Friday, 24 October 2008

Thoughts on Suicide

Let me make clear right at the start of this piece that I am not, have not been, thinking about suicide nor has the post been sparked off by any family or friends thinking about suicide. The assisted suicide of the paralysed rugby player, Daniel James,  has made me think about the role of family or friends when a loved one is contemplating suicide. 

I am not concerned in this post about the legal position but only the moral position.  This is a subject on which a treatise could be written and probably has been but not by me.  In this short post I can only touch on the most simplistic arguments.

I can imagine that many will believe that one must actively work to prevent suicide of a loved one so as to prolong life but I don't buy into this any more.

If the state always worked to prolong life and prevent premature death then I might have more sympathy but the state doesn't always do so.  NICE guidelines prevent some patients from receiving treatment which would prolong life whilst allowing treatment for others.  Therefore, the state prolongs the life of some and hastens the death of others who want to live longer.  Those whose deaths are hastened by the state haven't made the decision to die sooner.  That decision has been made for them.  Why therefore, should a loved one not help to hasten the death of one who has chosen to die sooner?  

But just because the state hastens the death of some doesn't make the decision moral and nor does it for individuals. 

 

Therefore, how does one judge the moral issues?

 

I contend that IF it is moral for a person to commit suicide then it must be moral for another to assist that suicide but this does not mean that there is a moral duty on another to assist.  However, I believe that there is a moral duty on another not to prevent a suicide.  [More of this point later]

 

Let's consider the morality of a person who commits suicide.  Many will say that it is immoral to do so; some on religious grounds.  Who determines the morality of an action?  We can all have a view but only the person alone has the moral authority to decide to commit suicide.  If the moral authority does not reside with that person then who does decide.

The state?  How would the state decide?  Does the state own us?  No!

A religion or religious leaders?  How can a religion / religious leaders decide for those who are not believers?  They can't but what of believers?  I would contend that, even for believers, religion or religious leaders do not have the moral authority but if believers wish to give up their own authority to their religion then that is a matter for them.

If not the state and not religion what options remain. Where might the basic moral authority lie?  I can not see beyond the individual. 

I believe the individual has the moral authority to commit suicide and further that authority is not diminished even if the individual has a partner and children.The individual will, in all likelihood, take family into account in a decision but having family should not, cannot make suicide an immoral act.

Now having come to the conclusion than an individual has the moral authority to commit suicide then by extension it is moral for another to assist that suicide.

 

What happens if the other person finds suicide an immoral act.  What should this person do if a loved one  - or, in fact, anyone - wishes to commit suicide? 

Must this other person assist?  No?  One cannot be forced to participate in an act which one finds immoral.

Should the other person who considers suicide an immoral act do everything to prevent the suicide?  I imagine that this would be a very contentious area.  In this example there is a clash of moral authorities: the person who wants to commit suicide who, I contend, has the moral authority to carry out the suicide and the other who just as strongly believes the act is immoral and should be prevented.

Basically, there are three acts which the other person can take:

1   work to prevent the suicide and to prolong life

2   do nothing to prevent or assist the suicide

3   work to assist the suicide

To the potential suicide victim (victim is an interesting word given that suicide is an event of choice and not of chance) option 1 is unacceptable but to the other person 1 is the only acceptable choice. 

What to do? 

Whose moral choice takes precedence?

 

There are those who would say that in this situation the preservation of life must take precedence but those are likely to be the same people who believe suicide is an immoral act.  This is a circular argument: those saying suicide is an immoral act say life should be preserved because suicide is an immoral act. 

Something more is needed.

I can break this moral dilemma by saying simply that the person most affected by the act has moral precedence and that is the person who wishes to commit suicide. 

Ultimately the individual must have the moral authority to act on himself and another person should not intervene to prevent that act, that suicide.

 

In real life, however, I expect the situation to be quite different. 

If one comes across an attempted suicide one is unlikely to stop and think about the moral dilemmas involved.  Rather one is likely to "dive" in and attempt to save the "victim".  Last year I did.  I never stopped to think. I acted to preserve life.  Was it a moral act?  This post would say that it was not.

 

Another dilemma - morality versus the ingrained reaction to an emergency.

 

Another day perhaps I'll look at this too.

16 comments:

  1. who defines the "emergency"? what situation makes it an "emergency"? The samaritans don't classify suicide as any sort of emergency so they won't take any action if peopel call them and say they're committing suicide. Is that right or wrong? is it legal? is it moral?

    Its a very interesting and deep post. I think that young man made a very brave descision.

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  2. Some interesting thoughts and thanks for sharing. It is a delicate line to draw but I think one of the things that needs to be absolutely clear is the mental health of the person making the decision.

    Personally, I find it uncomfortable but I don't like to make a moral judgement on the choice of someone who has capacity to make that decision but then, I've never been in the situation of having someone close to me suffer in that way and I know it's an easier judgement to make from the 'outside'.
    Great post though.

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  3. Anon Thanks. The emergency is defined by the other - non-suicide - person. Can only be this.

    So one the one hand we have the other person classifying - in panic - an action as an emergency and the Samaritans et al deciding that as policy they will not intervene. In this respect they seem closer to my moral thinking but I'm not sure.

    If one calls Samaritans one may be looking for help, may not have decided to commit suicide. Not to be offered help when in need is a strange moral decision. I must look up Samaritans to find out why this is their approach.

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  4. cb

    Thanks for your positive comments.

    Yes, the state of mind is important and, to be honest, I deliberately steered clear of the subject because I felt the post would get too complicated. I should have mentioned that but by the end of the post I wss so glad to have finished that I forgot.

