Suicide and its Assistance-Becker

Let me state at the outset that I believe a free society should allow the right to end one’s life through suicide. A suicide decision is not made lightly since the great majority of people cling to life even under the most dreadful circumstances. Only people who feel quite hopeless about their future seriously contemplate suicide.

Rational forward–looking persons with good information about their future circumstances would commit suicide only when convinced that they would be worse off by continuing to live. David Hume said (in his Essays on Suicide and the Immortality of the Soul) “That suicide may often be consistent with interest and with our duty to ourselves no one can question, who allows that age, sickness, or misfortune may render life a burden, and make it worse than annihilation.” Schopenhauer was also confident about the rationality of suicide, “It will generally be found that, as soon as the terrors of life outweigh the terrors of death, a man will put an end to his life” (Parerga and Paralipomena).

Although I support the right to suicide, ideally it is best to have a cooling off period to make sure that a suicide is not attempted in a moment of great agitation that will pass before long. For example, a teenage boy may hang himself because he is bluntly rejected by his girl friend. If his hanging were prevented, he would likely have realized in a few months that he will be attracted to other girls as much or more than to the one who rejected him. He would be ashamed that he was so upset by her rejection.

Anti-depression drugs and stays in psychiatric hospitals are attempts to allow momentary agitations to pass. Many individuals voluntarily seek psychiatric help and go on these drugs when depressed and feel that life is not worth living. A difficult question for persons who support the right to suicide is when, if ever, governments should be given the power to forcibly prevent suicide attempts in order to allow time for less hasty decisions? This is especially a difficult question because individuals who make one attempt at suicide are likely to try again at a later time.

However, momentary feelings of despair are not usually the cause of the desire for assistance in committing suicide. Elderly men and women with painful diseases and terminal illnesses are usually the ones who want help in committing suicide since their pain and suffering are not temporary and are unlikely to pass. They may hope that new medical discoveries will reduce their pain, and perhaps also significantly extend their life expectancy. Such hope is what keeps many elderly persons with serious and painful illnesses upbeat and willing to face the future.

Others give up hope of any significant improvements in their condition, perhaps because of slow progress in combating the diseases they have, such as lung cancer or painful arthritis. Some of them may seek assistance in ending their lives, partly because they are too weak to do that on their own. A more important reason why they seek assistance is a fear of death that prevents them, so to speak, from pulling the trigger on their lives. After the sentence quoted above Hume adds “I believe no man ever threw away life, while it was worth keeping. For such is our natural horror of death”, and Schopenhauer makes the same observation “But the terrors of death offer considerable resistance…”

Some argue against the right to suicide not on religious grounds, or on libertarian considerations (John Stuart Mill was against suicide because he believed no one has a right to take away the need to make future choices), but because it hurts children, parents, and spouses. Yet an altruistic person takes into account the effects on those he loves in his contemplations about whether to commit suicide. Conversely, they try to convince him to seek medical help instead. Just as modern societies do not prevent a person from marrying someone disliked by his parents, I see little reason why society should interfere on these ground with decisions about suicide.

Comments

[Jimbino]

In the interests of English grammar,

"For example, a teenage boy may hang himself because he is bluntly rejected by his girl friend. If his hanging were prevented, he would likely have realized in a few months that he will be attracted to other girls as much or more than to the one who rejected him."

should read:

"For example, a teenage boy may hang himself because he was bluntly rejected by his girl friend. If his hanging had been prevented, he would likely have realized in a few months that he might have been attracted to other girls as much or more than to the one who had rejected him."

Grammar aside, I find it ironic that Nazis at the Nuremburg trials exercised a suicide denied today to good and decent Amerikans.

[Mitchell]

Becker writes, "Although I support the right to suicide, ideally it is best to have a cooling off period to make sure that a suicide is not attempted in a moment of great agitation that will pass before long. For example, a teenage boy may hang himself because he is bluntly rejected by his girl friend. If his hanging were prevented, he would likely have realized in a few months that he will be attracted to other girls as much or more..."

How long should the cooling off period be? A few months? Does he have to register with an assisted-suicide professional beforehand and make his case in front of a panel of mental health experts? I raise these questions not because I disagree with Becker but because I do not believe that Becker intends to suggest that society should allow a right to suicide that includes lovesick teenagers. The question is more interesting if we consider lovesick adults (but I suspect that Becker would not support a right to suicide in that case either).

If the cooling off period is several months then the moratorium could largely mitigate the benefits of suicide because the enormous pain and heartbreak of several months (perhaps even years) would become a sunk cost. If suicide is not desired after such an period then one might be tempted to say that the cooling off period was successful in helping the individual reach a rational, forward-looking resolution (as an opponent of assisted suicide would likely claim). But the decision may only be rational and forward-looking (the first usually implies the second) through the lens shaped during the cooling off period. The initially "rational" decision may have been suicide. Strict libertarian theory needs a tie-breaker.

