Wednesday, 8 January 2014

Suicide. Are there sound, valid reasons for it? Can mental suffering be enough to justify ending one's life? For me it seems obvious: of course there are.

Is there a level of suffering where ending one's life become a rational, viable option? If we are talking about physical pain and discomfort and a diminished quality of life in which there is no evidence for potential improvement, or even evidence of further decline, then most people would say yes, in that case, ending one's life would only be a reasonable and rational option to explore. Cases resembling this sort of scenario could involve a person with a terminal illness with a bleak prognosis and the expectation of an extremely painful and undignified demise, or an ex-sportsman so severely injured in an accident that his only method of communication is through blinking, thereby losing all his livelihood and career prospects, ability to communicate effectively, engage socially, pursue aspirations, be healthy, has lost all quality of life etc. In such situations, the case for suicide, or even assisted suicide, can be made without too much objection.
There are still going to be controversial instances of assisted suicide and there will always be a fine line between what is treatable or curable, and what is not.
But surely the question should not be 'is this person's condition treatable?' but rather 'is this person suffering to a greater extent than they agree to take on? Is this person prepared to continue suffering to this extent for the potential gains that may come of it?'

My point is that it is irrelevant to point to the good that may come after the suffering a person endures, how 'good' those things may be, or how likely it may be that the person will experience good things after their suffering, the experience of suffering and the foreknowledge of suffering to come is all that is relevant, and all that should be relevant, to any person empathetic to the possible suffering of other human beings and to the conscious experience of undesirable pain.

This is why I firmly believe that a person's mental suffering and torment should, in principle, although difficult (but not implausible) in practice, be reasonable grounds for ending one's life, assisted or not.
Advances in the field of neuroscience tell us that pain, both physical and emotional, occur in the brain. You may think that your toe hurts when you stub it, but in reality there is no pain located physically in your foot, it is happening in your brain and you are being tricked into feeling that the pain is located in the same region where the incident occurred on the body. We know this to be true because the anaesthetics in hospitals do nothing to alter the skin or nerve endings around the incision of the surgeons blade, but instead make changes in the manifestation of the experience we label 'pain' occurring in the brain. Everything we experience is realised in the brain as an organ, we are simply tricked into believing that our toe literally 'feels' the pain of being stubbed. With appropriately advanced technology, one could link up an artificial limb to the nervous system and one would really 'feel' the same pain when the artificial toe is stubbed.
In this sense, there doesn't seem to be a clear difference between physical pain and emotional or mental pain, except that only the former is virtually mapped onto our body to trick us into assuming locations for the pain. Mental suffering occurs and is actualised in the brain, in a way much less tangible to us. We cannot pinpoint it's experienced location on the body, except to sometimes complain of the onset of a headache due to emotional or mental stress that day. There is no readily available medicine we can take that works in a similar way, the best we have are antidepressants and mood stabilisers that work over long periods of time to reduce undesired extremes in emotional suffering, but does nothing to cure the source of the problem, often it barely makes substantial difference in isolation.

Therefore, it follows that mental suffering should be regarded as no less pertinent or 'real' than physical pain. Both are located in the brain, and both should be taken seriously as valid and sound reasons for ending one's life.
I will now present what I see to be a fair analogy to the relationship between a person and his experience of suffering, and the link between that and reasonable suicidal desires.
Imagine being in a stereotypical torture chamber. There are all variety of despicable machines and devices around you, some of greater hideousness and callousness than others, but all inflict physical pain of some sort, to some extent.
You are trapped in a machine that inflicts an amount of pain that causes you to scream out every so often, and makes you wince as it slowly grinds and turns. It inflicts pain that illicits a bodily response, but not so much that you cry out in agony. Imagine any device or implement of torture to fit the bill as you wish.
You have been in this contraption for 5 minutes. The operator of this device says to you, 'You have a choice. Continue enduring this pain for the remainder of the hour, at which point all torture will immediately cease and you will receive a prize of 1 million pounds, or, stop proceedings now and walk away.'
It's a tempting offer. It hurts, but you know exactly when the pain will end, and you know how much it hurts as you have experienced it for 5 minutes.
You look around and realise that there are multiple people in the room, each entrapped in a contraption of their own, each being made the same offer, with the same cash prize. The only difference between each person is the machine with which they are being tortured. Each machine is different in construct, and each is better or worse than the other. Some only make the person entrapped squeak a little every so often, others have them screaming in agony, begging for an end to their living hell. Each is asked the same question after 5 minutes, whether to end or to endure the pain. Some withstand it and soldier on, some opt out and leave.
In this situation, the thing that matters most is not whether you should continue or fold, but whether it is your choice to do so.
The issue of whether you choose to endure the pain, knowing the prize at the end and knowing the experience of how much it hurts, is totally yours to make, but what if the rules changed and suddenly you were forced to continue with the process? This is equivalent to being preventing a person from committing suicide, or not allowing someone to have the assisted suicide they desire. Of course there will be those saying 'but it can get better for those with things like depression' but that isn't the point.
It could be argued whether it will get better, and by what means you attest to know this, but even if we just assume that the person will recover, why should this be a reason for them not to end the suffering they experience now? How is this different to your torture operator saying, 'but why would you want to end it now, when you'll win a million?' Because the pain you will have to endure is so much that you do not care for any prize at the end, even being better off than when you started, because it is the experience of suffering which you wish to cease. Even if he increased the prize to 2 million, or 10, or 100 million every year for the rest of your life, there is a level of suffering, in principle, to which you would wish to end no matter what the gains come its conclusion. It could be that there are possible gains that are worth a certain level of suffering, but that the gain is too small relative to the suffering you would have to endure, or it could simply be that you deem the suffering so great that no potential gain would be sufficient for its endurance. This would undoubtedly differ from person to person, but that would not matter, for it is the choice of the individual who has experienced and will continue to experience that level of suffering as to whether it be ended or not.

