Sunday, November 23, 2014

Suicide and love: Do actions speak louder than words?

The spark for this post came from an offhand sentence in a recent student paper—and the paper wasn’t even on suicide:
“To Brittany Maynard, the cost of treatment afflicting her with a bald head, 1st degree burns, morphine-resistant pain and suffer from cognitive abilities outweighed the benefit of spending the last six months with the people she loved in the condition she is currently in."
If you do not yet know about Brittany Maynard’s publicly pre-announced suicide—her now-famous editorial “My Right to Die with Dignity at 29” came out only last month—she moved from California to Oregon for one reason and one reason only: to legally obtain a prescription of lethal drugs from an Oregon doctor.

When I Googled Brittany’s name today (November 21), the first listed link was a piece on (!) promoting a posthumous Compassion & Choices video released yesterday (November 20) which uses Brittany’s tragic circumstances to again promote its own political goals.

There are many things worth discussing about Brittany’s tragic situation and decision, the political goals of C & C, and the relations between them. But in this short post I’d like to make just one small point that relates to something unsettling I’ve noticed about what Brittany constantly stressed in her editorial and her videos: the love between her and family and friends.

I’m reluctant to even attempt making this point. But here goes:
My decision to take my own life for prudential reasons—reasons referring to the anticipated benefits and burdens of continuing to live—necessarily makes a certain kind of statement—not merely about the value of my life to me, but the value of others’ lives to me.
(This point is different than the oft-heard claim that my decision to take my life because of a condition I have—like a brain disease—necessarily expresses a certain kind of statement about the value of other people’s lives with that condition.)

One can make this point strongly, and in ways that sound harsh. But one can make it in softer ways as well.

Here’s a strong statement of the point by G. K. Chesterton over a century ago (1902):
“Grave moderns told us that we must not even say “poor fellow,” of a man who had blown his brains out, since he was an enviable person, and had only blown them out because of their exceptional excellence. Mr. William Archer even suggested that in the golden age there would be penny-in-the-slot machines, by which a man could kill himself for a penny. In all this I found myself utterly hostile to many who called themselves liberal and humane. Not only is suicide a sin, it is the sin. It is the ultimate and absolute evil, the refusal to take an interest in existence; the refusal to take the oath of loyalty to life. The man who kills a man, kills a man. The man who kills himself, kills all men; as far as he is concerned he wipes out the world. His act is worse (symbolically considered) than any rape or dynamite outrage. For it destroys all buildings: it insults all women. The thief is satisfied with diamonds; but the suicide is not: that is his crime. He cannot be bribed, even by the blazing stones of the Celestial City. The thief compliments the things he steals, if not the owner of them. But the suicide insults everything on earth by not stealing it. He defiles every flower by refusing to live for its sake. There is not a tiny creature in the cosmos at whom his death is not a sneer. When a man hangs himself on a tree, the leaves might fall off in anger and the birds fly away in fury: for each has received a personal affront. Of course there may be pathetic emotional excuses for the act. There often are for rape, and there almost always are for dynamite. But if it comes to clear ideas and the intelligent meaning of things, then there is much more rational and philosophic truth in the burial at the cross-roads and the stake driven through the body, than in Mr. Archer's suicidal automatic machines…”
Here’s a softer, narrower, more cautious statement of the point (from me):
Whether or not you think it morally wrong or a sin, my choice to end my life for prudential reasons is not only a commentary on the value I place on my life, but is also a commentary on the value I place on the potential and actual contents of my life—including the people I love.
Of course, not all suicides are equal in this way, or even made for prudential reasons in the first place: Socrates is not Saul, Romeo is not Robin Williams, and Juliet is not Judas.

But so-called ‘rational’ suicides—in particular, those in which a mentally competent adult decides to take her own life because she fears the anticipated blessings of continuing to live will be outweighed by the anticipated burdens—cannot but send a jarring message to loved ones.

The message? “My life is no longer worth living.” Translated? “You are no longer worth me living for.”

When I choose to end my life on purpose for prudential reasons, even though my words to those surrounding me may be “I love you,” my actions are, at the same time, saying, “I would rather die than spend more time with you.”

I think this interpretation of my act is correct even factoring in my fear of pain and losing control.

