Comment Of The Day: “Sunday Ethics Picnic, 8/15/2021: Afghanistan Accountability And Suicide Ethics”

This Comment of the Day, by new commenter David C, is more emotional than most EA COTDs, but the topic is an emotional one: suicide. Checking the web on the topic, there are so many essays and articles about why suicide is not a “selfish act” that I sense a politically correct mandate at work. Depression is a serious illness that is stigmatized, depressed people commit suicide in large numbers, ergo criticizing suicide is a cruel attack on victims who deserve only sympathy and empathy.

I will accept a rebuke for writing in the post that “suicide has been accurately called the most selfish human act of all.” I should not have written “accurately,” and I apologize and retract it. It is an act the is often selfish, unless we want to absolved suicides from all responsibility for their actions, which seems to be David’s orientation.

I am not entire inexperienced in the area of depression and suicide. I served on an NIH task force on the former, and have had a roommate and three first cousins kill themselves. One cousin threw himself from an overpass and fell through the window of a passing truck. Selfish? The truck driver could not continue driving after experiencing that trauma. His brother deliberately drown himself in front of his former fiancee as she watched helplessly. Selfish? Often…not always…suicide is an intentional act of aggression and hostility toward society. The harm these acts do to family and others is extreme: I’ve seen it. Do note that the post comment upon was about grandstanding suicides for effect, involving people hurling themselves off a prominent public attraction. David’s argument seems to be “they are sick,” so they can’t be blamed—none of them.

I also believe that sanctifying suicide makes it more common by making it more acceptable. Once, when it was considered a crime and a sin, society looked on suicide as a shameful act. As with addiction, sex outside of marriage and unwed pregnancy, removing the element of shame also increased conduct that has serious societal drawbacks.I think its fair to say that killing oneself has serious societal drawbacks, and that if potential suicides were encouraged to give serious thought to how their deaths would affect others, they might seek less violent solutions to their very real problems. Or should be take the position that the depressed are not capable of being ethical, and we should not expect them to be?

Here is David C’s Comment of the Day on the post, Sunday Ethics Picnic, 8/15/2021: Afghanistan Accountability And Suicide.

***

I have avidly followed your blog for well over 2 years now. Occasionally I feel let down by some of your remarks on mental health, but perhaps my expectations are unreasonable as it is not your wheelhouse. The pandemic has shown us many things but chief among them is that every person’s mental health can be vulnerable in the right circumstances. I know this is very complicated issue but I feel equipped to make some points.

Yes it is a myth that talking about suicide will plant and germinate the idea in a person’s head. Hotlines are more accessible than ever with smartphones. Whether people avail themselves of hotlines is one question, and whether they help is another, but it is always better to be aware of the existence of the resources that are out there. And yes, as far as I know there is research that suggests that if people are fixated for whatever reason on a certain means of suicide, they will not turn to another method if access to that method is removed.

To tar the act wholesale as selfish in my eyes tends to be a facile dismissal of what is a profoundly complex matter. And if that accusation is launched one could certainly charge those who demand the person in pain remain alive as equally “selfish” at least. After all, isn’t it easy to ask other people to endure pain that you don’t experience? Not to mention when it comes to such an issue of such great sensitivity I don’t find such language to be helpful and conducive to anything positive. We need to be talk openly, and in many cases it is just dead inaccurate. And as someone with a mountain of experience in crisis intervention, I can tell you why: in many cases these people are convinced, literally convinced that their families, friends, society, the WORLD is better off without their presence. Selfish…what a word to describe them! And whether you think their thinking is misguided or distorted or whatever doesn’t matter (even if it may be) because what matters is what they believe at the time of their action. I have no doubt you can appreciate that.

I would agree that carrying out suicide in such a public way, making them party to something like that, is not….shall we say, good. It’s unfair to the witnesses. You say though: “knowing that they will cause the maximum amount of trauma to the living”? Did they? A lot of time it is done on a sudden impulse and we cannot rule that out. No time for consideration. And maybe they are so focused on ending their own agony that other considerations fall by the wayside.

