Alleging Suicide Is a Human Right

Mike Quattrocchi

Suicide is a human capability in nature; to be recognized as something more, it takes society. For centuries, society’s major institutions have judged suicide as inherently aberrant. Not everyone has agreed, and over recent years support for rational suicide has advanced, with some framing it as a human right. Arguments treating suicide as a human right are not persuasive, however, markedly failing to distinguish such a right from human capability. Support turns heavily on attributes shared with the capability rather than on an affirmative foundation. Further, these arguments insufficiently develop how a human suicide right would be integrated, exercised, and supported in society while coexisting with a human right to life.

Suicide as a human right is distinct from suicide as a limited right conditioned on circumstances such as terminal illness with short-lived expected survival. It is suicide for everyone autonomous; justifications beyond autonomy are irrelevant.

Capability vs. Right

Liberty, autonomy, self-ownership, and ability to choose are intrinsic to suicide as a capability. These are attributes insufficient for society to endorse this capability as a human right, notwithstanding they may constitute moral underpinnings. Human rights are complex, most and conceivably all imposing duties upon others in society. Suicide as a capability in nature imposes no obligation on anyone, but as a human right may impose obligations upon the rest of society—perhaps to not prevent, or even to facilitate, suicide. A human suicide right would carry far-reaching implications, and attributes shared with the capability to kill oneself do not justify endorsement.

Lynn Hunt’s Inventing Human Rights: A History explicates that human rights require more than origination in our humanness and equal applicability to everyone everywhere. She emphasizes they “are not the rights of humans in a state of nature; they are rights of humans in society.” Human rights are “set forth” when declared by society. She argues convincingly, detailing history and underpinnings to social changes, that human rights are founded as much in emotion as in reason. Shared outrage toward practices that had become “no longer acceptable,” such as unequal justice, slavery, and torture, were germane to the declaration of specific human rights. Even if reason can be found to support suicide as a human right, would it draw sufficient emotional support? Human rights shape civil society and the connections among its residents. Unlike human rights recognized in history’s major declarations*, the exercise of a human suicide right would be unique in ending all others and, as contended by some, paradoxically ending the inalienable right to life.

In his editorial in the October/November 2018 Free Inquiry, Tom Flynn (quoting ethicist Joseph Fletcher) endorses suicide as the “signature of freedom.” It’s a compelling metaphor, but what extends this freedom of choice beyond a capability? What is it about suicide that would incentivize society, bent on the evolution-driven preservation of the human race, to recognize the ability to choose death as a human right? Is there something more than quintessential autonomy? Should society also declare self-mutilation of one’s body a human right?

Advocates for a human suicide right may contend that a right to life implies a right to death. The capability to choose continuing life certainly implies the capability to choose death. But rights involve more than options of capability. If rights reflect how society designs itself and a human right to life underlies society’s design around preserving life, what about this right to life implies a right to suicide? The idea that an inalienable right to life implies a right that may not be able to coexist with it leads to an especially entangled paradox.

Arguments for suicide as a human right often come across more like defenses than foundations. Jennifer Michael Hecht in Stay: A History of Suicide and the Arguments against It chronicles supportive arguments from the Enlightenment to the present, even by some of history’s major philosophical voices, as largely reactive against the institutional condemnation of suicide. Support for a human right of suicide rejects the idea that we owe staying alive to anyone or any institution for any reason. But the strongest support for suicide as a human right turns on the inherent freedom in autonomous self-death. Hecht notes that Michel Foucault, a contemporary philosopher highly supportive of a suicide right, appeared to view suicide as “a grand act of self-determination,” a sentiment certainly aligned with “the signature of freedom.” Given the extensive commentary over so many years, it seems peculiar that support for a human right of suicide is largely reactive and not buttressed upon something more affirmative than the freedom of a human to do so. Somehow it hints of answering the philosophical question of “Why?” with the obligatory “Why not?”

Integration in Society

How society absorbs a human suicide right is underdeveloped in supportive arguments. There are big questions and bigger impediments, beginning with its cornerstone: autonomy.

