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..
Why is it the responsibility of suffering people to suffer without end for your emotional benefit? You aren’t entitled to anyone else’s pain.
You state the suffering people must stay alive for you and the relatives that won’t help them survive or escape pain, but you don’t explain how or why you deserve that sacrifice.
You don’t really point to a path away from suicide while stating that suicidal people must sacrifice their autonomy for the emotional well-being of others.
For instance, why should a suicidal person in chronic pain who cannot get their healthcare team to believe their pain or their relatives to help with daily needs keep living their horrible torture of a life for you? What’s in it for them?
Help isn’t available. If you have no one to help you to bathe or dress and no way to stop physical pain, how can you live for the people not helping you like that?
Why can’t those who aren’t helping just deal with their emotional pain when the people they fail can’t survive anymore? Why isn’t your emotional health your responsibility rather than that of people suffering so badly they want to die?
You should probably try to consider that the people you want to endure suffering until their physical condition results in a painful, slow death are actually people whose emotional pain you shouldn’t dismiss unless you have a solution to it.
What is your non-death solution for people who cannot get physical pain controlled and do not have anyone to assist their daily needs? Explain how to tolerate the suffering. Why are people in chronic pain obligated to protect the feelings of people around them who are not doing anything to help?
“They feel hopeless that things will ever change. Indeed, they do not simply feel hopeless. They are convinced their situation is hopeless.” You know, I am getting really fed up with this mentality. no, not the belief that one’s situation is hopeless but the idea that there is always hope and if you disagree then “your mind is simply not in the right place,” “you have a mental illness” etc. The more I hear it, the more desperate it sounds, almost as if the people who say it cannot comprehend in any way the possiblity that some lives are indeed destined to be horrible even if they’re presented with any evidence showing otherwise. Some situations ARE hopeless. there is no other way to put it. some people will experience problems for life from abuse to chronic illness to poverty and more. i understand wanting to prevent impulse suicides but some suicides have been thought out carefully and for a long time and are motivated by situations that can be lifelong like the ones i mentioned, problems that by the way maybe could actually be fixed if we started addressing them directly instead of telling it’s victims mindless platitudes such as “it gets better” or resorting to these other pathetic suicide prevention methods that are clearly doing nothing to address the greater issue. too bad the mental health industry is too lazy to do anything about it. oh well. if you cannot aknowledge this then you do you i suppose but don’t bother trying to convince others who know better. you cannot truly aknowldege the harshness of life without aknowledging what makes life harsh.
Indeed. And I think society and any rational mental health professional understand that many situations are hopeless. That’s why care is aimed almost exclusively at young people who they have a chance at fixing.
Which I don’t mind that. It’s the best use of resources. What I don’t like is the insincerity, where people look at a hopeless situation and look the person right in the eyes and say they’re mistaken. They insist on one thing about depression and suicide but between the lines it is entirely, “Yeah, you’re right. You’re not a valid member of society. We can’t extract any money out of you. Go ahead and do it. But do it on your own, in some painful or unreliable way please in a place where we can’t see you .”
I am 59 years old have battled for 40 years with repeated episodes of depression ,I have had multiple traumas in both childhood and as an adult. I wouldn’t know what is wrong as adult trauma changed my diagnosis that eventually sucked the life out of me and I can’t resolve it as I have no faith in professionals that can mess you up so much. I am now homeless and am agitated or irritable as everything I see or try to do is so overwhelming. I hate myself for failing multiple suicide attempts and there really is no hope. Everything crisis lines suggest is also increasing despair as it is impossible to do if you are stuck in a situation of horror and I am sad and the pain is too much. I feel so frustrated that it causes anger and this repeated cycle day in day out needs to stop. I can’t even manage to die unless I want to accept the labels I didn’t deserve by ending my life and causing harm to people who have been good to me. I want peace to be my last feelings and I guess I don’t even deserve that. I hate life period and I have to stop this torture. I wish somebody would help me to not have to suffer anymore. Nothing can repair the damage anymore. It doesn’t matter to people at all if you suffer and nobody gets it.