I know it can take for many people a lot of imagination to even begin to conceive of the desperation that someone who does something like this might have been feeling. I know I am inclined to be more understanding than many, though at the same time I do try to have empathy for those for whom understanding does not come naturally because I recognize that our ability , and this is a universal , to empathize is a function of our lived experiences.

I am just trying to view this in all its complexity as well as I can, and be wary of being so quick to ascribe motives or thoughts to people. I mean, one of the victims was a barely a teenager, a child! I am sure the young age (and all the victims were young) informs the controversy.

As far as trauma on the living goes in general, I can tell you that the pain some suicidal people feel/felt is much worse and it is often compounded by the knowledge that they’ll be facing it for the rest of their lives. I know the general public has a tendency to underestimate the severity of what some people experience or fail to appreciate that not everything is able to be ameliorated or mitigated by treatment, which follows from the things I mentioned above. In a word : it sucks. Hard. For everyone. The people afflicted or suffering, the people in their lives, and the world at large. I’m sure you know that reality doesn’t always square itself away neatly and I also know you know it is not wise or truly helpful to overly reduce complex things. And few topics match these in their complexity.

I guess I didn’t answer your question about the best course of action. I don’t know. The people who might consider using it aren’t demanding protection from it. I don’t have any coherent proposal regarding this sculpture but I just wanted to share some other thoughts on the topic. I don’t expect you to fully agree but I wanted to write nonetheless.

23 thoughts on “Comment Of The Day: “Sunday Ethics Picnic, 8/15/2021: Afghanistan Accountability And Suicide Ethics”

  1. During college in the late ‘sixties and early ‘seventies, I remember Sylvia Plath’s “The Bell Jar” was a really popular book among coeds. Suicide made cool. Terrible. Frankly, I think gender has become the new, hip, cool thing among young people, girls in particular. I think it’s hip to be non-traditionally aligned sexually. Very destructive to the individuals involved and to society as a whole. What used to be just weird and essentially beyond the pale is now not only acceptable, it’s admirable. Dumb.

  2. Suicide is too often an overreaction to issues that should have better solutions, but I also get irked by that blanket accusation of selfishness. But feeling trapped and short of alternatives is not the same as being careless of other’s health if you want to end it. Suicide for an emotional upset is out of proportion for the problem. Jumping or other forms of suicide that risk others is somewhere between stupid and evil.

    Being in the end stages of life and in the dead-end of hospice is a valid reason that I never saw ALL suicides as selfish. Quality of life, exhaustion from pain of the fatal diagnosis, and not willing to bankrupt the family to extend what cannot be changed become more important than weeks hooked to machines. I am at that endstage now. And while I want to live, checking out before my organs finish failing in agony is the acceptance stage of grieving. If you can check out without harming others over an unredeemable issue, it may not be selfish.

    • Well said. If you are terminal and in agony most of the time or on life support you should have a living will which will spare your family of the grief of having to decide what your wishes might might have been.
      Aside from that, suicide amongst the chronically mentally ill and impulsive suicide over a major loss has become an epidemic especially among young people and those who perceive themselves to be isolated.

  3. In some circles, it seems fashionable to lump suicide in with “gun violence” as if it is the same thing. This, in my view, is troubling, a cheap shot, intended only to muddy up the true nature of gun violence and to make the problem seem bigger and the need for more draconian gun control measures more acceptable. Suicide is suicide and a totally different thing… and more complex as the commentator explains.

  4. I’d like to see those studies—or single study?—that shows that suicidal people don’t try another method if their favored one is made unavailable. How do you measure something like that? The third of my cousins to commit suicide hanged herself, but police said her home showed “signs of other unsuccessful suicide attempts”? What seems more likely, some empty pill bottles, or nooses scattered around the place? I am equally dubious about it being a “myth” that “talking about suicide will plant and germinate the idea in a person’s head.” Michelle Carter is in jail based on that “myth”: https://ethicsalarms.com/2017/06/18/the-michelle-carter-verdict/

      • “Even things as minor as packaging pills in those plastic and foil bubbles will result in a decrease in poisonings with little to no increase by other means.”

        How would you measure that? It’s correlation, but not causation.

