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SUICIDE: A Civil Right
by Lawrence Stevens,
J.D.
Thinking about suicide is commonplace. In his book Suicide,
published in 1988, Earl A. Grollman says "Almost everybody
at one
time or another contemplates suicide" (Second Edition, Beacon
Press, p. 2). In his book Suicide: The Forever Decision,
published
in 1987, psychologist Paul G. Quinnett, Ph.D., says "Research
has
shown that a substantial majority of people have considered suicide
at one time in their lives, and I mean considered it seriously"
(Continuum, p. 12). Nevertheless, thinking about suicide
is
generally speaking frowned upon and by itself is enough to result
in involuntary "hospitalization" and so-called treatment
in a
psychiatric "hospital", particularly if the person in
question
thinks about suicide seriously and refuses (so-called) outpatient
psychotherapy to get this thinking changed. The fact that
people
are incarcerated in America for thinking and talking about suicide
implies that despite what the U.S. Constitution says about free
speech, and despite claims Americans often make about America
being
a free country, many if not most Americans do not really believe
in
freedom of thought and speech - in addition to rejecting an
individual's right to commit suicide.
In
contrast, the assertion that people have a right to
not only think about but to commit suicide has been made by many
people who believe in individual freedom. In his book
Suicide in
America, published in 1982, psychiatrist Herbert Hendin, M.D.,
says: "Partly as a response to the failure of suicide prevention,
partly in reaction to commitment abuses, and perhaps mainly in
the
spirit of accepting anything that does not physically harm anyone
else, we see suicide increasingly advocated as a fundamental human
right. Many such advocates deplore all attempts to prevent
suicide
as an interference with that right. It is a position succinctly
expressed by Nietzsche when he wrote, `There is a certain right
by
which we may deprive a man of life, but none by which we may
deprive him of death.' Taken from its social and psychological
context, suicide is regarded by some purely as an issue of personal
freedom" (W. W. Norton & Co., p. 209). In
his book The Death of
Psychiatry, published in 1974, psychiatrist E. Fuller Torrey,
M.D., said this: "It should not be possible to confine people
against their wills in mental `hospitals.' ... This implies that
people have the right to kill themselves if they wish. I
believe
this is so" (Chilton Book Co., p. 180). In 1968 in
his book Why
Suicide?, Dr. Eustace Chesser, a psychologist, asserted: "The
right
to choose one's time and manner of death seems to me unassailable.
... In my opinion the right to die is the last and greatest human
freedom" (Arrow Books, London, pp. 123 & 125). In
On Suicide,
published in 1851, Arthur Schopenhauer said: "There is nothing
in
the world to which every man has a more unassailable title than
to
his own life and person" (H. L. Mencken, A New Dictionary
of
Quotations, Knopf, 1942, p. 1161). In a books-on-tape
audiocassette version of their book Life 101, published
in 1990,
John-Roger and Peter McWilliams tell us: "The consistency
of
descriptions from a broad range of individuals points to the
possibility that death might not be so bad. ... Suicide is always
an option. It is sometimes what makes life bearable. Knowing
we
don't absolutely have to be here can make being here a little
easier." Suzy Szasz, a victim of Systemic Lupus Erythematosus,
confirms this view in her book Living With It: Why You Don't
Have
To Be Healthy To Be Happy after an acute flare-up of her disease
during which she contemplated suicide: "As many an ancient
philosopher has noted, I found the very freedom to commit suicide
liberating" (Prometheus Books, 1991, p. 226). In ancient
times
(circa 485-425 B.C.), Herodotus wrote: "When life is so burdensome
death has become for man a sought after refuge." In
his book The
Untamed Tongue, published in 1990, psychiatrist Thomas Szasz
as-
serts: "Suicide is a fundamental human right. ...society
does not
have the moral right to interfere, by force, with a person's
decision to commit this act" (Open Court Publishing Co.,
p. 250-
251).
To
these statements of support for the right to commit
suicide, I will add my own: In a truly free society, you own
your
life, and your only obligation is to respect the rights of
others.
I believe everyone is entitled to be treated as the sole owner
of
himself or herself and of his or her own life. Accordingly,
I
think a person who commits suicide is well within his or her rights
in doing so provided he or she does so privately and without
jeopardizing the physical safety of others. Family members,
police
officers, judges, and "therapists" who interfere with
a person's
decision to end his or her own life are violating that person's
human rights. The often expressed view that the possibility
of
suicide justifies psychiatric treatment even if it must be imposed
against the will of the potentially suicidal person is wrong.
