Wednesday, July 30, 2008

The Sense of the Asymmetry

In my most recent piece, "The Austrian Basement and Beyond: Consequences of Rejecting the Antinatalist Asymmetry," I introduced a couple of examples - the Austrian Basement and Slum World - in order to make a point about the intuitive soundness of the asymmetry that philanthropic antinatalism rests upon, and the consequences of rejecting the asymmetry.

In the Austrian Basement case, I introduced a scenario that, I think, is difficult to analyze in good faith while rejecting the asymmetry. If absent pain were not good, why should we feel a sense of relief should E. F. decide to use the birth control? If absent pleasure were not a much lesser moral consideration - were it not in fact merely neutral or not good, but not bad either - why should we feel horror at the prospect of babies being born into the dungeon?

This is especially important for those who still cling to the "non-identity problem" as a genuine problem. "How can a baby be harmed by being born into the dungeon? Before the baby is born, there's no one to be harmed! And if no one is harmed, it is not a wrong. So procreate away!" But, of course, it is wrong. We have a duty to avoid creating babies in dungeons. To demand that there be someone to be harmed before we recognize a wrong strikes me as a bit silly. I am with Professor Benatar that it is enough that an outcome be bad for a person, in the sense of worse than the alternative (nonexistence), to qualify the bringing about of that outcome as a wrong.

In the case of Slum World, I attempted to put a concrete face on the so-called "repugnant conclusion" of aggregate well-being measures, and to demonstrate that the claim that nonexistent people have for happiness/existence is weak (that absent pleasure, if someone is not thereby deprived, is merely neutral). The prospective inhabitants of Slum World do not have a strong claim to come into existence. The nonexistence of their pleasures is merely neutral, and the nonexistence of their pain is just good. This is true even though, once born, the inhabitants of Slum World would presumably choose to keep living (lead lives worth continuing). Low Population Splendor World is good, Slum World is awful, and rejecting the asymmetry seems to require one to claim otherwise.

Coming into existence is sui generis, and it is difficult to construct clear examples to use in testing intuition that aren't just different situations of bringing people into existence. My last example, below, attempts to illustrate something like the asymmetry without being about bringing people into existence.

3. Commercial Children's Television

An advertisement for a new children's toy runs several times per hour on a commercial children's television program. The advertisement creates a desire for the toy in the children who see the commercial. Of these children, many of them will eventually receive the toy from their parents, but others will not. Still other children, cruelly brought to life in the households of liberal academics, do not have televisions and therefore do not see the advertisement, and never desire the toy at all.

a. Which group out of the three is best off?

b. Do television advertisers actually do children good by creating desires that might later be fulfilled?

Tuesday, July 29, 2008

The Austrian Basement and Beyond: Consequences of Rejecting the Antinatalist Asymmetry

David Benatar's philanthropic antinatalism, explored in his book Better Never To Have Been: The Harm of Coming Into Existence, rests on an asymmetry between pain and pleasure: that, while absent pain is always good, absent pleasure is merely neutral, not bad, given that there is no one who was deprived of this pleasure. A related asymmetry is that, while there is a moral duty to avoid having a child who will be miserable (lead a life not worth continuing), there is no moral duty to create a child who would lead a life very much worth continuing.

Benatar explains the pain/pleasure asymmetry in depth in Chapter 2 of the book, and those who feel they have a slam-dunk logical objection to the asymmetry might be advised to read the detailed treatment of the asymmetry in the chapter before assuming Professor Benatar just missed the objection. Ultimately, though, there remain real, non-trivial objections to the asymmetry, because the asymmetry is built using the common ethical philosophy tool of explaining and analyzing commonly held intuition. Since the asymmetry is ultimately based on intuition, it may be disputed by those who, in good faith, do not share the intuitions upon which it is built.

Many, however, deny the asymmetry without fully grasping the consequences of the asymmetry. I wish to map out some ethical problems that those who deny the asymmetry must explain in a manner consistent with rejecting the asymmetry.

1. The Austrian Basement

E. F. has been kidnapped by her father and imprisoned in an Austrian cellar since her early adolescence. Her father repeatedly rapes her over the course of several years. E. F. gives birth to several children sired by her father. She reasonably believes that all these children have severe health problems, and that at least the female children will likely be abused by her father as they grow up.

