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A review of "Suicide: The Forever Decision"
Book author: Paul G. Quinnett
The Crossroad publishing company, 1998, 156 pages.
(You can download the book in pdf format)
This book seems rather unique in that its cover does not depict it as prevention oriented. The title emphasizes the aspect of making a decision. The subtitle of the book is : "For those thinking about suicide, and for those who know, love, or counsel them." which is rather benign.
The back cover raises some doubts about the author's intention. It contains several reader's testaments, which seem rather pro-life. However, upon further inspection, the author seems to be pro-choice: "Suicide is a solution. No matter what anyone tells you, suicide does solve problems, at least your problems. And if you succeed it solves them once and for all" (p 1). "Suicide is a decision every single human being has. Sometimes it is our only decision. And sometimes, for some people, at least in my view, maybe it is the right decision" (p 3).
This review has two purposes. The obvious one is to review the book, and to determine whether it may be of use to ashers. The other one is a review, not just of this book, but of the kind of help offered to us, by the traditional mental health establishment, to make the choice whether to be or not to be. At least on the surface, Quinnett seems to be pro-choice, thus his approach might be the most an asher can hope for, from a mental health professional.
Quinnett's book is aimed at the general public rather then to mental health professionals. Having a written document of his attempt to "group-council" his readers, provides a rare opportunity to assess the way mental health professionals work, and what kind of real help they can offer to ashers. This can seldom be done for most clinical workers.
The Postponement Argument
Following the strong pro-choice statements at the beginning of the book, the author follows with the reasonable claim that to make a decision on this issue, we need to know all of the relevant facts, or as Quinnett says, "And I mean every single one." (p 4)
In principle, this seems like sound advice. In practice, Quinnett uses this argument to get his readers to read the book till its end. In fact, one could never hope to know all relevant facts. Nobody does. Still people make decisions all the time, based on partial information. A decision about suicide should be no exception. Of course, one should try to get as much information as reasonably possible, but once this is done a decision can be carried out. Otherwise not only a decision about suicide would be impossible, but every other decision as well. But since this argument appears at the beginning of the book, it seems reasonable to listen to it, and read on.
However, it seems that Quinnett thinks this argument should apply all the time: "... in the next few hours or days or weeks, something may happen that you didn't expect, something that will give you reasons to live." (p 28). Of course nobody can know the future, not even Quinnett. And since the readers don't know either, this would imply that the readers cannot ever make a decision to exit.
Quinnett continues and easily gets carried away. In some points he states that the probability that things improve is extremely high: "... if I had to bet on it- even when I don't know you or what your situation is - I'd bet that you are going to get over it, through it, or around it. And I would win the bet." (p 51). In other cases, he shifts from a possibility that the situation may improve, to absolute certainty: "Did they (suicidal people) know that someone out there in the future of their lives would come to love and cherish them? Did they know that, within a few days, things could begin to change for the better..." (p 31). Does Quinnett know something about our future that we do not?
Quinnett is quick to prevent his readers from indulging in similar tricks: "Unless you can know your future perfectly, it seems to me you cannot know with any certainty that, in fact, things will get worse" (p 131). It seems that predicting the future only works when the prediction says that things will get better...
The author is quite a prophet: "I firmly believe that if you will but put the decision to end your life off, you will, in the days and weeks ahead, find fewer and fewer reasons to choose suicide. ... How else, I ask you, can all the millions of people who have given the suicide decision some consideration still be alive?" (p 133) Actually, there many reasons why others continue to live, reasons which have little to do with things getting better[1]. For example, because suicide is not easy to carry out (as the author expounds in chapter 15), or because of not wanting to hurt family and friends (chapter 16).
It seems that Quinnett has little knowledge in decision making, taking uncertainty into account. The correct way of making such a decision is not by asserting that one option will happen and the other will not. Rather, the probabilities of each of these events should be assessed. Neither of them are certain, and neither impossible.
But is Quinnett interested in helping his readers make a rational decision? It seems that his only interest is to prolong the life of his readers, even at the cost of prolonging their misery.
Logic
Quinnett attempts to analyze the false logic of suicidal people. For example, he presents the problem of constricting the number of options available: "Either my life improves, or I must kill myself." (p 22). Quinnett claims that the problem here is that the person has determined only 2 options, while there might be more. The author suggests that the person might just continue living miserably... However, isn't this precisely the situation a typical suicidal person is trying to avoid? In that case, remaining in such a state is not a solution to the problem, as defined by the person : to get out of their current situation.
