Suicide (Stanford Encyclopedia of Philosophy) Cite this entry Search the SEP • Advanced Search • Tools • RSS FeedTable of Contents• What's New• Archives• Projected ContentsEditorial Information• About the SEP• Editorial Board• How to Cite the SEP• Special CharactersSupport the SEPContact the SEP ©Metaphysics Research Lab,CSLI,Stanford University  Open access to the SEP is made possible by a world-wide funding initiative. Please Read How You Can Help Keep the Encyclopedia FreeSuicideFirst published Tue May 18, 2004; substantive revision Tue Jul 29, 2008Suicide is an enigmatic and disconcerting phenomenon. Because ofothers' inability to directly occupy the mental world of the suicidal,suicide appears to elude easy explanation. This inexplicability isstunningly captured by Jeffrey Eugenides in his novel The VirginSuicides. In the novel, the narrator describes the reactions ofseveral teenaged boys to the suicides of five sisters. The boys keep acollection of the dead girls' belongings, repeatedly sifting throughthem in a vain attempt to understand their deaths. In the end we had the pieces of the puzzle, but no matterhow we put them together, gaps remained, oddly shaped emptinessesmapped by what surrounded them, like countries we couldn't name.(Eugenides 1993, 246) Undoubtedly, the challenge of simply fathoming suicide accountsfor the vast array of attitudes toward suicide found in the history ofWestern civilization: bafflement, dismissal, heroic glorification,sympathy, anger, moral or religious condemnation. Suicide is now anobject of multidisciplinary scientific study, with sociology,anthropology, psychology, and psychiatry each providing importantinsights into suicide. Particularly promising are the significantadvances being made in our scientific understanding of theneurological basis of suicidal behavior (Stoff and Mann 1997) and themental conditions associated with it. Nonetheless, certain questionsabout suicide seem to fall at least partially outside the domain ofscience, and indeed, suicide has been a focus of philosophicalexamination in the West since at least the time of Plato. Forphilosophers, suicide raises a host of conceptual, theological, moral,and psychological questions. Among these questions are: What makes aperson's behavior suicidal? What motivates such behavior? Is suicidemorally permissible, or even morally required in some extraordinarycircumstances? Is suicidal behavior rational? This article willexamine the main currents of historical and contemporary philosophicalthought surrounding these questions.1. Characterizing Suicide2. Highlights of Historical Thought 2.1 Ancient and Classical Views of Suicide 2.2 The Christian Prohibition 2.3 The Enlightenment and Modern Developments 3. The Morality and Rationality of Suicide 3.1 Moral Permissibility 3.2 The Deontological Argument from the Sanctity of Life 3.3 Religious Arguments 3.4 Libertarian Views and the Right to Suicide 3.5 Social, Utilitarian, and Role-Based Arguments 3.6 Suicide as a Moral Duty? 3.6 Autonomy, Rationality, and Responsibility 3.7 Duties Toward the Suicidal 4. ConclusionBibliography A. Historical (pre-1900) Works Cited B. Works Cited, 1900-Present C. Further Reading Other Internet ResourcesRelated Entries1. Characterizing Suicide Surprisingly, philosophical difficulties emerge when we evenattempt to characterize suicide precisely, and attempts to do sointroduce intricate issues about how to describe and explain humanaction. In particular, identifying a set of necessary and sufficientconditions for suicide that fits well with our typical usage of theterm is especially challenging. A further challenge is that becausesuicide is strongly colored by negative emotional or moralconnotations, efforts to distinguish suicidal behavior from otherbehavior often clandestinely import moral judgments about the aims ormoral worth of such behavior. That is, views about the nature ofsuicide often incorporate, sometimes unknowingly, views about theprudential or moral justifiability of suicide and are therefore notvalue-neutral descriptions of suicide. Definitions of suicide are"sometimes dependent on prior judgments about its justifiability"(Lebacqz & Englehardt 1980, 701). Theorists about suicide oftenfail to divorce questions about whether an act was suicide fromwhether its motives were admirable or odious. Hitler, most peoplecontend, was clearly a suicide, but Socrates and Jesus werenot. (Though on Socrates, see Frey 1978) Suicide still carries astrongly negative subtext, and on the whole, we exhibit a greaterwillingness to categorize self-killings intended to avoid one's justdeserts as suicides than self-killings intended to benefit others(Beauchamp & Childress 1983, 93–94.) Some go so far as to deny thepossibility that an act of self- killing motivated by altruism cancount as suicide (Margolis 1980). Such conceptual slipperiness complicates moral arguments about thejustifiability of suicide by permitting us to ‘defineaway’ self-killings we believe are justified as something otherthan suicide, whereas it would be desirable to identify first adefensible non-normative conception of suicide and then proceed todiscuss the moral merits of various acts of suicide (Kupfer 1990). Inother words, ‘suicide’ should not be equatablewith wrongful self-killing in the way that‘murder’ is equated with wrongful killing ofanother, lest we render ourselves unable to refer even to thepossibility of a morally justified self-killing. Some philosophers,on the other hand, have embraced the apparently value-laden characterof suicide, suggesting that word ‘suicide’ has as one itsfunctions the ascription of moral responsibility, and insofar asdisagreements about the extent to which agents themselves (as opposedto social conditions, medical facts, etc.) are morally responsible fortheir deaths persist, so too will apparently conceptual disagreementsabout the nature of suicide persist (Stern-Gillett 1987).Supposing, however, that a purely descriptive account of suicide ispossible, where should it begin? While it is tempting to say thatsuicide is any self-caused death, this account is vulnerable toobvious counterexamples. An individual who knows the health risks ofsmoking or of skydiving, but willfully engages in these behaviors anddies as a result, could be said to be causally responsible for her owndeath but not to have committed suicide. Similarly, an individual whotakes a swig of hydrochloric acid, believing it to be lemonade, andsubsequently dies causes her own death but does not engage in suicidalbehavior. Moreover, not only are there self-caused deaths that are notsuicides, but there are behaviors that result in death and arearguably suicidal in which the agent is not the cause of her own deathor is so only at one remove. This can occur when an individualarranges the circumstances for her death. A terminally ill patient whorequests that another person inject her with a lethal dose oftranquilizers has, intuitively, committed suicide. Though she is notimmediately causally responsible for her death, she appears morallyresponsible for her death, since she initiates a sequence of eventswhich she intended to culminate in her death, a sequence which cannotbe explained without reference to her beliefs and desires. (Such acase might also be an example of voluntary euthanasia.) Likewise, those who commit ‘suicide by cop,’ where anarmed crime is committed in order to provoke police into shooting itsperpetrator, are responsible for their own deaths despite not beingthe causes of their deaths. In these kinds of cases, such agents wouldnot die, or would not be at an elevated risk for death, were it notfor their initiating such causal sequences. (See Brandt 1975, Tolhurst1983, Frey 1981, but for a possible objection see Kupfer 1990).Furthermore, many philosophers (Fairbairn 1995, chapter 5) doubtwhether an act's actually resulting in death is essential to suicideat all. It is common to speak of ‘attempted’ or‘failed’ suicides, instances where because of agents'false beliefs (about the lethality of their behavior, for example),unforeseen factual circumstances, others' interventions, etc., an actwhich might have resulted in an agent's death does not.Hence, suicidal behavior need not result in death, nor must thecondition that hastens death be self-caused. It follows, thereforethat, first, a correct account of suicide (contra Durkheim 1897) mustemphasize the non-accidental relationship between suicidalbehavior and death (i.e., death is in some respect the aim ofsuicidal behavior). Second, what appears essential for a behavior tocount as suicide is that the person in question chooses todie. Suicide is an attempt to inflict death upon oneself andis "intentional rather than consequential in nature." (Fairbairn 1995,58) These conclusions imply that suicide must rest upon anindividual's intentions (where an intention implicates anindividual's beliefs and desires about her action. (See Brandt 1975,Tolhurst 1983, Frey 1978, O'Keefee 1981, McMahan 2002, 455) Oneintention-based account of suicide (similar to Graber 1981, 57) wouldsay, roughly, that A person S's behavior B is suicidal iff S believed that B, or some causal consequenceof B, would make her death at least highly likely, andS intended to die by engaging in B. This account renders the notion of suicide as self-inflicted attempteddeath more precise, but it is not without its shortcomings.Condition (a) is a doxastic condition, and is meant to ruleout as suicides deaths (or increased risks for death) caused by anindividual's behavior where the individual causes these