The cover article of Free Inquiry’s previous issue (“By My Own Hand: Suicide Can Be a Wise and Gentle Choice,” by Lowrey R. Brown) was expected to generate more controversy than it did. Consider the timing: Though the decision to publish Brown’s essay in the August/September 2018 issue was made months in advance, “By My Own Hand” appeared mere weeks after celebrities Kate Spade and Anthony Bourdain committed suicide and after the Centers for Disease Control and Prevention (CDC) announced a 25 percent increase in the U.S. suicide rate since 1999. The headline of a June 9 New York Times story on the CDC report declared suicide a “public health crisis.”1
Nonetheless, response to Brown’s essay was muted. (See one mildly critical Letter to the Editor in this issue.) Perhaps Free Inquiry readers hold sufficiently sophisticated views on suicide that Brown’s article did not occasion controversy.
In the interest of sparking dialogue, here comes a more radical take on suicide. Mine.
In 2016, almost 45,000 Americans age ten and older killed themselves; a record number. Suicide has become the nation’s tenth leading cause of death. Still, is that a crisis? Is it unrelievedly bad news? Or might the rise in suicides signify in part that more Americans are overcoming the repressive stigma that has cloaked suicide so unfairly and for so long? Even in the middle of his “crisis” story, Times reporter Benedict Carey noted that in the view of some experts, suicide might be:
… simply becoming more acceptable. “It’s a hard idea to test, but it’s possible that a cultural script may be developing among some segments of the population,” said Julie Phillips, a sociologist at Rutgers.
Prohibitions are apparently loosening in some quarters, she said. Particularly among younger people, Dr. Phillips said, “We are seeing somewhat more tolerant attitudes toward suicide.”
In surveys, younger respondents are more likely than older ones “to believe we have the right to die under certain circumstances, like incurable disease, bankruptcy, or being tired of living,” she said.
The CDC report notes that “more than half of people who died by suicide did not have a known diagnosed mental health condition at the time of death [emphasis in original].”2 If you’re wedded to a dogma popular among anti-suicide activists—namely, that every (or almost every) suicide results from mental illness—you might seek to dismiss that statistic. That’s what University of Pittsburgh psychiatry professor David Brent attempted in a slightly earlier New York Times story, telling Benedict Carey: “The reason most suicide decedents don’t have a known mental disorder is that they were never diagnosed, not that they didn’t have one.”3
If Dr. Brent provided evidence to support his sweeping claim, journalist Carey failed to report it.
There’s another way to interpret this data. If more than half of people who commit suicide had no psychiatric diagnosis—and even if we allow that some fraction of the undiagnosed were mentally ill—we’re still left with many, many people whose choice of suicide was presumably rational. Let’s crunch the numbers. Take the 2016 figure of 45,000 suicides, assume that 45 percent of them had psychiatric diagnoses, and then assume that another 25 percent (an arbitrary number) were mentally ill but undiagnosed. That leaves 30 percent—on these figures, 13,500 people—who likely made rational choices to end their lives.
That strikes me as the opposite of a crisis. Growing numbers of Americans may simply be recognizing that their lives belong not to God, not to the government, not even to their families, but rather to themselves. Growing numbers may be recognizing that their lives are their own and that to cut them short, if they sincerely desire to do so, is their right.
In that light, what should we say about the rise in suicides? Surely there is tragedy for those whose fatal actions did stem from mental illness. But for those who die by their unclouded choice, suicide may be best understood as an ultimate expression of self-empowerment. When thoughtful, rational people reject being locked into existences they would rather discard—whether by dead religious concepts or morbid taboos—this is progress, even if at the same time it is bittersweet.
So it’s fair to ask who or what deserves a share of credit for this development. No small part redounds to … well, us. Infidels, freethinkers, atheists, and later secular humanists have long espoused liberal views of suicide. How long is “long”? In the eighteenth century, David Hume (1711–1766) famously wrote, “Has not every one … the free disposal of his own life? And may he not lawfully employ that power with which nature has endowed him?” Nineteenth-century agnostic orator Robert Green Ingersoll (1833–1900) declared: “The old idea was that God made us and placed us here for a purpose and that it was our duty to remain until he called us,” suggesting perhaps too hopefully that “The world is outgrowing this absurdity.” (That did not happen in Ingersoll’s time; it may be happening in ours.) Twentieth-century secular humanist and psychiatric iconoclast Thomas Szasz (1920–2012) asserted, “We have just as much right and responsibility to regulate how we die as we have to regulate how we live,” adding that “dying voluntarily is a choice intrinsic to human existence [emphasis in original].”
Or consider the towering humanist ethicist Joseph Fletcher (1905–1991),4 who proclaimed simply: “Suicide is the signature of freedom.”5
Thousands of rank-and-file secular humanists and other freethinkers likewise advocated for each person’s freedom to live—or die—as he or she wishes. In recent years some of that activism has narrowed, focusing on the mechanics of matters like implementing physician-assisted suicide laws state by state. But there is a vibrant humanist tradition of opposing “life at any cost” dogmas across the board, whether in regard to abortion, euthanasia (as we once more frankly called it), the ethics of aggressive medical care for the seriously ill, and suicide.
