RATIONAL SUICIDE

James L. Werth, Jr., author of [1], conducted a survey of 400 members of the National Register of Health Care Providers in Psychology. They were asked to define rational suicide.

Three basic criteria were mentioned. First, the decision-maker should have a hopeless condition - this includes cases of low quality of life and psychological as well as physical pain. Second, the decision-maker should be free of coercion, whether coercion consists of internal factors like ageist or ableist beliefs or external factors like greedy relatives or cost-conscious medical professionals or institutions. Third, the decision-maker should be engaged in sound decision-making.

The subcriteria for sound decision-making included the following:

1. The decision-maker should be mentally competent, which eliminates people with treatable depression and other judgment-clouding impairments.
2. The decision-maker should nonimpulsively consider other options, such as psychotherapy, antidepressants, assisted living or support groups.
3. The decision should be consistent with the decision-maker's values.
4. The decision-maker should consider the impact suicide will have on significant others.
5. The decision-maker should consult with others, such as religious leaders, disability advocates, physical therapists or hospice personnel.

Most of these criteria make sense, but others are not realistic.

That criteria that the decision-maker situation be hopeless is open to interpretation. Arguably, there is always hope even for the worst cases, even if the actual probability of improvement is miniscule. A more precise criteria would be that the chances of improvement are reasonably small.

Another problem is the requirement that the decision maker consult with others. Today, this is not realistic for many who are considering suicide, since therapists are bound to the values of society, which are different than those of ashers. Given this fact, some types of consultation are useless.

In spite of these, this survey shows that even health care providers acknowledge that suicide can be a rational decision.

Glenn C. Graber addresses the possibility of rational suicide[2]. The conclusion reached is that some suicides are rationally justified: "It is rationally justified to kill oneself if a reasonable appraisal of the situation reveals that one is better off dead." In addition the following conclusions were presented:

The judgment that a certain person is (or is not) better off dead should be justified exclusively:

1. From the person's own point of view.
2. Within limits, on the basis of the person's own tastes and preferences.
3. On the basis of actual preferences (present and future), rather than abstract capabilities.

The prospective suicide's judgment of whether he or she would be better off dead is not the last word on the matter. The person may be mistaken:

1. The person may make a wrong prediction about the degree to which his or her present values are likely to be satisfied.
2. The person may make a wrong prediction about the nature of his or her future values.
3. The person may have mistaken values.

Finally, an additional important conclusion is that "in judging whether a person would be better off dead, we must take into account not only the person's present and future values but also his or her personal ideals and personal integrity."

REFERENCES

[1] James L. Werth, Jr., Rational Suicide, Implications for Mental Health Professionals, Taylor & Francis, 1996.

[2] Glenn C. Graber, "Mastering the Concept of Suicide", in Suicide, Right or Wrong, ed. John Donnelly, 1998.