Suicide as a Moral Issue
Who Should Control When and How We Die?
“Suicide is an event that is a part of human nature. However much may have been said and done about it in the past, every person must confront it for himself anew, and every age must come to its own terms with it.”
—Johann Wolfgang von Goethe (1749–1832)
Behind Goethe’s simple statement lies a profound truth: dying voluntarily is a choice intrinsic to human existence. It is our ultimate, fatal freedom. That is not how the right-thinking person today sees voluntary death: he believes that no one in his right mind kills himself, that suicide is a mental health problem. Behind that belief lies a transparent evasion: relying on physicians to prevent suicide as well as to provide suicide—and thus avoid the subject of suicide—is an evasion of personal responsibility fatal to freedom.
Not long ago the right-thinking person believed that masturbation, oral sex, homosexuality, and other “unnatural acts” were medical problems whose solution was delegated to doctors. It took us a surprisingly long time to take these behaviors back from physicians, accept them comfortably, and speak about them calmly. Perhaps the time is ripe to rethink our attitude toward suicide and its relation to the medical profession, accept suicide comfortably, and speak about it calmly. To accomplish this, we must de-medicalize and destigmatize voluntary death and accept it as a behavior that has always been and will always be a part of the human condition. Wanting to die or killing oneself is sometimes blameworthy, sometimes praiseworthy, and sometimes neither; it is not a disease; it cannot be a bona fide medical treatment; and it can never justify deprivation of liberty.
Death Transformed
Increasing life expectancy, advances in medical technology, and radical changes in the regulation of drug use and the economics of health care have transformed how we die. Formerly, most people died at home. Today, most people die in a hospital. Formerly, patients who could not breathe or whose kidneys or livers or hearts failed to function died. Now, they can be kept alive by machines, transplanted organs, and immunosuppressive drugs. These developments have created choices not only about whether to live or die but also about when and how to die.
Birth and death are unique phenomena. Absent celibacy or infertility, practicing birth control—that is, procreating voluntarily—is a personal decision. Absent accidental or sudden death, practicing death control—that is, dying voluntarily—is also a personal decision. The state and the medical profession no longer interfere with birth control. They ought to stop interfering with death control.
As individuals, we can choose to die actively or passively, practicing death control or dying of disease or old age. As a society, we can choose to let people die on their own terms or force them to die on terms decreed by the dominant ethic. Camus maintained that suicide is the only “truly serious philosophical problem.” It would be more accurate to say that suicide is our foremost moral and political problem, logically anterior to such closely related problems as the right to reject treatment or the right to physician-assisted suicide.
Faced with a particular personal conduct, we can approve, facilitate, and reward it; disapprove, hinder, and penalize it; or accept, tolerate, and ignore it. Over time, social attitudes toward many behaviors have changed. Suicide began as a sin, became a crime, then became a mental illness, and now some people propose transferring it into the category called “treatment,” provided the cure is under the control of doctors.
Crucial Questions
Is killing oneself a voluntary act or the product of mental illness? Should physicians be permitted to use force to prevent suicide? Should they be authorized to prescribe a lethal dose of a drug for the purpose of suicide? Personal careers, professional identities, multibillion-dollar industries, legal doctrines, judicial procedures, and the life and liberty of every American hang on how we answer these questions. Answering such questions requires no specialized knowledge of medicine or law. It requires only a willingness to open our eyes and look life—and death—in the eye. Evading that challenge is tantamount to denying that we are just as responsible for how we die as we are for how we live.
The person who kills himself sees suicide as a solution. If the observer views it as a problem, he precludes understanding the suicide just as surely as he would preclude understanding a Japanese speaker if he assumed that he is hearing garbled English. For the person who kills himself or plans to kill himself, suicide is, eo ipso, an action. Psychiatrists, however, maintain that suicide is a happening, the result of a disease. Against this mindset, the view that, a priori, suicide has nothing to do with illness or medicine, which is my view, risks being dismissed as an act of intellectual know-nothingness, akin to asserting that cancer has nothing to do with illness or medicine.
We are proud that suicide is no longer a crime, yet it is plainly not legal; if it were, it would be illegal to use force to prevent suicide and it would be legal to help a person kill himself. Instead, coercive suicide prevention is considered a life-saving treatment and helping a person kill himself is (in most jurisdictions) a felony.
Supporters and opponents of policies concerning troubling social issues—such as slavery, pornography, abortion—have always invoked a sacred authority or creed to justify the policies they favored. Formerly, God, the Bible, the Church; now, the Constitution, Law, Medicine. It is an unpersuasive tactic: too many deplorable social policies have been justified by appeals to Scriptural, Constitutional, and Medical sanctions.
The question of who should control when and how we die is one of the most troubling issues we face today. The debate is in full swing. Once again, the participants invoke the authority of the Bible, the Constitution, and Medicine to cast the decisive ballot in favor of their particular program. It is a spineless gambit: persons who promote particular social policies do so because they believe that their policies are superior to the policies of their adversaries. Accordingly, they ought to defend their position on the grounds of their own moral vision, instead of trying to disarm opponents by appealing to a sanctified authority.
For a long time, suicide was the business of the Church and the priest. Now it is the business of the State and the doctor. Eventually we will make it our own business, regardless of what the Bible or the Constitution or Medicine supposedly tells us about it.
Comment by dana on 2 July 2010:
no one has the right to destroy his/her life because our own life was never ours but it’s God’s.we are only bound to preserve it and do things which are pleasant in the eyes of our HEAVENLY FATHER..