Brittany Maynard and those like her are sometimes treated primarily as victims—of disease, or C & C, or both. It’s human nature to pity victims and to try to comfort them, reassure them, give them what they want, and avoid causing them to feel guilt or shame.

But perhaps treating them this way risks morally infantilizing them.

Why not treat them like moral adults, and show them how their actions speak like words?


  1. Hi Russell, Good on you for taking on this important issue. I agree that choosing to end ones life in such circumstances is saying something about the value one places on the experiences of others and on one's relationships with others. I think you haven't mentioned an important aspect of considering others, though. In at least some cases when a person is in extreme pain, her loved ones may suffer because of her pain (because they love her and don't want her to suffer). Loved ones realize that they will no longer get to be with the person who is suffering. But the lived ones understand that all future time spent with the one who is suffering will be bittersweet at best. Part of really loving someone is feeling their pain like it is ones own, lest it be a shallow fairweather kind of love. If the relations between these parties are truly loving relations, then everyone will be aware of how the negativity of the suffering is spread in a way that multiplies rather than divides. I don't want to be understood as suggesting that we should never live or never support our loved ones in their time of need. In hopeless situations where extreme suffering is the norm and all prognoses point to more suffering and death, love of others need not be a reason to stay your own hand.

  2. Dan, I agree that when I am about to undergo suffering prior to death, the ones who love me and surround me will likely suffer along with me. (They won't get pleasure from watching me suffer. They won't think, 'at last, Russell is getting some of the suffering he deserves; this should be fun to watch.' Hopefully.) In fact, Brittany Maynard consistently refers to this suffering of her loved ones as part of her explanation for the calculations (if you can call them that--perhaps 'thinking' is a more neutral term for it) she engaged in prior to her death. One of the things I find troubling, though, is that the recognition of this fact is given the particular sort of weight it is. Yes, suffering is multiplied by staying alive. But isn't that just part of the package of loving someone? Part of me wants to say, 'that's precisely where love shows its true colors, when both lovers engage on continuing on together, even though they know that their individual sufferings will increase, and even though they know that the sum total of their individual sufferings will increase.' While there's a danger of having a kind of morbid fascination with suffering that I certainly want to avoid, there's also a danger (at least I see it as a danger) of having a view of suffering that says 'unless this suffering will lead to some other kind of experiential good for the sufferers, or for someone else, then the suffering is pointless.'

  3. Russell, thanks, for this provocative piece: you definitely know how to dance on this stage.

    I really think you are making an important point, viz., that the gift of life and experience, even in what we think of as absolutely dreadful conditions, is too easily undervalued. I know that this is not your fundamental point, but I choose to attribute it to you anyway.

    But I think your admirable concern for the people left behind may be generalizing from a prototypical case of suicide in which the person who takes his or her own life does it out of some implicit or explicit disappointment with the people closest to them, which of course is devastating and cruel. This was not Brittany's condition, however, and one sees no evidence that those closest to her have experienced her decision in this way. You are committing yourself to a prediction, I think, which is that most decent caring people will nevertheless experience it this way, regardless of the expressed reasons for the suicide, and I wonder what your grounds for this might be. I have had a little personal experience with this, and I have found that the people who insist on the importance of extending the life of a suffering person tend to be those who have actually cared for them least. Often they are people who have been completely removed from the situation and whose sudden strong feelings of righteousness or compassion seem evidence of moral immaturity at best.

    Dan puts the point in terms of avoiding suffering, but I think of it in more in terms of the conditions of a meaningful life. I want to be alive as long as I can be meaningfully engaged with the people I love. When that is no longer a practical possibility, then I want to take my leave, while warmly thanking everyone I'll be leaving behind. I attach a very high value to, as Brittany said, going out on my own terms- if I have a religion, it is the religion of personal freedom and responsibility (that's a Kyle call, btw) - so for me sacrificing a brief period of time where I may still be capable of a modicum of such engagement for the purpose of eliminating an extended period of time when I am not, is a reasonable compromise in the direction of satisficing the goal of a meaningful existence.

