartless and manipulative, and that the experience will equip him to appreciate more the girl he will meet who will truly share love with him. And if he’s in clinical depression, to get him to a doctor who will rectify his endorphin and serotonin levels.

I’m not judging his rationalization for his decision – that’s his problem. I am judging whether he is capable of making a rational decision, and acting to prevent him from doing something irreparable until he can. The former is respecting his right to decide his own fate. The latter is showing appropriate compassion and “due diligence” in my love for him as a fellow human. To me, at least, that makes sense. Your reactions?

19

can you explain to me why you believe a physician should hold this power in this highly personal decision??

in what way is a physician trained or qualified to make this decision??

20

I’m going to use the David B. approach here. :wink:
maralinn:

Unbearable according to whom? Isn’t anyone who commits suicide suffering from an unbearable quality of life? If it was bearable, he probably wouldn’t choose suicide.

Physicians rarely agree on anything, and few would agree on this. Why is the physician’s opinion more important than the opinion of the person whose life is under consideration? In my experience, physicians rarely consider quality of life or even the patient’s own wishes when making a decision. Why would anyone wish to leave his most important decision up to them?

I agree with this. It’s shameful to leave your family destitute or without a clue what to do next.

Almost no physician in the world would agree to assist.
Why would a physician be necessary if a person is competent to do the act without assistance? Wouldn’t it be preferable to involve as few people as possible so that your blood (literally and/or figuratively) is on fewer hands? What if your quality of life is unbearable, but there is no physician willing to assist? Are you just SOL?

I get it. You’re saying that suicide is never justified. Right?