Friday, March 30, 2012

How the Suicide Prohibition Hurts Non-Suicidal People

In Anglo-American law, recent decades have seen a shift in the treatment of suicide. Suicide was once treated as a crime for which one could be punished if unsuccessful. Now, suicide is treated as the consequence of a mental illness from which one must be "rescued," by coercive means if necessary, for one's own good.

I have argued that there is still a de facto suicide prohibition, for the following reasons:

  1. People who attempt suicide and fail are often imprisoned in a hospital as a result.
  2. People who attempt suicide are forcibly "rescued" and brought back to life against their will, if possible - sometimes to a state of very low quality of life, such as akinetic mutism.
  3. Those who express a desire to commit suicide are often imprisoned in a hospital as a result; this process is much more humiliating and degrading than outsiders might realize.
  4. The drug prohibition (drug war) means that barbiturates are unavailable - barbiturates being the only means of suicide considered humane enough to be used in states that allow physician-assisted suicide for terminally ill people.
  5. Helping another person to commit suicide is prosecuted as a crime in all but the most limited situations in the few states that allow physician-assisted suicide. Suicide is the only act that is not itself a crime, but which assisting another person to commit is a crime.

The suicide prohibition, as outlined above, is often said to be in the best interests of the suicidal persons themselves - a paternalistic justification that does not sit well with those who value personal liberty. I have argued that it would be much better for us to be allowed to kill ourselves securely and peacefully, with a modicum of dignity.

What I wish to discuss in this post is the ways in which the suicide prohibition harms even people who are not themselves suicidal.

1. Coercive Care Costs Money

Forcible treatment of people who attempt suicide in emergency rooms and hospitals costs between one billion and four billion dollars per year in the United States. This unwanted treatment does not benefit anyone and harms taxpayers and the entire medical system.

2. Dangerous Methods Create Externalities

People denied access to comfortable means of suicide (like barbiturates) will often use less reliable means that endanger bystanders, such as chemical reactions inside enclosed areas and traffic collisions. In addition, common means of suicide such as standing in front of a train, shooting oneself at a shooting range, or jumping from heights are emotionally painful for those who witness or involuntarily participate in the event.

3. We Take Our Organs With Us

When a person commits suicide in our system, he or she must do so in a manner that avoids contact with hospitals, preventing him or her from donating healthy organs to those who need them. Over 6,000 people die every year in the United States waiting for an organ; over 34,000 people commit suicide every year, taking with them healthy hearts, lungs, livers, eyes, and skin that could be used to save the lives of people who want to live. In other words, the suicide prohibition kills 6,000 people per year who want to live. Does society's interest in forcing a person to stay alive when he wants to die really justify allowing another person to die when he wants to live? Should society prevent suicidal people from saving the lives of others who actually want to live?

4. The Fantasy Of Rescue Tempts Attention Seekers

The practice of "rescuing" people who attempt suicide by forcibly treating them tempts people who don't really want to die, but are in pain and crave attention, to endanger themselves. If suicide were legal and easy, and suicide attempters were not interfered with, the signalling value of a suicidal gesture would be destroyed. By destroying the signalling value, hence the incentive to self-harm, we could better protect those who don't really want to die. As it is, the fantasy of rescue tempts those who don't really want to die into harming themselves, hoping for a rescue that might not come. Undoubtedly, thousands of people who didn't really want to die, die from suicide every year; if reliably lethal barbiturates were available and "rescue" unheard-of, non-suicidal people would have much less social incentive to engage in dangerous, ambiguous self-harm events.

5. We Can't Say Goodbye To You - Or Talk It Over

Friends and family left behind by a suicide often complain that the suicide didn't give any warning, and didn't say goodbye. Unfortunately, even if a suicidal person wants to talk over his decision with family and friends or say goodbye, he cannot, because he risks imprisonment in a hospital. If suicide were legal, it would be much less unexpected and tragic for those left behind, and suicidal people would be able to rationally talk over their decision with other people. As it is, we're on our own.

24 comments:

  1. Why do you suppose that most people really would find it much less "tragic" that a loved one or friend committed suicide under such a post-prohibition regime?

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    1. Prohibition, including the kind of Junior Spy "learn the warning signs of suicide" stuff, seems to promote a feeling of responsibility for the suicide of others. I think getting rid of prohibition would be a way of seeing suicide as an individual choice, rather than a tragedy to be prevented. I believe a sense of preventability, and the feeling of responsibility, are both implicated in the feeling of tragic-ness.

      If I could have, or should have, prevented a suicide, I'm going to regret it more. If it's just a natural process, like a death from cancer, I'd suspect it's going to be perceived as sad but less tragic.

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    2. There are studies on suicide survivors as opposed to those bereaved by other causes, but I haven't seen studies on those bereaved by suicide compared to each other, based on how responsible they feel, etc. That's the kind of study that would help here.

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  2. Hmmmm love the post, but not so sure about that "We Can't Say Goodbye To You - Or Talk It Over". I talked about this a while ago, about whether unexplained suicide or explained suicide would be worse (http://estnihil.blogspot.co.uk/2012/02/magical-marvelous-mirth-filled-prison.html). It essentially comes down to the choice between having loved ones feeling as if they could have done something to help and didn't, so endless regret, or couldn't have done anything at all (explained suicide) and therefore were powerless, causing depression. I too, wish for more studies on the matter.

    Though the fact that there's no possibility of actually choosing to explain is probably still a bad one.

