## 1. Characterizing Suicide



Characterizing suicide precisely faces a number of philosophical
challenges.



One challenge stems from the strongly negative emotional or moral
connotations of the term 'suicide'. Efforts to distinguish
suicidal behavior from other behavior often clandestinely import moral
judgments about the aims or moral worth of such behavior. That is,
views about the nature of suicide often incorporate, sometimes
unknowingly, views about the prudential or moral justifiability of
suicide and are therefore not value-neutral descriptions of suicide
(Paterson 2003, 353, Cholbi 2011, 17-20). For example, Hitler,
most people contend, clearly died due to suicide, but Socrates and
Jesus did not (though on Socrates, see Frey 1978). That the deaths of
the morally villainous are more readily seen as suicides than the
deaths of the morally admirable illustrates that suicide still carries
a strongly negative subtext. A similar phenomenon is present within
societal discourse concerning individuals near the end of life who
seek medical assistance to die. Advocacy and professional
organizations have largely succeeded in changing the terminology used
in public discussions of such individuals from 'assisted
suicide' or 'physician-assisted suicide' to
'assisted dying' or 'death with dignity,'
despite the strong similarities between these acts and suicide of
other kinds. (Friesen 2020, Reed 2020) Presumably, such groups have
done so from the belief that the negative connotations of
'suicide' will reduce public support for the cause of
legalizing medical assistance in dying.



'Suicide' may well turn out to be a value-laden concept,
one that cannot be defined in a morally neutral way.
Nevertheless, it would be desirable to identify a
defensible conception of suicide that is not value-laden
(Stern-Gillett 1987, Kupfer 1990) For those debating the morality of
'suicide' are likely to be at cross purposes if some
define 'suicide' as *wrongful
self-killing*(in the way that 'murder' can be
defined as *wrongful killing of another*) while others
operate with a definition that does not entail that all acts of
suicide are wrongful. The former rules out the prospect of
morally defensible 'suicide' while the latter allows for
it. A more fruitful debate is likely to result if such debates are
organized around a shared descriptive definition of suicide that does
not beg the question about the possibility of its being justified.



If a purely descriptive account of suicide is possible, where should
it begin? While it is tempting to say that suicide is any self-caused
death, this account is vulnerable to obvious counterexamples (though
for a defense of such a view, see Dowie 2020). An individual who knows
the health risks of smoking or of skydiving, but willfully engages in
these behaviors and dies as a result, could be said to be causally
responsible for her own death but not to have died by suicide.
Similarly, an individual who takes a swig of hydrochloric acid,
believing it to be lemonade, and subsequently dies causes her own
death but does not engage in suicidal behavior. Moreover, not only are
there self-caused deaths that are not suicides, but there are
behaviors that result in death and are arguably suicidal in which the
agent is not the cause of her own death or is so only at one remove.
This can occur when an individual arranges the circumstances for her
death. A terminally ill patient who requests that another person
inject her with a lethal dose of tranquilizers has, intuitively, died
by suicide. Though she is not immediately causally responsible for her
death, she appears morally responsible for her death, since she
initiates a sequence of events which she intended to culminate in her
death, a sequence which cannot be explained without reference to her
beliefs and desires. (Such a case exemplifies
 voluntary euthanasia.)
 Likewise, those who die via 'suicide by cop,' where an
armed crime is committed in order to provoke police into killing its
perpetrator, are responsible for their own deaths despite not being
the causes of their deaths. In these kinds of cases, such agents would
not die, or would not be at an elevated risk for death, were it not
for their initiating such causal sequences. (See Brandt 1975, Tolhurst
1983, Frey 1981, but for a possible objection see Kupfer 1990.)



Furthermore, many philosophers (Fairbairn 1995, chapter 5) doubt
whether an act's actually resulting in death is essential to
suicide at all. Just as there can be attempted murders or attempted
acts of deception, so too can there be 'attempted'
suicides, instances where because of agents' false beliefs
(about the lethality of their behavior, for example), unforeseen
factual circumstances, others' interventions, etc., an act which
might have resulted in an agent's death does not.



Hence, suicidal behavior need not result in death, nor must the
condition that hastens death be self-caused. Definitions according to
which suicide occurs when a person acts knowing that her act will
cause her own death (Durkheim (1897)) thus fail to capture how death
is in some respect an *aim* of suicidal behavior. Second, what
appears essential for a behavior to count as suicide is that the
person in question *chooses to die*. From the perspective of
the suicidal actor, that she may die from her act is, in the case of
suicide, not a mere coincidence. An act's being suicide, rather
than merely being risky to one's life, thus seems to depend on
the individual's *intentions*, where an intention
implicates an individual's beliefs and desires about her action.
(See Brandt 1975, Graber 1981 Tolhurst 1983, Frey 1978, O'Keeffe
1981, McMahan 2002, 455, Paterson 2003, Cholbi 2011, 20-31, Hill
2011) An intention-based account of suicide would say, roughly,
that


1. A person *S*'s behavior *B* is suicidal iff
	1. *S* believed that *B*, or some causal consequence of
	*B*, would hasten her death (i.e, her death would occur earlier
	in time than it would have in *B*'s absence), and
	2. *S* intended to die by engaging in *B*.



This account renders more precise the notion of suicide as an effort
to bring about one's own death, but it is not unproblematic.



Condition (a) is a *doxastic* condition. It implies that deaths
(or increased risks for death) resulting from an individual's
act that causes death (or the risk thereof) are not suicides if the
individual acts in ignorance of the relevant risks of her behavior
(for example, when an individual accidentally takes a lethal dose of a
prescription drug). At the same time, (a) accounts for cases such as
the aforementioned terminally ill patient whose death is caused only
indirectly by her request to die. Condition (a) does not require that
*S* *know* that *B* will put her at a
significantly greater risk for death, nor even that *S*'s
beliefs about *B*'s lethality be true or even justified.
Suicidal individuals sometimes have false beliefs about the lethality
of their chosen suicide methods, greatly overestimating the lethality
of over the counter painkillers while underestimating the lethality of
handguns, for instance. An individual could believe falsely, or on the
basis of inadequate evidence, that placing one's head in an
electric oven significantly increases one's chances of dying,
but that behavior is nonetheless suicidal. The demand that *S*
believe that *B* makes death highly likely is admittedly
inexact, but it permits us to navigate between two extreme and
mistaken views. On the one hand, it implies that behavior which is in
fact only marginally more likely to cause a person's death is
not suicidal (you are more likely to die driving your car than in your
living room, but driving your car hardly qualifies as
'suicidal'). On the other hand, to demand that S believe
that *B* certainly or almost certainly will cause
*S*'s death is too strict, since it will rarely be the
case (given the possibility of intervening conditions, etc.) that
*B* will necessarily cause *S*'s death, and in
fact many suicidal individuals are ambivalent about their actions
(Cholbi 2011, 31-35), an ambivalence which is in turn reflected
in their selecting suicide methods that are far from certain to cause
death. Condition (a) also allows us to distinguish genuinely suicidal
behavior from suicidal *gestures*, in which individuals engage
in behavior they believe is *not* likely to cause their death
but is nonetheless associated with suicide attempts, while in fact
having some other intention (e.g., gaining others' attention) in
mind.