    I think the challenge for you is to clearly identify the conditions that would make you change your mind about this. Otherwise, you are reasonably subject to the criticism that you are using your considerable reasoning skills to justify a view that is simply not for sale under any circumstances. I would definitely change my mind if I saw strong evidence that the people left behind really can be reasonably predicted to be irrevocably harmed by suicides of this kind. And I am even open to evidence of a purely moral harm, e.g., that it makes us into less caring people, i.e, people less capable of entering into sustained caring, loving relationships. I just don't know of any at the moment.

  4. First, just to get it out of the way, I believe that we are just barely beginning to understand mental afflictions and illnesses (a larger social understanding and acceptance is to come a long time from now, if it does). Trying to understand them through a rigidly rational lens is to be making the same mistake as science and folk-science have been making in trying to understand the human mind. To be exposed to a suicidal situation of this sort, one will see that rationalizing does not play the ultimate role in the final choice (I will try to provide a hopefully suitable example).

    I see that there is a picture with an accompanying quote, "I am choosing to suffer less. To put myself and my family through less pain." To ask if actions do speak louder than words, we should not look at this statement as questioning the value of loved ones. This one final action is a compilation of all things said, and left unsaid, and the combination of these that were left out of public light. We should not see the action as saying one thing, and that it is saying more than any given verbal statement.

    To continue, statements to the press or statements to the masses, and trying to generalize suicide for the masses to understand (for a brief news article or video) does not get the right picture across of what is actually happening. Also, what is being said may be for the benefit of ease in understanding for the masses, and not an accurate picture of what was going on. Furthermore, it is impossible to truly understand what was going on through a collection of statements, with a complex situation such as this. It is like trying trying to understand the world through the mind of a person from a different culture. You should not look at the person, their culture, and way of understanding the world to make judgments. One must see the world through their eyes, and in this particular subjective case, that may just be impossible for some. It is hard to understand if there has been no personal experience or connection (in an intimate sense) with a case or even multiple cases. No matter how mentally competent a person may appear, the rationality is not the same between a person contemplating death and a person not.

    To address the idea of rationalizing suicide and the the epistemic value of suffering:

    I think to say that one can quantitatively weigh out the options of suicide is to trivialize the situation, and to even trivialize human life. I do not believe it to be normal that we purely quantitatively work our way through life (even certain Vulcan's are prone to this human feature). Though humans may want to work in this way, there is always an underlying qualitative feature that accompanies human thought.

    So, I do not think there was any exact point where she could have shown on a graph and say "this is the level where my family's love is outweighed." There must be some qualitative point, through the juggling thoughts, where one comes to a final acceptance (something that just 'feels' right in moving on). There is nothing more to weigh, because there was nothing to weigh, just an answer to the larger question that was always there, "does this feel like it is my time to leave." Does life no longer feel proper.

    1. Now, is there some sort of epistemic value we can give suffering? Is there good suffering and bad suffering, or is all suffering good, and how can we measure or tell which it is?

      I don't believe I need that answered to make my point final and ultimate point.

      I believe to go through trials and tribulations can be very important in a bonding experience. In fact, to suffer with one another may be constitutive of love (whatever that may be exactly), but I do not believe it is necessary and may be counter-factual up to a degree. I can imaging situations of being in war, where bonding through suffering may carry one another through hard times (and love is not needed). This may be true even in love. Though to suffer, it seems that we presume an end to the suffering. If there was no end, there would be no suffering. If the episode of suffering does not pass on its own, there must be a subjective point of suffering one can only take.

      Though it was said, this was to end the suffering, I believe actions do speak louder than words. There must have been another underlying factor in which suicide was decided (that was not only suffering). I think this may go back to the qualitative feeling of no longer needing to live. It was her acceptance of this fact. It was also the acceptance on the family's part. I believe that acceptance is more constitutive of love than suffering. They did not have much more time left in which to suffer, but they could come to accept. In this, they are able to love one another more than they would have in a time burdened by suffering.

  5. Randy (sorry, the 'Reply' button right below your post isn't quite working for me),

    I'm fine with the point you attributed to me ('viz, that the gift of life and experience, even in what we think of as absolutely dreadful conditions, is too easily undervalued.'), and even if I wasn't, this would hardly be the place to complain, since my method in this post is all about attributing things to people even when they don't explicitly say them.

