Many of this site’s readers send me angry emails or texts. They post challenging comments. Some are so passionately opposed to suicide prevention that they resort to harassment. I have received threatening missives and phone calls from numerous people. Some urge me to kill myself.
A common argument is that people should be free to die by suicide without intervention by others, no matter what:
“For some people there is little to be done sadly and if they want to exit life then I completely understand and I believe they should be helped: either by medical personnel or at least by giving them access to pain-free means. This is the humane, moral and decent thing to do and it respects their autonomy and human dignity…”
That comment, by a reader named Zara, raises good points. It is just one comment among many that have caused me to question myself:
By advocating for stopping people from suicide except in the context of terminal illness, am I wrong?
Why don’t people, regardless of terminal illness, have the right to end their own life, without anybody interfering, interrupting, or otherwise intervening?
What if the suicidal person’s mental or physical suffering truly is intolerable and with no end coming soon, if ever?
Is it inhumane to stop a suffering person from ending their life?
Why?
Why not?
The Most Difficult, if Fleeting, Question
People who long for suicide typically want to escape unbearable torment. They experience deep emotional or physical pain, or existential malaise, or fear, or trauma, or psychosis, or material hardships like poverty, or something else so powerful that it snuffs out the biologically ingrained will to live.
They feel hopeless that things will ever change. Indeed, they do not simply feel hopeless. They are convinced their situation is hopeless.
People intent on suicide often want to end their lives for very compelling reasons.
I think of all this, and a troubling question settles on me. I dedicate my work to suicide prevention, but even I wonder, if momentarily:
Why not let them die by suicide?
Suicide Prevention and the Greater Good
In preventing suicide, yes, we are trying to help the suicidal person. We know, based on years of research about suicide attempt survivors, that even intensely suicidal people are likely to regain the desire to live. As I describe in the post “Where Are They Now?: The Fate of Suicide Attempt Survivors,” most people who survive a suicide attempt do not later die by suicide.
But we are not only helping the suicidal person by working hard to prevent suicide. We also are helping people who care about the suicidal person.
Suicide hurts the living. We strive to prevent suicide not only to save the suicidal person from dying prematurely and unnecessarily. We also strive to prevent suicide to save children from losing parents, parents from losing children, partners from losing love, and communities from losing valued individuals.
As Jennifer Michael Hecht wrote in her book, Stay: A History of Suicide and the Arguments Against It: “The whole of humanity suffers when someone opts out.”
In seeking to prevent one person’s suicide, we also seek to prevent even more suicides. People who lose someone they love to suicide are at higher risk for suicide themselves. One suicide can lead to another, what is called “suicide contagion.”
Please let me be clear: In describing the harm that suicide does to others, I am not blaming the suicidal person. Rather, I blame the forces that lead to suicide, just as the blame for a person’s death to cancer belongs to the cancer, not to the person who died. In this regard, the person who died by suicide is suicide’s victim – but not the only one.
A World Without Suicide Prevention
Some people lament that suicide prevention measures deprive people of the ultimate liberty – that is, the freedom to die on one’s own terms.
Consider the alternative: A society where people are not stopped from dying by suicide. Where parents and children and friends and lovers watch, without recourse, as tragedy unfolds. Where there is no pathway for keeping a suicidal person safe without the person’s consent, even though the chances are very high that the person will recover the will to live if given the chance. Where friends, family, and professionals are not allowed to prevent what might be preventable.
A society that tries to prevent suicide sends the message to people who suffer, and to those who love them, that their lives matter. That suicide is not the answer. That people care and can try to help. That things have a good chance of getting better.
No doubt, we need to do more as a society. On a large scale, people need more resources and more reasons to want to stay alive. If society treated people better – if there were more jobs, better access to health care, and less violence, for example – fewer people would want to die.
Society needs to do more for suicidal people besides keep them alive and miserable. But letting people kill themselves without providing any means for prevention isn’t a solution, either.
Questions In Search of Answers
More emails from strangers will come to me, missives full of challenges, perhaps even anger. I know this. I anticipate some of the comments:
You are selfish. Why should one person suffer so that others don’t?
Why should people stay alive to help society when society doesn’t provide enough help to people who stay alive?
Who decides what is best for the suicidal person? For society?
Those are good questions, and maybe I will tackle them in future posts.
What are your answers?
Copyright 2018 by Stacey Freedenthal, PhD, LCSW. Written for SpeakingOfSuicide..
How ill do you think I have to be in order for assisted suicide/euthanasia/… to be OK for me? Does it have to be terminal? If so, what about all the non-terminal illnesses that can’t be cured or treated well?
And does the illness have to be physical? If yes, what about the few mentally ill people who have spent long times in therapy etc. to little or no avail?
How low does my quality of life have to become? And don’t you think it’s selfish of people to say, “I’d rather see you suffer tremendously than know you dead”? They sure have said that to me a lot, even if they know that I’m chronically ill and that I only want to die if things ever get too bad…
An even stronger argument, Vlad, is to ask why you should need anyone else’s approval or agreement is order to have access to suicide, which manifests your own ultimate control of your own body. People should be able to command the assistance of a doctor to help them commit suicide comfortably and securely, since this assistance is essential to their ability to realize their ultimate autonomy over their own body.