Condition (b), however, is far more knotty. For what is it to intend
that death result from one's behavior? There are examples in
which condition (a) is clearly met, but whether (b) is met is more
problematic. For instance, does a soldier who leaps upon a live
grenade tossed into a foxhole in order to save his comrades engage in
suicidal behavior? Many, especially partisans of
 the doctrine of double effect
 would answer 'no': Despite the fact that the soldier knew
his behavior would likely cause him to die, his intention was to
absorb the blast so as to save the other soldiers, whereas his death
was only a foreseen outcome of his action. Needless to say, whether a
clear divide exists between foreseen and intended outcomes is
controversial, and critics raise the worry that almost any outcome can
be described as foreseen (Glover 1990, ch. 6). (It is of course
possible that whether death is foreseen or intended has no bearing on
whether an act counts as suicide but still bears on whether any
particular suicidal act is justified.) Some would argue that given the
near certainty of his dying by jumping on the grenade, his death was
intended, for even though death is not the justifying aim of his
action and he may prefer not to die, his dying nevertheless has his
endorsement in the circumstances in which he acts (Tolhurst 1983,
Cholbi 2011, 26-31). A further complication is that current
psychological evidence suggests that suicide is often an ambivalent
act in which individuals who wish to die must nevertheless overcome
the ordinary human fear of death (Cholbi 2011, 31-34, Joiner
2010, 62-70). Given this ambivalence, whether an act that
posed an apparently lethal threat to the agent who performed it
was intended to hasten her death can be hard to decipher. When a
person dies in such circumstances, it may prove difficult whether to
classify the death as resulting from suicide (i.e., intentional
self-killing) or as accidental. Such cases might indicate the need for
a third category besides intentional suicide and accidental death
(Cholbi 2007).



The essential logical difficulty here resides in the notion of
intending to die, for acting so as to produce one's death nearly
always has some *other* aim or justification. That is, death is
generally not chosen for its own sake, or is not the end of suicidal
behavior. Suicidal behavior can have any number of objectives: the
relief of physical pain, the relief of psychological anguish,
martyrdom in the service of a moral cause, the fulfillment of
perceived societal duties (e.g., *suttee* and
*seppuku*), the avoidance of judicial execution, revenge on
others, protection of others' interests or well-being. (See
Fairbairn 1995, ch. 9, for a taxonomy of the varieties of suicide.)
Therefore, it is not the case that suicidal individuals intend death
per se, but rather that death is perceived, rightly or wrongly, as a
means for the fulfillment of another of the agent's aims (Graber
1981, 56). In short, there do not appear to be any compelling examples
of "noninstrumental" self-killings in which "the
overriding intention is simply to end one's life and there is no
further independent objective involved in the action"
(O'Keeffe 1981, 357). Nor does requiring that the individual
*wish* to be dead (Fairbairn 1995, ch. 6) address this issue,
since again, what one wishes is presumably not death itself but some
outcome of death. Both the grenade-jumping soldier and the depressed
individual may wish not to die insofar as they might prefer that their
desires could be satisfied without dying or without putting themselves
at the risk thereof. However, this is consistent with their willingly
choosing to die in order to satisfy their aims.



Some (e.g., Beauchamp 1992, Cholbi 2011, 35-37) might wish to
add a further condition to (a) and (b) above:


3. *S* was not coerced into *B*-ing.



What speaks in favor of condition (c)? Typically, coercion
denotes intervention by others wherein a person comes to find
herself with a reason to act in a certain way because of
another's threat or use of force. Coerced decisions seem not to
be entirely our own, inasmuch we act in accordance with the will of
the coercer rather than acting freely on the basis of our own prior
desires. Applied to cases where individuals act intentionally to
hasten their own deaths, this implies that such cases are not
instances of suicide, for while the individual may cause their own
death, they do not have their own reasons to end their
lives. Hence, according to condition (c), a spy threatened with
torture lest he relinquish crucial military secrets who then poisons
himself did not die by suicide since the spy's captors compelled
him to take his life. 



Whether an attempt to intentionally hasten one's death is
coerced or not is relevant to whether that attempt is
*justified*. But condition (c) may rest on an
irrelevant distinction: Many of the reasons individuals have for
intentionally hastening death arguably originate outside themselves
much in the way that a coerced agent's reasons originate outside
themselves too. An extremely ill patient S may opt to take their own
life rather endure severe and ongoing physical pain. But compare
S to T, who opts to take their own life because of severe and ongoing
physical pain caused by the choices of her torturer U. S and T seem to
have the same kinds of reasons to intentionally hasten their own
deaths, reasons originating outside themselves. According to condition
(c), the crucial difference is that T is not engaging in suicide
because T's reasons originate in U's decision to engage in
torture, whereas S is engaging in suicide because S's reasons do
not originate in the will or decisions of another individual. Can the
nature of an action depend upon whether the reasons that justify it
originate in another person's will or decisions? This does not
seem obvious. Coercion does not seem to alter the action as such, even
if it alters whether their actions are justified or blameworthy. A
person coerced into singing is singing, no less than a person who
sings of her own accord; a person coerced into withdrawing money from
her bank account withdraws money from her bank account, no less than
if she did of her own accord; etc. Condition (c) thus seems to impose
on the definition of suicide a requirement that does not seem to apply
to other types of action.



This brief attempt at conceptual analysis of suicide illustrates the
frustrations of such a project, as the unclear notion of suicide is
apparently replaced by equally unclear notions such as intention and
coercion. We may be attracted to increasingly convoluted analyses of
suicide (Donnelly 1998, 20) or accept that suicide is an 'open
textured' concept instances of which are bound together only by
weak Wittgensteinian family resemblance and hence resistant to
analysis in terms of necessary and sufficient conditions (Windt
1981).



An alternative to providing necessary and sufficient conditions for
suicidal behavior is to view it along a continuum. In the
psychological sciences, many suicidologists view suicide not as an
either/or notion but as a gradient notion, admitting of degrees based
on individuals' beliefs, strength of intentions, and attitudes.
The Beck Scale for Suicidal Ideation is perhaps the best example of
this approach. (See Beck 1979.)


## 2. Highlights of Historical Western Thought

 This section outlines the main currents of historical
philosophical thought about suicide in 'the West' (Europe,
the Middle East, and North America). Such an emphasis should not
obscure the rich traditions of thought originating outside those
geographical confines, however. Important thinkers from Africa, Asia,
and the indigenous populations of the Western hemisphere took a
philosophical interest in suicide. Little appears to unite
philosophical thinking about suicide from these traditions aside from
the fact that they are far less influenced by monotheism than is the
Western tradition. Some of the ethical considerations concerning
suicide raised in these traditions are also found in Western thought.
For instance, the claim that suicide may violate ethical duties to
others is addressed by Confucius, who primarily views the matter
through the lens of filial piety (Confucius 2003). Others, for example
the Jain practice of *sallekhana*, a type of spiritual fasting
intended to hasten death, do not seem to have correlates in the
Western tradition (Umaswati 1992). Unfortunately, the diversity of
positions within the non-Western traditions preclude easy summation.
Those interested in these traditions are urged to consult Battin
(2015). (The
 online archive
 of Battin (2015) is particularly useful in this regard; users can
search for philosophical writings on suicide based on geographic
origin and intellectual tradition.)

### 2.1 Ancient and Classical Views of Suicide



Western philosophical discourse about suicide stretches back at least
to the time of Plato. As John Cooper has noted (Cooper 1989, 10),
neither ancient Greek nor Latin had a single word that aptly
translates our 'suicide,' even though most of the ancient
city-states criminalized self-killing.