Provided the person in question is not violating the rights of
others, that person's autonomy is of more value than enforcement
of
what other people consider rational or of what other people think
is in a person's best interests. In a free society where
self-
ownership is recognized, "dangerousness to oneself"
is irrelevant.
In the words of the title of a movie starring Richard Dreyfuss:
"Whose Life Is It, Anyway?" The greatest human
right is the right
of self-ownership, one aspect of which is the right to life, but
another aspect of which is the right to end one's own life.
Whether or not a person supports the right to commit suicide is
a
litmus test of whether or not that person truly believes in self-
ownership and the individual freedom that comes with it, the
individual freedom that many of us have been taught is the reason-
for-being of American democracy.
One
reason some oppose the right to commit suicide is
theological belief that is sometimes expressed this way: "God
gave
you life, and only God has the right to take life from you."
Using
this reasoning to justify interfering with a person's right to
commit suicide is imposing religious beliefs on people
who may not
share those beliefs. In America where we supposedly have
freedom
of (and from) religion, this is wrong.
Another
reason some people believe it is ethical to
interfere with a person's right to think about or commit suicide
is
belief in mental illness. But a so-called diagnosis of "mental
illness" is a value judgment about a person's thinking
or behavior,
not a diagnosis of bona-fide brain disease. So-called mental
illness does not deprive people of free will, but on the contrary
is an expression of free will (which reaps the disapproval
of
others). Those who say mental illness destroys "meaningful"
free
will or who call the beliefs of others irrational (and therefore
necessarily caused by mental illness) are accepting the idea of
mental illness as brain disease without adequate evidence or are
refusing to accept the beliefs of others only because they differ
from their own.
Sometimes people oppose the right to commit
suicide because of belief in a sort of entirely non-biological
mental illness. The error of this way of thinking is that
without
a biological abnormality the only possible defining characteristic
of mental illness is disapproval of some aspect of a person's
mentality or thinking. But in a free society, it shouldn't
matter
if the thinking of a person meets with the disapproval of others,
provided the person's actions do not violate the rights
of others.
Furthermore,
there isn't any good evidence that mental illness
by any generally accepted definition is usually involved in a
person's
decision to commit suicide. In her book about teenage suicide,
Marion Crook, B.Sc.N., says "teens considering suicide are
not
necessarily mentally disturbed. In fact, they are rarely
mentally
disturbed" (Every Parent's Guide To Understanding Teenagers
&
Suicide, Int'l Self-Counsel Press Ltd., Vancouver, 1988, p.
10).
Psychologist Paul G. Quinnett, Ph.D., makes this observation in
his
book Suicide: The Forever Decision: "As we have
already discussed,
however, you do not have to be mentally ill to take your own life.
In fact, most people who do commit suicide are not legally
`insane.' So it seems we have a very interesting problem.
To
prevent you from killing yourself, doctors like myself will stand
up in court and say something to the effect that, by reason of
a
mental illness, you are a danger to yourself and need treatment.
But - and this is the weird part - you may, in a matter of a few
hours to a couple of days, get up one morning and say, `I've
decided not to kill myself, after all.' And if you can convince
us
you mean what you say, you can leave the hospital and go home.
Question: Are you now completely cured of your so-called mental
illness? Obviously not, since the chances are you were never
`mentally ill' in the first place. ... As I have said, I
do not
believe you have to be mentally ill to think about suicide"
(pp.
11-12). Dr. Quinnett's statement is a clear admission that
allegations of mental illness to justify incarcerating suicidal
people often are deliberate dishonesty, even by the definition
of
mental illness that exists in the minds of the professionals who
make the allegations of mental illness. They make these
allegations of mental illness even though they know they are false
because involuntary psychiatric commitment laws require a finding
of "mental illness" before involuntary commitment may
take place.
Making deliberately false accusations of "mental illness"
under
oath in a court of law to satisfy commitment laws for the purpose
of discouraging suicidal thinking or preventing suicide is a way
to
avoid coming to terms with the fact that incarcerating people
only
because they happen to think their lives are not worth living
or
because they have attempted to end their own lives is a form of
authoritarianism and despotism. In the case of people who
have
only thought about (not attempted) suicide, it is imprisonment
for
mere thought-crime similar to that illustrated by George
Orwell in
his novel 1984.
