Whilst the missus was watching Emmerdale last night we got to discussing one of the current storylines. This includes a parapalegic who has made the decision to end their life. This then followed on to a discussion about mental health and the support that people are given.

When someone is suicidal we automatically consider them to be in need of counselling or psychiatric care because we can identify that they may be suffering from severe depression. It is this point which my partner was focused on. She stated the stages of acceptance that people who have become disabled go through and suggests that the feelings of suicide may pass once these people come through the other side with the help of counselling.

The point I failed to get across to her though is that once someone reaches the decision to end their life they are considered to be in need of support. There is no way I can see that someone who has received support can say "I've had the support, you've helped me but I still want to end my life" and for that to be accepted and supported.

Am I making any sense here? I just want to know if anyone agrees that someone can make a reasoned rational decision to end their life without suffering from depression or mental illness?

If you're in a great deal of physical pain that cannot be addressed?

If you're so old that you can no longer control your bowels and retain your dignity?

virphen wrote:If you're in a great deal of physical pain that cannot be addressed?

If you're so old that you can no longer control your bowels and retain your dignity?

What about simply being sick of being contained inside a body you can't move?

mattwilson wrote:

virphen wrote:If you're in a great deal of physical pain that cannot be addressed?

If you're so old that you can no longer control your bowels and retain your dignity?

What about simply being sick of being contained inside a body you can't move?

I wouldn't see that is a symptom of mental illness.

In fact, even if the underlying cause of the poor quality of life is mental illness, then suicide can be quite rational as well - the issue is not the rationality of suicide, but whether the underlying condition (be it mental or physical) can be addressed. If it can not, well a decision to commit suicide can be considered perfectly rational, imo.

Complicated. Can one choose to fall without being unbalanced or does one have to be unbalanced to fall?

My point is that there is a mental state where suicide is logical and seems reasonable, especially where the alternatives are unavoidably worse, ie just about to burn to death anyway - as a convenient example.

When the alternatives do not seem to an impartial outsider to be worse, just another boring day tomorrow for eg, it seems hard to understand the decision to end life. The obvious conclusion is depression, which might change at any time.

I have been reduced to a close to suicidal state many times, and certainly I would describe the state of mind I have been in as depression, probably easily treatable, but it definitely did not feel abnormal at the time. I do not think any altered state really feels abnormal once in it, only on exiting that state and noticing the difference is it apparant that something was altered. This is why people often feel ok to drive when drunk. Despite many experiences of the state and the bad decisions and poor reactions in that state, when you are there it does not feel that different.

I guess while suicidal someone can give every appearance of logical thought and rationality, even no appearance of depression, but still be in an altered state without being aware of it. I do not know if it is possible to be suicidal in a 'healthy' way, the term is counterintuitive, but I would submit that it is impossible to know for sure that someone intending to commit suicide is not making a terrible mistake, that they would not necessarily make tomorrow.

Then again, some altered states are permanent, such that they represent the norm for the person.

To summarise a disjointed reply, I would say that suicide can be the right decision, even for someone not facing something objectively worse, because it depends on your character, your drives, what you enjoy and respect, and your reasonable expectations for the future. For many people a life others would fight for or even desire for their children is one not even worth living, and who are we to say they are wrong without an objective purpose for life? We can only try and satisfy ourselves that they are not the victim of a temporary condition they were not aware of as temporary.

Reasoned might not equal rational. As a child I reasoned that I'd have been better off not having been born. My attempts to end my life were painful but ultimately unsuccessful. But the decisions were arrived at through reasoning (such as it was) nonetheless. In adulthood, in the midst of depression brought on by PTSD, I again attempted to end my life. The decision was reasoned, in that it made sense when I thought it through. Rational? Absolutely not, at least not from where I am now. At the time, it certainly seemed that way to me.

Personally, and working in the broad area of mental health, I think there are very few, if any completely rational decisions to end one's life. But such judgements of reason & rationality are subjective, with few if any objective yardsticks. I know this, in the midst of distress, rational reasoning gives very different results to similar processes in different circumstances. The trick is maybe to understand the circumstances that give rise to such distress, and address the distress adequately. Do that & the rational reasoning will undoubtedly change. Of course, there might well be some circumstances we can't change, in which case ...