In Year 10 of her imprisonment, with four children born and removed from her by her father, she discovers a box (unknown to her father) hidden under a floorboard in her cell, containing everything she needs in order to practice undetectable birth control.

a. Does she have a duty to practice birth control and avoid having more babies? Does she have a duty not to practice birth control, because she would be depriving her unborn babies of life (which, while it would have certain problems, would nevertheless presumably be worth living)? (Assume she would like the company of more babies, but fears the pain of more unassisted childbirth, and the "interests of the unborn children" is the concern that will break the tie, given her personal ambivalence.)

b. Why?

c. (Only for those who think that antinatalism requires suicide.) If you answered that the daughter has a duty to practice birth control, is that the same as saying that the real-life E. F.'s seven children have worthless lives and should be put to death?

Of course, I'm making up the part about the birth control choice, but here's an excerpt from the real life story:

The dungeon in which they lived was so small that the older ones had to watch as his father delivered his daughter’s subsequent children. Presumably they also had to watch as he had intercourse with his daughter to beget them – she claims that he repeatedly raped her – and regularly beat her. The dungeon contained one padded room, its walls and floor covered in rubber, the purpose of which is still unclear.

2. Slum World

The Supreme World Leaders meet in Tokyo in 2100 and decide that the world has a choice. Either the 2100 world population of 3 billion can be maintained in relative splendor, with fresh kumquats and sensory implants for everyone, or the world population can be increased to 100 billion, with everyone living in conditions similar to the conditions of a 20th century slum, apparently endured by upwards of 900 million people circa the year 2000.

a. Which condition should the Supreme World Leaders choose?

b. Why?

c. If you answered that Low Population Splendor World is preferable to Slum World, what about the interests of the unborn people who would have come into existence had Slum World been selected? Aren't they being harmed by not being brought into existence? What right to the inhabitants of Low Population Splendor World have to deny the extra 97 billion people a right to exist, just for the sake of the happiness of 3 billion?

Friday, July 25, 2008

The Moral Effect of "Being Glad It Happened"

In my post "When It's Permissible To Force Someone To Stay Alive For His Own Good" and elsewhere, I have addressed the fact that many people who are forcibly prevented from committing suicide later report being glad they were forced to stay alive. This fact is often used to justify coercive suicide prevention practices.

Similarly, the vast majority of people appear to report that they are glad to have been born. This is occasionally used as a justification for procreation (against antinatalist arguments).

While I am not attempting, in this piece, to address the question of whether suicide or procreation is right or wrong, I wish to question the validity of the argument that goes something like this:
  1. Action
  2. Object of the action is later glad the action occurred
  3. Therefore, Action was morally correct.

I will jump right in with an illustrative counterexample: genital mutilation of children. In many countries, female children are subject to genital mutilation, usually for the purpose of maintaining their chastity by making sex painful or less pleasant, though sometimes for other purposes. Those of us who find the genital mutilation of children horrifying are confronted with the fact that, in many cases, women who were genitally mutilated as children grow up to participate in, and actively perpetrate in many cases, the genital mutilation of their own daughters. The fact that they practice genital mutilation on their own children is strong evidence that these woman are glad to have been genitally mutilated. But does this make forcible genital mutilation of children morally right? Clearly not.

In many cases, we may suffer wrongs that begin a chain of causation that leads to a subjectively good result. It should not take much introspection to come up with cases in our own lives when someone committed a wrong against us for which we were ultimately grateful, because the eventual consequences of the wrong were subjectively pleasant or otherwise beneficial. My claim is that this after-the-fact feeling of gladness does not render the initial act any less wrong.

More on the parallels between birth and female genital mutilation in my piece, "Birth and Consent: An Alternate Philanthropic Route to Antinatalism."

The "glad it happened" justification seems to be a species of the Golden Rule Argument - if you're glad you're alive, have more babies (who will presumably be glad to be alive). If you're glad you were prevented from committing suicide, prevent others from committing suicide. And so on. The problem with this line of thinking is people like me - people who are not happy to be alive, and who sincerely wish to die. What effect would a Golden Rule have when applied to me - should I go around killing people because I want to die? Hardly. It is moral for me to respect the lives and desires of others, just as I feel it is moral for others to respect my wish to die. I think "do unto others as you would like to have done unto you" has a serious flaw, and the variety of human experience is that flaw.