I believe it is very harmful to attack someone for believing passionately that given a chance most people who are actively suicidal right now may well regain that will to live, firmly disapprove of the targeting you have received. A classical example is a nurse / doctor being berated for bringing someone back – do you put lack any understanding of how utterly wrong it is to expect healers to ‘gracefully accept the patients right to die’…
As a suicide survivor I would advocate all day long that we ensure the person in that position is helped to be able to weigh up the enormity of a life in balance and ensure they can see there is hope – beyond that it is their decision and all anyone can hope is they make the best decision for them and then their loved Ones
Elinor, good points! Thanks for sharing here.
I truly admire what you do to prevent suicide. My husband died by suicide a few months ago and it destroyed me. I feel so alone and deserted. Worst of all I am terrified because now I am the sole provider and care taker of my three small children. I wish my husband would have gotten help, I wish that so much!
A widow,
I’m very sorry for your loss. I hope you will take a look at the resources I list for people who have lost a loved one to suicide. A support group might be especially helpful for you during this terribly painful time. Thank you for sharing here.
As in the exercise of all freedoms, the side-effects can be either negative or positive for other people. The person holding the freedom should weigh the side-effects of their choice on others in all cases. In some cases, the horror of continuing to live for the person holding the autonomy right to die over their own existence may outweigh any concerns about the side-effects on others, in other cases it will not. It is for the person holding the right to continue living or to die to draw the balance. On the other hand, it would be a horrible intrusion and massively selfish to force someone to life who did not want to live just because you happen to want him or her to live.
Not gonna lie I was feeling okay and then these comments were making me feel more suicidal. To me someone who isn’t suicidal saying “you have a right to kill yourself” sounds a hell of a lot like “kill yourself”, and someone who is saying the same thing is projecting their own feelings onto me.
If you think of all the contexts in which the phrase ‘you have a right to X’ is used in English you can easily recognize that they are not imperatives, nor do they imply instructions or commands. ‘You have a right to buy a house, to join the army, to major in English Literature, to marry Mary,’ etc., all imply open options, not commands, so the same should be true of recognizing that you have a right to commit suicide. A right describes an option, not an obligation.
In America, at least, anything that can be medicalized will be, for the generation of profit. Not because American society cares so deeply for its individual citizens that suicide occupies the level of concern that therapists making money off of books (who don’t have the time to deal with serious questions on an individual level, of course), the press, the WHO or whomever would have you believe. Even on this forum, the basic issues are avoided, and while I don’t have empirical data to back this up, I would wager that at least 50% have issues leading to chronic suicidal ideation that are socially determined – they have to do with isolation, lack of access to quality mental health services, over-medication, joblessness, etc. all of which I experience and deal with on a daily basis. The who industry is a pile of bullshit, frankly, and has very little to do with any serious examination of the existential issues to which people here are alluding. I have a new idea – to hell with therapists, unless you’re lucky enough to have one who really understands you, to hell with the industry around the medicalization of mental illness…perhaps the best therapy would be to work together, face to face, to change the society itself. Thats what some of the humanists and definitely the Marxist psychologists were saying back in the ’60s. Personally, I think they were spot on.
I think the honest English translation of the phrase, “You are clinically depressed” is “I hereby announce that I invalidate all the opinions you have on the topic relevant to your sadness and label them symptoms of a chemical imbalance in your brain, even though I have never conducted any chemical analysis of your brain to see if there are any imbalances there. Further, I now take possession of your invalidated sadness which I have announced is only a medical symptom, and so I can legally treat you as a child, since you are not in your right mind, and I can also make money off of you by making you my psychiatric patient. In addition, drug companies can make a fortune off of you selling you pills to restore the imbalance in your brain which we don’t even know exists.”
In truth, the patient’s problem is simply whatever there is in the objective world which is bothering him or her: the death of a loved one, the loss of a job, poverty, loneliness, incurable illness, etc., which often cannot be repaired and so the patient either remains profoundly sad forever or prefers to die rather than continue in a state of misery. If the real world problem could be removed, you would be surprised how quickly the imaginary ‘chemical imbalance in the brain’ justifying the description of this situation as a clinical depression would disappear.
What absolute conspiratorial nonsense. The fact of the matter is, whether you personally have experienced clinical depression or not, there are those of us for whom it is a constant and overwhelming force totally removed from factors in the objective world.
Guess what: I have a fantastic family, close friends, a caring partner who I love deeply, financial security, and no world-shaking/life-changing events in the last few years, but suicidal machinations still worm their way through my mind nearly every hour of every day. And, at least in my experience, while not curative by any means antidepressants and SSRI’s have nonetheless acted to slowly but surely transform my mental experience of the world.
I’d strongly urge you not to speak on behalf of all “sad” people, but hey what do I know, I’m only sad.
Absolutely!
It looks like someone wants to refute what you (an apparently upsetting object of the external world) has to say on the issue.
That’s quite ironic.
It’s amazing how some people can be histrionic in their defense of drugs that are essentially no different than so-called illicit drugs..They make you feel good as long as you take them.. which is your entire life. Stop taking them and watch what happens.
The irony is that the people with these various conditions who would need to rise up to make this change are unable to do so because of those conditions.
With the mentally ill, many of us can’t get out of bed or leave our houses. Many who can think the system, and life itself, is hopeless and not worth fighting for. Many others due to their conditions are considered ‘unreliable narrators’ and have no credibility within general society.
The people who DO have that kind of energy probably believe the system works because they’re doing OK.
IMO the only thing that might work regarding change is if people with power realize how much productivity and money is lost due to mental illness issues, and how that might be harnessed for their own gain.