Comment by RF on 6 July 2010:
11 years to the month, first comment. Wow. No Dana, I own my body and I’ll pretty much fight to the death to protect that right.
Comment by Bill on 7 July 2010:
What is moral and ethical about suicide? From all the contributions I have read so far the pro-suicide group limits they’re argument to the quality of life of the individual. Do we live for ourselves or do we live for the betterment of the world around us for starters? In our pain and suffering can this be a means of helping develop true and good character in others? The “right to die” is our choice, but perhaps we a missing out on seeing the bigger picture.
Comment by FU on 21 April 2011:
god dana did you even read the article??
Comment by Beth on 2 August 2011:
Dana said,
“no one has the right to destroy his/her life because our own life was never ours but it’s God’s.we are only bound to preserve it and do things which are pleasant in the eyes of our HEAVENLY FATHER..”
Thus by your statement, no one can voluntarily sacrifice their lives for others as many do in law enforcement and the military. Giving your life up for another is not pleasant and has many consequences.
It is fine if you believe this in your own religious practice, but it is immoral to project it onto others. Suicide does not violate the rights of others.
Bill said,
“Do we live for ourselves or do we live for the betterment of the world around us for starters?”
No moral religous creed advocates that in order to live for the betterment of others we have to forcibly prevent others from doing things we do not like or belive in. No where in the Bible does it advocate forcing people to live as we morally think they should. The Bible offers punishment for those that violate the rights of others as a consequence. Jesus NEVER advocated forcing others to live as he taught. In order to better the lives around us, we have to VOLUNTARILY try to convince them of things or try to persuade them. There is no moral justification for forcing others to not commit suicide.
If we live for the betterment of society around us, it must come about voluntarily as free choice is the moral agent. If force is used, then there is no moral or religous virtue.
Bill, the bigger picture is all about free moral choice. If we are not free to choose virtue, then we are essentially robots. I do not believe this was God’s intent.
Comment by Kate on 26 December 2011:
I think this article underestimates the medical causes of suicidality. Let me say right off the bat that I do not have a polarized view on the morality of suicide – I believe that each instance is highly unique, and that in some cases, suicide is a viable option. Suicidality, however, is the result of a somehow malfunctioning brain. During states of depression, the higher processing centers of the brain (including those responsible for reasoning) are suppressed – often due to a lack of neurotransmitters necessary for the proper functioning of the brain – causing more reasoning skills, and a tendency to fixate and overemphasize temporary problems. This is a medically treatable condition. People who have experienced suicidal tendencies first hand, and have subsequently been receptive to treatment often find difficulty in relating to their previous selves – their previous state and what they were thinking while in a suicidal state. That being said, there are individuals who experience a chronic state of suicidality. In these instances, I respect the notion of moral suicide. Depression of that magnitude is a severe form of emotional pain, and forcing an individual to suffer through that for years, decades or even a lifetime is cruel.
Before making any definitive judgments on the validity of suicide, I would ask the author and readers to first accept that each individual’s experiences, emotions and wishes are unique. Therefore, though some suicide is moral, to welcome suicide into our cultural norms would be to abandon an segment of the population which is seriously ill and in need of more reasoned judgment.
Comment by Charlie Faber on 4 February 2012:
The religious aspect cannot really be argued against the constitution or thousands of years of developed human morality. I believe that all life should be preserved if possible, and anyone considering suicide should go to see a therapist. In the end, however, everyone has a right to make an informed decision after careful deliberation. If their decision is to end their own life, you should respect it. The decision should not be made rashly, but should be considered for some time so that the person is able to make a knowledgeable decision.
Many say that suicide impacts family and loved ones harshly and because of this pain, it is immoral. This argument is flawed because it is simply selfish for someone to say “You can’t commit suicide, because it would make me unhappy.” You have no idea the suffering the person may be experiencing or how bad their life is at that time. You don’t really know if things will really get better for them, yet you tell them they will anyway. A person’s decision should be respected, not scorned.
If this argument was about the human morality of committing suicide, please do not bring in God, due to the fact that the sanctity of life is a purely religious belief.
Comment by Tristan on 2 April 2012:
Beth. Shut your face.
Comment by Mr. Hindt. on 2 April 2012:
BETH! SHUTUP YOU’VE GOT NO IDEA! TRISTAN IS AWESOME WHEN HE SAYS THAT YOU NEED TO KEEP THAT PIEHOLE OF YOURS CLOSED!
Comment by Beth on 16 April 2012:
Tristan,
No, I won’t. Now, do you have something of importance to add to the discussion or do you just like to issue commands out of ignorance or to get attention to yourself?
Comment by deedee on 12 May 2012:
I don’t think suicide is ok. By any means. Physical, morally, from the pov of those left behind, based on the self-respect and love you’re supposed to have…it involves the love you are supposed to have for the entity that you represent, as a human being, and bassically Life is the best thing we get, since we don’t know some bigger deal than this. A suicide is a bad, coward, joke on this matter, and it should be dealt with in a very serious matter, involving professionals, care, and any signs of it should never be overlooked. Although we know that society is a fucked up system, in lack of a better one, it rests upon its fucked up shoulders to treat this responsability with its bravest powers, because it matters, and we don’t even realise how much. If we weren’t to be alive, we would not exist, and society needs to make the desire of the human to die its top priority, because in the case of such a wish existing, it means there is something fundamentally wrong with society and therefore with the human, shaped by it. So aside from it being a moral problem, moreover it developped as a social issue and even tho we have the means to deal with it, we choose not to, and that is like assisting to a suicide and not doing anything about it. It’s like being part of the crime. People shouldn’t think suicide is ok.