Secular humanists and other freethinkers indeed deserve credit for what seems to be a growing acceptance of the right to commit suicide.6
That said, I must note that our movement also has emphatic suicide opponents. Among the better-known is author Jennifer Michael Hecht, whose earnest anti-suicide tome Stay I critiqued at substantial length in a 2014 book review.7
Nothing I’ve written here is meant to belie the fact that many suicides do result from mental illness. But “many” is not all. It isn’t even, necessarily, most. Those who choose rationally to end their lives should not be subject to interdicts rooted in the ideas that their lives belong to someone or something other than themselves. Nor should their freedom of action be curtailed by mere assertions that suicidal intent invariably reflects madness. To limit the options of rational individuals as though they were mentally ill, when they are not, is to traduce their freedoms.
Hecht disagrees, of course. In Stay, she wrote: “it is an intellectual and moral mistake to see the idea of suicide as an open choice that each of us is free to make.” Above, we encountered David Brent’s unproven contention that every undiagnosed suicide is better understood as not diagnosed yet. Best-selling anti-suicide writer Kay Redfield Jamison famously asserted that the rate of mental illness among suicides is 90 percent.8 Proof, however, remains elusive.
Whether the percentage of successful suicides who are in full control of their faculties is 10 percent (Jamison’s number) or greater than 50 percent (the CDC’s number), we’re talking about far too many Americans who are reflexively disempowered—sometimes, physically restrained—for acting on rational decisions to halt their flows of experience.
We need to recognize the mantra “Everyone who attempts suicide is mentally ill” for what it is: an empty dogma and a slur. And, I would submit, we need to recognize that the appropriate response to every suicidal thought or action may not be prevention at all costs. Every suicide attempt need not be frustrated by any means available, up to and including physical force.
Granted, determining whether any particular suicide results from mental illness or rational choice can be extremely difficult. That difficulty is compounded when, say, one happens upon another’s suicide attempt in progress. But when we recognize that a goodly number of suicides do not result from mental illness—that some suicides, at least, and perhaps a plurality of them, reflect rational agency in action—our view of suicide in toto will acquire added nuance.
Joseph Fletcher was right. For those of sound mind who choose that course, suicide is the signature of freedom—which is to say that suicide is a human right. That needs to be said more often.
- Benedict Carey, “Slowly, Confoundingly, Suicide Became a Public Health Crisis.” The New York Times, June 9, 2018.
- Centers for Disease Control and Prevention, “Suicide Rates Rising across the U.S.” Press release, June 7, 2018.
- Benedict Carey, “Suicide Rate Climbed 25 Percent Even as Prevention Efforts Grew.” The New York Times, June 8, 2018.
- Fletcher is unjustly neglected today, but he founded situation ethics—a branch of ethics with which the humanist movement became famously connected. He later played a seminal role in imposing a humanist stamp on the developing ethics of advanced life support, particularly regarding the right of the seriously or terminally ill to refuse treatment. See Richard Taylor, “Joseph Fletcher: The Father of Biomedical Ethics,” FI, Spring 1984.
- Joseph Fletcher, “In Defense of Suicide” (in Albin Eser, ed., Suizid und Euthanasie [Stuttgart: Ferdinand Elke Verlag, 1976]).
- It’s worth noting that in this essay I reject one imposed language change for which the suicide-prevention community has lobbied intensely. Use of the phrase “committed suicide” is discouraged; “died by suicide” is preferred. This is meant to reduce the presentation of suicide as a supposedly dastardly act, depicting it instead as the fruit of a mental illness, of which the decedent is a victim. That seems reasonable if one presumes that everyone who commits suicide is mentally ill. I, of course, contend that a great many suicides are rational—indeed, that the suicides of sane, rational persons can be viewed as triumphs of personal agency. In such cases, the idea that someone died by deliberate, clearly-chosen action is central: suicide doesn’t happen to them, they choose it. Having made their choice, they perform the act: “committing suicide” is precisely what they do. I see no shame in portraying the act dynamically, and so I will say—and write—that someone “committed suicide” whenever I consider that description apt.
- Tom Flynn, “Less Secular Than It Seems” (review of Jennifer Michael Hecht, Stay: A History of Suicide and the Philosophies against It). Free Inquiry, April/May 2014. Most historical quotations used in this article are drawn from that review. I have elsewhere addressed the issue of suicide’s licitness on several occasions. See also my “The Final Freedom: Suicide and the ‘New Prohibitionists,’” FI, Spring 2003; and “If You Want Something Done Right … ,” Secular Humanist Bulletin, Spring 1997.
- Kay Redfield Jamison, Night Falls Fast: Understanding Suicide. New York: Knopf, 1999. Curious whether Jamison’s 90 percent figure is data or dogma? Consider that a nineteen-year-old book is still considered an important source for that statistic.