Plato explicitly discussed suicide in two works. First, in
*Phaedo*, Socrates expresses guarded enthusiasm for the thesis,
associated with the Pythagoreans, that suicide is always wrong because
it represents our releasing ourselves (i.e., our souls) from a
"guard-post" (i.e., our bodies) the gods have placed us in
as a form of punishment (*Phaedo* 61b-62c). Later, in the
*Laws*, Plato claimed that suicide is disgraceful and its
perpetrators should be buried in unmarked graves. However, Plato
recognized four exceptions to this principle: (1) when one's
mind is morally corrupted and one's character can therefore not
be salvaged (*Laws* IX 854a3-5), (2) when the
self-killing is done by judicial order, as in the case of Socrates,
(3) when the self-killing is compelled by extreme and unavoidable
personal misfortune, and (4) when the self-killing results from shame
at having participated in grossly unjust actions (*Laws* IX
873c-d). Suicide under these circumstances can be excused, but,
according to Plato, it is otherwise an act of cowardice or laziness
undertaken by individuals too delicate to manage life's
vicissitudes. Aristotle's only discussion of suicide
(*Nicomachean Ethics* 1138a5-14) occurs in the midst of a
discussion of the possibility of treating oneself unjustly. Aristotle
concludes that self-killing does not treat oneself unjustly so long as
it is done voluntarily because the harm done to oneself is consensual.
He concludes that suicide is somehow a wrong to the state or the
community, though he does not outline the nature of this wrong or the
specific vices that suicidal individuals allegedly exhibit.



To contemporary readers, the most striking feature of Plato's
and Aristotle's texts on suicide is their relative absence of
concern for individual well-being or rights. Both limit the
justifications for suicide largely to considerations about an
individual's social roles and obligations. In contrast, the
Stoics held that whenever the means to living a naturally flourishing
life are not available to us, suicide may be justified, regardless of
the character or virtue of the individual in question. Our natures
require certain "natural advantages" (e.g., physical
health) in order for us to be happy, and a wise person who recognizes
that such advantages may be lacking in her life sees that ending her
life neither enhances nor diminishes her moral virtue.



> 
> When a man's circumstances contain a preponderance of things in
> accordance with nature, it is appropriate for him to remain alive;
> when he possesses or sees in prospect a majority of the contrary
> things, it is appropriate for him to depart from life.... Even
> for the foolish, who are also miserable, it is appropriate for them to
> remain alive if they possess a predominance of those things which we
> pronounce to be in accordance with nature (Cicero, III, 60-61).
> 



Hence, not only may concerns related to one's obligations to
others justify suicide, but one's own private good is relevant
too. The Roman Stoic Seneca, who was himself compelled to engage in
suicide, was even bolder, claiming that since "mere living is
not a good, but living well", a wise person "lives as long
as he ought, not as long as he can." For Seneca, it is the
quality, not the quantity, of one's life that matters.


### 2.2 The Christian Prohibition



The advent of institutional Christianity was perhaps the most
important event in the philosophical history of suicide, for Christian
doctrine has by and large held that suicide is morally wrong, despite
the absence of clear Scriptural guidance regarding suicide. Although
the early church fathers opposed suicide, St. Augustine is generally
credited with offering the first justification of the Christian
prohibition on suicide (Amundsen 1989). He saw the prohibition as a
natural extension of the fifth commandment:



> 
> God's command 'Thou shalt not kill,' is to be taken
> as forbidding self-destruction, especially as it does not add
> 'thy neighbor', as it does when it forbids false witness,
> 'Thou shalt not bear false witness against thy neighbor.'
> (Augustine, book I, chapter 20)
> 



Suicide, Augustine determined, was an unrepentable sin. St. Thomas
Aquinas later defended this prohibition on three grounds. (1) Suicide
is contrary to natural self-love, whose aim is to preserve us. (2)
Suicide injures the community of which an individual is a part. (3)
Suicide violates our duty to God because God has given us life as a
gift and in taking our lives we violate His right to determine the
duration of our earthly existence (Aquinas 1271, part II, Q64, A5).
This conclusion was codified in the medieval doctrine that suicide
nullified human beings' relationship to God, for our control
over our body was limited to *usus* (possession, employment)
where God retained *dominium* (dominion, authority). Law and
popular practice in the Middle Ages sanctioned the desecration of the
suicidal corpse, along with confiscation of the individual's
property and denial of Christian burial.



The rediscovery of numerous texts of classical antiquity was one of
the spurs of the Renaissance, but for the most part, Renaissance
intellectuals generally affirmed the Church's opposition to
suicide and were not sympathetic to the more permissive attitudes
toward suicide found among the ancient pagans. Two intriguing
sixteenth century exceptions were Thomas More and Michel de Montaigne.
In his *Utopia*, More appears to recommend voluntary suicide
for those suffering from painful and incurable diseases, though the
satirical and fantastical tone of that work makes it doubtful that
More supported this proposal in reality. In his *Essais*,
Montaigne relates several anecdotes of individuals taking their own
lives and intersperses these anecdotes with quotations from Roman
writers praising suicide. While his general skepticism prevented
Montaigne from staking out a firm moral position on suicide, he gives
only a nod to the orthodox Christian position and conceptualizes the
issue not in traditional theological terms but as a matter of personal
judgment or conscience (Minois 1999, 89-92).



The Protestant Reformers, including Calvin, condemned suicide as
roundly as did the established Church, but held out the possibility of
God treating suicide mercifully and permitting repentance. Interest in
moral questions concerning suicide was particularly strong in this
period among England's Protestants, notably the Puritans (Sprott
1961). Nonetheless, the traditional Christian view prevailed well into
the late seventeenth century, where even an otherwise liberal thinker
such as John Locke echoed earlier Thomistic arguments, claiming that
though God bestowed upon us our natural personal liberty, that liberty
does not include the liberty to destroy oneself (Locke 1690, ch. 2,
para. 6).



In all likelihood, the first comprehensive modern defense of suicide
was John Donne's *Biathanatos* (c. 1607). Not intended
for publication, *Biathanatos* drew upon an array of classical
and modern legal and theological sources to argue that Christian
doctrine should not hold that suicide is necessarily sinful. His
critique is in effect internal, drawing upon the logic of Christian
thought itself to suggest that suicide is not contrary to the laws of
nature, of reason, or of God. Were it contrary to the law of nature
mandating self-preservation, all acts of self-denial or privation
would be similarly unlawful. Moreover, there may be circumstances in
which reason might recommend suicide. Finally, Donne observes, not
only does Biblical Scripture lack a clear condemnation of suicide,
Christian doctrine has permitted other forms of killing such as
martyrdom, capital punishment and killing in wartime (Minois 1999,
20-21).


### 2.3 The Enlightenment and Modern Developments



Donne's casuistical treatise was an early example of the
liberalized Enlightenment attitudes of the 1700s. The Thomistic
natural-law stance on suicide came under increasing attack as suicide
was examined through the lens of science and psychology. Where
Christian theology has understood suicide as "an affair between
the devil and the individual sinner" (Minois 1999, 300),
Enlightenment philosophers tended to conceive of suicide in secular
terms, as resulting from facts about individuals, their natural
psychologies, and their particular social settings. David Hume gave
voice to this new approach with a direct assault on the Thomistic
position in his essay "Of suicide" (1783). Hume saw
traditional attitudes toward suicide as muddled and superstitious,
rooted in confused understandings of God's relation to the
created human world. (Lecaldano 2016) According to the Thomistic
argument, suicide violates the order God established for the world and
usurps God's prerogative in determining when we shall die.
Hume's argument against this thesis is intricate but rests on
the following considerations:


1. If by the 'divine order' is meant the causal laws
created by God, then it would always be wrong to contravene these laws
for the sake of our own happiness. But clearly it is not wrong, since
God frequently permits us to contravene these laws, for he does not
expect us not to respond to disease or other calamities. Therefore,
there is not apparent justification, as Hume put it, for God's
permitting us to disturb nature in some circumstances but not in
others. Just as God permits us to divert rivers for irrigation, so too
ought he permit us to divert blood from our veins.
2. If by 'divine order' is meant the natural laws God has
willed for us, which are (a) discerned by reason, (b) such that
adherence to them will produce our happiness, then why should not
suicide conform to such laws when it appears rational to us that the
balance of our happiness is best served by dying?
3. Finally if by 'divine order' is meant simply that
which occurs according to God's consent, then God appears to
consent to *all* our actions (since an omnipotent God can
presumably intervene in our acts at any point) and no distinction
exists between those of our actions to which God consents and those to
which He does not. If God has placed us upon the Earth like a
"sentinel," then our choosing to leave this post and take
our lives occurs as much with his cooperation as with any other act we
perform.



