Suicide: A Cry For Moral, Legal Or Medical Help?

Suicide is the act of intentionally causing one's own death. The risk factors are numerous and the signs associated and reasons varies. According to the World Health Organization (WHO) every year there are close to 800 000 deaths by suicide which makes suicide the 10th leading cause of death in the world.

As stated suicide is the act of intentionally causing one’s own death regardless of the method that is used, however when an act is done to intentionally take one’s own life and the outcome is not death then it is referred to as an attempt to commit suicide. Considering the previously mentioned statistics from the WHO and taking into consideration the understanding of attempt to commit suicide, one can safely deduce that there are more than 800 000 suicide attempts worldwide yearly.

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Attempts to commit suicide and suicide is of great concern worldwide as it is locally. During the COVID-19 crisis in Grenada there was a number of suicide related deaths and attempts. This has increases the intensity of questions being asked to law enforcement and other stakeholders on policies, ways and means of combating and finding solutions to this issue that affects us all and also the overall stance or view that needs to be taken towards suicide. The issue of suicide can be viewed at from different perspectives namely moral/religious, legal and health however there is a question that stands out, from which perspective should society view attempted suicide and suicide?

In most forms of Christianity, suicide is considered a sin, based mainly on the writings of influential Christian thinkers of the Middle-Ages, such as St. Augustine and St. Thomas Aquinas. In Catholic doctrine, the argument is based on the commandment 'Thou shalt not kill' (made applicable under the New Covenant by Jesus in the Gospel of Matthew), as well as the idea that life is a gift given by God which should not be spurned, and that suicide or the attempt to commit suicide is against the 'natural order' and thus interferes with God's master plan for the world. However, it is also believed that mental illness or grave fear of suffering diminishes the responsibility of the one committing suicide. Conservative Protestants (Evangelicals, Charismatics, Pentecostals, and other denominations) have often argued that suicide is self-murder, and therefore anyone who commits it is sinning and it is the same as if the person murdered another human being. An additional view concerns the act of asking for salvation and accepting Jesus Christ as personal savior, which must be done prior to death. This is an important aspect of many Protestant denominations, and the problem with suicide is that once dead the individual is unable to accept salvation. The unpardonable sin then becomes not the suicide itself, but rather the refusal of the gift of salvation. Within the Orthodox tradition suicide is viewed as a rejection of God's gift of physical life, a failure of stewardship, an act of despair, and a transgression of the sixth commandment found in Exodus 20:13 which states 'You shall not kill'. Although there is no express biblical warrant condemning or specifically prohibiting suicide, there are however scriptures which hints or scratches the surface of the issue leaving room for debate e.g. 1 Corinthians 3:17 ESV: If anyone destroys God's temple, God will destroy him. For God's temple is holy, and you are that temple; and Ecclesiastes 7:17 ESV: Be not overly wicked, neither be a fool. Why should you die before your time? The latter of the mentioned scriptures references dying but in order to create a link between the scriptures and suicides, one has to deduce such.

During Medieval times it was common place as a punishment for those who committed suicide to not have a Christian burial and in some countries the corpse of those who died by suicide was mutilated and their property taken over by the state. Currently these practices are mainly prohibited however the Orthodox Church still denies a Christian burial to those who have died by suicide. There isn’t any known penalty under Christianity for those who have committed or attempted to commit suicide although under Roman Catholicism there is the concept of excommunication.

Under Judaism the focus is placed on the importance of valuing this life, and as such, suicide is tantamount to denying God's goodness in the world. Despite this, under extreme circumstances when there has seemed no choice but to either be killed or forced to betray their religion, Jews have committed individual suicide (Samson, the woman with seven sons) and as a grim reminder there is even a prayer in the Jewish liturgy for 'when the knife is at the throat', for those dying 'to sanctify God's Name' but this may be mainly linked to martyrdom. These acts have received mixed responses by Jewish authorities, regarded by some as examples of heroic martyrdom, while others state that it was wrong for them to take their own lives in anticipation of martyrdom.