However, as a practical matter, American society (or any other society) would not tolerate legally sanctioned, assisted-suicide for people who are merely heartbroken. Our legal system would not allow it even if she was the right person for you and your first real love and she dated someone else even though the other guy didn't really care about her because you wanted to get to know her as a friend before asking her out but she didn't wait for you to make a move and you thought that they would eventually break up so you didn't interfere because you thought that it would be improper and you didn't even get her number before graduating high school because they didn't break up and you didn't want to tamper so you waited and agonized for over ten years and only stayed in touch once in a while because she wasn't really interested anymore but you kept turning down other people anyway because you had somehow convinced yourself that you were holding out for her until you found out that she was getting married and your life was no longer worth living. WHYYYYYYYYYYYYY?

[Mitchell K.]

The New England Patriots just lost to the New York Giants in the Super Bowl... again! I don't think I can take this anymore.

Someone please put me out of my misery.

[Paul Weiser]

A few comments…

Authority: First, the doctor is a font of authority. Authority is that which excuses us to do what we otherwise know is wrong (such as undressing in front of a stranger). Hence the need for assisted-suicide advocates to involve the doctor (in answer to one poster’s question).

But the doctor gains this authority by rigid adherence to a traditional body of rules (partly codified in the Hippocratic Oath) which boils down to his commitment not to harm – and, if possible, to help – us. For this reason alone we allow him to prescribe potential poisons (in sub-lethal doses) or cut us with knives. Our acceptance of his authority is based on his membership in a profession absolutely opposed to intentionally procuring death. (The Hippocratic Oath does not allow for rationalization and evasion about “quality of life” or “futile care.”)

Motivations of others: Suggestible people who would not commit suicide themselves may be persuaded, by others who find their lives inconvenient, to avail themselves of doctor-assisted suicide. These others may include doctors once their adamant opposition to causing death is compromised.

Patient’s motivation: It has been truly said that suicide is, on the one hand, a permanent solution to a temporary problem and, on the other, a cry for help. May the doctor, when applied to for assistance in suicide, counsel or enforce continued life (with immediate involuntary commitment to custodial care) if in his judgment the patient’s motives are inadequate or curable? (A purely Hippocratic doctor would, of course, always exercise this option if counseling did not suffice.)

Foreseeable unintended consequences: once the “right” to suicide assistance is valorized politically, doctors will be forbidden to withhold or counsel against it and remain licensed as doctors. If this sounds implausible, consider the situation with abortion.

[NEH]

One brief moment of angst and pain, then Oblivion. Ahh... suicide. In my book it's the Cowards way out, but in some extreme situations it may be the better course. Remember the old adage, "Save a bullet for yourself" or "We shoot horses don't we?" Think of the medical procedure of Triage, in the worst cases those who can't benefit from medical intervention are left to die or pumped full of morphia to alleviate the pain in the hopes that when they are gotten back to they've passed. Wouldn't this be considered a form of assistance?

As for the legal aspects of it all, it's a matter of State Law. Some States allow it, others don't. I do believe that there is no right or wrong answer. It's entirely situational and a matter of conscience...

[Ken Leonard]

Why is it that we consider it proper and compassionate to put an aged and beloved pet out of its' misery when it is near death but are prevented by religious beliefs from helping a loved one who is pleading with us to end their suffering and facing an agonizing death? Were it not for a sympathetic doctor, I could have been charged with murder and spent the rest of my life in jail for trying to give my wife a dignified death while she wasted away from a painful cancer with only weeks to live.

I think both Becker and Posner have just skimmed the surface with their bloodless philosophical discussions. If either had ever faced the problem of having a loved one slowly die an agonizing death in a Catholic hospital that would not honor a written DNR, neither could have written such a silly argument.

I also think that both should have done a much better job of researching current writings on this subject by simply reviewing materials from one of several professional organizations devoted to educating the public about this very contentious matter. All they needed to do was to go back and look at the very wise and articulate articles published in connection with Bush's and Ashcroft's efforts to bring the entire weight of the federal government to support their religious beliefs in the matter of Terry Schiavo.

While we on the front lines of this fight to allow people the free choice to have a dignified death appreciate their comments in agreement with our cause, both Posner and Becker write what I consider one of their weakest arguments on any subject.

Shame on you both for such a half hearted and cursory commentary about such an important and emotional topic.

[Jack]

Becker seems to begin with "suicide" itself, not "assisted" and I suppose he's right to support the "right" as for the most part there is little to be done about an individual suicide.

Still, don't most of us think a a suicide absent dire medical problems is a sickness to be treated and avoided? Those having been near any suicide well know the hurts that impact loved ones and even acquaintances..... it's far from a "lone act" with no victims. But suicide will be with us regardless of government sanction.

Becker hardly gets to the more complex matter of "assisted" but his reasoning would seem to extend to favoring assisted as well. It is more complex too, as we have to protect the individual from undue influence (our new corporate personhood "deciding" "he's not worth it?") from others or even a disguised murder. So we have to involve "government" when it comes to allowing the assistance be it no more than agreement from a physician or a board with no monetary interests at stake.

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an altruistic person takes into account the effects on those he loves in his contemplations about whether to commit suicide.

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However, momentary feelings of despair are not usually the cause of the desire for assistance in committing suicide. Elderly men and women with painful diseases and terminal illnesses are usually the ones who want help in committing suicide since their pain and suffering are not temporary and are unlikely to pass.

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Although I support the right to suicide, ideally it is best to have a cooling off period to make sure that a suicide is not attempted in a moment of great agitation that will pass before long.

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