Obviously, the majority of people are happy to be alive. Perhaps the majority of "rescued" attempted suicides are even happy to have been rescued. But this line of thinking turns action into a consequentialist game of playing the odds. Respecting the values of individuals - even those with unusual desires - and placing a high value on consent, is a more coherent and appealing strategy. "Do unto others as they would have done unto them."

Thanks to Sister Wolf for crystallizing the argument at her site!

Thursday, July 24, 2008

States Coerce Their Citizens By Prosecuting Their Doctors

In the UK, Dr. Iain Kerr, a family physician, was suspended from his practice for six months for prescribing 30 tablets of the sleeping pill sodium amytal to an elderly, ill adult patient at her request.

The patient did not use the pills to die, but disposed of them when she found out Dr. Kerr was being investigated for acceding to her request. She later committed suicide using a much less reliable drug cocktail consisting of Temazepam, antihistamines and painkillers.

Dr. Kerr told the General Medical Counsel:
I think when dealing with someone holding a rational view of the circumstances in which they want to end their life, it was my duty to at least consider whether he or she had a reasonable opinion and that it was my duty to assist if I thought I agreed with that patient's assessment.

Prosecuting physicians who risk sanctions to respect the choices of their patients and treat them as rational adults is yet another way in which governments act coercively to prevent suicides, without addressing the suffering that causes suicides in any way.

It is unfortunate that the General Medical Counsel felt the need to sanction Dr. Kerr for his act. But he may stand before any man or god, confident that his action was the morally correct one and the one most respectful of humanity.

Thursday, July 17, 2008

The "Unwanted Life" Diagnosis

When providing a medical treatment of any sort, physicians are generally expected to produce a diagnosis of a medical problem that the treatment is intended to correct. In most cases, the medical problem is one that anyone would recognize as a medical problem, such as diabetes or a broken leg. However, one of the most widely prescribed medical treatments is contraception. But what "medical problem" do you diagnose in order to prescribe contraception?

People in institutional settings (locked hospitals, homes for the developmentally disabled, etc.) are, of course, sexually active. The doctors that care for them must provide contraception to prevent pregnancy - usually injected hormone contraception. The surprising (to me) diagnosis you most commonly see on the chart of an institutionalized patient, when a doctor is prescribing contraception to her, is "unwanted fertility." Fertility is something we think of as healthy - but doctors may diagnose "unwanted fertility" as a medical problem for which contraception is the preferred treatment.

I think this is an interesting solution, although the diagnosis is often, strictly speaking, a fiction, as many female residents of group homes and such will tell you they definitely want to get pregnant - what is really meant is that the patient's fertility is unwanted by her guardian.

A similar diagnostic possibility is necessary in the case of the rational suicide. A diagnosis of "unwanted life" could form the basis for the provision of lethal means of suicide that require a prescription, without requiring general legalization of the lethal drugs. The diagnostic criteria might even include more than just a wish to die - requirements might include that the wish be persistent (repeated requests over a period of time), that it not be accompanied by (or motivated by) delusions, and that the wish to die be clear and unambiguous.

Although I do not think there is a moral right to procreate (for anyone), I am concerned with the use of the "unwanted fertility" diagnosis against the expressed wishes of patients, even though these patients would likely not be able to care for any children borne by them. It is a convenient solution, but it stretches the truth a bit. This worry is even more important in the analogous "unwanted life" case. The "unwanted life" diagnosis would never be appropriate in cases where the life of the subject is unwanted by someone other than himself (his guardian, say) rather than unwanted by the subject of the diagnosis. Likewise, if a person met the criteria for the "unwanted life" diagnosis, despite having some sort of mental illness as defined by the DSM-IV, it would be inappropriate for his wish to be denied because others disagreed with his wish to die.

Wednesday, July 16, 2008

A List of My Responses to J. David Velleman Articles

This is a list of various responses I have made to arguments that J. David Velleman advances against a right to suicide.

Life Rights and Death Rights - in which I briefly introduce, and more briefly consider, Velleman's argument that giving (terminally ill or disabled) people a right to die harms them even if they are fully rational and can be trusted to make choices that maximize their various interests.