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  3. Succint and completely accurate, Sister Y. Don't know if it'd be of any interest to you or anyone else, but a few years ago Gary (Inmendham of YouTube fame) had a debate with a guy who was about to enter medical school about the right-to-suicide. It's well worth a watch. Part 1 can be found at

    http://www.youtube.com/watch?v=Op4Mq5CPd0U

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  4. Succint and completely accurate, Sister Y. Don't know if it'd be of interest to you or anyone else, but a few years ago Gary (Inmendham of YouTube fame) had a debate with a guy who was about to enter medical school about the right-to-suicide. It's well worth a watch. Part 1 can be found at

    http://www.youtube.com/watch?v=Op4Mq5CPd0U

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    1. forget inmendham; he's not a high-functioning depressive. not at all! he's white trash.

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    2. On that note, I JUST this week read in the Baumeister book that the phrase "poor white trash" was probably invented by black southerners, those generally considered lowest on the hierarchy hence least able to achieve self-worth, to distinguish themselves from a category that could be defined as even lower than themselves.

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    3. Bullshit, inmendham is great -- a true individual.

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  5. Apologies for the double-posting.

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  6. I saw the Dr Kevorkain movie, it was horrible how he approached the terminal with his logical "you can donate organs and save lives" speech. It made sense but i don't know. Also, donating your organs results in more children. So no.

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    1. It's up to the recipients what they do with the organs - but I don't think it's wrong to save lives simply because it might result in more children. I want suffering people not to suffer, even if that means they might go on to breed. And I certainly think it should be my choice to donate my organs - not the choice of the government. I sounds like your problem with The Good Doctor is his pressuring patients - isn't the government forbidding us from donating organs (by forbidding suicide, forcing us to sneak around) much worse than that?

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    2. "but I don't think it's wrong to save lives simply because it might result in more children."

      They already have a death sentence, they will die eventually. If they die before procreating=win! If you save them, they procreate,they die, more suffering,more procreate,etc etc.I see things different and i actually have a paper from town hall with the explicit "no organ donor", in my country you have to get this if you don't want to donate if by some chance you die and your organs are preserved, your family can still give the okay sign to donate - with this paper they are stopped (my family probably would do it,goodhearted breeding hypocrites).

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    3. Whatever you tell yourself to get to sleep at night, dude.

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    4. zzzzzzzzzzzzzz

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  7. 'Crave attention'? REALLY? The tired old 'attention-seeking' cliche? It is NOT about that - anyone who is in pain deserves care and help. more importantly, many people feel very conflicted about suicide, that part of
    them wants to do it and part of them doesn't. Asking for help can be a last attempt by the part of them that doesn't want to die, to get help. Suicidal people will always want to be 'rescued'.

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    1. Unfortunately I believe, this "'attention-seeking' cliche" is precisely why most suicides are stigmatized, to the detriment of those who DO want to end their lives, and not be mocked more needlessly than they already suffer from. Take away that attention incentive, and at least people will take suicide decisions with more respect rather then dismissing it as mere "selfish narcissist fancy".

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    2. I understand that this sounds insensitive. Please try to think beyond appearances and initial emotional responses. There are, we might say, two groups of people: one suffering group who just want to die, and another suffering group who just wants help.

      If we assume everyone is in Group B, and "rescue" everyone from suicide, we perversely ENCOURAGE people to risk their lives to get "saved." If, instead, we refused to "rescue" anybody, people who want help would have to use less dangerous (to them), more proactive means of getting help. The fantasy of rescue tempts people who don't really want to die into harming themselves, and meanwhile screws those of us who really do want to die. Overall, it's a poor policy to forcibly revive suicides.

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    3. Sister,

      Here's another point in defense of your argument. The prohibition on suicide adds to the social stigma against it. For many families, that stigma is exactly what makes the suicide so difficult to endure.

      If our law looked upon suicide not as something "evil" and "scandalous", an indication of "failure" on the part of the suicider and his or her family, but rather as an intelligent, practical, honorable, completely understandable and defensible response to the disgusting and intolerable circumstances that life on earth often brings, the families left behind would suffer much less.

      The suffering in suicide is not in the loss of the person, who has suffered enough and wants to peacefully accelerate the checkout process, but in the huge drama that our chimpanzee minds make of it.

      @jesse_livermore

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  8. My post above may have made it seem that I was suggesting that a preference for death requires incurable suffering to be justified. It does not. There are plenty of compelling reasons besides incurable suffering that one might not want to stick around any more.

    A person doesn't want to wake up early Sunday morning... Or Monday morning, or Tuesday morning, or Wednesday, or ever. OK, what's the catastrophe in this? The person spent 14 billion years dead, and is going to die shortly anyways (30 years = tomorrow). The only relevant concern is the impact on those left behind, and suicide prohibitions, with the scandal and judgment they place on the suicider and family, only worsen that impact.

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  9. Dude drinks malathion (the pesticide) in suicide attempt, vomits when "rescued," sickens paramedics.

    If barbiturates were legal, he would have either (a) taken them and died, or (b) realized he would die if he took them, and not taken them.

    Nobody would be sick.

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  10. Truer words were never spoken.

    You nailed it in this post, on each point.

    I've taken a risk and I've chosen to talk about it more or less openly with everybody. Mostly because I believe the law is an ass and is denying me my rights --- and everyone else their rights.

    I believe it's proactively evil, tantamount to torture.

    And the laws are supported by real people, so I am accusing them of being proactively evil, and engaging in immoral activities that are tantamount to torture.

    Just to be clear.

    But I do respect those people I know who are respecting my autonomy, even though most (not all) disagree with my desire.

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  11. There is one point missing: The suicide prohibition creates alienation for those who feel that it attacks their basic liberties. I had several encounters with complete strangers who unilaterally declared an obligation on my part to live and feel pain against my will. During this process, my solidarity with society fell to zero, and then inversed to hostility. I would now pay money to harm society in retaliation, if I could.

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