The Forever Decision by Paul Quinnett   Chapter 3

"DON'T I HAVE A RIGHT TO DIE?"

A lot of suicidal people I've worked with have asked me this question and, frankly, I don't have a very good answer. In a way, I'm glad I don't. But since I imagine you may have asked yourself this same question, I'm going to share with you what I have told others.

First, 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. I am not a minister or a priest or any kind of church authority. I am not a judge. If anything, I have been trained to save lives, not to help people end them. At least from a legal
point of view, I think I can give you a partial answer: No, you do not have an absolute right to kill yourself.

At this moment in the history in America and most other countries it is still against the law to attempt suicide and if you try it, unpleasant legal consequences may follow. Although it rarely happens now, not so long ago people were put in jail for attempting suicide. But in the last few decades suicide has become less of a crime and more of a symptom that something is desperately wrong with people who try it and that, if given some help, they will give up the idea and get on with living.

Frankly, there is a great deal of confusion about this right-to-die business. On the one extreme are those people who argue no one has a right to die under any circumstances and, on the other extreme, are those who say all of us have a right to die any time we so choose, including by suicide.

Most of the right-to-die debate centers around the issue of whether a person who is terminally ill or very old and sick and not expected to improve with sometimes painful treatments, has the right to refuse medical care and/or request medical assistance in dying.

There are groups of people organized to push for legislation that would permit physician-assisted "death with dignity" for those who are terminally ill. And there are those opposed to any form of self- or other-assisted suicide under any circumstances. While some might disagree, it seems to me that the goals of both groups are humane and none, so far as I know, argues for the right to
suicide if you are young and healthy. Perhaps if we could all look forward to competent medical care and sophisticated pain management at the ends of our lives, this debate would evaporate.

So unless you have recently gotten the word that you are terminally ill and about to die sometime in the near future, I'm going to assume that you are thinking about suicide for different reasons.

You might ask, "What happens if I attempt to kill myself and don't succeed?"

Every state and most countries have some kind of involuntary-treatment law that permits a judge, on the basis of professional testimony, to put you in a hospital for treatment and to prevent you from making further attempts on your life. The government must prove you are mentally ill and therefore need treatment, but it can generally do this without all that much trouble. You lose,
however temporarily, your civil rights when this happens.

As we have already discussed, however, while most people who die by suicide are depressed and suffering from a brain disorder, you do not have to be psychotic to take your own life. In fact, most people who do die by suicide are not legally "insane.” So it seems we have a very interesting problem.

To prevent you from killing yourself, doctors like myself will stand up in court and say something to the effect that, by reason of a mental illness, you are a danger to yourself and need treatment. But - and this is the weird part - you may, in a matter of a few hours to a couple days, get up one morning and say, "I've decided not to kill myself, after all." And if you can convince us you mean what you say, you can leave the hospital and go home. Question: Are you now completely cured of your so-called mental illness?

Obviously not since the chances are you were never "mentally ill" in the first place. But this doesn't mean you may not be depressed or angry or in a major life crisis and need counseling.

Being detained in a hospital because of suicidal thinking or after making an attempt on your life only means that, in the opinion of people like me, you were so confused or off balance or upset that - at least at the time - you were in danger of making a very bad decision.

So, you have every right to ask, if I am not "crazy;” why is thinking about suicide a symptom and, if it is a symptom, what is it a symptom of?

As I have said, I do not believe you have to be mentally ill to think about suicide. Research has shown that a substantial majority of people have considered suicide at one time in their lives, and I mean considered it seriously - maybe as seriously as you. And these were normal people, just as you are. I've talked to lots of people who have seriously considered suicide. Some of them say that at the time they were thinking about it they must have been "temporarily insane." Maybe that's as good an explanation as we need for now.

For the moment let's just accept the fact that, at the present time in America and most civilized countries, it is not okay to try to kill yourself and that, if you try it, you may lose your freedom - if only for a few days.

The people who have the authority to try to stop you from dying by suicide are people like me: psychologists, psychiatrists, social workers, nurses, physicians, and all sorts of mental health and drug- and alcohol-treatment specialists. The police have responsibilities as well. These professionals, for lack of a better term, are called the mental health system. And it is this "system,” however good or bad, that you will come into contact with if you attempt suicide, are discovered and do not succeed. If you succeed and die by your own hand well I think you know what "system" takes care of your remains.

H ere is a word of caution: For a lot of reasons I won't bore you with, you can't always count on the system to respond perfectly. If you make an attempt on your own life and fail, consider this: Sometimes the police will investigate and take whatever action they think is necessary. They may take you to a hospital, or they may not. They may let you go on the promise you won't try to kill yourself again. They might even take you to jail, especially if you endangered someone else in your attempt.

If you go or are taken to a hospital by friend or family or the police, sometimes the doctors will treat you and let you go home. Sometimes they will admit you to a psychiatric ward in the hospital. Or, if they do not have a psychiatric ward, they may make arrangements to send you to a state mental hospital. It depends on the hospital and how the system works in your town or area.

Sometimes, if the doctors think you need inpatient psychiatric care and you are unwilling to go voluntarily, they will put you in a psychiatric facility even if you do not want to go. As I have mentioned, most governments have laws on the books that permit them to do this. And, as I said, you can lose your freedom, at least for a time.