Velleman's Sorrow of Options - in which I review Velleman's pro-forced-life argument in more detail, attempt to identify problems with the argument, and apply the argument given different starting conditions to get shocking conclusions.

Respecting and Erasing, in which I respond to J. David Velleman's pro-forced-life paper "A Right of Self-Termination?" In his article, Velleman proposes that suicide is nearly always morally wrong, because by taking one's own life, one acts in such a way that denies the inherent value of a person in general. I argue that killing oneself (and destroying something in general) does not at all require denying a person's (or a thing's) value, and that a person or a thing that is absent often paradoxically has a high value.

Altruism and the Value of Life: Another Response to Velleman - in which I challenge the ideas set forth in "A Right of Self-Termination?" in a different way, this time by contrasting Velleman's position (that suicide to end suffering is wrong because it involves trading "mere" agent-relative benefits for a human life) with the commonly-held intuition of the moral worthiness of altruistic suicides.

Monday, July 14, 2008

The Kind of Suicide Prevention I Can Get Behind

I'm still on a break, but wanted to briefly mention a study that exemplifies the kind of suicide prevention I fully support. The study, published in the Archives of Opthalmology (July 2008), links suicide with low vision - but only when health is poor in general. Risk of suicide is elevated (though not statistically significantly) for individuals with low vision only, but is significantly elevated for individuals who are in poor health and have visual impairment - well above the increased risk for individuals with poor health alone.

The intervention proposed by the authors of the study is not to lock up everyone with low vision, or to have their doctors ask them humiliating questions to check for depression, but, shockingly, "better treatments for the underlying conditions that cause visual impairment." (The authors also encourage eye doctors to be aware of the increased risk and provide appropriate referrals, but the primary recommendation of the study seems to be better treatment of visual problems.)

This is the kind of suicide prevention that even one who believes strongly in a right to suicide can support. This sort of study identifies specific types of suffering that lead to suicide, and recommends actually relieving the specific types of suffering. If this type of intervention were implemented - if old, sick people got better vision care - suicides would likely be prevented, but they wouldn't be the suicides of people determined to die, people whose true end is death. The suicides averted by this type of intervention would be bad suicides - suicides by people who value their lives but suffer so greatly from a specific problem (or problems) that they choose to end their lives. There is nothing humiliating or coercive about better vision care. I would love to see more studies like this, and more interventions of this type.

Thursday, July 10, 2008

Searching for Something

I'm not claiming this is found poetry the way I usually do. It's something else. It's more than poetry, because it's an interplay between the searchers, those who type in queries, and the sought, those who can provide the information. We make it more complicated by watching the intimate process of searching - seeing the steps the searchers take to get to us. By viewing their keywords and sources and geographic locations and screen colors and operating systems and more, we learn about those who would search us out and learn from us (and often about those who are searching for something else entirely).

The queries of the searchers are as inscrutable as any human question posed to a God. Google being, of course, a God.

Search sent x total visits via y keywords
Dimension: Keyword

"ai entity". civ 3, "destroy"
abortion booties
"best suicide" organ donors
can you p-zombie
dead salience
deontological rights in the army
do guns kill, no antidepressants do
force feed my boyfriend
find the courage for filicide*
from hell the mental health treatment
"holy granoly"
how do you say suicide in a sentence?
"how many people die due to violent lyrics"
how to kill yourself in prison
i want to commit suicide but i need someone to take care of my cats
is familicide good
inviolable nuts
if she let's you eat her out she likes you
is it illegal to wish death on someone
leading cause of unfriendliness
nembutal suicide gay
peanuts and its utilities
philosophy of science "lie to children" -wikipedia
politically correct response for a sneeze
psychology of the sexy librarian
"rape victim who fucks back"
reason of exist of prostitution
ruslana genital
seana shiffrin married
self aggrandizing cunt cory doctorow
selfish pronatalism africa
should they kill people with horrible tumors
successful suicides how did they do it ?
suffering with major depression i have come to work without washing i am not functioning at all
suicide -bomb -attack -blast -bombing loneliness
suicide breeders
suicide by hanging with bra
"tarasoff" tattoo
thomas nagel yakima
treating suicidal patients with a bungy jump?
vegetarian suicide rate
view from hell, a pet
view sexy position
want to procreate w/ me
what does leprosy do to plants
what is the esoteric meaning of a wasp's nest?
what is wrong with the austrian basement
why people like prostitution
women want men to do and they kill themselves in the process
women who make men suicidal
would a zombie harm us
yudkowsky "sexual jealousy"
"worm wrestle"

And if this seems out of character, it's just the Ambien talking.