But what if they make the wrong decision, you say? Well, how would you know? No two torture devices are the same, and we cannot know the pain experienced of another. It may be that George in the corner, after 5 minutes of his machine, can stand no more and chooses to quit, while Ben chooses to endure the whole hour even though we may look at his machine and see that it is clearly more intense and wicked in its infliction of agony. We can judge that we may be able to withstand the torment of George's machine, we are free to make such a statement if we wish, but that does not mean that George should have to. George should be free to opt out, whatever the pain or the prize, because it is his body, his suffering, and his potential experiences in question.
'But there are people who have been forcefully prevented from committing suicide who have been grateful for people preventing them!'
Yes, and there are children who have been beaten who will recommend the practice as adults, so it can't always be bad, can it? There are people who have come to be conscious after years on life support, so we shouldn't switch anyone off, should we? There are babies that have been born prematurely at an age when abortion would be permitted, so we shouldn't abort at that precise number of weeks? There are people who say they choose to be straight after being gay, so it's a choice, right?
 It may be that some people are now thankful for intervention in their own attempted suicide, but there are also many people who are not thankful, and who's suffering is either prolonged or made worse because of such intervention. And we will never know about the suicides of whom are now grateful that they could take their own life, because they are dead and so cannot tell us. The only suicidal people alive are those who have either been prevented from committing suicide and are grateful, or those who still wish to end their lives and are simply 'still in the process of receiving treatment'. They will either continue such suicide attempts until they succeed, or eventually be convinced that life is worth living and will be the show-piece of 'treating' suicidal tendencies. A bit like pointing to the disproportionately low number of women raped in city centres while wearing burqas, and asserting that burqas are therefore an effective preventative measure against rape and empowers women, while ignoring the countless women forced into wearing burqas, and the oppression of women that the burqa symbolises and promotes.

 Should the possibility of people eventually being grateful for the intervention of suicide attempts, outweigh the prolonged suffering of those who wish to end their pain, or the possibility of increased suffering when suicide is prevented? If so, on what grounds? If you are to take away a persons human right to be in control of their own body and to end their own suffering if they choose to do so, then you must surely have reasonable grounds to take these sort of actions. People should be able to take their own life if they choose to do so, and if you force them to continue living - not 'help' - but force them into prolonged suffering, then you should have specific reasons relating either to that individual expressing a wish for intervention when suicide is to be attempted, or have grounds to believe that they are acting impulsively. However, if they discuss the issue with you and clearly express their desire to end their life, then to proceed to forcefully prevent the fulfilment of such a desire would be nothing less than selfish and unethical. It would show wilful disregard for the experience of suffering and a true lack of concern for the person's ultimate well-being in favour of ones own desires for that person.
The fact that there is a chance that some people may be thankful for being prevented from taking their own life, does not justify the prolonging of suffering of those who still wish to die and are forced to endure yet more suffering, nor does it justify the acts of intervention that have actually increased the suffering of individuals with suicidal desires.

To fail to recognise the validity of mental suffering as a reason for a person wishing to end their life, is to be wilfully ignorant of current scientific knowledge about the brain and the experience of suffering, and to callously ignore the desires of those most desperate to escape such suffering, and to instead be motivated by the selfish desires of the individual at the expense of another. To do this while claiming to be of benefit to the same individual is to fool oneself about what is truly of benefit to a person experiencing suffering, and to employ the tactic of 'guilt-tripping' i.e. to explain that family members would rather the person be alive and in a state of pain so as to avoid the loss of a loved one, is a grotesque act of emotionally kicking a person while he's down, where there is already barely further room to fall.

I invite those who disagree with my admittedly controversial view regarding allowing suicide for both mental reasons as well as physical, to state what their objections are and why, on any media platform they wish. I enjoy discussion and debate. As of writing I can see no flaws with my argument, but would be happy to be made aware of such flaws if they do indeed exist.