outcomes butdoes so out of ignorance of the relevant risks of her behavior, aswhen an individual accidentally takes a lethal dose of a prescriptiondrug. At the same time, (a) accounts for cases such as theaforementioned terminally ill patient whose death is caused onlyindirectly by her request to die. Condition (a) does not require thatS know that B will put her at asignificantly greater risk for death, nor even that S'sbeliefs about B's lethality be true or even justified.Suicidal individuals often have false beliefs about the lethality oftheir chosen suicide methods, greatly overestimating the lethality ofover the counter painkillers while underestimating the lethality ofhandguns, for instance. An individual could believe falsely, or on thebasis of inadequate evidence, that placing one's head in an electricoven significantly increases one's chances of dying, but that behavioris nonetheless suicidal. The demand that S believe thatB makes death highly likely is admittedly inexact, but itpermits us to navigate between two extreme and mistaken views. On theone hand, it rules out as suicidal behavior that which is in fact onlymarginally more likely to cause a person's death (you are more likelyto die in your car than in your living room) and is rarely utilized asa suicide method anyway. On the other hand, to demand that S believethat B certainly or almost certainly will cause S'sdeath is too strict, since it will rarely be the case (given thepossibility of intervening conditions, etc.) that B willnecessarily cause S's death, and in fact, many suicidalindividuals are ambivalent about their actions, an ambivalence whichis turn reflected in their selecting suicide methods that are far fromcertain to cause death. It also allows us to distinguish genuinelysuicidal behavior from suicidal gestures, in whichindividuals engage in behavior they believe is not likely tocause their death but is nonetheless associated with suicide attempts,while in fact having some other intention (e.g., gaining others'sympathy) in mind.Condition (b), however, is far more knotty. For what is it to intendby one's behavior that death result? There are examples in whichcondition (a) is met, but whether (b) is met is more problematic. Forinstance, does a soldier who leaps upon a live grenade tossed into afoxhole in order to save his comrades engage in suicidal behavior?Many, especially partisans of the doctrine of double effect, wouldanswer ‘no’: Despite the fact that the solider knew hisbehavior would likely cause him to die, his intention was to absorbthe blast so as to save the other soldiers, whereas his death was onlya foreseen outcome of his action. Needless to say, whether a clear andnon-manipulable divide exists between foreseen and intended outcomesis controversial (Glover 1990, ch. 6) (It is of course possible thatwhether death is foreseen or intended has no bearing on whether an actcounts as suicide but still bears on whether that suicide isjustified.) Some would argue that given the near certainty of hisdying by jumping on the grenade, his death was at least weaklyintended, in Alvin Goldman's sense (Tolhurst 1983). At the same time,cases that are commonly viewed as suicide do not exhibit anfull-fledged intention to die. Current psychiatric theory holds thatmany examples of suicidal behavior do not aim at death but are "criesfor help." In such cases, the person does not wish to die,but intends to gain others' attention in such a fashion that holds outthe possibility of death. However, it seems correct to say that when aperson who issues a cry for help does die, despite not intending todie, their death is neither foreseen, since the person actuallyintends not to die, nor wholly accidental, since the personknowingly engaged in behavior that she believed will make her deathsignificantly more likely, making her death in an obvious senseself-inflicted. (But see Graber 1981, 58) Such a case might indicatethe need for a third category besides intentional suicide andaccidental death. (Cholbi 2007) The essential logical difficulty here resides in the notion ofintending to die, for acting so as to produce one's death nearlyalways has some other aim or justification. That is, death isgenerally not chosen for its own sake, or is not the end of suicidalbehavior. Suicidal behavior can have any number of objectives: therelief of physical pain, the relief of psychological anguish,martyrdom in the service of a moral cause, the fulfillment ofperceived societal duties (suttee and seppuku,e.g.), the avoidance of judicial execution, revenge on others,protection of others' interests or well-being. (See Fairbairn 1995,ch. 9, for a taxonomy of the varieties of suicide.) Therefore, it isnot the case that suicidal individuals intend death per se, but ratherthat death is perceived, rightly or wrongly, as a means for thefulfillment of another of the agent's aims. (Graber 1981, 56) Inshort, there do not appear to be any compelling examples of"noninstrumental" self-killings in which "the overriding intention issimply to end one's life and there is no further independent objectiveinvolved in the action." (O'Keefee 1981, 357) Nor does requiring thatthe individual wish to be dead (Fairbairn 1995, ch. 6)address this issue, since again, what one wishes is presumably notdeath itself but some outcome of death. Both the grenade-jumpingsoldier and the depressed individual issuing a ‘cry forhelp’ may wish not to die insofar as they might prefer thattheir desires could be satisfied without dying or without puttingthemselves at the risk thereof. However, this is consistent with theirwillingly choosing to die in order to satisfy their aims.Some (e.g., Beauchamp 1992) might wish to add a further condition to (a) and (b) above:S was not coerced intoB-ing.Yet again, both the concept of coercion and its applicability toinstances of risky or self-harming behavior is unclear. Typically,coercion denotes interference by others. So, according to condition(c), a spy threatened with torture lest he relinquish crucial militarysecrets who then poisons himself did not commit suicide, some wouldcontend, since the spy's captors compelled him to take his life.However, one can imagine a similar situation in which the agent of"coercion" is not another person. An extremely ill patient may opt totake his own life rather than face a future fraught with physicalpain. But why should we not say that this patient was coerced by hissituation and therefore did not commit suicide? Because of theirdesires, loyalties, and values, both the spy and the ill patient sawthemselves as having no other alternative, given their ends, but tocause their own deaths. In both instances, the economy of theindividuals' reasons for actions was modified by circumstances outsidetheir control so as to make death a rational option where itpreviously was not. Thus, there does not appear to be grounds forrestricting coercion only to interference by other people, sincefactual circumstances can be similarly coercive. Either anyfactor, natural, human, or otherwise, that influences an individual'sreasoning so as to make death the most rational option counts ascoercion, at which point condition (c) hardly functions as arestriction at all, or cases such as the spy facing torture aresuicides too and (c) is unnecessary. (See Tolhurst 1983, 113–115)This brief attempt at conceptual analysis of suicide illustrates thefrustrations of such a project, as the unclear notion of suicide isapparently replaced by equally unclear notions such as intention andcoercion. We may be attracted to increasingly baroque or impracticalanalyses of suicide (Donnelly 1998, 20) or accept that suicide is an‘open textured’ concept instances of which are boundtogether only by weak Wittgensteinian family resemblance and henceresistant to analysis in terms of strict logical conditions. (Windt1981)An alternative to providing necessary and sufficient conditions forsuicidal behavior is to view it along a continuum. In thepsychological sciences, most suicidologists view suicide not as aneither/or notion but as a gradient notion, admitting of degrees basedon individuals' beliefs, strength of intentions, and attitudes. TheBeck Scale for Suicidal Ideation is perhaps the best example of thisapproach. (See Beck 1979)2. Highlights of Historical Thought2.1 Ancient and Classical Views of Suicide Philosophical discourse about suicide stretches back at least to thetime of Plato. Still, prior to the Stoics at least, suicide tended toget sporadic rather than systematic attention from philosophers in theancient Mediterranean world. As John Cooper has noted (Cooper 1989,10), neither ancient Greek nor Latin had a single word that aptlytranslates our ‘suicide,’ even though most of the ancientcity-states criminalized self-killing.Plato explicitly discussed suicide in two works. First, inPhaedo, Socrates expresses guarded enthusiasm for the thesis,associated with the Pythagoreans, that suicide is always wrong becauseit represents our releasing ourselves (i.e., our souls) from a"guard-post" (i.e., our bodies) the gods have placed us in as a formof punishment (Phaedo 61b-62c). Later, in the Laws,Plato claimed that suicide is disgraceful and its perpetrators shouldbe buried in unmarked graves. However, Plato recognized fourexceptions to this principle: (1) when one's mind is morally corruptedand one's character can therefore not be salvaged (Laws IX854a3–5), (2) when the self-killing is done by judicial order, as inthe case of Socrates, (3) when the self-killing is compelled byextreme and unavoidable personal misfortune, and (4) when theself-killing results from shame at having participated in grosslyunjust actions. (Laws IX 873c-d) Suicide under thesecircumstances can be excused, but, according to Plato, it is otherwisean act of cowardice or laziness undertaken by individuals too delicateto manage life's vicissitudes. Aristotle's only discussion of suicide(Nicomachean Ethics 1138a5-14) is a difficult and confusingpassage in which he attempts to explain how suicide can be unjust anddeserving of punishment if the individual who could be treatedunjustly is the suicidal individual herself. He concludes that suicideis somehow a wrong to the state, though he does not outline the natureof this wrong or the specific vices that suicidal individualsexhibit.What is perhaps most striking about Plato's and Aristotle's texts onsuicide is the relative absence of concern for individual well-beingor autonomy. Both limit the justifications for suicide largely toconsiderations about an individual's social roles and obligations. Incontrast, the Stoics largely believed that the moral permissibility ofsuicide did not hinge on the moral character of the individualpondering it. Rather, the Stoics held that whenever the means toliving a naturally flourishing life are not available to us, suicidemay be justified, regardless of the character or virtue of theindividual in question. Our natures require certain "naturaladvantages" (e.g., physical health) in order for us to be happy, and awise person who recognizes that such advantages may be lacking in herlife sees that ending her life neither enhances nor diminishes hermoral virtue.When a man's circumstances contain a preponderance ofthings in accordance with nature, it is appropriate for him to remainalive; when he possesses or sees in prospect a majority of thecontrary things, it is appropriate for him to depart fromlife…. Even for the foolish, who are also miserable, it isappropriate for them to remain alive if they possess a predominance ofthose things which we pronounce to be in accordance withnature. (Cicero, III, 60–61)Hence, not only may concerns related to one's obligations to othersjustify suicide, but one's own private good is relevant too. The RomanStoic Seneca, who was himself compelled to commit suicide, was evenbolder, claiming that since "mere living is not a good, but livingwell", a wise person "lives as long as he ought, not as long as hecan." For Seneca, it is the quality, not the quantity, of one's lifethat matters.2.2 The Christian ProhibitionThe advent of institutional Christianity was perhaps the mostimportant event in the philosophical history of suicide, for Christiandoctrine has by and large held that suicide is morally wrong, despitethe fact that no passage in Scripture unequivocally condemnssuicide. Although the early church fathers opposed suicide,St. Augustine is generally credited with offering the firstthoroughgoing justification of the Christian prohibition onsuicide (Amundsen 1989). He saw the prohibition as a natural extensionof the fifth commandment:The law, rightly interpreted, even prohibits suicide,where it says ‘Thou shalt not kill.’ This is provedespecially by the omission of the word ‘thy neighbor’,which are inserted when false witness is forbidden in the commandmentthere is no limitation added nor exception made in favor of any one,and least of all in favor of him on whom the command is laid!(Augustine, book I, chapter 20)Suicide, Augustine determined, was an unrepentable sin. St. ThomasAquinas later defended this prohibition on three grounds. (1) Suicideis contrary to natural self-love, whose aim is to preserve us. (2)Suicide injures the community of which an individual is a part. (3)Suicide violates our duty to God because God has given us life as agift and in taking our lives we violate His right to determine theduration of our earthly existence (Aquinas 1271, part II, Q64, A5).This conclusion was codified in the medieval doctrine that suicidenullified human beings' relationship to God, for our control over ourbody was limited to usus (possession, employment) where Godretained dominium (dominion, authority). Law and popularpractice in the Middle Ages sanctioned the desecration of the suicidalcorpse, along with confiscation of property and denial of Christianburial.The rediscovery of numerous texts of classical antiquity was one ofthe spurs of the Renaissance, but for the most part, Renaissanceintellectuals generally affirmed the Church's opposition to suicideand were not sympathetic to the more permissive attitudes towardsuicide found among the ancient pagans. Two intriguing sixteenthcentury exceptions were Thomas More and Michel de Montaigne. In hisUtopia, More appears to recommend voluntary suicide for thosesuffering from painful and incurable diseases, though the satiricaland fantastical tone of that work makes it doubtful that Moresupported this proposal in reality. In his Essais, Montaignerelates several anecdotes of individuals taking their own lives andintersperses these anecdotes with quotations from Roman writerspraising suicide. While his general skepticism prevented Montaignefrom staking out a firm moral position on suicide, he gives only a nodto the orthodox Christian position and conceptualizes the issue not intraditional theological terms but as a matter of personal judgment orconscience (Ferngren 1989, 160–161).The Protestant Reformers, including Calvin, condemned suicide asroundly as did the established Church, but held out the possibility ofGod treating suicide mercifully and permitting repentance. Interest inmoral questions concerning suicide was particularly strong in thisperiod among England's Protestants, notably the Puritans. Nonetheless,the traditional Christian view prevailed well into the lateseventeenth century, where even an otherwise liberal thinker such asJohn Locke echoed earlier Thomistic arguments, claiming that thoughGod bestowed upon us our natural personal liberty, that liberty doesnot include the liberty to destroy oneself (Locke 1690, ch. 2,para. 6).In all likelihood, the first comprehensive modern defense of suicidewas John Donne's Biathanatos (c. 1607). Not intended forpublication, Biathanatos drew upon an array of classical andmodern legal and theological sources to argue that Christian doctrineshould not hold that suicide is necessarily sinful. His critique is ineffect internal, drawing upon the logic of Christian thought itself tosuggest that suicide is not contrary to the laws of nature, of reason,or of God. Were it contrary to the law of nature mandatingself-preservation, all acts of self-denial or privation would besimilarly unlawful. Moreover, there may be circumstances in whichreason might recommend suicide. Finally, Donne observes, not only doesBiblical Scripture lack a clear condemnation of suicide, Christiandoctrine has permitted other forms of killing such as martyrdom,capital punishment and killing in wartime (Minois 1999, 20–21).2.3 The Enlightenment and Modern DevelopmentsDonne's casuistical treatise was an early example of the liberalizedEnlightenment attitudes of the 1700's. The Thomistic natural-lawstance on suicide came under increasing attack as suicide was examinedthrough the lens of science and psychology. Where Christian theologyhas understood suicide as "an affair between the devil and theindividual sinner" (Minois 1999, 300), Enlightenment philosopherstended to conceive of suicide in secular terms, as resulting fromfacts about individuals, their natural psychologies, and theirparticular social settings. David Hume gave voice to this new approachwith a direct assault on the Thomistic position in his unpublishedessay "On suicide" (1783). Hume saw traditional attitudes towardsuicide as muddled and superstitious. According to the Thomisticargument, suicide violates the order God established for the world andusurps God's prerogative in determining when we shall die. Hume'sargument against this thesis is intricate, as he tends to juxtaposedistinguishable but closely related considerations, but in essenceHume attacks the seemingly arbitrary and contradictory notions ofnatural law used to condemn suicide. Hume's argument is more or lessas follows:If by the ‘divine order’ is meant the causal laws created byGod, then it would always be wrong to contravene these laws for thesake of our own happiness. But clearly it is not wrong, since Godfrequently permits us to contravene these laws, for he does not expectus not to respond to disease or other calamities. Therefore, there isnot apparent justification, as Hume put it, for God's permitting us todisturb nature in some circumstances but not in others. Just as Godpermits us to divert rivers for irrigation, so too ought he permit usto divert blood from our veins.If by ‘divine order’ is meant the natural laws God haswilled for us, which are (a) discerned by reason, (b) such thatadherence to them will produce our happiness, then why should notsuicide conform to such laws when it appears rational to us that thebalance of our happiness is best served by suicide?Finally if by ‘divine order’ is meant simply thatwhich occurs according to God's consent, then God appears to consentto all our actions (since an omnipotent God can presumablyintervene in our acts at any point) and no distinction exists betweenthose of our actions to which God consents and those to which He doesnot. If God has placed us upon the Earth like a "sentinel," then ourchoosing to leave this post and take our lives occurs as much with hiscooperation as with any other act we perform.Furthermore, suicide does not necessarily violate