At one point, the author suggests the reader turn to god: "... if finding a way to your God is what you need, then I strongly encourage you to begin that journey. And to begin it now." (p 75). Here religion is not a goal in itself. It is not the pursuit of truth that interests Quinnett. Religion is merely a means to keep one alive, even if the religion is false, it does not matter.
In addition, the book is plagued with cyclic reasoning. For example, the author argues why a therapist must be anti-suicide: "If a therapist does not affirm the value of life and make strong arguments against death and suicide, how can the sufferer?" (p 146). If you assume that suicide must be bad then this is valid reasoning. However, this assumption is precisely what ashers contest.
What is misleading about Quinnett is that he acknowledges some obvious logical claims which most other books don't. For example, the claim that suicide is a solution. Thus Quinnett seems more reasonable and rational, however, this only goes so far. After such statements the author continues to present his own opinion, sometimes without any logical connection to what has been established throughout the chapter.
Scare Tactics
Quinnett leaves the most convincing chapters to the end of his book. Chapter 15 focuses on the consequences of an unsuccessful suicide: "Most people contemplating suicide do not realize how difficult it is to kill a human being." (p 117). This is followed by examples of people who have failed, the damage which was inflicted, the effects of various methods, and the treatment in mental institutions. "I know that what I have said here may amount to some kind of scare tactic, that I'm trying to frighten you out of your thoughts about the suicide solution. And, in a way, I suppose I am." (120) "I hope that what I have said here does, in fact put a bit of uncertainty into your thinking about suicide. Perhaps if I can convince you that your best-laid plans can go awry and that you just could end up in much worse shape than you can possibly imagine, then maybe you will think twice about killing yourself." (121)
Quinnett does not offer any advice on how to minimize these dangers, even though in doing so he might help lessen the hazardous affects he warns us of.
Chapter 16 continues the assault by emphasizing the pain of survivors, i.e. friends and family of the person committing suicide. "If you are a child (committing suicide), you will have stolen something from your parents, something they can never replace. You will have stolen the future they dreamed for you, the satisfaction that might have come to them to see you grow into an adult and succeed where they may have failed." (p 126)
Quinnett continues rather emotionally: "... suicide is not a single quiet thing you do only to yourself. Rather, it is like pulling the pin on a hand grenade while you are surrounded by everyone who knows you. ... it will send fragments into all those around you and they will be victims, too. Innocent ones." (p 129).
In fact, this is in fundamental conflict with chapter 13, which talks about immature parents who blame their children for their own unhappiness. The author fears that some children will consider suicide as a means to make their parents happy. Quinnett proceeds by claiming that "your mother's happiness is her job, not yours" (p 101). According to this statement, it is not clear whether Quinnett recommends to take others into account in the decision of suicide. Apparently, Quinnett's biased recommendation is that the affect on others be taken into consideration only if this affect happens to be negative.
Quinnett also tries to convince the readers that nothing could be done to lessen the blow: "The most-elaborate notes or explanations or warnings can never comfort the pain those you leave behind will endure" (p 127). Actually, one can write a better note[2]. In fact, there is scientific research about this issue[3]. Why doesn't Quinnett share this with his readers? There are two possibilities. The first, that he is unaware of such research, the second is that he does not want to disclose such information to his readers. In the first case, the cause is mere ignorance (which is surprising since we are counting on Quinnett to be a knowledgeable expert), but the second is even worse : it implies that Quinnett is using his expertise to hide and distort scientific evidence. If this is the case, it constitutes a betrayal of his readers, who trust him to be a scientific authority, sharing with his readers scientific truths, rather than their contortion.
Biased Decision Process
The author is consistent in his presentation. Options which affirm life are presented optimistically, (and arguably unrealistically), with many practical suggestions of how to go about and improve ones life. Options which may lead to death are presented under the worst assumptions, and no advice is given, for example how to exit painlessly, with no damage and with high probability, even though such advice could easily be collected from scientific resources
If a choice is to be made then the logical way to proceed is to find the best options and choose among them. For example, suppose you wanted to buy a car, there are many cars you can choose from. At first, you try to narrow down your choice to two car models. You are not going to narrow down your choice to be between a new BMW and a 30 year old skateboard, but this is the kind of choice Quinnett is offering.
Quinnett's presentation of suicide is extremely biased. Not only does he not offer any advice, but he exploits his professional skills to provide false information under the pretense of scientific truth. If you are really trying to make a decision, the book will provide biased information which is likely to distort your decision process.
Honesty
Honesty is a theme that appears numerous times in the book, starting at the prefix: "I am going to talk to you about suicide. And because your life is at stake, I am not going to fool around. I am not going to kid you. I am not going to mince words. Rather, I intend to be just as honest and straightforward as I know how to be." (p x).
