When I was practicing law from the mid-1970s into the 1980s, there was tremendous emphasis given in the popular media and within the bar association to the cause of suicide prevention. Hotlines proliferated, anti-suicide billboards were ubiquitous, and a great deal of attention was paid to saving the lives of despairing people. 
Attitudes have shifted since then. Not only does suicide prevention receive less emphasis, but certain segments of society have grown pro-suicide—or more accurately stated, pro- some suicides.
Who can deny it? Pro-suicide billboards, mostly sponsored by the Final Exit Network, make headlines. The late Jack Kevorkian was lionized for helping to end the lives of more than one hundred and thirty disabled and terminally ill people, even becoming the subject of a hagiographic movie starring Al Pacino. “How to commit suicide” books can be found at your local retailer, and assisted suicide advocacy groups are treated as respectable “patients’ rights” groups in the media. Meanwhile, as debates rage about the best way to cap the surging cost of our medical system, a Vermont newspaper editorialized in favor of legalizing assisted suicide as a way to help pay for that state’s new single-payer health plan.
Why the shift in attitudes? Over the last two decades, the euthanasia movement has argued that some suicides were “rational” and that killing is a proper way to eliminate human suffering. Indeed, the idea of “rational suicide” has even found minority acceptance within the mental health professions. Thus, in 2009, an article published in Psychosomatics noted:
Definitions of rational suicide have been appearing in the literature of psychiatry and mental health for at least 120 years. According to a 1986 article, in rational suicide “1) the individual possesses a realistic assessment of his situation; 2) the mental processes leading to his decision to commit suicide are unimpaired by psychological illness or severe emotional distress; and 3) the motivational bases of his decision would be understandable to the majority of uninvolved observers from his community or social group.”
Meanwhile, suicide has been turned into a medical treatment in some states and nations, with doctors allowed to assist the suicides of those diagnosed as terminally ill in Oregon and Washington. In Washington, doctors are legally required to lie on death certificates by claiming that assisted suicide deaths were really caused by the underlying disease. Meanwhile, suicide is on the ballot in Massachusetts, where voters will decide on November 6 whether doctors there, as in Oregon, should be allowed to legally prescribe lethal overdoses.
Some European countries have ventured even more deeply into the pro-suicide thicket. The Netherlands allows euthanasia for the terminally ill, the disabled, the elderly “tired of life,” and the seriously depressed. Dutch doctors are also permitted to teach suicidal patients how to kill themselves.
The Belgians are even more enthusiastic about euthanasia, now coupling it with organ harvesting and allowing joint suicides. Meanwhile, Switzerland allows the operation of for-profit suicide clinics to which people fly from all over the world to be made dead—a phenomenon dubbed “suicide tourism”—as that country’s Supreme Court declared a constitutional right to assisted suicide for the mentally ill.
With such attitudes and advocacy becoming ubiquitous, is it any wonder that our commitment to suicide prevention appears to have waned? For example, how many readers know the date of 2012 International Suicide Prevention Day? (Cue the Jeopardy music.) Time’s up! It was September 10.
Did you hear anything about it? I sure didn’t. Suicide Prevention Day used to make quite a splash. But these days it comes and goes each year without stirring a ripple.
Making matters worse, the suicide prevention community has been largely silent in the face of pro-suicide advocacy. For example, the Surgeon General of the United States issued a new suicide prevention policy to coincide with Prevention Day—including new emphasis on outreach to at-risk gay youth. That’s great, but I noted with a sinking heart the document’s silence about assisted suicide. The World Health Organization has been similarly derelict, urging that preventers restrict access to “common methods of suicide” and engage in “many levels of intervention and activities” to protect the suicidal. The guidelines also point out that “adequate prevention and treatment of depression . . . can reduce suicide rates, as well as follow up contact.”
In contrast, rather than helping people stand against the darkness, the assisted suicide movement seduces people toward embracing it through talk of “death with dignity.” Rather than ensuring access to treatment for mental illness, they claim it often isn’t needed because suicides apparently inspired by serious sickness, disability, or mental illness are not really suicide, but “aid in dying.” They even want the means provided. Thus the euthanasia/assisted suicide movement thwarts suicide prevention by promoting precisely opposite values and actions.
If the World Health Organization and the U.S. Surgeon General want to issue a truly clarion call to prevent suicides, they must emphasize that means all suicides, not just some. Yes, that is to engage a highly controversial issue. But are they there to be liked by all or to save lives?
This much I know: Until and unless we stand up against assisted suicide, Suicide Prevention Days will remain invisible.
Wesley J. Smith is a senior fellow at the Discovery Institute’s Center on Human Exceptionalism. He also consults for the Patients Rights Council and the Center for Bioethics and Culture.
RESOURCES
Addison County Independent, “Political Pragmatism is Key to Vt.’s Health Care Reform”
“Distinguishing Among Irrational Suicide and Other Forms of Hastened Death: Implications for Clinical Practice,” by Cavin P. Leeman, MD, FAPM, Psychosomatics, May-June 2009
Office of the U.S. Surgeon General and the National Action Alliance for Suicide Prevention, “2012 Strategy for Suicide Prevention”
World Health Organization, “Suicide Prevention”
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Comments:
As for Dr. Death. I live in downtown Royal Oak where he lived for many years. Every once in a while you would see him on Main Street and people would stop and ASK FOR HIS AUTOGRAPH. After he died, one of the art galleries put a large memoral display in its main window. We're all New York and San Francisco and London and Berlin and Beijing now. There's no place to be a hick moralist.
Here in Royal Oak, Michigan Dr. Death was fairly common sight on Main Street. People would stop him and ask for his autograph. When he died an art gallery placed a large memorial in their display window to the man who made despair fashionable beyond music and dress. Now it was a lethal accessory in the final dress up.
Meanwhile, my sister's "significant other" for ten years whom she just went through a horrifying break-up with, was calling me at the strangest hours and haranguing me that I was defying my sister's obvious wish to die. This woman had loads of money and was able to arrange to have two neurosurgeons (one considered the best in Washington), a nurse, a social worker, my sister's former psychologist who was an incompetent (this according to a psychiatrist at a reputable mental hospital after interviewing her) and herself to meet with me in a conference room. They wanted to convince me to pull the plug, and when I made it clear to them that I wouldn't do it, the young neurosurgeon said, "You do understand, don’t you, that your sister is like a vegetable?" And I said, "That's fine...I'll just water her with the other plants every morning."
My sister came around and was progressing daily. The first thing she said to me was "Thanks for saving my life." You see, my sister, a severe alcoholic who went through alcohol withdrawal while in a coma, hadn't experienced life outside her alcohol addiction for over 20 years, and now free from it for the first time began to look at life differently, and she was excited about going to a rehab house close to where I lived where she was also happy about being enrolled in a 12-step-program.
But her friend started bringing her alcohol in the nursing home and got her to sign herself out to get more, and then with big bags of money her “friend” got a high-profile lawyer to get power-of-attorney, which I fought, but a judge ruled in her favor, and she then proceeded to arrange for my sister's death.
What I came to understand over time was that my sister coming back was no miracle. It was just this unspoken understanding by “specialists” and sometimes emotionally beaten-down-relatives, long before euthanasia was legalized in Washington, that the "low-lifes", persons determined not to have any value by “specialists in the field”, are simply better off dead. And like I said, the "superior" doctors, nurses and social workers in consort with a woman who had grown to detest my sister did all in their power to make sure my sister would die.
Substantively though, the training is more or less the same thing. But I thought that was an interesting point.