any duties towardother people, according to Hume. Reciprocity may require that webenefit society in exchange for the benefits it provides, but surelysuch reciprocity reaches its limit when by living we provide only a"frivolous advantage" to society at the expense of significant harm orsuffering for ourselves. In more extreme situations, we are actuallyburdens to others, in which case our deaths are not only "innocent,but laudable."Finally, Hume rejects the thesis that suicide violates our duties toself. Sickness, old age, and other misfortunes can make lifesufficiently miserable that continued existence is worse thandeath. As to worries that people are likely to attempt to take theirlives capriciously, Hume replies that our natural fear of deathensures that only after careful deliberation and assessment of ourfuture prospects will we have the courage and clarity of mind to killourselves.In the end, Hume concludes that suicide "may be free of imputation ofguilt and blame." His position is largely utilitarian, allied with astrong presumption of personal liberty. The Enlightenment was ofcourse not univocal in its comparatively permissive attitudes towardsuicide. The most vociferous opponent of suicide in this period wasImmanuel Kant. Kant's arguments, though they reflect earlier naturallaw arguments, draw upon his view of moral worth as emanating from theautonomous rational wills of individuals. (Cholbi 2000) For Kant, ourrational wills are the source of our moral duty, and it is therefore akind of practical contradiction to suppose that the same will canpermissibly destroy itself. Given the distinctive worth of anautonomous rational will, suicide is an attack on the very source ofmoral authority.To annihilate the subject of morality in one's person isto root out the existence of morality itself from the world as far asone can, even though morality is an end in itself. Consequently,disposing of oneself as a mere means to some discretionary end isdebasing humanity in one's person… (Kant 423)The nineteenth and early twentieth centuries brought severaldevelopments that, while not explicitly philosophical, have shapedphilosophical thought about suicide. The first was the emergence, innovels by Rousseau, Goethe, and Flaubert, of a Romantic idealized‘script’ for suicide, according to which suicide was theinevitable response of a misunderstood and anguished soul jilted bylove or shunned by society (Lieberman 2003). The second was therecognition of psychiatry as an autonomous discipline, populated byexperts capable of diagnosing and treating melancholy, hysteria andother ailments responsible for suicide. Lastly, largely thanks to thework of sociologists such as Durkheim and Laplace, suicide wasincreasingly viewed as a social ill reflecting widespread alienation,anomie, and other attitudinal byproducts of modernity. In manyEuropean nations, the rise in suicide rates was thought to signal acultural decline. These latter two developments made suicideprevention a bureaucratic and medical preoccupation, leading to a waveof institutionalization for suicidal persons. All three conspired tosuggest that suicide is caused by impersonal social or psychologicalforces rather than by the agency of individuals.Suicide was an important concern for the twentieth centuryexistentialists, who saw the choice to take one's life as impressedupon us by our experience of the absurdity or meaninglessness of theworld and of human endeavor. Albert Camus illustrated this absurdityin his philosophical essay The Myth of Sisyphus. For Camus,Sisyphus heroically does not try to escape his absurd task, butinstead perseveres and in so doing resists the lure ofsuicide. Suicide, Camus contends, tempts us with the promise of anillusory freedom from the absurdity of our existence, but is in theend an abdication of our responsibility to confront or embrace thatabsurdity head on. (Campbell and Collinson 1988, 61–70). Jean-PaulSartre was likewise struck by the possibility of suicide as anassertion of authentic human will in the face of absurdity. Suicideis, according to Sartre, an opportunity to stake out our understandingof our essence as individuals in a godless world. For theexistentialists, suicide was not a choice shaped mainly by moralconsiderations but by concerns about the individual as the sole sourceof meaning in a meaningless universe.3. The Morality and Rationality of Suicide3.1 Moral PermissibilityThe principal moral issue surrounding suicide has been Are there conditions under which suicide is morally justified, andif so, which conditions?Several important historical answers to (1) have already beenmentioned.Note that this question should be distinguished from three others:Should other individuals attempt to prevent suicide?Should the state criminalize suicide or attempt to prevent it?Is suicide ever rational or prudent? Obviously, answers to any one of these four questions will bear on howthe other three ought to be answered. For instance, it might beassumed that if suicide is morally permissible in some circumstances,then neither other individuals nor the state should interfere withsuicidal behavior (in those same circumstances). However, thisconclusion might not follow if those same suicidal individuals areirrational and interference is required in order to prevent them fromtaking their lives, an outcome their more rational selves mightregret. Furthermore, for those moral theories that emphasize rationalautonomy, whether an individual has rationally chosen to take her ownlife may settle all four questions. In any event, theinterrelationships among suicide's moral permissibility, itsrationality, and the duties of others and of society as a whole iscomplex, and we should be wary of assuming that an answer to any oneof these four questions decisively settles the other three.3.2 The Deontological Argument from the Sanctity of LifeThe simplest moral outlook on suicide holds that it is necessarilywrong because human life is sacred. Though this position is oftenassociated with religious thinkers, especially Catholics, we findsimilar positions in Kant and in Ronald Dworkin (Dworkin 1993).According to this ‘sanctity of life’ view, human life isinherently valuable and precious, demanding respect from others andreverence for oneself. Hence, suicide is wrong because it violates ourmoral duty to honor the inherent value of human life, regardless ofthe value of that life to others or to the person whose life itis. The sanctity of life view is thus a deontological position onsuicide.The great merit of the sanctity of life position is that it reflects acommon moral sentiment, namely, that killing is wrong in itself. Thechief difficulties for the sanctity of life position are these:First, its proponents must be willing to apply the positionconsistently, which would also morally forbid controversial forms ofkilling such as capital punishment or killing in wartime. But it wouldalso forbid forms of killing that seem intuitively reasonable, such askilling in self-defense. To accept the sanctity of life argument seemsto require endorsing a thoroughgoing pacifism.Secondly, the sanctity of life view must hold that life itself, whollyindependent of the happiness whose life it is, is valuable. Manyphilosophers reject the notion that life is intrinsically valuable,since it suggests, e.g., that there is value in keeping alive anindividual in a persistent vegetative state simply because she isbiologically alive. It would also suggest that a life certain to befilled with limitless suffering and anguish is valuable just by virtueof being a human life. Peter Singer (Singer 1994) and others haveargued against the sanctity of life position on the grounds that thevalue of a continuing life is not intrinsic but extrinsic, to bejudged on the basis of the individual's likely future quality oflife. If the value of a person's continued life is measured by itslikely quality, then suicide may be permissible when that quality islow (see section 3.5) (This is not to suggest that quality of life assessments arestraightforward or uncontroversial. See Hayry 1991 fordiscussion).Finally, it is not obvious that adequate respect for the sanctity ofhuman life prohibits ending a life, whether by suicide or other means.Those who engage in suicidal behavior when their future promises to beextraordinarily bleak do not necessarily exhibit insufficient regardfor the sanctity of life. (Dworkin 1993, 238) To end one's life beforeits natural end is not necessarily an insult to the value of life.Indeed, it may be argued that suicide may be life-affirming in thosecircumstances where medical or psychological conditions reduceindividuals to shadows of their former fully capable selves. (Cholbi2002)3.3 Religious ArgumentsTwo general categories of arguments for the moral impermissibilityof suicide have emerged from the Christian religious tradition. Thefirst of these is the aforementioned Thomistic natural law tradition,critiqued by Hume (see section 2.3) According to this tradition, suicide violates the natural law God hascreated to govern the natural world and human existence. This naturallaw can be conceived of in terms of (a) natural causal laws, such thatsuicide violates this causal order, (b) teleological laws, accordingto which all natural beings seek to preserve themselves, or (c) thelaws governing human nature, from which it follows that suicide is‘unnatural’ (Pabst Battin 1996, 41–48). These natural lawarguments are no longer the main focus of philosophical discussion, asthey have been subjected to strenuous criticism by Hume and