        • It looks like we can also thank the UK for recent legislation change on packaging Paracetamol (known as acetaminophen and Tylenol here) to reduce misuse. The studies show decreases in both overdoses and liver transplants. I’ve not found anything around the presence of a substitution effect of people choosing other medicines or chugging aitomotive fluids because a general decline by all methods had complicated the potential to detect it in the studies found.

          One (small) region showed no decline at all, so I guess that justifies the boilerplate “more studies are needed”.

  5. I was a law enforcement crisis negotiator and CNT leader for more than twenty years, and our team dealt with many more potential suicides than with hostage takers or barricaded criminals. I never had a case with a potential suicide who did not turn away from that option, nor did any other members of our CNT while I was still working. This is not to boast of our skills as negotiators (really just well-trained listeners), but to point out that in my experience, none of those who came under our watch, either by self-reporting or by reaching out to a friend or relative, were beyond help, even many with whom we interacted while they literally had a gun in-hand. Suicide is a permanent solution to a usually temporary problem, and can be a selfish act, although I have no doubt that one’s idea of what is selfish is skewed by the mindset that can even fathom self-destruction as a reasonable response to being emotionally upset. I have listened to people in crisis for literally hours on end, hearing many sad and even heartbreaking stories, before they accepted our offers of psychological / psychiatric help, but it was certainly time well-spent. My county, like many others, is fortunate to have a very skilled mental health crisis response team with doctors, nurses, counselors and access to a broad array of other resources that can help the suicidal individual and his or her family in overcoming the difficulties that brought the person to the point of suicide. Isolation is the enemy.

  6. The Japanese concept of seppuku is an example of suicide that’s NOT due to mental illness. The original method of disembowelment was meant to be a deliberate middle finger to one’s enemies. “I’m killing myself to deprive you of the honor of capturing me, not because I’m afraid of torture (which is why I’m using this painful method).” To this day, suicide is supposedly a major problem in Japan, since many see it as an honorable exit after one has “lost face” beyond retrieval.

    In individual cases, I can understand attributing suicide on mental illness as a means of going easy on the bereaved, and to help those considering suicide, but I’m wary of using mental illness as a catch-all explanation. Most destructive behavior comes from ignorance or poor judgement, not mental illness. Using that as a go-to excuse is just another way of saying, “The devil made me do it.”

  7. Why did you completely ignore the commentor’s most important point? That people who commit suicide feel that the world would be better off without them?

    Did you skip over that part on purpose? I feel like you probably did.

    • I don’t know why you think that’s persuasive or even relevant. How one “feels” does not justify what one does—this is ethics. Murderers frequently feel that the world would be better off without their victims too—does that mitigate their actions? The Commenter argues both sides: “Oh, these people do this because THEY are in so much pain, so they don’t consider others” and “Oh, they FEEL they are doing everyone else a favor.” FACT: we have an obligation to use ethical analysis to make ethical choices. The latter is a rationalization, whether the suicide convinces himself of it or not.

      • You don’t know why the commentator’s most important point is persuasive or even relevant?

        That’s convenient. I guess that’s why you totally ignored it then.

        We aren’t talking about what’s “justified”…that’s you changing the argument. Suicide is probably never justified. What we’re talking about is your “selfish” comment. And how one “feels” absolutely changes if it’s selfish or not. Especially if that “feeling” is caused by a mental illness and that illness makes you certain the world would be better off with you dead.

        Also, you comparing people who commit suicide to murderers is pretty gross and ignorant.

        Murders don’t kill because they think the world will be a happier, better place with their victims dead. You just made that up thinking you created some neat analogy.

        It’s obviously not rational to kill yourself, and I dont know why you think people with a mental illness are thinking rationally at all. So to call it “selfish” just shows you don’t understand it.

        • That part about murderers….Even if we did believe they killed to make things “better”…they do it for themsleves, not for others. Total opposite of why people commit suicide.

          • WHAT????? Now suicides are all altruistic are they? There are certainly suicides that are, in fact, selfless and even true sacrifices. I will not allow my family, for example, to exhaust its resources on squeezing out the last, painful, useless, wildly expensive months of my own life when the young and living member of my family can put the money to far better use.

            But rational, ethical and responsible people like that don’t jump from tourist attractions.