Even people who
oppose the right to commit suicide
because of their belief in mental illness sometimes can be made
to
understand the erroneousness of their biological theorizing or
their belief in some kind of non-biological mental illness by
asking them if they would see any point in living if they were
suffering from a terminal disease involving excruciating, unreliev-
able physical pain or were completely paralyzed from the neck
down
with no chance of recovery. Once people admit there are
any
circumstances in which they would choose death, they often
see
suicide is the result of a person's personal judgment about his
or
her circumstances in life rather than a biological malfunction
of
the brain or some conception of non-biological mental illness.
Some
may feel it is right to use force to prevent suicide
because of their belief that the potentially suicidal person's
desire to die is probably temporary and will probably go away
or
subside if he or she is forced to live a short time longer until
the acute emotional reaction to a recent traumatic event has faded
with time. Those advancing this argument sometimes acknowledge
a
person does have a right to commit suicide if he or she is not
acting impulsively. But most evidence indicates few if any
people
who commit suicide do so impulsively. As Earl A. Grollman
says in
his book Suicide (in which he opposes the right
to commit suicide):
"Suicide does not occur suddenly, impulsively, unpredictably"
(p.
63). In his book Suicide: The Forever Decision, psychologist
Paul
G. Quinnett, Ph.D., says: "I have talked to hundreds of suicidal
people... If I can make another guess about what has been going
on
inside your head and heart, it is that you have had long and
difficult discussions with yourself about whether to live or die"
(pp. 18-19). Rather than being impulsive, suicide is something
people do after long contemplation as part of their efforts to
deal
with what they consider intolerable life circumstances.
The
usual justification for involuntary incarceration and
so-called treatment of those considering or attempting suicide
is
alleged dangerousness to oneself. But even people who don't
agree
with the principle of self-ownership should ask themselves:
dangerousness to oneself in the eyes of whom? To
an onlooker,
suicide may seem to always be harmful to the person ending his
or
her life. But that's not how the person committing suicide
sees
the situation. People commit suicide because they decide
continued
living in their particular circumstances is a greater harm
to
themselves than death. This is made abundantly clear by
Francis
Lear, editor-in-chief if Lear's magazine, in her autobiographical
book, The Second Seduction: "I ALWAYS HAVE an `exitline.'
A stash
of lithium. A building tall enough to kill, not maim, for
godsake,
not maim. One goes out in suicide, one simply goes out,
gets out,
wriggles, bolts, and does not some back merely smashed up or,
as
the first priority, left with the ability to feel. One does
not go
out in a half-assed manner. Suicide has many consequences.
It
will hurt people who love you, it can splatter the sidewalks;
but
its purpose, the reason for its magnetism, is that it is the only
guaranteed, surefire way to end, blitz, detonate a critical mass
of
suffering. Suicide, reduced to its pure essence, is a delivery
system that moves us from pain to the absence of pain. If
the gods
contrive against us and the planets are in disarray, if the earth
cracks open beneath us, we must always have a way out" (Harper-
Perennial, 1992, p. 26). As Dr. Eustace Chesser said, "Suicide
is
a deliberate refusal to accept the only conditions on which it
is
possible to go on living" (Why Suicide?, op. cit.,
p. 122).
A
person's reasons for choosing death may or may not make
sense to other people. In a free society, however, that
doesn't or
at least shouldn't matter. It is a very personal and subjective
determination, so how can anyone else reasonably claim to know
that
a suicidal person is making the "wrong" decision in
terms of "dan-
gerousness to himself" or herself as experienced by that
person?
As William Glasser, a psychiatrist, says in his book Positive
Addiction: "we should keep in mind that we can never
feel another
person's pain" (Harper & Row, 1976, p. 8). In general,
I agree
with psychiatrist Mark S. Gold's assertion that "suicide
is a
permanent solution to a temporary problem" (The Good News
About
Depression, Bantam Books, 1986, p. 290). However, the
determination of whether it is best to suffer through a miserable
present in the hope of getting to a possibly better future is
a
value judgment. A person could legitimately decide a hopefully
better future does not justify choosing to experience an unbearable
present. No one should claim the right override, by force,
a
person's value judgements and decisions about something as personal
as this.