So a follow on question, does anyone have the right to say "No you can't kill yourself because you might get over this feeling"?

Suicide is actually quite a rational choice if one agrees with the view that behaviour is the goal-directed attempt of the individual to satisfy their needs as they experience them. If their need is to exit from the hell of living day-by-day with mental illness and all help has failed, suicide is a rational option. While watching the jumpers from the WTC on 9/11, I thought 'why the hell would they do that? That's crazy!' well, because by doing so they satisfied their need of escaping the fire, even if they were only able to experience the benefits for a second or two.

mattwilson wrote:So a follow on question, does anyone have the right to say "No you can't kill yourself because you might get over this feeling"?

I think they can say whatever they like, but my personal values suggest to me that one should try hard to get someone to consider all other options, but at the very end of the trail no one has a right to make someone carry on living.

That's a difficult question. I was angry at being thwarted in my attempt. Resentment surfaced for a long time after (and still does at times). It strikes at the heart of any sense of autonomy. But from a perspective of now rather than then, it was a fucking silly thing to try & do.

As someone with chronic pain, that is only partially allieviated by medication, I can easily see a situation where a fully rational decision could be made to end one's life.

Beat you to it mattwilson.

Why must it be reasoned?
What if the unreasonable is overwhelming?

It isn't the decision to commit suicide that is irrational - it is accepting it. Acceptance is not rational, it is emotional.

Steve wrote:It isn't the decision to commit suicide that is irrational - it is accepting it. Acceptance is not rational, it is emotional.

This sounds right to me.

Steve wrote:It isn't the decision to commit suicide that is irrational - it is accepting it. Acceptance is not rational, it is emotional.

Love is emotional. Is it irrational to accept it?

Does a person have an obligation to remain alive until something extraneous to his will ends it?

I see no reason why one couldn't make a rational and reasoned decision to end their life in some circumstances. A situation I have seen as an observer many times is the terminal patient who is receiving maximum doses of pain relief which has become ineffective, begging to be allowed to die. Their agony can last weeks before nature takes it's course.

This has led me to consider how I would respond in a similar situation. I'm fairly confident that most people, if given their choice would sooner die in their sleep when their time comes and not know too much about it. If that wasn't going to be likely, if sleep rarely lasted more than a few minutes due to a ridiculous amount of pain and that was going to be the way my life was going to continue until I finally croaked, I'd sooner have the chance to say my farewells and thank yous and then press a button that put me to sleep and brought about my death in the manner of my own choosing.

For me, IMHO, it's about death and what death means to people. To the majority, it's something to be avoided at all costs, you've got your whole life ahead of you, there are ups and downs but most problems are surmountable. For those whose problems are insoluble, like the terminally ill, those people trapped in a tall burning building etc, death is not an avoidable event but there can be a choice in the manner in which it arrives. It isn't necessarily about whether to end your life in some circumstances but merely choosing how it happens.

Is that reasoned enough?

Dawn wrote:

Steve wrote:It isn't the decision to commit suicide that is irrational - it is accepting it. Acceptance is not rational, it is emotional.

This sounds right to me.

Actually, I should correct my response by saying that in certain situations acceptance of this decision will be rational. Given our natural instinct to live, if one is rational, such a decision will be an emotional one as well. Emotion and reason can coexist.

What is the point of asking the question if suicide is a reasonable choice?
To get permission? No one needs anyone's permission.
All the shoulds and coulds and ifs and buts count for nothing more than nose picking.
If it really mattered then there would be some way to change a person's mind, there would be reasons that change a person's mind. There are none.

Why not just let the defective off themselves, they are just whiners who want to bring everyone else down. Good riddance--eh?

The point could be that if there was a consensus that suicide could be a reasoned decision, it would probably be easier to deal with legislature on euthanasia, assisted suicide. It is not an easy subject, but there is a lot of, understandable, prejudice about potential or factual suiciders.

On one hand we base our society, laws, on the so-called free will, but when it comes to certain mental conditions, state of mind not diagnosis, we do not seem to have a problem to deny certain individual decisions or at least discount them as invalid or illegal or simply .. mental. What to say? In a world where 1000s still die from hunger every day, we do not hesitate to demonstrate that our mirror neurons fire in guardian formation.