Furthermore, suicide does not necessarily violate any duties toward
other people, according to Hume. Reciprocity may require that we
benefit society in exchange for the benefits it provides, but surely
such reciprocity reaches its limit when by living we provide only a
"frivolous advantage" to society at the expense of
significant harm or suffering for ourselves. In more extreme
situations, we are actually burdens to others, in which case our
deaths are not only "innocent, but laudable."



Finally, Hume rejects the thesis that suicide violates our duties to
self. Sickness, old age, and other misfortunes can make life
sufficiently miserable that continued existence is worse than death.
As to worries that people are likely to attempt to take their lives
capriciously, Hume replies that our natural fear of death ensures that
only after careful deliberation and assessment of our future prospects
will we have the courage and clarity of mind to kill ourselves. In the
end, Hume concludes that suicide "may be free of imputation of
guilt and blame." His position is largely utilitarian, allied
with a strong presumption of personal liberty.



But Enlightenment philosophy was not univocal in its comparatively
permissive attitudes toward suicide. The most noteworthy opponent of
suicide in this period was Immanuel Kant. Kant's arguments,
though they reflect earlier natural law arguments, draw upon his view
of moral worth as emanating from the autonomous rational wills of
individuals (Cholbi 2000, 2010). For Kant, our rational wills are the
source of our moral duty, and it is therefore a kind of practical
contradiction to suppose that the same will can permissibly destroy
the very body that carries out its volitions and choices. Given the
distinctive worth of an autonomous rational will, suicide is an attack
on the very source of moral authority.



> 
> To annihilate the subject of morality in one's person is to root
> out the existence of morality itself from the world as far as one can,
> even though morality is an end in itself. Consequently, disposing of
> oneself as a mere means to some discretionary end is debasing humanity
> in one's person... (Kant 423)
> 



(For a contemporary expression of this Kantian view of suicide, see
Velleman 1999.)



Suicide continued to be an important topic in post-Kantian German
philosophy (see Stellino 2020). Like Hume, Arthur Schopenhauer
rejected virtually all moral arguments for the moral objectionability
of suicide. Surprisingly though, Schopenhauer's pessimistic
philosophical outlook nevertheless led him to condemn suicide. The
desire to end our lives, according to Schopenhauer, arises from our
will's unceasing but ultimately futile pursuit of our desires.
Hence, rather than denying this striving or extricating us from the
fundamental predicament of human existence, suicide ends up affirming
this striving and so represents a misguided grasp at freedom.
(1819:425-27) Friedrich Nietzsche, in contrast, shared
Schopenhauer's rejection of pious moralizing about suicide and
his belief in the striving of the will, but concluded that suicide is
at least sometimes rational. For Nietzsche, suicide can be a
praiseworthy assertion of one's will, a way to lend one's
individual life meaning in an otherwise meaningless world. (1883)



The nineteenth and early twentieth centuries also brought several
developments that, while not explicitly philosophical, have shaped
philosophical thought about suicide. The first was the emergence, in
novels by Rousseau, Goethe, and Flaubert, of a Romantic idealized
'script' for suicide, according to which suicide was the
inevitable response of a misunderstood and anguished soul jilted by
love or shunned by society (Lieberman 2003). The second was the
emergence of psychiatry as an autonomous discipline, populated by
experts asserting their ability to diagnose and treat melancholy,
hysteria and other ailments sometimes thought responsible for suicide.
Lastly, largely thanks to the work of sociologists such as Durkheim
and Laplace, suicide was increasingly viewed as a social ill
reflecting widespread alienation, anomie, and other attitudinal
byproducts of modernity. In many European nations, the rise in suicide
rates was thought to signal a cultural decline. These latter two
developments made suicide prevention a bureaucratic and medical
preoccupation, leading to a wave of institutionalization for suicidal
persons. All three conspired to suggest that suicide is caused by
impersonal social or psychological forces rather than by the agency of
individuals.


## 3. The Morality and Rationality of Suicide


### 3.1 Moral Permissibility



The principal moral issue surrounding suicide has long been whether
there are conditions under which suicide is morally justified, and if
so, which conditions. Several important historical answers to this
question have already been mentioned.



This question should be distinguished from three others:


1. Should other individuals attempt to prevent suicide?
2. Should the state criminalize suicide or attempt to prevent
it?
3. Is suicide ever rational or prudent?



These four questions interrelate in complex ways. For instance, it
might be assumed that if suicide is morally permissible in some
circumstances, then neither other individuals nor the state should
interfere with suicidal behavior (in those same circumstances).
However, this conclusion might not follow if those same suicidal
individuals are irrational and interference is required in order to
prevent them from taking their lives, an outcome they would regret
were they more fully rational. Furthermore, for those moral theories
that emphasize rational autonomy, whether an individual has rationally
chosen to take her own life may settle all four questions. In any
event, the interrelationships among suicide's moral
permissibility, its rationality, and the duties of others and of
society as a whole is complex, and we should be wary of assuming that
an answer to any one of these four questions decisively settles the
other three.


### 3.2 The Deontological Argument from the Sanctity of Life



The simplest moral outlook on suicide holds that it is necessarily
wrong because human life is sacred. Though this position is often
associated with religious thinkers, especially Catholics, Ronald
Dworkin (1993) points out that atheists may appeal to this claim as
well. According to this 'sanctity of life' view, human
life is inherently valuable and precious, demanding respect from
others and reverence for oneself. Hence, suicide is wrong because it
violates our moral duty to honor the inherent value of human life,
regardless of the value of that life to others or to the person whose
life it is. The sanctity of life view is thus a deontological position
on suicide.



The great merit of the sanctity of life position is that it reflects a
common moral sentiment, namely, that killing is wrong in itself. But
the sanctity of life view faces several challenges. The first is that
its proponents need to show that it is consistent with the
justifiability of other forms of killing many have thought defensible,
such as killing in wartime or killing in self-defense. Why, in other
words, are other forms of killing morally permitted but suicide is
not? Second, the sanctity of life view appears to assert that simply
being alive, irrespective of the current or expected quality of a
person's life, confers value on a human life. But Peter Singer
(1994) and others have argued against the sanctity of life position on
the grounds that the value of a continuing life is not intrinsic but
extrinsic, to be judged on the basis of the individual's likely
future quality of life. If the value of a person's continued
life is measured by its likely quality, then suicide may be
permissible when that quality is low (see
 section 3.5).
 Third, we may question the inference from the sanctity of life to the
moral impermissibility of suicide. Those who engage in suicidal
behavior when their futures promise to be extraordinarily bleak do not
seem to exhibit insufficient regard for the sanctity of life (Dworkin
1993, 238). Indeed, it may be argued that suicide may affirm the value
of human lives in those circumstances where medical or psychological
conditions reduce individuals to shadows of their former fully capable
selves (Cholbi 2002).