Now then, if you are reading a lot of "sometimes" as we go along here it is because, despite laws designed to prevent suicide, these laws are never carried out in exactly the same way from one place to another or even from one day to the next. People in the system --psychologists, psychiatrists, emergency-room people, policemen and women, etc. -- all have different opinions about people who attempt suicide. Some of them, to be honest, don't like people who try to kill themselves. Some of them would just as soon you would succeed and get it over with.

Some people (and this should not be news to you) don't give a damn whether you live or die. I've heard some of them say, "They're going to do it sooner or later anyway, so why bother?"

My point is this: Attempting suicide is a risky business.

And I don't mean that as a joke. But there is one thing of which you can be sure: if you make an attempt on your own life and the proper authorities find out about it, they will take some kind of action.

And if they believe you are serious about dying by suicide, they are going to do every legal thing they can to stop you. Your reasons for wanting to die, even if they seem like very good ones to you, won't make any difference.

Right or wrong, you've got to look at it from our point of view. If we truly believe you represent a danger to yourself, we simply are not going to take your word that you won't try to hurt yourself again. We may not know you, but at least we know you are a fellow human being who is hurting so badly that you don't want to live any longer. And if we know this, we are not going
to sit on our hands and do nothing.

I also need to warn you that even some mental health professionals do not agree about what action should be taken to try to stop a suicidal person from following through on his or her threat. Some professionals believe that each person, so long as he or she is not obviously insane, has the ultimate responsibility for living or dying. And so, should you happen upon one of these
professionals, he or she may not pull out all the stops and see to it that you go to a hospital. He or she may agree with you that you have a right to die if you so choose and, if that's what you elect to do, then you are going to take all the responsibility for your own death.

But the great majority of professional helpers see any suicidal gesture or threat as serious and will do whatever they deem is necessary to try to stop you. If you're lucky, you'll meet professionals who really care.

And you should know, too, that doctors and counselors and hospitals and mental health centers get sued all the time for making mistakes about suicidal people. If they know someone is suicidal and don't take all reasonable precautions, including hospitalizing the person against his will, and that person kills himself, then they are open for a lawsuit. So most of us do the conservative thing when we have an actively suicidal person on our hands; we lock him or her up. Whether this is always for "their own good" or "our own good" I can't say - maybe it is a bit of both.

In most states and countries the authorities can keep you in a hospital against your will only so long --generally a few days to a few weeks. But if you keep trying to kill yourself, they will keep you just as long as they feel they need to. There is nothing that makes a mental health person feel worse than to release a formerly suicidal patient from the hospital only to learn that he killed
himself the next day.

From our side of it, we feel we are giving you a chance to consider other alternatives, get some help and rethink whether or not you really want to die. We know that most people who are considering the suicide decision will get better, their crisis will pass, and, sooner or later, they will want to live again. Knowing this, we will buy them some time, even if they insist they don't want our help. It's as simple as that.

A couple of more notes on the right to die. In ancient Greece, people who were considering suicide could go to the senate and make a case for why they should be permitted to end their own lives. If they could make a good enough case, they were permitted to take poison. No such higher governmental authority exists today.

Religions, by and large, have considered suicide a sin. Many still do, although more and more churches and religions see suicide as a symptom of an illness. In our major religions the belief is that since God granted the miracle of life, only He can end it. And you, as one of His children, do not have the right to stop something God has started. Suicide is, in most religions, against God’s
will.

Over all the centuries that suicide was considered a sin, you could not be buried in sacred ground if you took your own life. And in some places and times, a suicide's body was put on public display as a bad example, or simply tossed in a ditch outside of town. In many countries throughout the middle ages and even into the Enlightenment a suicide was often punished after
the fact of his death; his property was confiscated and his family made to pay for his “crime.”

But in some other cultures, suicide is not specifically against the law and, under special circumstances, even an honorable way to exit this life. The Japanese are the best known for acts of suicide, which, in their culture and under certain circumstances, can be considered good and proper ways to leave this world.

And, finally, there are those people who sacrifice their own lives so that others may live: the soldier who throws himself on a hand grenade to save his buddies, the pilot who stays with his airplane to avoid hitting a schoolyard filled with children, and all sorts of people who knowingly put their lives in harm's way for the sake of others. These, to my way of thinking, are not so
much acts of suicide as acts of heroism. But here in America, and in most other countries, it is still not okay to try to kill yourself, especially if your reasons for wanting to do so are not considered sufficient. And even if they are very good reasons -- you are in constant physical pain, you are going to die soon anyway, etc.-- you may not be able to find anyone in authority who will take the responsibility to say, yes, you can end your own life.

But I can hear you thinking, "What the hell does he know? He doesn't know how I feel. He doesn't know what I've been through. And he can't possibly know what's best for me.” Well, you've got me there. Everything you may have just thought is absolutely true. I don't know you. I don't know your circumstances. I don't know what is best for you.

But I do know one thing: If you kill yourself, this conversation is finished and so is every other conversation you may ever have. And once you are gone, it won't matter much whether you had a right to die or not.

So for now let's agree about something. Let's agree that even though suicide is against the civil laws of the land and against whatever God you may believe in, and against what your friends and family believe in, you and I both know that you can still kill yourself.

If you really want to end your own life, you can. I certainly can't stop you, your friends can't stop you, your parents can't stop you, and the police can't stop you. Even if they put you in a hospital for a few days to a few weeks, you can always stop talking about suicide and promise the doctors you won't do it and then, when they let you out, you can go ahead and kill yourself.

So, you and I both know something. We know that when we get right down to it, there is only one person who can decide whether you will live or you will die. And it isn't me. Right?

Right.