    Still, I did not mean to commit to (and I hereby commit myself against) the prediction you suggest I am committing myself to ('most decent caring people will nevertheless experience it [the suicidal decision of a loved one] this way [as expressing disappointment with the survivors, as devastating and cruel], regardless of the expressed reasons for the suicide').

    I can see how the wording of my post can be interpreted as making precisely this prediction in more than one place. But each time, that's because I failed to distinguish between making a statement (sending a message, etc.) and successfully communicating that message to others.

    (Ryle somewhere talks about some verbs [like 'winning'] having a process sense ['he's currently winning the race!'] and a success sense ['he won!'], and when I said people 'send' a message I only meant it in the process sense.)

    I really do not think that all (or even most) survivors get this message. And that's probably a good thing. I hope no one will read my post as a call to help survivors wake up and smell the coffee of how they've been insulted.

    If my post has any practical upshot (besides better understanding), I hope that it will prompt potential suicide victims to think of another reason not to go through with it and to stay with us a bit longer.

    The basis for the claim that this jarring message is being sent, then, is not the experiences of survivors, and although sometimes those experiences might be consistent with the claim, I'm happy to forego that support and cut any evidential link between them. I'm happy to admit that some or all survivors do not feel that the victim of suicide was even implicitly sending such a message. The basis of the claim that this message is being sent, rather, is a certain sort of analysis of what it might mean to make a choice for prudential reasons. If someone says 'I am doing this because I prefer X to Y' it does not take a philosopher to recognize that X and Y can be accurately filled in with 'kill myself' and 'live with you.'

    Why might this messaging claim provide a reason not to take my life? Well, people will sometimes do (or refrain from doing) something, even if they do not think it will affect another person, when the doing of that thing expresses something. People sometimes want to be (or not to be) the kind of person who says something (or not), even if nobody else is listening. For example, speaking to a beloved person who has died by visiting their plot in a cemetery even though you do not think that they or anyone else can really hear you. Well, because they want to be the kind of person who says something to someone. Like 'I love you.'

  6. Michael,

    Welcome to the dance. You bring up several points that I agree with, but I'm going to focus merely on one you raise in your last paragraph: "Though it was said, this was to end the suffering, I believe actions do speak louder than words. There must have been another underlying factor in which suicide was decided (that was not only suffering)."

    While the other factor you then introduce ('the qualitative feeling of no longer needing to live') seems plausible to me, I'm not sure we have to look for another factor in the first place, and I did not want my original post to be read as though I am insisting on searching for another factor. (I'm not saying you were reading my original post that way. But just in case you were, let me distance myself from that point, and let you think it and defend it as your own, original point.)

    Rather, I'm happy to admit that 'suffering' is the reason why some people end their life. Or (to take Randy's example) 'meaninglessness' or 'lack of meaningful contribution.' I'm happy to take those self-reported explanations at face value. But I'm wanting to analyze what they mean, in comparative terms. "Suffering" (I think) may mean "my suffering was too high a price to pay for being with you."

    Also, I'm not sure I agree with your point that people's rationality concerning death cannot be approached the same way as their rationality concerning other things.

    1. Russell: (This is Cliff Anderson, late in replying as usual.) I have to say, the quote from G.K. Chesterton made me gag, particularly his remark that suicide is "the ultimate and absolute evil". I realize this was a much stronger claim than you were trying to make, but it needs some comment anyway. Like most people in a culture like ours, Chesterton reacts to suicide by blaming the victim; suicide is a personal failing. This is to completely ignore the huge number of cases where society is really to blame. Case in point: roughly the same number of Vietnam war vets (around 55,000) have killed themselves as were killed in combat. The same pattern is repeating itself with Iraq and Afghan war vets (between 12 and 22 vets, on average, kill themselves every day). Why do they do this? Lots of reasons I'm sure, but chief among them is the fact that they are thrown into battle without any plausible justification (setting aside the bogus reasons the military tries to give them) and given the horrendously destructive power of modern military weaponry, they end up killing far more civilians than (supposed) enemies. Then they come home to a country that is largely indifferent to the whole undertaking and doesn't even have the decency to pay for the war. Who wouldn't have suicidal thoughts after being treated like that? Their suicides are not a personal failing, they are a public failing.