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This position assumes that suicide results from competent people making autonomous, rational decisions to die, and then claims that society has no business "interfering" with a freely chosen life or death decision that harms no one other than the suicidal individual. But according to experts who have studied suicide, the basic assumption is wrong.
A careful 1974 British study, which involved extensive interviews and examination of medical records, found that 93 percent of those studied who committed suicide were mentally ill at the time. A similar St. Louis study, published in 1984, found a mental disorder in 94 percent of those who committed suicide. There is a great body of psychological evidence that those who atntempt suicide are normally ambivalent, that they usually attempt suicide for reasons other than a settled desire to die, and that they are predominantly the victims of mental disorder.
A suicide attempt powerfully calls attention to one's plight. The humane response is to mobilize psychiatric and social service resources to address the problems that led the would-be suicide to such an extremity. Typically, this counseling and assistance is successful. One study of 886 people who were rescued from attempted suicides found that five years later only 3.84 percent had gone on to kill themselves. A Swedish study with a 36-year follow-up found only 10.9 percent later killed themselves. Paradoxically, the prospects for a happy life are often greater for those who attempt suicide, but are stopped and helped, than for those with similar problems who never attempt suicide. In the words of academic psychiatrist Dr. Erwin Stengel, "The suicidal attempt is a highly effective though hazardous way of influencing others and its effects are as a rule ... lasting."
In short, suicidal people should be helped with their problems, not helped to die.
[A]s a clinical suicidologist, and therapist who has interviewed or treated over 800 suicidal persons and their families, I have been impressed [that those] who are suicidal are more like each other than different, including ... those who choose "rational suicide". ... [A]ll suicides, including the "rational," can be an avoidance of or substitute for dealing with basic life-and-death issues. The suicidal person and significant others usually do not know the reasons for the decision to commit suicide, but they give themselves reasons. That is why rational suicide is more often rationalized, based upon reasons that are unknown, unconscious, and a part of social and family system dynamics. ... The proponents of rational suicide are often guilty of tunnel vision, defined as the absence of perceived alternatives to suicides.
Why, then, are there so many personal stories of people in hospitals and nursing homes having to cope with unbearable pain? Tragically, pain control techniques that have been perfected at the frontiers of medicine have not become universally known at the clinical level. What we need is better training in those techniques for health care personnel -- not the legalization of physician-aided death.
|True respect for the rights of people with disabilities would dictate action to remove those obstacles -- not "help" in committing suicide.|
Most people with disabilities will tell you that it is not so much their physical or mental impairment itself that makes their lives difficult as it is the conduct of the nondisabled majority toward them. Denial of access, discrimination in employment, and an attitude of aversion or pity instead of respect are what make life intolerable. True respect for the rights of people with disabilities would dictate action to remove those obstacles -- not "help" in committing suicide.
Under the equal-protection clause of the Fourteenth Amendment to the U.S Constitution, legislative classifications that restrict constitutional rights are subject to strict scrutiny and will be struck down unless narrowly tailored to further a compelling governmental interest. ... A right to choose death for oneself would also probably extend to incompetent individuals. ... [A] number of lower courts have held that an incompetent patient does not lose his or her right to consent to termination of life-supporting care by virtue of his or her incompetency. . . [T]he ["substituted judgment"] doctrine authorizes ... indeed, requires -- a substitute decision maker, whether the court or a designated third party, to decide what the incompetent person would choose, if that person were competent.... Therefore infants, those with mental illness, retarded people, confused or senile elderly individuals, and other incompetent people would be entitled to have someone else enforce their right to die.Thus, if direct killing is legalized on request of a competent person, under court precedents that have already been set, someone who is not competent could be killed at the direction of that person's guardian even though the incompetent patient had never expressed a desire to be killed.
2. E. Robins, THE FINAL MONTHS 12 (1981).
3. See, e.g, Dorpat & Boswell, An Evaluation of Suicidal Intent in Suicide Attempts, 4 COMPREHENSIVE PSYCHIATRY 117 (1964).
4. See H. Hendin, SUICIDE IN AMERICA 223 (1982); Jensen & Petty, The Fantasy of Being Rescued, 27 PSYCHOANALYTIC Q. 327, 336 (1958); K. Menninger, MAN AGAINST HIMSELF 50 (1938); Rubinstein, Meses & Lidz, On Attempted Suicide, 79 A.M.A. ARCHIVES NEUROLOGY AND PSYCHIATRY 103, 111 (1958); & Stengel, SUICIDE AND ATTEMPTED SUICIDE 113 (1964).
5. Jensen & Petty, supra note 4; Rubinstein, supra note 4, at 109; & Stengel, supra note 4, at 73.
6. Rosen, The Serious Suicide Attempt: Fiue Year Follow Up Study of 886 Patients, 235 J.A.M.A. 2105, 2105 (1976).
7. Dahlgren, Attempted Suicides 35 Years Afterward, 7 SUICIDE AND LIFE-THREATENING BEHAVIOR 75, 76, 78 (1977). 8. Stengel, supra note 4, at 113-14.
9. Joseph Richman, Letter to the Editor, "The Case against Rational Suicide," Suicide and Life-Threatening Behavior, VoI. 18, No. 3 (Fall 1988): p. 288.
10. James H. Brown, Paul Henteleff, Samia Barakat and Cheryl J. Rowe, "Is It Normai for Terminally Ill Patients to Desire Death?" American Journal of Psychiatry, VoI. 143, No. 2 (February 1986): p. 210. 11. See footnote 9
12. Flora Johnson Skelly, "Don't dismiss depression, physicians say," American Medical News, September 7, 1992, p. 28. 13. Ibid
14. Pieter Admiraal, "Euthanasia in the Netherlands - A Dutch Doctor's Perspective" (presented at the national convention of the Hemlock Society, Sheraton Crystal City, Arlington, Virginia, September 1986).
15. Walter Weber, Letter to the Editor, "What Right to Die?" Suicide and Life-Threatening Behavior, Vol. 18, No. 2 (Summer 1988): p. 181.
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