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..
No one can know how another person really feels about his or her own life, or how much pleasure or terror, dread, and oppression fills the existence of any other human being. Since we cannot know this, since we cannot, in principle, walk in someone else’s shoes and experience their existence as they experience it, we cannot possibly know if life is livable for them or not, so our fundamental respect for the autonomy of other human beings requires us to respect their own decisions about what they want to do.
The basic approach of the website sponsor seems to be that suicide should be resisted because of the pain it causes other people, but since we cannot know whether the pain of continuing to live is greater or less than the pain that that person dying by suicide would impose on their friends and relatives we cannot make the judgment for them that one choice is better than the other. Generally, for intensely personal choices, like who we love, who we want to marry, what job we want to select, which country we want to give our loyalty to, etc., it is the tradition of our society to respect the individual’s autonomy to make that choice for himself or herself, rather than to let what other people feel about that choice determine the freedom of the person making the choice. It should be the same with suicide.
Wow, sometime people gets wore down mentally trying to help a person in need, that they can easily start wondering about letting someone complete their suicide, sometime you might need a group help
People assume that life, which some individuals want to free themselves from, must always and under every circumstance be so valuable that it must always be wrong to want to escape it. But given what we all know of the enormous variety of human experience, we should realize that life may be a thrill for some, a duty for others, and an absolute horror for still others, and let them all do with life as they will. In this sense life is like anything common to most people but also different in each person’s experience, such as marriage, parenting, work, sleep, exercise, sex, reading, studying, religion, etc. For some people some of those institutions will be great, for others just indifferent, and for others even oppressive, so let’s be understanding and allow people to respond to these common experiences as their individual perspective and feelings require, rather than tyrannically prescribing to everyone exactly how they must value everything, regardless of their personal experience.
The sad truth is that if someone is hell bent on killing themselves, you cannot stop them. You can put them in a closed ward-they will lie to get out of it. You can take away toxic substances, then they will use a belt to hang themselves. If someone truly wants to die, you cannot do anything except locking them up. And that is basically what psych wards are: prisons for those who want to end their suffering. There are people out there beyond help and so maybe suicide can sometimes be merciful towards these people-but most suicidees aren’t like that.
What a stunning coincidence that I came to this page today. Just this morning I moved from thoughts of thinking my adult daughter may successfully take her own life to being fairly sure she will and wondering how I will live once she’s gone.
She is my best friend. Birthing and contributing to raising this amazing young woman is about the only thing of value I’ve done in my life. She’s been in so much pain for so long, been in therapy and hospitalized and tried so hard to shed the black dogs that have followed her since her teens. I think she’s entitled to quit, to end the pain, even though it will mean the end of her life and likely mine.
I’ve worked with people at the end of their lives. I’ve always thought it was terrible for family and friends to demand their loved ones endure futile treatment, continue to eat and drink even though miserable and keenly aware that their bodies are telling them it’s over. Why should I demand anything different of the one who is the sun, moon and stars to me?
I’ve tried in every way I know to let her know she matters to me and to so many others. I’ve shown her in ways untold that she matters. I’ve offered a vision of a life with less pain. But she can’t see it, she can’t feel it, and more than that she’s lost all hope of ever seeing it.
Should I Baker Act her to try to see to it that she continues, in agony, to breathe the same air that I do? That seems pretty selfish to me.
Thanks for your clear and insightful thoughts, Kate. We can only hope they help educate the hybrid psychiatrist-policemen who cannot understand the true reality of suicide, and who just blindly lash out it, preventing it, forbidding it, and dismissing it as nothing but the product ‘depression’ which needs some ‘happy pills’ so that they can avoid having to think abound it seriously.
I find the idea of trying to prevent suicide as absurd as if the people enjoying a film in the theater were to grab onto someone disgusted with the film who was trying to leave the theater and keep him in his seat. The general assumption of our culture is that people know infinitely better than others do what they want for themselves and have the right to act on their desires unless they invade the rights of others, and no one has the right to force another human who wants to die nonetheless to continue living. I suspect a lot of the self-righteous, sanctimonious urge to force others to live comes from the general fear of all people that life may really not be worth living after all, so we don’t want anyone to force us to think about the real value of life and the option of suicide too seriously, so we label their actions the product of depression and mental illness so we don’t have to worry about the implications for ourselves.