* WTF?

Thursday, July 3, 2008

What Distinguishes "Assisted" Suicide From Regular Suicide?

"Assisted suicide," in the popular use of the term, can probably be distinguished from garden-variety "suicide" in two ways:
  1. Assisted suicide requires the assistance of some third party to carry out the act.
  2. Usually, "assisted suicide" connotes suicide by a person who is terminally ill.

I wish to challenge the accuracy and importance of the first distinction, and to examine how it interacts with the second distinction.

Assisted suicide, by definition, requires the assistance of another person. It conjures images of doctors injecting a lethal drug into a patient at the patient's request. But that is now how it often works in practice. Oregon's law is considered an "assisted suicide" law, but the "assistance" consists only in a physician writing a prescription for a lethal dose of Nembutal - not in helping to administer the drug. But is this really assistance?

The purported "assistance" going on in this type of "assisted suicide" is merely an artifact of our particular system of drug prohibition. We consider suicide by gunshot to be a suicide, rather than an assisted suicide; but why not call it an "assisted suicide," since the procedure for buying a gun requires the assistance of others? I think we would not call it an assisted suicide in the latter case. The distinction seems to be that, "assisted suicide" requires that the person providing assistance do so knowing the suicidal purpose of the person who is assisted. But the only reason the person wishing to commit suicide needs to let the doctor intrude on his personal life in this way is that he cannot obtain the drug in any other way. We too easily accept our drug prohibition as a given, when in fact it is a policy decision. There is not so much difference between "assisted suicide" and plain old suicide, except that in the former case, another person has been made privy to the suicidal person's private decision, often because the state requires the intrusion.

"Assisted suicide" in the form of a prescription is necessary, in most cases, merely because proper drugs are not available through other means. It is not "assisted suicide" any more than divorce with the help of a judge is "assisted divorce." But, in some cases, the physical inability to kill oneself is the circumstance that requires "assistance." This circumstance is especially likely in cases of people who are terminally ill. Here again, the "assistance" required may be for legal or practical reasons. If proper drugs are not available for legal reasons, the person who wishes to die may have to send a relative in place of himself overseas to seek out the necessary drugs. Or, the person who wishes to die may actually need physical assistance in dying, such as an injection, or assistance holding the cup if the drugs are taken by mouth.

I suspect that many people who oppose "assisted suicide" are concerned about the act of assisting someone to die in this latter sense. They fear that, rather than willingly choosing to die to end their own suffering, people may be put to death because they are disabled or inconvenient or expensive to provide for. To its credit, the Oregon law specifically requires a personal request, as well as an assessment of legal "capability" and many other safeguards, to prevent murders from disguising themselves as assisted suicides. I think the fears mentioned above should be taken seriously, and in this limited circumstance, I approve of the restrictions.

But these restrictions are not necessary when it comes to people who are fully competent and need no physical assistance in taking their own lives. The only comfortable sort of suicide - a suicide by overdose of fast-acting barbiturates - is only "assisted suicide" in that competent adults are generally prohibited from accessing the necessary drugs. Lift or even relax the barbiturate prohibition, and forced life becomes chosen life. There is no compassionate reason for forcing capable, suicidal adults to choose between shooting themselves in the head, cutting their arteries, hanging themselves, or living a life of unbearable misery and indefinite duration.

The Suicide Prohibition is Humiliating and Cruel

In a just society, a Nembutal prescription would be available to any adult who asked for it and could articulate a clear wish to die, along with a non-delusional reason for wanting to die.

There is no compelling moral reason to force people to stay alive who do not wish to live. A few serious ethical justifications have been offered for the assisted suicide prohibition for the terminally ill, but it is doubtful that these complex ethical arguments, or the paternalistic arguments offered on behalf of people with disabilities, are what's really behind the general suicide prohibition in its political form. The suicide prohibition exists because policy has almost no thought for ethics, except for the poorly-realized "folk ethic" that is as far into ethical thought as most human beings ever get. "Folk ethics" allows people to tolerate things like slavery, female subjugation, and marriage prohibition for gay people. Real ethics does not.