Statements about his attempts to be honest and frank appear in almost every chapter. We have to wait till the last chapter to read that "Since you have read most of this book, I suppose in a way I have tricked you. .... now you find, in the last chapter, that ... I am an enemy of the suicide decision in almost every single circumstance. I hope you do not feel tricked, but if you do, I hope you will see my purpose as I intended it - and that purpose is in keeping with what I believe: To keep you alive until you find your own reasons to life." (p 147)
It would seem that not only is Quinnett pro-life, but he is not willing to make distinctions between pro-suicide, pro-choice and pro-life. Even though he had tried to present himself as pro-choice throughout the book, he concludes that if one is not pro-life then he must be pro-suicide. There is no such position as pro-choice.
Beyond this, it is rather disappointing to read a book based entirely on tricking the audience, while at the same time, claims of honesty abound throughout the book.
Credentials
Near the beginning of the book, the author confesses: "... it is not for me, a psychologist, to say whether you have a right to die. There is nothing in my training or background or personal experience that gives me any special knowledge about the subject.... If anything, I have been trained to save lives, not to help people end them." (p 10). So to begin with the author is not trained to address the main goal of the book: to decide whether or not to exit.
Conclusion
Many of the chapters address different aspects or cases of people considering suicide, such as loneliness, depression, anger, stress, and drugs. The author tries to cover all cases, since he does not know the reader personally. The only case he does not address are people who may still want to exit, in spite of previous help they have received. Quinnett knows that such people exist: "Sure, there are a few depressions we can't seem to help very much. We can't figure out why a person continues to be depressed even after we've tried everything we know. But this is a small number." (p 50). Despite the author's attendance to the needs of groups of people in numerous situations (some of these groups perhaps being small as well) the book contains nothing to assist the group of people who are the most deprived of assistance.
To summarize, the book starts out as pro-choice, however, it raises unrealistic hopes in order to keep people alive, it is plagued with logical fallacies and cyclic reasoning, it uses exaggerated emotional scare tactics to deter the reader from suicide, it hides and distorts scientific evidence which may assist those who wish to exit, it offers no advice for people who do not benefit from what current mental health services can offer, it distorts the thinking and decision process of those who are considering suicide, it is dishonest, deceitful, and written by somebody, who according to his own words, is not trained in the subject.
You might be surprised to learn that in spite my criticism, I think there is also some very good information in the book. Life affirming information of course. However, I believe a book should be judged according to it's self-professed goals. If I had bought an encyclopedia, and found it contains a romance novel, no matter how good it was, I would be extremely disappointed. Quinnett's book is presented as a book to help in the deliberation process of whether or not to commit suicide, but it's purpose is suicide prevention.
If you want to buy a book to help in the deliberation process, I wouldn't recommend this book. Actually, there are no truly pro-choice books. However, it is better to buy a pro-life book which states clearly that it is prevention oriented. At least you know what you are buying and are prepared to screen out parts which do not fit your values.
It is possible to draw conclusions from this book as to how therapists may attempt to assist ashers in deciding whether to commit suicide: "In my work with suicidal people I have decided that once someone has come into my office and entered my frame of reference, they have entered my value system, my personal and, yes, philosophical world. And therefore, as a counselor and healer, my decision will always be to do all I can to prevent what I consider to be an unnecessary act of suicide." (p 146). Quinnett makes an excellent observation. Therapists have a value system. Usually, this value system is similar to that of the consensus in society. Since ashers have a different value system[4], there is little hope for genuine assistance.
Quinnett makes no explanation of why the patient, which is actually a client of a service, does not get to set the value system. Why do therapists have a right to impose their value system upon others?
If you try to obtain professional help about whether to exit, you will probably get what Quinnett's book provides with abundance: false hopes, logical fallacies, cyclic reasoning, trickery and scare tactics. Therefore, if you go to a therapist, you should probably confine yourself to discussing issues which help you explore the possibility of life. As for making the decision of whether or not to exit, you will have to make it yourself.
REFERENCES
[1] ASH FAQ part 3/4: Are you for real?, sec 6 : It is easy to commit suicide. RU4real.html
[2] How to write a suicide note Note.html
[3] Rudestam K. E. and Agnelli P. "The effect of the content of suicide notes on grief reactions", Journal of Clinical Psychology, March 1987, Vol 43, No. 2.
[4] ASH FAQ part 1/4: Introduction. sec 1.2 : What is the a.s.h subculture? intro.html