### 3.3 Religious Arguments



Two general categories of arguments for the moral impermissibility of
suicide have emerged from the Christian religious tradition. The first
of these is the aforementioned Thomistic natural law position,
critiqued by Hume (see
 section 2.3)
 According to this tradition, suicide violates the natural law God has
created to govern the natural world and human existence. This natural
law can be conceived of in terms of (a) natural causal laws, such that
suicide violates this causal order, (b) teleological laws, according
to which all natural beings seek to preserve themselves, or (c) the
laws governing human nature, from which it follows that suicide is
'unnatural' (Pabst Battin 1996, 41-48). These
natural law arguments are no longer the main focus of philosophical
discussion, as they have been subjected to strenuous criticism by Hume
and others (though see Gay-Williams 1996). These criticisms include
the following: (1) the natural law arguments cannot be disentangled
from a highly speculative theistic metaphysics; (2) the claims of
natural law are confuted by observations of human nature (e.g., the
existence of self-destructive human behaviors casts doubt on the claim
that we "naturally" preserve ourselves); and (3) other
acts (e.g., religious martyrdom) which God is assumed not to condemn,
also violate these natural laws, making the prohibition on suicide
appear arbitrary.



The second general category of religious arguments rest on analogies
concerning the relationship between God and humanity. For the most
part, these arguments aim to establish that God, and not human
individuals, has the proper moral authority to determine the
circumstances of their deaths. One historically prominent analogy
(suggested by Aquinas and Locke) states that we are God's
property and so suicide is a wrong to God akin to theft or destruction
of property. This analogy seems weak on several fronts. First, if we
are God's property, we are an odd sort of property, in that God
apparently bestowed upon us free will that permits us to act in ways
that are inconsistent with God's wishes or intentions. It is
difficult to see how an autonomous entity with free will can be
subject to the kind of control or dominion to which other sorts of
property are subject. Second, the argument appears to rest on the
assumption that God does not wish his property destroyed. Yet given
the traditional theistic conception of God as not lacking in any way,
how could the destruction of something God owns (a human life) be a
harm to God or to his interests (Holley 1989, 105)? Third, it is
difficult to reconcile this argument with the claim that God is
all-loving. If a person's life is sufficiently bad, an
all-loving God might permit his property to be destroyed through
suicide. Finally, some have questioned the extent of the duties
imposed by God's property right in us by arguing that the
destruction of property might be morally justified in order to prevent
significant harm to oneself. If the only available means to save
myself from a ticking bomb is to stash it in the trunk of the nearest
car to dampen the blast, and the nearest car belongs to my neighbor,
then destroying his property appears justified in order to avoid
serious harm to myself. Likewise, if only by killing myself can I
avoid a serious future harm to myself, I appear justified in
destroying my life even if it is God's property.



Another common analogy asserts that God bestows life upon us as a
gift, and it would be a mark of ingratitude or neglect to reject that
gift by taking our lives. The obvious weakness with this "gift
analogy" is that a gift, genuinely given, does not come with
conditions such as that suggested by the analogy, i.e., once given, a
gift becomes the property of its recipient and its giver no longer has
any claim on what the recipient does with this gift. It may perhaps be
imprudent to waste an especially valuable gift, but it does not appear
to be unjust to a gift giver to do so. As Kluge (1975, 124) put it,
"a gift we cannot reject is not a *gift*". A
variation of this line of argument holds that we owe God a debt of
gratitude for our lives, and so to kill ourselves would be
disrespectful or even insulting to God, (Ramsey 1978, 146) or would
amount to an irresponsible use of this gift. Yet this variation does
not really evade the criticism directed at the first version: Even if
we owe God a debt of gratitude, disposing of our lives does not seem
inconsistent with our expressing gratitude for having lived at all
(Beauchamp 1992). Furthermore, if a person's life is rife with
misery and unhappiness, it is far from clear that she owes God much in
the way of gratitude for this apparently ill-chosen "gift"
of life. Defenders of the gift analogy must therefore defend the claim
that life, simply because it is given to us by a loving God, is an
expression of God's benevolent nature and is therefore
necessarily a benefit to us (Holley 1989, 113-114).



In addition, there is a less recognized undercurrent of religious
thought that *favors* suicide. For example, suicide permits us
to reunite with deceased loved ones, allows those who have been
absolved of sin to assure their entrance to heaven, and releases the
soul from the bondage of the body. In both Christian and Asian
religious traditions, suicide holds the promise of a vision of, or
union with, the divine (Pabst Battin 1996, 53-64).


### 3.4 Libertarian Views and the Right to Suicide



For libertarians, suicide is morally permissible because individuals
enjoy a *right* to suicide. (It does not of course follow that
suicide is necessarily rational or prudent.) Libertarianism, which has
historical precedent in the Stoics and in Schopenhauer, is strongly
associated with the 'anti-psychiatry' movement of the last
half century. According to that movement, attempts by the state or by
the medical profession to interfere with suicidal behavior are
essentially coercive attempts to pathologize morally permissible
exercises of individual freedom (Szasz 2002).



Libertarianism typically asserts that the right to suicide is a
*right of noninterference*, to wit, that others are morally
barred from interfering with suicidal behavior. Some assert the
stronger claim that the right to suicide is a *liberty right*,
such that individuals have no duty to forego suicide (i.e., that
suicide violates no moral duties), or a *claim right*,
according to which other individuals may be morally obliged not only
not to interfere with a person's suicidal behavior but to assist
in that behavior. (See the entry on
 rights.)
 Our having a claim right to suicide implies that we also have rights
of noninterference and of liberty and is a central worry about
physician-assisted suicide (Pabst Battin 1996, 163-164). Since
whether we have a liberty right to suicide concerns whether it
violates other moral obligations, including obligations to other
people, I shall leave discussion of that issue to
 section 3.5
 and focus here on whether there is a right of noninterference.
(Whether suicidal individuals have a claim right to others'
assistance is addressed in
 section 3.8.)



A popular basis supporting a right to suicide is the idea that we own
our bodies and hence are morally permitted to dispose of them as we
wish. (Recall from
 section 3.3
 that some religious arguments for the impermissibility of suicide
depend on God's ownership of our bodies.) On this view, our
relationship to our bodies is like that of our relationship to other
items over which we enjoy property rights: Just as our having a right
to a wristwatch permits us to use, improve, and dispose of it as we
wish, so too does our having a right to our bodies permit us to
dispose of them as we see fit. Consequently, since property rights are
exclusive (i.e., our having property rights to a thing prohibits
others from interfering with it), others may not interfere with our
efforts to end our lives.



The notion of self-ownership gives rise to certain puzzles though.
Ownership seems to (a) involve two metaphysically distinct entities,
the owned (my wristwatch) and the owner (me), and (b), an act or event
by which one acquires a property right in thing owned. It is not
obvious how to make sense of either of these facts in the case of
self-ownership or ownership of one's body. While we can give
away our bodies (donating a kidney, for example, or willing that our
corpses be used for scientific research), our coming to own our bodies
is harder to grasp. We did not, after all, create our own bodies,
purchase them, etc. And while it may be true that we come to own our
bodies because they are a gift from others (God or our biological
parents), this seems to require that there already exist some
non-embodied self to serve as the recipient of this gift.
Self-ownership might therefore seem to require a controversial
dualistic metaphysics of the self, at odds with a naturalistic
philosophical perspective wherein we are essentially embodied beings.
(Cholbi 2011, 84-86) Perhaps self-ownership is a metaphor meant
to capture a similar property-like set of rights we have toward our
bodies,rights that allow us to exercise property-like control or
authority over our bodies. (Kluge 1975, 119) Finally, a right to
suicide rooted in a putative right of self-ownership would not be
unlimited. For uses of one's property, including its
destruction, can be harmful to others. Thus, even on the assumption
that we do own our own bodies, we may be morally required to refrain
from suicide when and because the destruction of our bodies harms
others. (See
 section 3.5
 for arguments concerning duties to others.)


