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 states 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 countrys 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.) Times up! It was September 10.
Did you hear anything about it? I sure didnt. 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. Thats great, but I noted with a sinking heart the documents 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 isnt 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 Institutes Center on Human Exceptionalism. He also consults for the Patients Rights Council and the Center for Bioethics and Culture.
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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