brothercyst: home + suicide

Sunday, July 15, 2007

home + suicide

The irritation caused by delays and obnoxious fellow passengers (I hated the guy I was sitting next to on the flight today) on my return to New York was mitigated by the fact that the waiting allowed me to read and nearly finish Peter Singer's Rethinking Life and Death, a book that came out almost fifteen years ago and made some cogent and reasonable arguments for a reevaluation of the "sanctity of life" moral ethic, saying frankly that (among many other things) not all human life is of equal value and that it is reasonable to harvest organs from humans who will never regain consciousness even if they are not "dead."

He also writes at great length about the right of incurably ill patients to exercise control over their deaths and says that physicians should be allowed to assist in well-considered suicide efforts. I agree with this but I wonder (because he doesn't get into it) how the new ethical code he describes would deal with physically healthy patients who request assistance in taking their own lives. Well, you say to yourself upon reading the previous sentence, if a physically healthy person wants to commit suicide, then he or she must not be of sound mind and therefore incapable of rationally making the decision to commit suicide; psychiatric treatment is the answer here. But what if the person is of sound mind? Should people only have agency over their own deaths if they are incurably ill? If a healthy, sane patient goes to a doctor and says, "I'd like you to prescribe enough painkillers to me for me to commit suicide... If you don't, I'm still going to kill myself--maybe, say, with a handgun, in a sort of half-assed way largely based on what I've seen in movies--but I'm asking you first, because I'd like to do it painlessly and in a way such that the end is smooth and assured..." then is the doctor ethically obligated to prescribe the drugs? (Of course not. If I go to the doctor and say, "Prescribe me Ritalin. If you don't, I'm just going to buy it on the street, where it might be expired or tampered with," he's certainly not obligated to do that if in his medical opinion I don't need Ritalin.) Are there any circumstances in which a physician might be ethically obligated to assist a patient who isn't terminal or in agonizing physical distress in taking his or her own life?

Of course, the question underlying the one I posed above is whether there is ever a legitimate reason to take your own life if you are not terminally ill or in unbearable pain. (Also, does anguish--sadness, loneliness, self-loathing, etc--count as unbearable pain?)

So--is there?


Maryland was pleasant. Ate a tremendous amount of apple/blueberry pie and pork tenderloin sandwiches (Singer would not approve, being a strong proponent of the animal liberation movement, apparently), and had mexican food with a neighbor/former classmate from many years ago.


Maria said...

Hm. And I thought I was the only one who ever thought about that whole 'suicide' thing. Interesting.

Richard said...

Nick, physically healthy people have never needed help killing themselves. I've known enough of them, who've done the job, often quite "cleanly," entirely on their own.

Asking a medical professional for help would indicate strongly that they are seeking psychiatric assistance to avoid their suicidal impulses, just as telling nonprofessionals of their plans always has.

Alex said...

As a follow-up to these thoughts, I'd recommend "The Undertaking" by Thomas Lynch, the undertaker-poet whose writing inspired Six Feet Under. He's remarkably thoughtful, and remarkably eloquent, about these matters--not too surprising, perhaps, given that he was born into a funeral home family.

Nick said...

I think that's absolutely right in a real world sense, Richard, but just as a thought experiment, we could conceive of a rational, healthy person who intended to commit suicide and, not having comprehensive medical knowledge, wanted to consult a doctor first. How would a physician be ethically obligated to react?

Again though, the answer to the above question wouldn't be applicable in any real world situation because it would be a fair assumption that the patient was asking for help/dissuasion.

Tao Lin said...

you should read 'animal liberation.' even if you have no interest in animal liberation it's still interesting and very readable.