### 3.5 Social, Utilitarian, and Role-Based Arguments



A fourth approach to the question of suicide's permissibility
asks not whether others may interfere with suicidal behavior but
whether we have a liberty right to suicide, whether, that is, suicide
violates any moral duties to others. Those who argue that suicide can
violate our duties to others generally claim that suicide can harm
either specific others (family, friends, etc.) or is a harm to the
community as a whole.



No doubt the suicide of a family member or loved one produces a number
of harmful psychological and economic effects. In addition to the
usual grief, suicide "survivors" confront a complex array
of feelings. Various forms of guilt are quite common, such as that
arising from (a) the belief that one contributed to the suicidal
person's anguish, or (b) the failure to recognize that anguish,
or (c) the inability to prevent the suicidal act itself. Suicide also
leads to rage, loneliness, and awareness of vulnerability in those
left behind. Still, some of these reactions may be due to the strong
stigma and shame associated with suicide, in which case these
reactions cannot, without logical circularity, be invoked in arguments
that suicide is wrong because it produces these psychological
reactions (Pabst Battin 1996, 68-69), i.e., the wrongfulness of
suicide cannot rest on the emotions provoked by the belief that it is
wrong. Suicide can also cause clear economic or material harm, as when
the suicidal person leaves behind dependents unable to support
themselves financially. Suicide can therefore be understood as a
violation of the distinctive "role obligations" applicable
to spouses, parents, caretakers, and loved ones. However, even if
suicide is harmful to family members or loved ones, this does not
support an absolute prohibition on suicide, since some suicides will
not leave survivors, and among those that do, the extent of these
harms is likely to differ such that the stronger these relationships
are, the more harmful suicide is and the more likely it is to be
morally wrong. Besides, from a utilitarian perspective, these harms
would have to be weighed against the harms done to the would-be
suicide by continuing to live a difficult or painful life. At most,
the argument that suicide is a harm to family and to loved ones
establishes that it is sometimes wrong (Cholbi 2011, 62-64).



A second brand of social argument echoes Aristotle in asserting that
suicide is a harm to the community or the state. One general form such
arguments take is that because a community depends on the economic and
social productivity of its members, its members have an obligation to
contribute to their society, an obligation clearly violated by suicide
(Pabst Battin 1996, 70-78, Cholbi 2011, 58-60). For
example, suicide denies a society the labor provided by its members,
or in the case of those with scarce talents such as medicine, art, or
political leadership, the crucial goods their talents enable them to
provide. Another version states that suicide deprives society of
whatever individuals might contribute to society morally (by way of
charity, beneficence, moral example, etc.) Still, it is difficult to
show that a society has a moral claim on its members' labor,
talents, or virtue that *compels* its members to contribute to
societal well-being no matter what. After all, individuals often fail
to contribute as much as they might in terms of their labor or special
talents without incurring moral blame. It does not therefore seem to
be the case that individuals are morally required to benefit society
in whatever way they are capable, regardless of the harms to
themselves. Again, this line of argument appears to show at most only
that suicide is sometimes wrong, namely, when the benefit (in terms of
future harm not suffered) the individual gains by dying is less than
the benefits she would deny to society by dying.



A modification of this argument claims that suicide violates a
person's duty of reciprocity to society (Cholbi 2011,
60-62). On this view, an individual and the society in which she
lives stand in a reciprocal relationship such that in exchange for the
goods the society has provided to the individual, the individual must
continue to live in order to provide her society with the goods that
relationship demands. Yet in envisioning the relationship between
society and the individual as quasi-contractual in nature, the
reciprocity argument reveals its principal flaw: The conditions of
this "contract" may not be met, and also, once met, impose
no further obligations upon the parties. As Baron d'Holbach
(1970, 136-137) pointed out, the contract between an individual
and her society is a conditional one, presupposing "mutual
advantages between the contracting parties." Hence, if a society
fails to fulfill its obligations under the contract, namely to provide
individuals with the goods needed for a decent quality of life, then
the individual is not morally required to live in order to reciprocate
an arrangement that society has already reneged on. Moreover, once an
individual has discharged her obligations under this societal
contract, she no longer is under an obligation to continue her life.
Hence, the aged or others who have already made substantial
contributions to societal welfare would be morally permitted to engage
in suicide under this argument.


### 3.6 Suicide as a Moral Duty?



To this point, we have addressed arguments that concern whether a
moral *permission* to engage in suicidal behavior exists, and
indeed, it is this question that has dominated ethical discussion of
suicide. Yet the social arguments against suicide are fundamentally
consequentialist, and some act-utilitarians have discussed the
correlative possibility that the good consequences of suicide might so
outweigh its bad consequences as to render suicide admirable or even
morally *obligatory* (Cosculluela 1995, 76-81). In fact,
in some cases, suicide may be honorable. Suicides that are clearly
other-regarding, aiming at protecting the lives or well-being of
others, or at political protest, may fall into this category (Kupfer
1990, 73-74). Examples of this might include the grenade-jumping
soldier mentioned earlier, or the spy who takes his life in order not
to be subjected to torture that will lead to his revealing vital
military secrets. Utilitarians have given particular attention to the
question of end-of-life euthanasia, suggesting that at the very least,
those with painful terminal illnesses have a right to voluntary
euthanasia (Glover 1990, chs. 14-15, Singer 1993, ch. 7). Yet
utilitarian views hold that we have a moral duty to maximize
happiness, from which it follows that when an act of suicide will
produce more happiness than will remaining alive, then that suicide is
not only morally permitted, but morally required.



However, the thesis that there may exist a "duty to die"
need not be defended by appeal to overtly consequentialist or
utilitarian reasoning. In the course of articulating what he terms a
"family-centered" approach to bioethics, the philosopher
John Hardwig (1996, 1997) has argued that sometimes the burdens that a
person imposes on others, particularly on family members or loved
ones, by continuing to live are sufficiently great that one may have a
duty to die in order to relieve them of these burdens. Hardwig's
argument thus seems to turn not on the overall balance of costs and
benefits that result from a person living or dying, but on the
fairness of the burdens that a person imposes on others by continuing
to live.



While generally acknowledging Hardwig's suggestion that duties
to others have been neglected in discussion of the ethics of suicide,
critics of morally required suicide raise a number of objections to
his proposal. (See Hardwig et al. 2000, Humber & Almeder 2000.)
Some doubt that the duty of beneficence to which Hardwig appeals
justifies anything stronger than a permission to take one's own
life when continuing to live is burdensome to others (Cholbi 2010b).
Others worry that a moral requirement to engage in suicide raises the
sinister and totalitarian prospect that individuals may be obliged to
engage in suicide against their wishes (Moreland & Geisler 1990,
94, Pabst Battin 1996, 94-95). This worry may reflect an
implicit acceptance of a variation of the sanctity of life view (see
 section 3.2)
 or may reflect concerns about infringements upon individual's
autonomy (see
 section 3.6).
 Other critics suggest that even if there is a duty to die, this duty
should not be understood as a duty that entails that others may compel
those with such a duty to take their lives (Menzel 2000, Narveson
2000). Questions about social justice and equality (whether, for
example, especially vulnerable populations such as women or the poor
might be more likely to act on such a duty) are also raised. One
utilitarian response to these objections is to reject a duty to die on
rule utilitarian grounds: Suicide would be morally forbidden because
general adherence to a rule prohibiting suicide would produce better
overall consequences than would general adherence to a rule permitting
suicide (Brandt 1975, Pabst Battin 1996, 96-98).