Establishing Autonomy

The ability to decide rationally about suicide is characteristically viewed as the measure of autonomy, a measure likely to include an age-eligibility below which capacity for rational suicide would be considered immature. Demarcating an age of mature capacity for rational suicide alone generates unsettling complications, augmented with identifying when ownership of our bodies transfers from caretakers to ourselves. Among the rationally mature, mental illness is the prime threat to autonomy. The decisive issue, however, is not mental illness but the impairment to rational choice that may result from mental illness. This distinction mirrors the legal model in which mental illness must result in impairment specific to the issue at hand to be decisive. Mental illness impairing ability to consult with counsel may render a defendant incompetent to stand trial. Mental illness impairing ability to appreciate the wrongfulness of criminal conduct may justify a finding of not guilty by reason of insanity. Mental illness rendering someone incompetent for rational suicide would no doubt impair autonomy. Developing criteria and a means to recognize this impairment would also be a struggle for a human suicide right, but it would be necessary for society to avoid depriving the exercise of this right to those with mental illness who are capable of so deciding. Depending on the definition of mental illness and the algorithm adopted, this number could be considerable. Incidentally, it is noted that the issue at stake is rationality compromised by pathology, such as clinically faulty reasoning, not rationality some may view as compromised by unsupported but normative beliefs—such as an age-eligible suicidal youth aspiring to be with a loved one in heaven.

Rational ability as a condition for the autonomous exercise of a suicide right involves a binary distinction. Someone either would or would not be rationally capable of suicide at the time of the act, a distinction that seems implicitly unstable. How would this distinction intersect with transient states? Mental illness dysfunction compromising rational suicide may improve over time, sometimes rather quickly, with or without treatment; likewise, dysfunction in some instances may fluctuate, transcending the distinction with some uncertainty and some frequency. Apart from mental illness impairing autonomy, circumstances such as significant loss and traumatic stress may attenuate rational judgment that nevertheless meets the standard for rational suicide. Impulsivity, a formidable suicide risk factor, may do likewise. What about substance use, compromising rational ability or not, where suicidal intent may be neutralized by sleeping it off? Adopting a transient, unstable eligibility to exercise this terminal human right is untenable.

Prevention

Assuming that age eligibility and a standard for rational suicide ability can be established—and somehow account for the instability that may accompany the standard—how would society integrate the exercise of this right? Because suicide remains a capability in society open to virtually anyone using any of many means, its exercise as a human right would likely include access to supportive methodology and venues. What about prevention? A human right to suicide seems at odds with prevention and, given the likelihood of duties imposed upon society to support this right, may prohibit prevention.

Some arguments supporting suicide as a human right seem to model prevention and nonprevention as situation-specific responses to a suicidal individual who may or may not be autonomous. Lowrey R. Brown, in FI (August/September 2018) asks, “What criteria should be used to determine when it is appropriate for society to prevent, delay, allow, or facilitate individuals’ exercising their right to their own lives?” These options collapse on either prevention (prevent, delay) or nonprevention (allow, facilitate). Prevention as a society-wide mission is consistent with a human right to life. Nonprevention as a society-wide mission is consistent with a human right to suicide. Arranging prevention and nonprevention situationally, individual by individual, acknowledges the incoherence of such society-wide missions operating together.

The coexistence of prevention and nonprevention would be a particular strain in facilities charged with custodial responsibilities for their residents. Prevention is a major focus of a duty to protect inmates in jails and prisons, venues elevating suicide risk. Because incarceration suspends liberty as criminal punishment, is it possible a human suicide right would also be suspended, preempting conflict between prevention and nonprevention? Would treatment facilities such as psychiatric hospitals and residential facilities, also charged with a duty to protect, be required to both prevent and not prevent?