        • A. Watch your mouth. You don’t address me in that tone here, or you don’t get to discuss here.
          B. Not all suicides are mentally ill. In particular, juvenile suicides are not mentally ill in many cases.
          C. If you don’t understand ethics, don’t presume to discuss ethics on an ethics blog. Ethics is not about “feelings,” and “feelings” don’t justify unethical acts.

          You are just arguing emotionally and not making substantive arguments. This was the last comment you get posted in this thread. (Check the commenter rules, which you obviously have not.) You’re in Ethics Alarms Time Out: you can post on other issues, but not on this one,for the next three days. Then you can try again, but it had better be unemotional and substantive.

          Make it so.

            • Well, Astral banned itself. If you say “I’m gone for good,” You’re gone for good. I had sent A to his room and suspended him from commenting on the suicide issue since all he could say was “But…but…feelings!” Feelings have nothing to do with ethics, so this triggered the EA stupidity rule. She never had the courtesy to read the guidelines, obviously, not anything else on the site, and apparently thought I would welcome someone coming here and blathering out uninformed opinions. I was particularly not in the mood to be accused of not tolerating dissent on day when I was being pummeled here left and right on all sorts of issues. But he banned himself.

  8. And yes, as far as I know there is research that suggests that if people are fixated for whatever reason on a certain means of suicide, they will not turn to another method if access to that method is removed.

    It took me a few days to get around to addressing this point for the original post. I’ll include the comment here instead.

    Or is the goal to just make sure they give up and go home to swallow sleeping pills?

    Studies have shown this is not the case. Rather, suicide is an impulsive choice at the intersection of desperate and a particular opportunity. The ideation is often linked to a particular method (jump off bridge, pills, etc). Suicidal individuals don’t systematically engage in various methods until they are successful; rather they fixate, as David C says, on a particular method as the solution; they are at most danger when they are at a low point and their preferred method is readily available.

    A famous example occurred in England, the trope of sticking one’s head into the oven to suffocate. Prior to the 1970’s, the island used primarily “town gas” for ovens (as opposed to natural gas or propane). Town gas was extracted from coal in a gasworks plant at the edge of town (hence town gas), and piped to each house. As a byproduct of the extraction process, carbon monoxide was produced, and piped directly to each home along with the hydrocarbons.

    Carbon monoxide produces a painless death; one loses conscious quickly prior to suffocation. Carbon monoxide is also nearly 100% effective at causing death. Plugging up the vents in the kitchen, blowing out the pilot light, and turning up the gas became an extremely popular method of suicide between the 1800’s and 1970’s, accounting for about half of all successful suicide deaths in England (I believe these statistics hold up elsewhere, too).

    When the England switched to natural gas starting in the 1970s, (ie, gas that is naturally extracted directly from underground wells), the suicide rate was cut in half. Natural gas does not contain carbon monoxide; it becomes fatal only when it displaces all oxygen in a room (or it explodes). Desperate people attracted to the easy death allowed by town gas gave up; they did not switch to another method.

    This reduction was permanent, and persists to this day. Without painless poison piped to their door, the those who were attracted to this method chose not to bother with death; they chose to live.

    The conversion to natural gas was entirely motivated by economics and avoidance of accidental death. It was cheaper to use gas that did not require expensive processing, and it reduced emissions at the edge of town, improving air quality. Public authorities also expected the small number of accidental deaths due to carbon monoxide would be reduced or eliminated, but simply assumed the suicidal would choose a different method; it caught everyone by surprise when it did not.

    I think everyone can agree that piping carbon monoxide directly to people’s homes is a bad idea. Yet, in the US, we face a similar situation that about half of all suicides are caused by firearms. Outlawing guns could similarly and permanently cut suicide deaths in half. Importantly, however, no one has an innate right ready access to poison. The US makes a values decision that the societal utility of the right to possess a gun outweighs the public safety hazard of the suicidal.

    This is a utilitarian balance, and we should admit as much. Like carbon monoxide, guns have a nearly 100% effectiveness rate, and cause a quick enough death with a shot to the head. Given this known risk, I personally for instance don’t think doctors asking about guns in a household is inappropriate, and public policy prohibiting such questions misguided. The state would have some justification in perhaps limiting such questions to being follow up questions based on responses indicating a potential suicide risk; there is still a government interest in protecting second amendment and privacy rights.