### 3.7 Autonomy, Rationality, and Responsibility



A more restricted version of the claim that we have a right to
noninterference regarding suicide holds that suicide is permitted so
long as--leaving aside questions of duties to others--it is
rationally chosen. In a similar vein, Kantians might claim that
suicidal choices must be respected if those choices are
*autonomous*, that is, if an individual chooses to end her life
on the basis of reasons that she acknowledges as relevant to her
situation. Such positions are narrower than the libertarian view, in
that they permit suicide only when it is performed on a rational basis
(or a rational basis that the individual acknowledges as relevant to
her situation) and permits others to interfere only when it is not
performed on that basis.



One initial challenge to the possibility of rational suicide rests on
the notion that suicide, being a choice to end one's life, is
*necessarily* irrational. The thought here is that any coherent
judgment of suicide's rationality requires comparing the state
of being alive (or continuing to live) with being dead. But either
because no one has sufficient knowledge of the state of being dead
(Devine 1978) or because suicide ensures that the suicidal person has
no future to look forward to (Cowley 2006), judgments that ending
one's life is rational are incoherent or misplaced.



In recent years, this 'two-state' requirement (that death
can only be judged rational or irrational if it is possible to compare
the state of being alive with the state of being dead) has been widely
rejected. In particular, the rationality of the decision to end
one's life need not be construed in terms of the value of being
alive versus the value of being dead (Luper 2009, 82-88).
Rather, the rationality of suicide concerns a choice about the value
or quality of different lives one could have: a shorter life, whose
duration is truncated by suicide, versus the longer life an individual
would be most likely to have if they forego suicide. As Richard Brandt
has put it, what those contemplating ending their lives are
considering are different durations or courses of their lives:



> 
> The person who is contemplating suicide is obviously making a choice
> between future world-courses: the world-course that includes his
> demise, say, an hour from now, and several possible ones that contain
> his demise at a later point... The basic question a person must
> answer in order to determine which world-course is best or rational
> for him to choose, is which he *would* choose under conditions
> of optimal use of information, when *all* of his desires are
> taken into account. (Brandt 1975)
> 



Hence, on this view, a rational judgment about one's own death
requires a comparison between the overall goodness of one's life
as it would be if it continued on its present course and the overall
goodness of one's life if that life ended before its present
course.



That suicide's rationality depends on comparing a life shortened
by suicide to a longer life has given rise to a rich philosophical
literature trying to identify the specific conditions under which a
person's decision to die is rational. For the most part, this
literature divides the conditions for rational suicide into
*cognitive conditions*, conditions ensuring that
individuals' appraisals of their situation are rational and
well-informed, and *interest conditions*, conditions ensuring
that suicide in fact accords with individuals' considered
interests.



Examples of this approach include Glenn Graber, who states that a
suicide is rationally justified "if a reasonable appraisal of
the situation reveals that one is better off dead." (Graber
1981, 65). An appraisal is reasonable, according to Graber, if it
results from a clearheaded assessment of how suicide would further or
impede one's overall interests, including one's present
and probable future values and preferences. Margaret Battin identifies
three cognitive conditions for rational suicide (a facility for causal
and inferential reasoning, possession of a realistic world view, and
adequacy of information relevant to one's decision), along with
two interest conditions (that dying enables one to avoid future harms,
and that dying accords with one's most fundamental interests and
commitments) (Pabst Battin 1996, 115).



For the most part, suicidal individuals do not manifest signs of
*systemic* irrationality, much less the signs of legally
definable insanity, (Radden 1982) and engage in suicidal conduct
voluntarily. However, these facts are consistent with the choice to
engage in suicidal behavior being irrational, and serious questions
can be raised about just how often the conditions for rational suicide
are met in actual cases of self-inflicted death. Indeed, the
possibility of rational suicide requires that certain assumptions
about suicidal individuals' rational autonomy be true which may
not be in many cases. A person's choice to undertake suicidal
behavior may not be a reflection of her considered interests, and so
her self-inflicted death would be an act that she would, in calmer and
clearer moments, recoil at. For instance, only some suicidal persons
engage in extensive planning for their own deaths. In many instances,
the final determination to end one's life is instead impulsive,
reflecting suicidal persons' proclivity toward volatility and
agitation (Cholbi 2002, Joiner 2010, 70-84). And although
repeated suicide attempts by the same individual are common, the
impulse to suicidal behavior is often transient and dissipates of its
own accord (Blauner 2003). Suicidal persons can also have difficulty
appreciating the finality of their deaths, believing that (assuming
there is no afterlife) they will somehow continue to be subjects of
conscious experience after they die. They may occasionally exhibit
romanticized and grandiose beliefs about the likely effects of their
deaths (delusions of martyrdom, revenge, etc.) Furthermore, suicidal
persons are often hesitant about their own actions, hoping that others
will intervene and signaling to others the hope that they will
intervene (Shneidman 1985). Considerations such as these seem to imply
that the choice to engage in suicide is often not rational in that it
does not reflect sound reasoning, an adequate grasp of one's
situation, or a clearheaded understanding of the implications of
one's suicide in relation to one's long-term
interests.



A further complication about the rationality of suicide is the evident
link between suicidal thoughts and mental illnesses such as
depression. Some studies of suicide indicate that over 90% of suicidal
persons displayed symptoms of depression before death, while others
estimate that suicide is at least 20 times more common among those
with clinical depression than in the general population. In cases of
suicide linked with depression, individuals' attitudes toward
their own death are colored by strongly negative and occasionally
distorted beliefs about their life situations (career prospects,
relationships, etc.). As Brandt (1975) observed, depression can
"primitivize one's intellectual processes," leading
to poor estimation of probabilities and an irrational focus on present
suffering rather than on possible future goods. Such findings provide
evidence that suicidal behavior is typically, though not necessarily,
irrational.



All the same, caution is in order both about the relationship between
suicidal thought and mental illness and about the relation between
mental illness and suicidal choices being rational or autonomous. The
mere fact of having a mental illness does not entail that one is
irrational or incompetent to make one's own choices. (See
 decision making capacity.) All
 the more, disagreement continues about the strength of the link
between suicide and mental illness, (Pabst Battin 1996, 5) and while
many of those who engage in suicidal behavior seem to be mentally ill,
the relationship is rather weak in the other direction: Most of those
with diagnosed mental illness such as depression do *not*
engage in suicidal behavior, implying that other factors besides
mental illness may be equally important in predicting suicide. (Joiner
2010) In addition, doubts can be raised about how the link is
understood. Some have argued that the mental health professions have
come to see some mental illness as defined by suicidal behavior, i.e.,
that it is a sign or symptom of a disorder such as depression or
schizophrenia that the individual in question is suicidal. But under
this understanding of the relationship, that mental illness is
responsible for suicidal behavior does not seem to be a testable
empirical or scientific hypothesis but a normative judgment about the
rationality of suicide. In other words, the link between suicide and
mental illness turns out to reflect a controversial normative judgment
that those contemplating ending their lives have
'disordered' minds. (Maung forthcoming)


### 3.8 Duties Toward the Suicidal



With the exception of the unqualified libertarian position that each
person has a right against others that they not interfere with her
suicidal intentions (Szasz 2002) each of the moral positions on
suicide we have addressed so far would appear to justify others
intervening in suicidal plans, at least on some occasions. Little
justification is necessary for actions that aim to prevent
another's suicide but are non-coercive. Pleading with a suicidal
individual, trying to convince her of the value of continued life,
recommending counseling, etc. are morally unproblematic, since they do
not interfere with the individual's conduct or plans except by
engaging her rational capacities (Cosculluela 1994, 35; Cholbi 2002,
252). The more challenging moral question is whether more coercive
measures such as physical restraint, medication, deception, or
institutionalization are ever justified to prevent suicide and when.
In short, the question of suicide intervention is a question of how to
justify paternalistic interference (Kleinig 1983, 96-104).