A religious justification is not an ethical justification. In a democracy, a religious justification has about as much genuine ethical power as an appeal to aesthetic preferences. Religious people who wish to make policy arguments must still do meta-ethics. In our society, they rarely bother to do so.

People feel bad when they hear about suicide. Since suicide is sad, people wish to prevent it for sentimental reasons. They fail to consider things like autonomy and the suffering of people who are forced to stay alive against their will. These concepts are not as easy for a primate brain to grasp as the folk-ethical appeal of the suicide prohibition. The suicide prohibition existed long before our modern model enshrined mental illness as the sole possible cause of suicide; like the practice of circumcision, the suicide prohibition is a practice in search of a reason.

But there is no reason.

In regard to the suffering and humiliation of those forced to stay alive against their will, here's an Australian news video about an elderly Australian man with incurable mesothelioma flying to Mexico with his wife to illegally take home the veterinary drug Nembutal for the purpose of suicide. The wife wonders angrily why he can't just buy it in Australia.

Despite the humiliation and exertion of this effort, they are the lucky ones. Apparently, according to some reports, even this method is now closed to those who wish to die.

Wednesday, July 2, 2008

Does Suicide Contagion Exist?

It is commonly accepted - I have been accepting it - that highly publicized media reports of suicides cause a phenomenon known as suicide contagion. That is, highly publicized suicides function as "social proof" that suicide is an acceptable option, and people in the area of publicity commit suicide using the publicized method in greater numbers. These are sometimes called "suicide clusters" and are apparently most common among young people.

The studies that provide the basis for the phenomenon of suicide contagion are, apparently, somewhat questionable. Many suffer from lack of control for important variables; those that are controlled suffer from problems with the control groups or small sample size. Using another method, some ecological studies have indicated that the suicide contagion phenomenon is real; others have contradicted those findings.

So say the authors of a 2001 study in the American Journal of Epidemiology, entitled "Is Suicide Contagious? A Study of the Relation between Exposure to the Suicidal Behavior of Others and Nearly Lethal Suicide Attempts" (Mercy et al., Am Epidemiol Vol. 154, No. 2, 2001). These authors set out to determine the strength of the suicide contagion phenomenon - whether suicidal behavior in parents or relatives, or (separately) friends or acquaintances, or recent media reports of suicide, affected serious suicidal behavior in young people.

The study authors interviewed 153 people, ages 13-34, who were "victims" of nearly lethal suicide attempts and who had been treated at local emergency rooms in the Houston, Texas, area. A control group of 513 subjects was similarly interviewed. The conclusion? Not only did the study fail to demonstrate any sort of "suicide contagion," but the authors note a statistically significant protective effect when a subject heard a news report of suicide within 30 days prior to the suicide attempt or had a friend or acquaintance make a suicide attempt. That is, the ER suicide-attempt group was actually less likely than the control group to be aware of a recent media report of a suicide, or to have experienced the suicidal behavior of an acquaintance! The suicide attempt of a parent or relative had no statistically significant effect on suicidal behavior, whereas the usual "suicide contagion" sources had a statistically significant protective effect - the opposite of what the suicide contagion model predicts. The authors are, of course, careful to note that more study is needed "to understand the mechanisms underlying these findings," but it does seem that the contagion hypothesis is worth questioning. The appearance of a contagion effect may be little more than apophenia, as with news reports attributing New York physician Douglas Meyer's jump-from-heights suicide to a contagion effect from Ruslana Korshunova's highly publicized suicide. From the study:
In this study, we found no evidence that exposure to the suicidal behavior of others is a risk factor for nearly lethal suicide attempts. Even among groups at relatively higher risk for suicidal behavior (i.e., males, alcoholics, depressed persons, adolescents), we found no indication of an effect. On the contrary, we found that exposure to accounts of suicidal behavior in the media and, to a lesser extent, exposure to the suicidal behavior of friends or acquaintances were associated with a lower risk of nearly lethal suicide attempts; however, this appeared to be evident only when the emotional and temporal distance between the exposed individual and the suicide model was greatest. . . . Greater temporal and emotional distance between an individual and a suicide model may enable a person to more fully appreciate the negative consequences of suicide. [Citations omitted. Emphasis mine.]

