Sunday, 13 October 2013

The Other Euthanasia Issue

Okay, there’s been some discussion about euthanasia recently.  I know that euthanasia was selected as an example of a thorny issue and Lokee’s article wasn’t intended to be limited to that topic.  That said, however, the consequent discussion (largely at r/philosophy) focussed on the specific rather than the general.

A question that arose in my mind was whether those responding negatively to the idea of legalised euthanasia are also against legalised suicide.

Suicide is has been decriminalised in most nations although it is illegal (and punishable!) in North Korea.  Attempted suicide is punishable in both Singapore and India and, in Russia, it may result in one being taking into psychiatric care.

To make things easy on ourselves, let’s consider only the larger of the western English speaking nations – the US, Canada, the UK and Australia.  In all these nations, suicide is legal while assisted suicide is (perhaps only briefly) legal in only Canada.

In general, it’s not a crime to assist someone do perform an act that is legal.  The legislation of these nations, however, makes a special case for suicide – even in Canada where the current legality of assisted suicide is due to a Supreme Court ruling on the constitutionality of the relevant legislation.

But that’s just the law.  So long as all the necessary boxes are ticked, legislative bodies can make anything illegal – here are a couple of random examples:  (1) In Maryborough, Massachusetts, you may not shoot a Welsh person on Sunday with a longbow in the Cathedral Close (personally, my preference is for a crossbow anyway, so this law is unlikely to affect me), and (2) in Palm Bay Florida, women may not wear pants (one wonders whether there was a deliberate decision to not use the word “trousers”).

Right, let’s get back to the more serious topic of suicide.

As far as I can tell suicide is legal in all the nations being considered, and it's not illegal in any of the countries, states or provinces that make up those nations.  It is vaguely possible that some cities in the US have misdemeanour laws against it.

Before I reach the point I want to make, I need to clarify that I am talking only about successful and seriously intended suicide.  Threatening to commit suicide is a tricky issue, since some people are at risk of following through on the threat, while others who make such threats are little more than a nuisance.  People who threaten to commit suicide should be taken seriously and, preferably, into care.  However, in the rare case that malign intent can be satisfactorily demonstrated, I have no issue with a person who maliciously threatens to commit suicide being punished by the law.  It is reasonable to expect that concern for the well-being of others should not be abused in this way.

Imagine then that a person is serious in their intent to commit suicide.  They make their plans in secret, in order to avoid causing legal problems for any loved ones, and follow those plans through to success – unassisted.  No law has been broken, but what are the consequences?

In an ideal case, the suicide would use a clean method of departure and someone would find the body just after it has gone cold – beyond the point at which resuscitation is possible but before the corpse has begun to decompose.  A thoughtful suicide could even organise the recovery of mortal remains in good time – perhaps via a scheduled email or the delivery of a letter at an appropriate time.

However, this is an ideal case.  There are just so many elements of a plan which may go awry.  Australian Bureau of Statistics figures from 1992 to 2002 tell us that of the 26,500 recorded suicides, poisoning by drugs was only used in about 13% of cases.  Other forms of poisoning, including the use of other more serious poisons, alcohol and car exhaust, accounted for almost 23%.  Hanging and suffocation made up 36%, although this was steadily rising in popularity from 25% in 1992 to 45% in 2002.  Firearms and explosives had a reverse trend, 14% over all, 21% in 1992 and 9% in 2002.  The remaining 14% of suicides were due to drowning, cutting (slit wrists), jumping and “unspecified means”.

About 1000 people die each year on the roads, and it is reasonable to assume that a significant, if not necessarily large, proportion of single vehicle accidents are suicide.  Data for this does not seem to be recorded and it is unclear how many of “unspecified means” were car accidents.  Let’s assume no more than 50 undetected suicides a year over a period of 11 years to total about 27,000 suicides in that period.

Of these, maybe as many as 5,000 were potentially clean drug suicides, in which the body could have been found without an unpleasant mess to deal with.  But there were in the order of 20,000 messy suicides – 2000 a year, all of which had to be dealt with by someone.

And these messy suicides would also almost always have come as a shock.  Someone has to identify the corpse which, already a harrowing task, will be made worse by any visible signs of the suicide method.  Certain methods can result in a period of great uncertainty and suffering for loved ones, for example jumping from a cliff into the surf can result in the body being lost for extended periods, if not forever. A method not overly popular in Australia, but apparently more common in the US, is “suicide by cop” – a method which can potentially lead to suffering on a massive scale if the trigger for the officer-assisted suicide is the shooting of innocent bystanders (such as the Aramoana massacre in New Zealand).
Another form of unwitting assistance provided to a suicide arises when someone leaps in front of a train or other vehicle – a method which again can lead to widespread suffering, from the poor person in command of the train (or other vehicle) to those responsible for clearing up afterwards and any witnesses to the death as well as relatives and friends.

So … my question is, if a person is seriously intent on committing suicide, why do we insist that there be a high likelihood that the consequences of that suicide should be messy and devastating for those they leave behind by denying them the option of a better planned, assisted suicide?


Imagine for a moment, the idea that assisted suicide, euthanasia, was freely available to anyone who wished to avail themselves of it.  Clearly, some form of regulation would be required.  There would be a requirement to ensure that someone petitioning for their own demise should be fully cognisant of their decision (possibly in advance for those suffering comas or intellectual deterioration).

Legislating for regulated euthanasia, I believe, would actually lead to a reduction in the number of suicides.

If I were so inclined, and had the option of a clean, painless, organised suicide in a clinic that was obligated to inform my next of kin at a time of my choosing, I would surely prefer that to the more risky and potentially agonising option of swerving into an on-coming truck, or of jumping from a cliff, or shooting myself.  I would take myself off to the clinic and talk to someone – and it is at this stage that, I believe, a lot of suicides could be averted.

If I had the opportunity to discuss my options with someone properly trained in dealing with potential suicides, I would have to clarify my reasoning not only to that counsellor, but also to myself.  How many people, given the time to stop and think it through properly, would go through with a suicide?  Some, certainly, but quite probably a lot fewer than currently have to screw their courage to the sticking place and do the deed.

Such a regime would not help those who act impulsively, nor those who commit suicide out of shame, but it’s difficult to believe that the option of assisted suicide would not be a far better option for everyone involved.

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