others(though see Gay-Williams 1996). These criticisms include that thenatural law arguments cannot be disentangled from a highly speculativetheistic metaphysics; that these claims are not confirmed byobservations of human nature (e.g., the existence of self-destructivehuman behaviors casts doubt on the claim that we "naturally" preserveourselves); and that other acts (e.g., religious martyrdom) which Godis assumed not to condemn, also violate these natural laws, making theprohibition on suicide appear arbitrary.The second general category of religious arguments rest on analogiesconcerning the relationship between God and humanity. For the mostpart, these arguments aim to establish that God, and not humanindividuals, have the proper moral authority to determine thecircumstances of their deaths. One historically prominent analogy(suggested by Aquinas and Locke) states that we are God's property andso suicide is a wrong to God akin to theft or destruction of property.This analogy seems weak on several fronts. First, if we are God'sproperty, we are an odd sort of property, in that God apparentlybestowed upon us free will that permits to act in ways that areinconsistent with God's wishes or intentions. It is difficult to seehow an autonomous entity with free will can be subject to the kind ofcontrol or dominion to which other sorts of property are subject.Second, the argument appears to rest on the assumption that God doesnot wish his property destroyed. Yet given the traditional theisticconception of God as not lacking in any way, how could the destructionof something God owns (a human life) be a harm to God or to hisinterests (Holley 1989, 105)? Third, it is difficult to reconcile thisargument with the claim that God is all-loving. If a person's life issufficiently bad, an all-loving God might permit his property to bedestroyed through suicide. Finally, some have questioned the extent ofthe duties imposed by God's property right in us by arguing that thedestruction of property might be morally justified in order to preventsignificant harm to oneself. If the only available means to savingmyself from a ticking bomb is to stash it in the trunk of the nearestcar to dampen the blast, and the nearest car belongs to my neighbor,then destroying his property appears justified in order to avoidserious harm to myself. Likewise, if only by killing myself can Iavoid a serious future harm to myself, I appear justified indestroying God's property (my life).Another common analogy asserts that God bestows life upon us a gift,and it would be a mark of ingratitude or neglect to reject that giftby taking our lives. The obvious weakness with this "gift analogy" isthat a gift, genuinely given, does not come with conditions such asthat suggested by the analogy, i.e., once given, a gift becomes theproperty of its recipient and its giver no longer has any claim onwhat the recipient does with this gift. It may perhaps be imprudent towaste an especially valuable gift, but it does not appear to be unjustto a gift giver to do so. As Kluge put it, "a gift we cannot reject isnot a gift" (Kluge 1975, 124). A variation of this line ofargument holds that we owe God a debt of gratitude for our lives, andso to kill ourselves would be disrespectful or even insulting to God,(Ramsey 1978, 146) or would amount to an irresponsible use of thisgift. Yet this variation does not really evade the criticism directedat the first version: Even if we owe God a debt of gratitude,disposing of our lives does not seem inconsistent with our expressinggratitude for having lived at all (Beauchamp 1992). Furthermore, if aperson's life is rife with misery and unhappiness, it is far fromclear that she owes God much in the way of gratitude for thisapparently ill-chosen "gift" of life. Defenders of the gift analogymust therefore offer a theodicy to defend the claim that life, becauseit is given to us by a loving God, is an expression of God'sbenevolent nature and is therefore necessarily a benefit tous (Holley 1989, 113–114).In addition, there is a less recognized undercurrent of religiousthought that favors suicide. For example, suicide permits usto reunite with deceased loved ones, allows us those who have beenabsolved of sin to assure their entrance to heaven, and releases thesoul from the bondage of the body. In both Christian and Asianreligious traditions, suicide holds the promise of a vision of, orunion with, the divine (Pabst Battin 1996, 53–64).3.4 Libertarian Views and the Right to SuicideFor libertarians, suicide is morally permissible because individualsenjoy a right to suicide. (It does not of course follow thatsuicide is necessarily rational or prudent.) Libertarianism, which hashistorical precedent in the Stoics and in Schopenhauer, is stronglyassociated with the ‘anti-psychiatry’ movement of the lasthalf century. According to that movement's critics, attempts by thestate or by the medical profession to interfere with suicidal behaviorare essentially coercive attempts to pathologize morally permissibleexercises of individual freedom (Szasz 2002).Libertarianism typically asserts that the right to suicide is aright of noninterference, to wit, that others are morallybarred from interfering with suicidal behavior. Some assert thestronger claim that the right to suicide is a liberty right,such that individuals have no duty not to commit suicide (i.e., thatsuicide violates no moral duties), or a claim right,according to which other individuals are morally obliged not only notto interfere with a person's suicidal behavior but are in fact morallyrequired to assist in that suicidal behavior. Our having a claim rightto suicide implies that we also have rights of noninterference and ofliberty and is a central worry about physician-assistedsuicide (Pabst Battin 1996, 163–164). Since whether we have a libertyright to suicide concerns whether it violates other moral obligations,including obligations to other people, I shall leave discussion ofthat issue to section 3.5 and focus here on whether there is a right of noninterference.A popular basis for the claim that we enjoy a right to suicide is theclaim that we own our bodies and hence are morally permitted todispose of them as we wish. (In section 3.3, we observed that some religious arguments for the impermissibility ofsuicide depend on God's ownership of our bodies.) On this view, ourrelationship to our bodies is like that of our relationship to otheritems over which we enjoy property rights: Just as our having a rightto a wristwatch permits us to use, improve, and dispose of it as wewish, so too does our having a right to our bodies permit us todispose of it as we see fit. Consequently, since property rights areexclusive (i.e., our having property rights to a thing prohibitsothers from interfering with it), others may not interfere with ourefforts to end our lives. The notion of self-ownership invoked in thisargument is quite murky, since what enables us to own ordinarymaterial items is their metaphysical distinctness from us. We can owna wristwatch only because it is distinct from us, and evenunder the most dualistic views of human nature, our selves are notsufficiently distinct from our bodies to make ownership of the body bythe self a plausible notion. Indeed, the fact that certain ways oftreating ordinary property are not available to us as ways of treatingour bodies (we cannot give away or sell our bodies in any literalsense) suggests that self-ownership may be only a metaphor meant tocapture a deeper moral relationship (Kluge 1975, 119). In addition,uses of one's property, including its destruction, can be harmful toothers. Thus, in cases where suicide may harm others, we may bemorally required to refrain from suicide. (See section 3.5 for arguments concerning duties to others)Another rationale for a right of noninterference is the claim that wehave a general right to decide those matters that are most intimatelyconnected to our well-being, including the duration of our lives andthe circumstances of our deaths. On this view, the right to suicidefollows from a deeper right to self-determination, a right to shapethe circumstances of our lives so long as we do not harm or imperilothers. As presented in the "death with dignity" movement, the rightto suicide is presented as the natural corollary of the right tolife. That is, because individuals have the right not to be killed byothers, the only person with the moral right to determine thecircumstances of a person's death is that person herself and othersare therefore barred from trying to prevent a person's efforts atself-inflicted death.This position is open to at least two objections. First, it does notseem to follow from having a right to life that a person has a rightto death, i.e., a right to take her own life. Because others aremorally prohibited from killing me, it does not follow that anyoneelse, including myself, is permitted to kill me. This conclusion ismade stronger if the right to life is inalienable, since in order forme to kill myself, I must first renounce my inalienable right to life,which I cannot do (Feinberg 1978). It is at least possible that noone has the right to determine the circumstances of a person'sdeath! Furthermore, as with the property-based argument, the right toself-determination is presumably circumscribed by the possibility ofharm to others.3.5 Social, Utilitarian, and Role-Based ArgumentsA fourth approach to the question of suicide's permissibility asksnot whether others may interfere with suicidal behavior but whether wehave a liberty right to suicide, whether, that