Note that this study also appears to call into question the statement of a psychologist, from the story I reported in my earlier post, that suicide contagion disproportionately affects those already severely depressed. This study found no effect, even among depressed people.

Much to their credit, the authors propose a couple of alternative readings of their data:

[W]e examined the effects of media exposure over a 30-day interval, in contrast to most prior studies, where media effects were examined immediately after exposure. It is possible that media exposure has its greatest impact on suicidal behavior immediately after the event and that its effects are diluted or even reversed as time passes. Alternatively, it is possible that suicide attempters may be more socially isolated than other groups and are therefore less likely to be exposed to suicide models in their social networks or in the media. [Citations omitted.]

Jumping From Heights: More on Gender Imbalance, and on Suicide Contagion

In a story related to model Ruslana Korshunova's suicide, Emily Friedman interviews Adam Kaplin, an assistant professor of Psychiatry at Johns Hopkins, who has this to say about jumping from heights as a suicide method:
"When people don't have access to firearms and get it into their head that they don't think pills are going to work, they think there is something about the finality of [jumping] and think 'If I just do this it will be over,'" said Kaplin, who told that while men and women are equally likely to attempt suicide by jumping, women are less likely to die after the fall because of their lighter body weight. [Emphasis mine.]

It's interesting and unusual to see a non-psychological reason posited to explain the difference between the success rates of men and women who attempt suicide. According to this story, suicide by jumping from heights accounts for only a small proportion of total suicides. But the high (perceived and actual) lethality of the method, coupled with similar rates of attempt and a plausible physical explanation for differential lethality, must make us a bit more skeptical about psychological explanations for the difference in gender rates of suicide success. I feel this lends some support to my hypothesis that women may attempt suicide more, but succeed less, because they have less access to and familiarity with guns.

And, later in the story, "clinical psychologist and suicide expert" Madelyn Gould challenges the idea that suicide contagion affects people who aren't really suicidal:

"[44-year-old New York attending physician Douglas Meyer, who committed suicide by jumping from heights shortly after Korshunova] could think that the model definitely accomplished what she was trying to accomplish and then that method could be seen as an option for him, even if he hadn't readily thought about it before," said Gould, who said this sort of copycat syndrome isn't seen in people who are not already severely depressed or contemplating suicide, and usually only affects those who have already mapped out a plan for their death. [Emphasis mine.]

Of course, this sort of statement, backed up by precisely no evidence, should be taken with a grain of salt, but it's interesting and rare to see any sort of statement challenging the idea that suicide contagion causes people to kill themselves who are not already inclined to do so.

Tuesday, July 1, 2008

Akrasia Plus Insight: More On Altruistic Suicides

Some suicides - what we might think of as "heroic suicides" or "altruistic suicides" - are committed for the benefit of others, perhaps to save others from death. Often, these are not even seen as belonging to the same class as regular suicides.

When considering altruistic suicides, does it matter whether the harm (perhaps death) the suicide saves others from would come from outside circumstances, or the suicide's own future actions if he were to stay alive?

Generally, people recognize the value of not harming others. Sociopathic personality disorder may be associated with many types of harm to others, but it seems reasonable to acknowledge that there are many people who, despite understanding that it is wrong to harm others, nevertheless go on doing so out of weakness of will. Some people cannot help themselves, in a practical sense, from doing serious wrong (as may be the case with some rapists). They know it is wrong and feel empathy for their victims, but go on harming people anyway. And some of these people, we might assume, have insight into their akratic condition - not only do they know that it is wrong to harm others, but they realize that they are likely to do it, no matter how much effort they expend to avoid doing so. I propose that when a person such as this commits suicide for the purpose of preventing his future harm to others, his suicide is altruistic. Note that this doesn't cover cases where, for example, convicted child molesters commit suicide upon release because of difficult living conditions, or even out of guilt for prior crimes. Many suicides might have the unintended consequence of avoiding harm to others, but I would only classify those as altruistic that have the purpose of preventing harm to others.

I mention this to show that the category of "altruistic suicides" might be broader than it appears.
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