I’ve caught up on the recent threads (both the ones about teachers, students, and young women’s agency — and the one about Pal Sarkozy and the question of whether an eleven year-old could ever sexually assault an adult). I’d been away from the computer for the holiday weekend, and when I’ve had some time to mull, expect to turn to both subjects again. For now, I want to answer a question posed to me by a reader named Natasha, who notes that I often write about the preciousness of autonomy.
My question is about sovereignty and suicide.
Some background, firstly: I have recently been involved in a heavy and emotionally tiring (if mentally stimulating) debate with a very firm pro-life friend of mine (i.e. no abortion in any circumstance except if there is no way whatsoever for both mother and child to survive). I am firmly pro-choice, and this stance is centered on my belief that people have a right to bodily sovereignty and being able to make decisions that affect that sovereignty.
The difficulty I am having is that I come quickly to an impasse when I consider this philosophy beyond a woman’s reproductive rights. How do I reconcile – if it is at all reconcilable – bodily sovereignty with stopping a person’s decision to commit suicide (which is a right of bodily sovereignty if any, isn’t it?) (or, actually, any type of harm to oneself)? It’s not that I believe suicide is immoral or wrong – a relative of mine killed himself and I could never think of what he did as “something evil”. I think it’s a very sad, grief-filled action that people should avoid, but I can’t see it as immoral. However, this doesn’t change the fact that if I saw someone attempt to jump off a bridge, I would try my best to restrain him or her from doing so.
I could argue that the person may have been irrational, but how can I decide that if, afterwards, the person seems perfectly rational? If a person is in persistent unbearable pain that will never end, my gut reaction to a plea for euthanasia is that it’s understandable and rational, and I wouldn’t deny that person their right to live with dignity. But what if they’re not so? What if they’re healthy and really honestly believe that they’re not happy anymore with life or that life is too horrible? To that scenario, I just want to say, “You’re not thinking this through!” and I would call the police if I have to to keep them from committing suicide.
We place all sorts of reasonable limits on the right of individuals to do as they please, limits which don’t automatically contradict the principle that individual autonomy — sovereignty over one’s flesh — is particularly precious. California requires adults to wear seat belts in cars and helmets when they ride motorcycles. The state knows that the behavior of not wearing helmets or seatbelts has verifiable social and economic costs to our health care system, costs that others will bear. Society limits our ability to do as we please when our behaviors impinge upon others; my freedom to swing my fist, of course, stops at your nose.
A close friend of mine discovered his sister’s body after she had taken her life. She had electrocuted herself with a hair dryer in a bathtub; he found her body more than 48 hours after her death. He needed a great deal of therapy to cope with the experience, and nearly a decade later, still suffers from nightmares. Very few people commit suicide in a way that doesn’t leave a nasty mess for others to clean up. It doesn’t strike me as unreasonable for the state to say that this particular exercise of sovereignty — the exercising of the “right not to be” — needs to be limited because of its enormous impact on others.
I’m a strong supporter of the right of the terminally ill to die with dignity; I have long supported doctor-assisted suicide for those who are in great pain or who are unwilling to cope with the loss of autonomy that comes with a degenerative disease. I think it is right and good to offer folks with late-state cancer or ALS the option of dying on their own terms with medical assistance. Of course, ethicists and physicians need to work together to make sure that no undue pressure from insurance companies or estate-hungry relatives is being brought to bear on the person who is contemplating dying. Euthanasia needs to be an option, never an imperative; I don’t buy the assertion that allowing the former will invariably lead to the imposition of the latter.
I’m also someone who has been suicidal as an adult. On more than one occasion I attempted to take my own life, using drugs or (the last time) with gas. Obviously, I was always ambivalent about dying; I chose methods that while dangerous, were likely to be unsuccessful in ending my life swiftly. I’m hugely grateful to those who, on six different occasions between 1987 and 1998, intervened and had me locked up in hospitals. I’m grateful to those police officers and physicians who decided that I met the criteria of someone who was incapable of exercising sovereignty over his body and his life, and needed to be placed — involuntarily — on locked wards. Had there been no laws granting the state the right to commit someone to treatment against his or her will, I might very well not be alive today.
I support the right to abortion. I do think that abortions are rightly performed by medical profesionals rather than by amateurs, which is why I so strongly support the work of Medical Students for Choice. Even when we exercise our right to autonomy, we still need help. And just as those who seek to terminate a pregnancy ought to seek out a doctor or nurse practitioner, so too those who are making a decision about ending their lives ought to do so in consultation with professionals.
Of course, the standard of rationality applies: doctors ought not refuse a woman’s request for an abortion, but may have excellent reasons for intervening in order to stop someone who is suicidal from following through on their impulses. Suicide is a permanent solution to what is — at least in a great many cases of mental rather than physical illness — a temporary and solvable problem. It tends to be the preferred option of those whose capacity to reason has been gravely compromised. And while I do not rule out the possibility that someone with severe depression might rationally choose suicide as more preferable to living on in endless agony, I’m reluctant to extend to them that right, at least outside of a clinical setting.
Any philosophical or theological belief will have dilemmas it cannot easily solve. Very few thinking people hold a position to which they will not admit exceptions. My own view of the individual is woven together from many disparate strands; I’ve read my Aristotle and my Aquinas, but love better my John Stuart Mill and my Isaiah Berlin. I’m a believer who has always found the arguments of the non-believers to be more intellectually compelling, but those of the faithful to be of indispensable comfort. And so I believe we are created beings, beings who were given the capacity to reason and to reflect and to feel. We were designed for a paradox — given free will to choose, and forced to limit some choices in order to live together in community.
We are meant, in the words of the prophet Isaiah, to “reason together” — perhaps with God, certainly with each other. And when we are at our loneliest and most despairing and most likely to end our lives, it doesn’t seem unjust to ask that we reason our way through our terrible dilemma, together. And when we’re really desperate, the state may just need to intervene, and force us to that place where we can “reason through our reasons” for wanting to die.