is, suicide violatesany moral duties to others. Those who argue that suicide can violateour duties to others generally claim that suicide can harm eitherspecific others (family, friends, etc.) or is a harm to the communityas a whole.No doubt the suicide of a family member or loved one produces a numberof harmful psychological and economic effects. In addition to theusual grief, suicide "survivors" confront a complex array offeelings. Various forms of guilt are quite common, such as thatarising from (a) the belief that one contributed to the suicidalperson's anguish, or (b) the failure to recognize that anguish, or (c)the inability to prevent the suicidal act itself. Suicide also leadsto rage, loneliness, and awareness of vulnerability in those leftbehind. Indeed, the sense that suicide is an essentially selfish actdominates many popular perceptions of suicide (Fedden 1938, 209).Still, some of these reactions may be due to the strong stigma andshame associated with suicide, in which case these reactions cannot,without logical circularity, be invoked in arguments that suicide iswrong because it produces these psychological reactions (Pabst Battin1996, 68–69). Suicide can also cause clear economic or material harm,as when the suicidal person leaves behind dependents unable to supportthemselves financially. Suicide can therefore be understood as aviolation of the distinctive "role obligations" applicable to spouses,parents, and other caretakers. However, even if suicide is harmful tofamily members or loved ones, this does not support an absoluteprohibition on suicide, since some suicides will leave behind few orno survivors, and among those that do, the extent of these harms islikely to differ such that the stronger these relationships are, themore harmful suicide is and the more likely it is to be morallywrong. Besides, from a utilitarian perspective, these harms would haveto be weighed against the harms done to the would-be suicide bycontinuing to live a difficult or painful life. At most, the argumentthat suicide is a harm to family and to loved ones establishes that itis sometimes wrong.A second brand of social argument echoes Aristotle in asserting thatsuicide is harm to the community or the state. One general form sucharguments take is that because a community depends on the economic andsocial productivity of its members, its members have an obligation tocontribute to their society, an obligation clearly violated bysuicide (Pabst Battin 1996, 70–78). For example, suicide denies asociety the labor provided by its members, or in the case of thosewith irreplaceable talents such as medicine, art, or politicalleadership, the crucial goods their talents enable them toprovide. Another version states that suicide deprives society ofwhatever individuals might contribute to society morally (by way ofcharity, beneficence, moral example, etc.) Still, it is difficult toshow that a society has a moral claim on its members' labor, talents,or virtue that compels its members to contribute to societalwell-being no matter what. After all, individuals often fail tocontribute as much as they might in terms of their labor or specialtalents without incurring moral blame. It does not therefore seem tobe the case that individuals are morally required to benefit societyin whatever way they are capable, regardless of the harms tothemselves. Again, this line of argument appears to show only thatsuicide is sometimes wrong, namely, when the benefit (in terms offuture harm not suffered) the individual avoids by dying is less thanthe benefits she would deny to society by dying.A modification of this argument claims that suicide violates aperson's duty of reciprocity to society. On this view, an individualand the society in which she lives stand in a reciprocal relationshipsuch that in exchange for the goods the society has provided to theindividual, the individual must continue to live in order to provideher society with the goods that relationship demands. Yet inenvisioning the relationship between society and the individual asquasi-contractual in nature, the reciprocity argument reveals itsprincipal flaw: The conditions of this "contract" may not be met, andonce met, impose no further obligations upon the parties. If a societyfails to fulfill its obligations under the contract, namely to provideindividuals with the goods needed for a decent quality of life, thenthe individual is not morally required to live in order to reciprocatean arrangement that society has already reneged on. As Baron d'Holbachwrote:If the covenant which unites man to society be considered,it will be obvious that every contract is conditional, must bereciprocal; that is to say, supposes mutual advantages between thecontracting parties. The citizen cannot be bound to his country, tohis associates, but by the bonds of happiness. Are these bonds cutasunder? He is restored to liberty. Society, or those who representit, do they use him with harshness, do they treat him with injustice,do they render his existence painful?… Chagrin, remorse,melancholy, despair, have they disfigured to him the spectacle of theuniverse? In short, for whatever cause it may be, if he is not able tosupport his evils, let him quit a world which from thenceforth is forhim only a frightful desert. (d'Holbach 1970, 136–137)Moreover, once an individual has discharged her obligations under thissocietal contract, she no longer is under an obligation to continueher life. Hence, the aged or others who have already made substantialcontributions to societal welfare would be morally permitted to commitsuicide under this argument.3.6 Suicide as a Moral Duty? To this point, we have addressed arguments that concern whether amoral permission to engage in suicidal behavior exists, andindeed, it is this question that has dominated ethical discussion ofsuicide. Yet the social arguments against suicide are fundamentallyconsequentialist, and some act-utilitarians have discussed thecorrelative possibility that the good consequences of suicide might sooutweigh its bad consequences as to render suicide admirable or evenmorally obligatory (Cosculluela 1995, 76–81). In fact, insome cases, suicide may be honorable. Suicides that are clearlyother-regarding, aiming at protecting the lives or well-being ofothers, or at political protest, may fall into this category (Kupfer1990, 73–74). Examples of this might include the grenade-jumpingsolider mentioned earlier, or the spy who takes his life in order notto be subjected to torture that will lead to his revealing vitalmilitary secrets. Utilitarians have given particular attention to thequestion of end-of-life euthanasia, suggesting that at the very least,those with painful terminal illnesses have a right to voluntaryeuthanasia (Glover 1990, chs. 14–15, Singer 1993, ch. 7). Yetutilitarian views hold that we have a moral duty to maximizehappiness, from which it follows that when an act of suicide willproduce more happiness than will remaining alive, then that suicide isnot only morally permitted, but morally required. However, the thesis that there may exist a "duty to die" need not bedefended by appeal to overtly consequentialist or utilitarianreasoning. In the course of articulating what he terms a"family-centered" approach to bioethics, the philosopher John Hardwig(1996, 1997) has argued that sometimes the burdens that a personimposes on others, particularly family members or loved ones, bycontinuing to live are sufficiently great that one may have a duty todie in order to relieve them of these burdens. Hardwig's argumentthus seems to turn not on the overall balance of costs and benefitsthat result from a person living or dying, but on the fairness of theburdens that a person imposes on others by continuing to live.While generally acknowledging Hardwig's suggestion that duties toothers have been neglected in discussion of the ethics of suicide,critics of morally required suicide raise a number of objections tohis proposal. (See Hardwig et al. 2000, Humber & Almeder 2000) Somedoubt that the duty of beneficence to which Hardwig appeals justifiesanything stronger than a permission to take one's own life whencontinuing to live is burdensome to others. (Drebushenko 2000) Othersworry that a moral requirement to commit suicide raises the sinisterand totalitarian prospect that individuals may be obliged to commitsuicide against their wishes. (Moreland & Geisler 1990, 94, PabstBattin 1996, 94–95) This worry may reflect an implicit acceptance of avariation of the sanctity of life view (see section 3.2) or may reflect concerns about infringements upon individual'sautonomy (see section 3.6). Other critics suggest even if there is a duty to die, this duty shouldnot be understood as a duty that entails that others may compel thosewith such a duty to take their lives. (Menzel 2000, Narveson 2000)Questions about social justice and equality (whether, for example,especially vulnerable populations such as women or the poor might bemore likely to act on such a duty) are also raised. One utilitarianresponse to these objections is to reject a duty to die on utilitariangrounds: Suicide would be morally forbidden because general adherenceto a rule prohibiting suicide would produce better overallconsequences than would general adherence to a rule permitting suicide(Brandt 1975, Pabst Battin 1996, 96–98).3.6 Autonomy, Rationality, and ResponsibilityA more restricted version of the claim that we have a right tononinterference regarding suicide holds that suicide is permitted solong as — leaving aside questions of duties to others — itis rationally chosen, or to put it in a Kantian vernacular, if it isundertaken autonomously. This position is narrower than thelibertarian view, in that it permits suicide only when performed on arational basis and permits others to interfere when it is notperformed on that basis.This approach has given rise to a rich philosophical literatureconcerning the conditions for rational suicide. For the most part,this literature divides the conditions for rational suicide intocognitive conditions, conditions ensuring that individuals'appraisals of their situation are rational and well-informed, andinterest conditions, conditions ensuring that suicide in factaccords with individuals' considered interests. Richard Brandtcaptures the spirit of this approach:The person who is contemplating suicide is obviouslymaking a choice between future world-courses: the world-course thatincludes his demise, say, an hour from now, and several possible onesthat contain his demise at a later point… The basic question aperson must answer in order to determine which world-course is best orrational for him to choose, is which he would choose underconditions of optimal use of information, when all of hisdesires are taken into account. It is not just a question of what weprefer now, with some clarification of all the possibilitiesbeing considered. Our preferences change, and the preferences oftomorrow are just as legitimately taken into account in deciding whatto do now as the preferences of today (Brandt 1975).Other examples of this approach include Glenn Graber, who states thata suicide is rationally justified "if a reasonable appraisal of thesituation reveals that one is better off dead." (Graber 1981, 65). Anappraisal is reasonable, according to Graber, if one judges rationallyabout the likelihood of her present and probable future values andpreferences being satisfied. On Graber's view, a suicide is rationalif it results from a clearheaded assessment of how suicide wouldfurther or impede one's overall interests. Margaret Battin identifiesthree cognitive conditions for rational suicide (a facility for causaland inferential reasoning, possession of a realistic world view, andadequacy of information relevant to one's decision), along with twointerest conditions (that dying enables one to avoid future harms, andthat dying accords with one's most fundamental interests andcommitments) (Pabst Battin 1996, 115).For the most part, suicidal individuals do not manifest signs ofsystemic irrationality, much the less the signs of legallydefinable insanity, (Radden 1982) and with the exception of severepsychopaths, engage in suicidal conduct voluntarily. However, thesefacts are consistent with the choice to engage in suicidal behaviorbeing irrational, and serious questions can be raised about just howoften the conditions for rational suicide are met in actual cases ofself-inflicted death. Indeed, the possibility of rational suiciderequires that certain assumptions about suicidal individuals' rationalautonomy be true which may not be in many cases. A person's choice toundertake suicidal behavior may not be a reflection of her true selfand her self-inflicted death could be an act that she would, in calmerand clearer moments, recoil at. In other words, even if there is aright to self-determination which in turn implies a right to suicide,it seems to imply a right to commit suicide only when one's true selfis making that determination, and there are numerous factors that maycompromise a person's rational autonomy and hence make the decision toengage in suicidal behavior not a reflection of one's consideredvalues or aims. Some of these factors cognitively distort agents'deliberation about whether to commit suicide. The act of suicide isoften impulsive and poorly thought out, reflecting the intensepsychological vulnerability of suicidal persons and their proclivitytoward volatility and agitation (Cholbi 2002). Suicidal persons canalso have difficulty fully acknowledging the finality of their death,believing that (assuming there is no afterlife) they will continue tobe subjects of conscious experience after they die. In what are knownas dyadic suicides, the suicidal individual actually looks forward tothe moment when she will (posthumously) enjoy having insulted orhaving exacted revenge upon another person.Particularly worrisome is the evident link between suicidal thoughtsand mental illnesses such as depression. While disagreement continuesabout the strength of this link (Pabst Battin 1996, 5) little doubtexists that the presence of depression or other mood disorders greatlyincreases the likelihood of suicidal behavior. Some studies of suicideindicate that over 90% of suicidal persons displayed symptoms ofdepression before death, while others estimate that suicide is atleast 20 times more common among those with clinical depression thanin the general population. In cases of suicide linked with depression,individuals' attitudes toward their own death are colored by stronglynegative and occasionally distorted beliefs about their lifesituations (career prospects, relationships, etc.). As Brandt (Brandt1975) observed, depression can "primitivize one's intellectualprocesses," leading to poor estimation of probabilities and anirrational focus on present suffering rather than on possible goodfuture states of affairs. The suicidally depressed also exhibitromanticized and grandiose beliefs about the likely effects of theirdeaths (delusions of martyrdom, revenge, etc.) Furthermore, suicidalpersons are often hesitant about their own actions, hoping that otherswill intervene and signaling to others the hope that they willintervene (Shneidman 1985). Finally, although repeated suicideattempts by the same individual are common, the impulse to suicidalbehavior is often transient and dissipates of its own accord (Blauner2003). Taken together, these considerations indicate that, even ifthere is a right of self-determination, the scope of suicidal conductthat genuinely manifests fully informed and rational self-evaluationmay be rare and so only occasionally will suicide be rational ormorally permissible, even when excusable because irrational. (PhilipDevine has even argued that suicide is necessarilyirrational: Because no one has experience of death, a suicidalindividual lacks the knowledge needed to judge continued life with itsalternative (Devine 1978). See also Cowley 2006.) Moreover, if suicideis frequently not an expression of individuals' rationalself-determination about their well-being, that suggests that othersmay have a prima facie reason to interfere with suicidalbehavior and so is there is no general right to noninterference. (See section 3.7)3.7 Duties Toward the SuicidalWith the exception of the libertarian position that each person hasa right against others that they not interfere with her suicidalintentions, each of the moral positions on suicide we have addressedso far would appear to justify others intervening in suicidal plans,at least on some occasions. Little justification is necessary foractions that aim to prevent another's suicide but arenon-coercive. Pleading with a suicidal individual, trying to convinceher of the value of continued life, recommending counseling, etc. aremorally unproblematic, since they do not interfere with theindividual's conduct or plans except by engaging her rationalcapacities (Cosculluela 1994, 35; Cholbi 2002, 252). The morechallenging moral question is whether more coercive measures such asphysical restraint, medication, deception, or institutionalization areever justified to prevent suicide and when. In short, the question ofsuicide intervention is a question of how to justify paternalisticinterference.As mentioned in section 3.6, the impulse toward suicide is often short-lived, ambivalent, andinfluenced by mental illnesses such as depression. While these factstogether do not appear to justify intervening in others' suicidalintentions, they are indicators that the suicide may be undertakenwith less than full rationality. Yet given the added fact that deathis irreversible, when these factors are present, they justifyintervention in others' suicidal plans on the grounds that suicide isnot in the individual's interests as they would rationally conceivethose interests. We might call this the ‘no regrets' or‘err on the side of life’ approach to suicide intervention(Martin 1980; Pabst Battin 1996, 141; Cholbi 2002). Since mostsituations in which another person intends to kill herself will beones where we are unsure of whether she is rationally choosing to die,it is better to temporarily prevent "an informed person who is incontrol of himself from committing suicide" than to do "nothing while,say, a confused person kills himself, especially since, in alllikelihood, the would-be suicide could make another attempt if thisone were prevented and since the suicidal option is irreversible ifsuccessful." (Cosculluela 1994, 40). Further psychiatric or medicalexaminations may settle the matter regarding the rationality of thesuicidal individual's decision. The coerciveness of the measures usedshould be proportional to the apparent seriousness of the suicidalperson's intention to die.A neglected aspect of our duties toward the suicidal is thepossibility that we may have a moral duty to aid others to commitsuicide. (This possibility is directly related to physician-assistedsuicide and the larger question of whether the right to suicide is aclaim right.) If there are circumstances that justify our interveningto prevent suicide undertaken irrationally or contrary to a