As mentioned in
 section 3.6,
 the impulse toward suicide is often sporadic, ambivalent, and
influenced by mental illnesses such as depression, all indicators that
suicide may be undertaken on irrational grounds. And while individuals
usually have the right to make bad or irrational decisions on their
own behalf, these indicators, when juxtaposed with the stakes of the
decision to end one's life (that death is irreversible, that
continued life is a condition of all other goods, etc.), justify
intervention in others' suicidal plans on the 'soft'
paternalist grounds that suicide is not in the individual's
interests as they would rationally conceive those interests. We might
call this the 'no regrets' or 'err on the side of
life' approach to suicide intervention (Martin 1980; Pabst
Battin 1996, 141; Cholbi 2002). Since most situations in which another
person intends to kill herself will be ones where we are unsure of
whether she is rationally choosing to die, it may well be justifiable
to temporarily prevent "an informed person who is in control of
himself from committing suicide" than to do "nothing
while, say, a confused person kills himself, especially since, in all
likelihood, the would-be suicide could make another attempt if this
one were prevented and since the suicidal option is irreversible if
successful" (Cosculluela 1994, 40). Further psychiatric or
medical examinations may settle the matter regarding the rationality
of the suicidal individual's decision. The coerciveness of the
measures used should be proportional to the apparent seriousness of
the suicidal person's intention to die (Cholbi 2011,
122-129).



Inquiry into the ethics of suicide prevention should also take stock
of variations in when preventive actions occur and how carefully
targeted they are. Some preventive actions, such as the short-term
institutionalization of suicidal persons, are undertaken in clinical
or criminal justice settings, whereas other preventive actions (such
as calls to suicide hotlines) occur at greater distance from the
suicidal individual. These different settings raise different ethical
concerns about individual rights, privacy, and autonomy, as well as
concerns trust and honesty. (On ethical questions related to suicide
hotlines, see Martin 2011.) Still other preventive actions
(restricting legal access to firearms or household poisons often used
in suicide, or adding lithium to drinking water supplies to reduce the
incidence of suicidal emotions) occur at a population level, thus
raising concerns not only about their efficacy but about the risks
posed to the non-suicidal individuals' well-being and rights.
(Cholbi 2011, 135-138, Ng, Sjostrand, and Eyal, 2019)



Lastly, if there is sometimes a duty to prevent acts of suicide, is it
ever morally permissible, or even morally obligatory, to aid others in
ending their lives? (This possibility is directly related to
physician-assisted suicide and the larger question of whether the
right to suicide is a claim right.) If there are circumstances that
justify our intervening to prevent suicide undertaken irrationally or
contrary to a person's self-interest, then the same
paternalistic rationale would justify our helping to promote or enable
those suicides that are rational and in accordance with a
person's self-interest.



Critics of a duty to assist in suicide assert that the widespread
moral acceptance of aiding others in suicide invites the prospect of a
'slippery slope,' wherein assisted suicide becomes so
commonplace that individuals (particularly members of vulnerable
populations such as the aged, the disabled, or socially marginalized
populations) for whom suicide is not rational could nevertheless be
susceptible to various forms of abuse, manipulation, or undue
pressure, By giving license for others to assist in suicides, critics
allege, we may unwittingly permit them to encourage suicides not
because those suicides are in fact in the best interests of the
individual in question, but because those suicides advance the
interests of other people or of institutions.(Pabst Battin 1996,
145-157). Whether such 'slippery slope' worries are
warranted is an empirical matter, and existing studies of societies
that have legalized assisted suicide by medical personnel do not
provide unequivocal support for these worries (Cholbi 2011,
148-157).


### 3.9 Suicide, Virtue, and Life's Meaning



Sections 3.1-3.8 largely address suicide as a question of
interpersonal morality, that is, as a question about our duties to one
another (though it should be noted that Kant's opposition to
suicide was rooted in his belief that it violates duties we owe to
ourselves rather than duties we owe to others). However, suicide also
raises what might be termed ethical questions, such as whether suicide
exemplifies virtue. Bogen (1980) observes that even when we have
adequately determined that a given act of suicide is morally
permissible, questions remain about whether that act represents
"the best way to live and to end one's life." A full
account of the ethics of suicide may therefore benefit by
supplementing the language of interpersonal obligation and rights with
the language of virtues and vices: Under what conditions does an act
of suicide exhibit a vice such as cowardice, for example? (Benatar
2021: 220-221) While such questions are germane to whether
suicide is defensible all things considered, they are infrequently
addressed in the philosophical literature (though see van Zyl 2000;
Hardwig 1997 can plausibly be read as claiming that continuing to live
is sometimes selfish).



Suicide also raises other normative questions that are not obviously
moral, such as how suicide may contribute to or detract from the
meaningfulness of an individual's life. For the twentieth
century existentialists, suicide was not a choice to be made mainly by
appeal to moral considerations but by analyzing whether suicide is an
appropriate response to the absurdity or meaninglessness of the world
and of human endeavor. Albert Camus illustrated this absurdity in his
philosophical essay *The Myth of Sisyphus*. For Camus, Sisyphus
heroically does not try to escape his absurd task of endlessly and
futilely pushing a rock up a mountain, but instead perseveres and in
so doing resists the lure of suicide. An appreciation of the absurdity
of life, Camus contends, should lead us to repudiate rather than
embrace suicide. For suicide avoids the encounter between human life
and its absurdity in an indifferent universe. (DeLancey 2021)
.Jean-Paul Sartre was likewise struck by the possibility of suicide as
an assertion of authentic human will in the face of absurdity. Suicide
represents, according to Sartre, an opportunity to stake out our
understanding of our essence as individuals in a godless world.
Questions of whether a life saturated with pain or suffering can be
meaningful have also played a part in recent debates about the
justification of assisted suicide (Little 1999, Varelius 2013).


## 4. Conclusion



As the foregoing discussion indicates, suicide has been and continues
to be a rich field of philosophical investigation. Recent advances in
medical technology are responsible for the extensive philosophical
attention paid to one kind of suicide, euthanasia or
physician-assisted suicide (PAS), while more
"run-of-the-mill" suicide motivated by psychological
anguish is somewhat overlooked. This is somewhat unfortunate:
Euthanasia and physician-assisted suicide raise issues beyond those
associated with other suicides, including the allocation of health
care resources, the nature of the medical profession, the
patient-physician relationship, and the prospect that allowing
relatively benign forms of killing such as voluntary euthanasia of PAS
will lead down a "slippery slope" to more morally
worrisome killings. However, many of the same issues and concerns that
surround PAS and euthanasia also surround run-of-the mill suicide, and
many writers who address the former often disregard the vast
literature on the latter. (In addition to the entry on voluntary
euthanasia, Dworkin *et al*. 1998, Barry 2007, Pabst Battin
2003, and Cholbi 2011, 139-61, provide overviews of the moral
debates surrounding euthanasia and PAS.)



Not only is suicide worthy of philosophical investigation in its own
right, it is a source of insight for various philosophical
subdisciplines: moral psychology, ethical theory, social and political
philosophy, the metaphysics of personhood, and action theory. Suicide
is also an area where philosophical interests intersect with those of
the empirical sciences. The collective efforts of philosophers and
others continue to illuminate one of the most enigmatic of human
behaviors.