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 asserts: “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, unrelievable 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 “dangerousness 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. 
.
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 concurring 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. You are free to make
copies for distribution to those you think will benefit.
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