    Now that the post is out I'll think about the mental health aspects and possibly do another very short post.

    It's possible that the mental health issues will be dealt with in the comments.

    Many thanks for raising this important tssue.

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  5. It is an interesting post and I guess in some ways too close to home for me.

    I see completely different types of suicide in a way. The first case might be someone who is mentally unstable at the time and sees suicide as the only answer to their pain/problems. But with treatment they could well be helped to live a life that would be satisfying to themselves. Every one would try to save this person if possible because they are not making a rational decision.

    Another case might be someone who is in intractable pain and suffering and perhaps in the end stages of life. Assuming they are considered able to make a rational decision why shouldn't they have help to commit suicide if needed?

    In the case of the young man in question he made a conscious rational decision that he could not accept the life that he was left with after his accident. But he needed help. Imagine watching him die of starvation if that was his only option. His parents accepted his decision and lovingly accompanied him to his destination. How is that illegal?

    Here some years ago, a young woman with ALS, Sue Rodriguez, fought all the way to the Supreme Court of Canada for the right to die by assisted suicide. She lost but in the presence of an MP (named) she was assisted to commit suicide by an unknown physician and no one was ever prosecuted for it.

    Not a very well developed comment for sure Calum, just a few thoughts from one whose family was devastated by a mentally ill member's suicide.

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  6. I have just come across an article from yesterday's online Times in which a doctor who prescribes the drugs for suicide - through Dignitas in Switzerland - gives his thoughts.

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  7. jmb Thanks

    Don't worry about "Not a very well developed comment" because all comments give food for thought and yours is just fine. My post is not very well developed. The subject is just so complex and so final.

    I'll think about the examples you raise.

    Again, thanks jmb.

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  8. Many years ago I has a suicidal friend. I managed to prevent her suicide twice. The third time I wasn't around, but she was found and made a recovery. She lived on, much happier, for years.

    Regarding your point about "diving in" in an emergency. How can we help our instinctive reactions? I trained as a nurse. I was fully conversant with resuscitation procedure. I was visiting my soon-to-be-husband one evening when his mother's heart stopped. My instant reaction was to go into the routine. I brought her round, and she was soon back to normal.
    Fine, you could say, a life saved. This was an old woman, suffering from alzheimers. The doctor admitted her to hospital, and she never left. She was unable to attend our wedding. Her body lived on for about eight years, but she knew nothing. From my standpoint now, would I struggle to bring her back to "life"? Probably not.

    A bit rambling, I know, but my point is that I interfered twice. I maintain that I was right the first time, but not the second.

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  9. Dragonstar You say: "Regarding your point about "diving in" in an emergency. How can we help our instinctive reactions?"

    We can't. That's why I said real life is so different. Moral issues don't crop up for us at these times.

    If, however, we knew in advance that a person was going to commit suicide and we had time to talk to them and think about the situation then moral issues might take over. No longer would we be in an emergency.

    I hope that's not too confusing.

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  10. I very well thought out post thank you. I came to the same conclusion as you at the end and was left with a dilemma.

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  11. A very interesting post Calum exploring an issue which is incredibly difficult for everyone concerned.

    The reaction of wanting to help prevent a suicide is a very natural one for many people - we, in many cases, strive hard to protect and prolong life. However, there is a hypocrisy in how we 'define' the prolonging of life, as you rightly point out - in some situations we fight tooth and nail, regardless of the wishes of the person concerned, whereas at other times we are happy for the doctor to 'ease their passing' with high doses of painkillers.

    What really infuriates me is the way that suicide (and other issues which can be tied into it such as self-harm) is often portrayed, as if it was some sort of selfish act or merely a form of attention seeking. Instead of recognising the trauma of the situation that someone must be in if they are contemplating such a serious act, there is a dismissal of the whole situation, and a classification of the person as being weak or difficult.

    Sadly, this perception is common amongst medical professionals, let alone the wider public. We need more education about the issues which can be connected to suicide (in the many different contexts in which it can occur) so that there is less judgement and more support.

    On a side note, I just want to say that this is an excellent site Calum and it is very powerful to be able to share in some of your thoughts and experiences. Keep up the good work, and hopefully through the comments that come on here you can see that there others who agree with you and are banging their heads against the wall of ignorance alongside you - eventually it'll fall down.

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  12. NAVIW

    Thanks for your positive comments.

    The points you make are excellent.

    You are so right about the trauma which brings people to self-harm and suicide. So often it is seen as attention-seeking. Those who end up in hospital are treated like dirt - stitches without local anaesthetic.

    It's great to find more and more people who are fighting.

    Thanks

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  13. Therefore, how does one judge the moral issues?

    It's crossed my mind for a few seconds at times but the bottom line is it's a one way trip to hell. You might not believe in hell but I figure - why take the chance?

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  14. CherryPie Sorry I've taken so long to reply. No excuse.

    Thanks for your positive comments.
    Are we great minds or the other?

    James I think the moral issues are relatively straightforward.
    The difficulties arise because those who get involved in a "suicide event" are unlikely to conside morality unless
    the involvement is in the early stages of planning. In these circumstances there may be time to stand back and think about all the issues.

    Suddenly coming across a suicide attempt leaves no time for thinking about morality. Perhaps one should take time but I think that "This is an emergency, 999" actions kick in.

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  15. I think we are great minds. But I am biased ;-)

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  16. calum, I keep coming back to this post and trying to decide what to say. I think I will post about it myself as I'm confused. As usual.
    Yours,
    Confused of Mumbles
    George is playing with an onion and I think I'm confused.

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