Most suicide prevention does not involve restraint. Prevention is common in outpatient mental health treatment with autonomous clients. Prevention as such is not just “don’t do it.” Over the past decades, suicide prevention has emphasized clinical management of suicide risk by addressing variables that may augment or reduce risk. Prevention often targets the development of functional skills that ideally may last a lifetime. It acknowledges that suicidal considerations may be continuous, vacillating, and fleeting in someone’s consciousness. While managing suicide risk is a primary focus of therapeutic intervention, the idea of rational suicide, including practitioner support for a client’s suicidal considerations, has filtered into clinical literature**. How might a human suicide right configure psychotherapy for suicidal clients? It is difficult to envision the clinical relationship skillfully balancing prevention and nonprevention.

… So What?

Justification tied essentially to attributes of a capability, an elusive affirmative foundation, and impediments to integration in society argue against declaring suicide a human right—one open to anyone determined capable of deciding autonomously. This is not to say we presently treat suicide in ways that make sense. Rejection of a suicide right limited by an affirmative foundation of relief from specified conditions severely and irreparably damaging well-being and exercised with stable autonomy should no longer be acceptable. Medicine’s maintenance of life beyond the welcomed tolerance of the body is not treasured by everyone.

The spirit of the times seeming to weigh ideas about suicide permissively may reflect a downturn in the denial of death, a downturn perhaps fueled by expanding acknowledgment that we are no more than a species. This permissibility has fostered commentary highlighting unending moral and practical complexities associated with suicide. Humanity remains uncertain how this capability for self-death best fits its individuals and its society. Perhaps continuing insights promoted by the times may help shape its adaptive value.

 


Notes

  • Hunt identifies society’s major declarations as the Declaration of Independence (1776, United States colonies), the Declaration of the Rights of Man and Citizen (1789, France), and the Universal Declaration of Human Rights (1948, United Nations General Assembly).
  • See, especially, James L. Werth’s article “Using Rational Suicide as an Intervention to Prevent Irrational Suicide.”

 


Further Reading

  • Brown, Lowrey R. “By My Own Hand: Suicide Can Be a Wise and Gentle Choice,” Free Inquiry, August/September 2018.
  • Consculleulla, Victor. “From Permissibility to Obligatory Suicide,” in The Ethics of Suicide. New York & London: Garland Publishing, Inc., 1995.
  • Donnelly, John. Suicide: Right or Wrong? Buffalo, New York: Prometheus Books, 1990.
  • Feinberg, Joel. “Voluntary Euthanasia and the Inalienable Right to Life,” Delivered in 1977 as The Tanner Lecture on Human Values. Philosophy and Public Affairs 17, No. 2 (1978).
  • Flynn, Tom. “The Signature of Freedom,” Free Inquiry, October/November 2018.
  • Hecht, Jennifer Michael. Stay: A History of Suicide and the Philosophies against It. New Haven and London: Yale University Press, 2013.
  • Hewitt, Jeanette. “Why Are People with Mental Illness Excluded from the Rational Debate?” International Journal of Law and Psychiatry 36:5–6 (2013).
  • Hunt, Lynn. Inventing Human Rights: A History. New York: W. W. Norton & Company, 2007.
  • Smith, Wesley J. “The Right-to-Die Movement Supports Death on Demand,” In Conners, Paul (Ed.), Suicide: Current Controversies. Detroit: Thomson Gale, 2007.
  • Urofsky, Melvin I. and Philip E. Urofsky (Eds.). The Right to Die: Definitions and Moral Perspectives. New York & London: Garland Publishing, Inc., 1996.
  • Werth, James L. “Using Rational Suicide as an Intervention to Prevent Irrational Suicide.” Crisis: The Journal of Crisis Intervention and Suicide Prevention 19:4 (1998).

Mike Quattrocchi

Mike Quattrocchi, PhD, is a retired clinical psychologist with a lengthy background of direct service in the public and private sectors and administrative oversight of various clinical settings; he has a special interest in selective areas of mental health law.


Suicide is a human capability in nature; to be recognized as something more, it takes society. For centuries, society’s major institutions have judged suicide as inherently aberrant. Not everyone has agreed, and over recent years support for rational suicide has advanced, with some framing it as a human right. Arguments treating suicide as a human …

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