person'sself-interest, then the same paternalistic rationale would justify ourhelping to promote or enable those suicides that are rational and inaccordance with a person's self-interest. The widespread moralacceptance of aiding others to commit suicide may portend substantialmoral perils, as it opens up the possibility that assisted suicidecould be vulnerable to various forms of abuse, manipulation, or unduepressure that make an otherwise irrational suicide rational (PabstBattin 1996, 145–157). For example, the family members and healthcare providers of a terminally ill patient might grow weary of thefinancial or personal burdens of caring for such a patient and decideto provide substandard palliatve care in order to make suicide moreattractive to that patient. Hence, by giving license for others toassist in suicides, we may unwittingly permit them to encouragesuicides not because those suicides are in fact in the best interestsof the individual in question, but because those suicides advance theinterests of other people or of institutions. Indeed, a good deal ofthe apprehension surrrounding physician-assisted suicide arise fromworries about whether laws and institutional practices can beformulated that both permit others to aid in rational suicide whilealso preventing abuses and manipulation.4. ConclusionAs the foregoing discussion indicates, suicide has been and continuesto be a rich field of philosophical investigation. Recent advances inmedical technology are responsible for the extensive philosophicalattention paid to one kind of suicide, euthanasia orphysician-assisted suicide (PAS), while more "run-of-the-mill" suicidemotivated by psychological anguish is somewhat overlooked. This issomewhat unfortunate: Euthanasia and physician-assisted suicide raiseissues beyond those associated with other suicides, including theallocation of health care resources, the nature of the medicalprofession, the patient-physician relationship, and the prospect thatallowing relatively benign forms of killing such as voluntaryeuthanasia of PAS will lead down a "slippery slope" to more morallyworrisome killings. However, many of the same issues and concerns thatsurround PAS and euthanasia also surround run-of-the mill suicide, andmany writers who address the former often disregard the vastliterature on the latter. (In addition to the entry on voluntaryeuthanasia, Barry 2007, Dworkin et al. 1998, and Pabst Battin2003 provide overviews of the moral debates surrounding euthanasia andPAS.)Not only is suicide worthy of philosophical investigation in its ownright, it is source of insight for various philosophicalsubdisciplines: moral psychology, ethical theory, social and politicalphilosophy, the metaphysics of personhood, free will and actiontheory. Suicide is also an area where philosophical interestsintersect with those of the empirical sciences. The collective effortsof philosophers and others continue to illuminate what has struck manypeople as the most incomprehensible and most troubling of humanbehaviors.BibliographyA. Historical (pre-1900) Works CitedSt. Thomas Aquinas, 1273, Summa Theologica.Aristotle, Nicomachean Ethics.St. Augustine. City of God. Marcus Dods, trans.Cicero, c. 2nd century BCE, De Finibus, trans. 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Brody (ed.), Dordrecht: Kluwer.Cosculluela, V. 1994, "The Ethics of Suicide Prevention",International Journal of Applied Philosophy, 9: 35–41.–––, The Ethics of Suicide, New York:Garland.Cowley, C., 2006, "Suicide Is Neither Rational NorIrrational", Ethical Theory and Moral Practice, 9:495–504.Devine, P.E., 1978, "On Choosing Death," in The Ethics ofHomicide, Ithaca: Cornell UP.Donnelly, J., 1998, "Introduction," in Suicide:Right orWrong?, J. Donnelly (ed.), Amherst, N.Y.: Prometheus.Drebushenko, D., 2000, "How Could There Be a Duty to Die?" inHumber, J., and Almeder, R. (eds.), Is There a Duty to Die?,Totowa, N.J.: Humana Press.Dworkin, G., Frey, R.G., and Bok, S., 1998, Euthanasia andPhysician-Assisted Suicide:For and Against, Cambridge: CambridgeUniversity Press.Dworkin, R., 1993, Life's Dominion, New York: Knopf.Eugenides, J., 1993, The Virgin Suicides, New York:Warner.Fairbairn, G., 1995, Contemplating Suicide: The Language andEthics of Self-Harm, London: Routledge.Fedden, H.R., 1938, Suicide: A Social and HistoricalStudy, London: Peter Davies.Feinberg, J., 1978, "Voluntary Euthanasia and the Inalienable Rightto Life", Philosophy and Public Affairs, 7 (1978).Ferngren, G.B., 1989, "The Ethics of Suicide in the Renaissance andReformation.", in Suicide and Euthanasia: Historical andContemporary Themes, B. Brody (ed.), Dordrecht: Kluwer.Frey, R.G., 1978, "Did Socrates Commit Suicide?",Philosophy, 53: 106–108.–––, 1981, "Suicide and Self-Inflicted Death",Philosophy, 56: 193–202.Gay-Willliams, J., 1996, "The Wrongfulness of Euthanasia",in Intervention and Reflection: Basic Issues in MedicalEthics, R. Munson (ed.), Belmont: Wadsworth.Glover, J., 1990, Causing Death and Saving Lives,London: Penguin.Graber, G.C., 1981, "The Rationality of Suicide" in Suicide andEuthanasia: The Rights of Personhood, S. Wallace and A. Eser(eds.), pp. 51–65., Knoxville: U. Tennessee Press.Hayry, M., 1991, "Measuring the Quality of Life: Why, How andWhat?", Theoretical Medicine, 2: 97–116.Hardwig, J., 1996, "Dying at the Right Time: Reflections onAssisted and Unassisted Suicide," in Ethics in Practice,H. LaFollette (ed.), New York: Blackwell.Hardwig, J., 1997, "Is There a Duty to Die?", Hastings CenterReport, 27: 34–42Hardwig, J. et al., 2000, Is There a Duty to Die?:AndOther Essays in Bioethics, New York: Routledge.Holley, D.M., 1989, "Voluntary Death, Property Rights, and theGift of Life", Journal of Religious Ethics, 17: 103–121. Humber, J., and Almeder, R. (eds.), 2000, Is There a Duty toDie?, Totowa, N.J.: Humana Press.Kluge, E.W., 1975, The Practice of Death, New Haven: YaleUniversity Press.Kupfer, Joseph, 1990, "Suicide: Its Nature and Moral Evaluation",Journal of Value Inquiry, 24: 67–81.Lebacqz, K. and Engelhardt, H.T., 1980, "Suicide", in Death,Dying, and Euthanasia, D.J. Horan and D. Mall, (eds.),. Frederick,Md.: Aletheia.Lieberman, L., 2003, Leaving You: The Cultural Meaning ofSuicide, Chicago: Ivan R. Dee.Margolis, J., 1975, Negativities: The Limits of Life,Columbus, O.: Merrill.Martin, R.M., 1980, "Suicide and False Desires", in Suicide:The Philosophical Issues, M. Battin and D. Mayo (eds.), New York:St. Martin's.Menzel, P.T., 2000, "The Nature, Scope, and Implications of aPersonal Moral Duty to Die," in Humber, J., and Almeder,R. (eds.), Is There a Duty to Die?, Totowa, N.J.: HumanaPress.McMahan, J., 2002, The Ethics of Killing: Problems at theMargins of Life, Oxford: Oxford University Press.Minois, G., 1999, History of Suicide: Voluntary Death inWestern Culture. Baltimore: Johns Hopkins University Press.Moreland, J.P. and Geisler, N.L., 1990, The Life and DeathDebate, Westport: Greenwood Press.Narveson, J., 2000, "Is There a Duty to Die?" in Humber, J., andAlmeder, R. (eds.), Is There a Duty to Die?, Totowa, N.J.:Humana Press.O'Keefee, T.M, 1981, "Suicide and Self-Starvation",Philosophy, 56: 349–363.Pabst Battin, M., 1996, The Death Debate. Ethical Issues inSuicide, Upper Saddle River, N.J.: Prentice-Hall.–––, 2003, "Euthanasia and Physician-AssistedSuicide," in H. LaFollette (ed)., Oxford Handbook of PracticalEthics, Oxford: Oxford University Press.Radden, J., 1982, "Diseases as Excuses : Durham and the InsanityDefense", Philosophical Studies, 42.3: 349–362.Ramsey, P., 1978, Ethics at the Edges of Life, New Haven:Yale University Press.Shneidman, E., 1985, Definition of Suicide, New York:Wiley & Sons.Singer, P., 1993, Practical Ethics. Cambridge: CambridgeUniversity Press.–––, 1994, Rethinking Life and Death,New York: St. Martin's.Stern-Gillett, S., 1987, "The Rhetoric of Suicide", Philosophyand Rhetoric, 20.3: 160–170.Stoff, D.M. and Mann, J.J., 1997, "The Neurobiology of Suicide:From the Bench to the Clinic." Annals of the New York Academy ofSciences, 836.Szasz, T., 2002, Fatal Freedom: The Ethics and Politics ofSuicide, Syracuse: Syracuse University Press.Tolhurst, W.E., 1983, "Suicide, Self-sacrifice, and Coercion",Southern Journal of Philosophy, 21: 109–121.Tong, R., 2000, "Duty to Die," in Humber, J., and Almeder,R. (eds.), Is There a Duty to Die?, Totowa, N.J.: HumanaPress.Windt, P., 1981, "The Concept of Suicide", in Suicide: ThePhilosophical Issues, M. Pabst-Battin and D.J. Mayo (eds.),London: Peter Owen.C. Further ReadingAlvarez, A., 1982, The Savage God: A Study of Suicide.New York: Bantam.Battin, M. and Mayo, D. (eds.), 1980, Suicide: ThePhilosophical Issues. New York: St. Martin's.Donnelly, J. (ed.), 1998, Suicide: Right or Wrong?Amherst, NY: Prometheus.Jamison, K. R., 2000, Night Falls Fast: UnderstandingSuicide, Vintage.Maltsberger, J.T., and Goldblatt, M., 1996, Essential Papers onSuicide. New York: NYU Press.Mayo, D., 1986, "The Concept of Rational Suicide", Journal ofMedicine and Philosophy, 2: 143–155.Nagel, T., 1970, "Death", Noûs, 4: 73–80.Novak, D., 1976, Suicide and Morality: The Theories of Plato,Aquinas, and Kant and Their Relevance for Suicidology, ScholarsStudies Press.Shneidman, E.S., 1998, The Suicidal Mind, Oxford: OxfordUniversity Press.Other Internet ResourcesAmerican Association of SuicidologyAmerican Foundation for Suicide PreventionEthics Updates, information on euthanasia, maintained by Lawrence M. Hinman, University of San DiegoLinks on Suicide and Philosophy, maintained by Matt Pianalto, University of Arkansas |
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