Since people living when they really don’t want to live must be suffering hideously, and the general goal of any humane society is to reduce human suffering, perhaps we should worry not about reducing the suicide rate, but about whether it should be higher? It may well be the case that people whose misery would be reduced by suicide are still living and suffering because of over-generalized life-affirming ideologies in religion, psychiatry, and social work viciously keeping them alive.
One of my questions is about passing it on to others.
People say suicide is selfish, as in the person is hurting others to ease their own pain. Yet, for that token, either way someone is being selfish and hurting for others. Either the person who lives for others, the suicidal, s/he lives instead of dying, and lives in pain so as not to spread the pain. Or s/he ends his/her own pain and others suffer. Either way one or the other ends up in pain. Who’s to decide what is right/wrong? Who is to say which is more important? Just something I wonder and would love to hear more about.
I find all of it very interesting. I think the main reason for why we as a society have adopted the attitudes we have towards suicide is because of religion. But that same morality doesn’t necessarily apply when you’re not religious.
I think suïcide prevention would fare better if it was suïcide support. I think that if there was no stigma and people knew there was an organisation that could help them make last arrangements, have conversations with family etc without telling them what to do or what not to do and to just be there. The whole process in itself would maybe even divert someone from doing an attempt, especially if all they wanted was to connect instead of die.
From a legal standpoint, such an organization based in the US could be charged with manslaughter. Not going to happen here. The only way that a person can seek any sort of assistance is if it is state sanctioned. Belgium now “allows” for physician assisted suicide for chronic depression and other psychiatric disorders. An interesting debate is ongoing in that particular country…
https://www.pbs.org/newshour/show/right-die-belgium-inside-worlds-liberal-euthanasia-laws
The Belgians, however, do not have to legally notify anybody, that’s still the responsibility of the patient.
I completely agree with this. I don’t lean completely to either side of this debate, I think suicide prevention is necessary to some extent, but also the taboo around suicide as a topic is terrible, and pushes people further to the edge. I think what would work is being able to openly talk about suicidal thoughts, rather than simply being taught to dismiss or ignore them. This would prevent people from being scared of reaching out because of the fear that their suicidal thoughts will lead to them being chained up in an asylum somewhere, knowing that if they want to, they can go through with what they want to do, but that there is also a place where they can openly talk about what they are feeling and why.
I’ve always found Jennifer Hecht’s quote, repeated in this article, to be absolute nonsense: “The whole of humanity suffers when someone opts out.” Being chronically unemployed in the USA, suffering from refractory depression in my late 50’s, I experience very little evidence to indicate that to the broader culture in which I exist that I am valued at all in life. Without serious attention to the social determinants of mental health, e.g. lack of access to meaningful employment, this sort of pronouncement of my objective value to the “whole of humanity” rings very hollow indeed.
I agree, since if anyone can overcome the enormous instinctual resistance we all have against death to make the conscious choice to take our own life, that act is in itself proof that our desire to die is infinitely greater than the desire of any number of others that we continue to live. The whole development of western culture has been to respect individual autonomy over social duty, so that children can now marry the person they want and adopt the career they want rather than what their family wants, as in previous generations, to cite just one example, so to insist that people ought to continue to live even if they don’t want to just to serve the interests of others is absurd. The selfishness of others to require those who want to commit suicide to continue to live just to please those external observers is beyond belief.
I think Brandon is right in the discussion with Rick, in that there are many blocks to suicide which mean that even those who sincerely desire to die persist in life without really wanting to be there. Some are afraid of the pain of death, others are existentially terrified of making the greatest change life admits of, and still others struggle unsuccessfully to overcome the irrational, biological instinct to stay alive whatever the cost, by their sober awareness that continued existence will only bring pain. The fact that so many people actually manage to overcome these impediments to suicide testifies to exactly how intractably hideous life can be.