Jackie, if it’s any consolation, I hear you and your pain.
I wish I could give you a hug as I feel much the same way as you.
In spite of many gratitudes, I simply don’t want to be here anymore and it’s too much.
Wow! I lost my wife a year ago. She was suffering physically and emotionally, and our healthcare system made it worse. The healthcare system failed her and she sought out relief from drugs that her daughter gave her and killed her. I have seen firsthand many failures of medical professionals (physical and mental), that I know our society is failing us. You posed 3 anticipated questions that are all excellent. But the following key word “maybe”. Maybe I’ll tackle these shows an understanding of the root problems, but a lack of commitment. Why not tackle these problems without doubt in your mind? I get the impression that you are not serious or are afraid to address the faults of our society.
Stacey, I just reread your original starter post, and had some additional thoughts. You were saying that by responding with suicide prevention efforts that it shows people care, that your life matters. But, Im starting to seriously disagree, and a lot of that has to do with the state I now live in and the pitiful they approach anything related to mental health. I see an extremely short sighted need to perform a duty, which is not the same as caring, which implies a sense of deep respect and regard for the person. I see none of that here. I don’t even see an understanding that the person has anything to do with whether they were successful in doing their job.
As a consumer, I have always played an active role in not only advocating for myself, but also by participating in improving the systems ability to effectively meet the needs of the people who seek help. That would define an essential part of the meaning of “Mental Health Recovery”. But in New Mexico, there is no understanding of that concept, even though they use the language and terms. Ive attended and tried to participate in many meetings, like the state committee for the yearlong planning for 988, and yet i have no value whatsoever to them as a consumer. Instead, its all top down, and is up to the bureaucrats and administrators, who obviously think they know best what should be done. I am so fed up, especially because this state has consistently failed at mental health, suicide and so many other things people need to live a meaningful rewarding life. Its funny because the thing I need most is the ability to contribute in a meaningful way, and yet when I try, its clear that I am meaningless to those who are simply blind to their need to learn. That just increases my hopelessness.
I’ve often said that people (therapists and ‘normies’) view us as being unreliable narrators simply by virtue of the fact that we’ve asked for help or that we are exposed as having mental issues. Those issues could be depression, depression with some extras, or another illness entirely. The way we’re regarded in this manner is generally the same.
Because we are regarded this way, our judgement is immediately written off as completely flawed and worthless and the real issues we face are dismissed as the ‘depression talking’ or paranoia or whatever other co-morbid condition we might (accurately or not) be diagnosed with.
But you can’t cure depression in my opinion unless the real underlying issues that caused it, and the life problems caused by being depressed and inert, are addressed. Also, since our judgement and opinions carry no weight, there is little or no individuality in treatment, and what might help me might be of no value to someone with a different personality or perspective. Depression is always treated as if it were a chemical imbalance and that the person suffering from it is doing just fine other than that.
I understand how you feel. I beat my head against a wall for over 4 years, seeking out treatment, telling people what was happening… you know, just like we’re told to do. And I found overall that it made me worse. Not just that my issues were being used by some people to attack me, but that the meds and the way I was being spoken to overall was a form of gaslighting – that I wasn’t just depressed but stupid and worthless and completely incompetent.
I stopped trying to reach out and these days I make sure I keep my guard up when talking about depression in real life. I let this stuff out online, particularly to other depressives, and privately try to rebuild my life brick by brick in the real world. Overall it has not been perfect but I’m learning how to manage things in a way that works for me and get better. I’ve had no remorse about going my own way.
I look at it as, you can’t control other people. You can’t stop trashheap human beings from saying negative things about you and kicking you when you’re down. You can’t convince administrators or doctors to do things differently. What you can control are your tools and your abilities and the decision whether to avoid or confront situations which can negatively impact your mood. It has to come entirely from within at least in my humble opinion.