Another
factor to consider is that mental health
professionals, contrary to their claim that they are preventing
suicide, more often are unwittingly promoting eventual
suicide. In
an article in the May-June 1974 New York University Law Review
titled "Involuntary Psychiatric Commitments to Prevent
Suicide",
New York University sociology professor David F. Greenberg, Ph.D.,
says studies on psychiatric suicide prevention "have been
either
inconsistent or negative" and suggest "that institutionalization
may not prevent suicide, but, in fact, may result in more suicides"
(p. 256, emphasis in original). Considering the harmfulness
of
today's biological "treatments" in psychiatry, the dreariness
and
sometimes cruelty of institutional life, and the effects of
psychiatric stigma, such as lowered self-esteem and discrimination
in education and employment, increased rates of suicide among
suicidal people who get psychiatric "treatment" compared
with a
similar population of suicidal people who do not get "treatment"
should be expected. The value of recognizing the right to
commit
suicide is not only respecting individual freedom but preventing
the harm and cruelty that often go on in the name of suicide
prevention.
While
courts have gone both ways in right-to-die cases,
judicial decisions defending the right to die are not unusual
and
are gaining favor. In his book Death With Dignity,
published in
1989, attorney Robert L. Risley points out that in general "court
cases clearly established the right to bodily integrity, confirming
that the basic right of self-determination includes the right
to
die, and that it overrides the state's duty to preserve life"
(Hemlock Society, Eugene, Oregon, 1989, p. viii).
The
U.S. Supreme Court addressed the question of whether
the U.S. Constitution protects the right to die in 1990 in the
case
of Cruzan v. Missouri, 497 U.S. 261. In the words of Time
magazine, in this case the U.S. Supreme Court "declared
for the
first time that there is indeed a right to die" (July 9,
1990, p.
59). Of the nine justices, all except Justice Scalia acknowledged
the right to die is a federal constitutional right. In his
con-
curring opinion, Justice Scalia argued vigorously against the
reasoning of the majority and dissenting opinions, both of which
acknowledged the right of self-determination is a constitutional
right and that it includes the right to die. Justice Scalia
opposed the view of the other eight justices, arguing vigorously
against what he called the right to commit suicide. But
in this
respect he stood alone on the Court.
Since
the rationale of these cases is that people have a
right of self-determination that includes the right to die, they
support my assertion that suicide is a civil right even though,
at
present, the right to die has been upheld only in cases involving
physically ill or disabled people who are conscious enough to
express their desire to die or who when healthy enough to express
an opinion indicated death is what he or she would want in the
circumstances. In fact, this justification is probably in
many
cases a mere excuse or rationalization to cover up the real reason.
If the sole reason for permitting death was the desire of the
ill
or disabled person, involuntary psychiatric commitment of suicidal
people would not take place. A bona-fide but unacknowledged
reason
ill or disabled people are allowed to deliberately end their lives
is they have become a burden to other people. In other words,
just
as able-bodied suicidal people are incarcerated for their own
supposed benefit (to prevent them from committing suicide) when
the
real reason is selfish concerns of others, people with severe,
permanent disability or incurable disease are allowed to die for
their own supposed benefit when a real but unacknowledged purpose
is to relieve others ("society") of the burden of caring
for them.
However, the reasoning of judicial opinions upholding the
right to die emphasize personal autonomy and self-determination
as
the basis for the decision and therefore support my opinion that
each person is the sole owner of himself or herself, of his or
her
own body, and of his or her own life. They support my opinion
that
the right to commit suicide is a civil right.
If you are a legislator who supports the right of self-
ownership you should introduce legislation to delete references
to
"dangerousness to oneself" in your state's psychiatric
commitment
laws. If you are a judge deciding questions of constitutional
law,
you should strike down as unconstitutional laws that imprison
("hospitalize") people only for supposed dangerousness
or harm to
oneself. Whoever you are, you should respect the autonomy
of all
of your fellow men and women whose conduct does not unlawfully
harm
others.
THE AUTHOR, Lawrence Stevens, is a lawyer whose practice has
included representing psychiatric "patients". His
pamphlets are
not copyrighted. Feel free to make copies.