    Returning to the question at hand: architecture. If an architectural design is so bad, it literally inspires people to kill themselves (har har), I think this is a legitimate artistic design consideration.

    In engineering, the “health, safety, and welfare” of the public is the paramount design criteria placed before all other considerations. For architects, canon one of the AIA Code of Ethics provides a similar (though less strict) duty to “thoughtfully consider the social and environmental impact of their professional activities, and exercise learned and uncompromised professional judgment”. Minimum codes require a 42″ barrier to protect against accidentals fall. Presuming this minimum were met, no professional negligence was involved in the design of the monument.

    Let us look at another purely ornamental architectural feature in New York: the observation deck of the Empire State Building. The building itself serves a utilitarian purpose of providing office space; allowing visitors to the top is purely incidental (although profitable). The deck has 8′ minimum barriers, a combination of plexiglass and wrought iron fencing. Some of this is to address the unique needs of a 1000 foot structure, namely preventing high winds from blowing people off. The bars of the fence obscure the view, and the plexiglass obscure the feeling of wind. The experience of the top is arguably diminished, but balanced against safety.

    The unanticipated consequence of people being drawn to throw themselves off the monument structure is a professional dilemma. Even if we neglect an active duty to prevent voluntary self-harm, there is still at least a passive duty to protect the public from the trauma of witnessing such an event. Visiting public art should be reasonably free of the risk of PTSD. Professionals cannot ignore a known risk, but must determine a reasonable balance.

    Going forward, the architects of the monument near Penn Station need to consider what are the essential elements of the experience. Is it the view? The wind? It being free and available to all visitors (I visited NYC by myself once; I’d be pissed if I weren’t allowed to visit the monument as a single visitor). Finding the correct balance of measures can very well eliminate the suicide risk for those attracted to this particular monument. Even if measures diminish the experience in finite ways, the reputation of visiting a suicide magnet itself diminishes the experience. The designers are forced to address an issue they did not create; they have an obligation to the public to do so.

    • Comment of the day, Rich. Very useful. But you must admit, the gas oven example doesn’t prove the general proposition that the comment claims—“if people are fixated for whatever reason on a certain means of suicide, they will not turn to another method if access to that method is removed.” For example, if all houses were installed with a “Kill me now” button and it was removed, I’m sure the suicide rate would go down dramatically. Whether taking away someone’s sleeping pills would have the same impact, I have no idea.

      • Thanks Jack!

        There are other examples, but not as dramatic. For instance, people will repeatedly overdose on sleeping pills, only to wake up a day later with a headache. This preferred method has only about a 1/20 chance of success, but they rarely switch to a more effective method. People who survive a hanging rarely switch to pills. Even wrist-slitting survivors may make repeated attempts, but not switch for instance to stabbing themselves in the jugular. Some people by moral luck stumble onto a survival fixation. Others get stuck on a deadly method and “succeed” frequently. Others still find themselves in a uniquely stressful moment and opportunistically latch onto any available method, but may never be inclined to repeat. Suicide intervention succeeds when it delays the overwhelming urge; making the preferred method unavailable can help make that delay indefinite.

  9. Guns are one method of suicide where they are available. In this regard, the U.S. is the third most populous nation on planet earth, and by far the number one most well armed civilian population on planet earth in all of history. We have a lot of guns in the U.S. Notwithstanding the vast availability of privately owned guns in the U.S., the U.S. is ranked 31st (14.5 per 100 thousand population) below 30 other nations in suicide rate all of which have far fewer guns in civilian ownership. For example Japan and South Korea have effectively no significant number of guns in civilian ownership and yet they have significantly higher national suicide rates, 16.5 and 26.9 respectively. The highest national suicide rate in the world is in Greenland at 58.28 suicides per hundred thousand population (2016), over 400 percent higher than the U.S. rate. And yet, Greenland has only 18.5 percent of the of the rate of gun ownership as the U.S. If guns “cause” suicides, why isn’t the U.S. number one in the world for suicides by rate and why don’t we have millions of suicides every year?

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