Islamic religious views are against suicide. The Quran forbids it by stating 'And do not kill yourselves, surely God is most Merciful to you. “Qur’an, Sura 4 (An-Nisa), ayat 29. The hadiths also state individual suicide to be unlawful and a sin. Narrated Abu Huraira: The Prophet said, 'He who commits suicide by throttling shall keep on throttling himself in the Hell Fire (forever) and he who commits suicide by stabbing himself shall keep on stabbing himself in the Hell-Fire.”Sahih al-Bukhari, 2:23:446. Stigma is often associated with suicide in Islamic countries.

In Hinduism, suicide is generally frowned upon and is considered equally sinful as murdering another in contemporary Hindu society. Hindu Scriptures state that one who dies by suicide will become part of the spirit world, wandering earth until the time one would have otherwise died, had one not taken one's own life. However, Hinduism accepts a man's right to end one's life through the non-violent practice of fasting to death, termed Prayopavesa; but Prayopavesa is strictly restricted to people who have no desire or ambition left, and no responsibilities remaining in this life. Jainism has a similar practice named Santhara. Sati, or self-immolation by widows, is a rare and illegal practice in Hindu society.

Generally while most religious beliefs condemns the act of suicide and the attempt to commit suicide, most do not have penalties nor do they prosecute the act of suicide or the attempt. There are consequences however associated with the act or attempt under most religious beliefs and they range from creating a stigma to being refused certain rites and rituals of the respective religious belief. It is commonly assumed that certain religious beliefs can act as a deterrent to suicide while others believe that it is devoutness to a certain faith that is decisive however the question remains would society benefit more if suicide is perceived in the religious world view?

Suicide: Morally and Rationally

When considering suicide morally and rationally one has to consider the philosophical views and arguments on the topic. Ancient philosophers generally agreed that suicide was wrong (Plato, Aristotle) and in the ancient/classical world self-killing was criminalized. During the Middle Ages came the advent of institutional Christianity and the formulation of the concept Christian prohibition. This was considered to be a natural extension of the 5th commandment made by St. Augustine. During the period of modern developments there was a shift in the general consensus held by philosophers as suicide was examined using science and psychology.

Ethics or moral philosophy is a branch of philosophy that 'involves systematizing, defending, and recommending concepts of right and wrong behavior'. The field of ethics, along with aesthetics, concerns matters of value, and thus comprises the branch of philosophy called axiology. Ethics seeks to resolve questions of human morality by defining concepts such as good and evil, right and wrong, virtue and vice, justice and crime.

In philosophy, rationalism is the epistemological view that 'regards reason as the chief source and test of knowledge' or 'any view appealing to reason as a source of knowledge or justification'. Additionally, rationalism is defined as a methodology or a theory 'in which the criterion of the truth is not sensory but intellectual and deductive'.

Firstly, as one considers suicide within the view of morals or ethics, it becomes apparent the existence of varying sub views or areas of study. Major of these are: Meta ethics, normative ethics and applied ethics.

Meta ethics focuses on the theoretical meaning and reference of moral propositions, and how their truth values (if any) can be determined. Meta ethics does not condone nor does it condemn suicide. When considering suicide under this view it basically asks the question “is it possible to know the right or wrong of suicide?” or even “do we even have any moral knowledge?” Under the same topic comes the study of non-cognitivism which is the view that when we judge something as morally right or wrong, this is neither true nor false. We may, for example, be only expressing our emotional feelings about these things.

Normative ethics focuses on the practical means of determining a moral course of action. It is the branch of ethics that investigates the set of questions that arise when considering how one ought to act, morally speaking. This means that when considering suicide normative ethics would be concerned with whether it is correct to hold such a belief (be it for or against). Under the study of normative ethics comes the theory of virtue ethics which describes the character of a moral agent as a driving force for ethical behavior. Meaning that if one considers suicide they will naturally do what is good if they know what is right. Evil or bad actions are the results of ignorance. Another theory utilitarianism posit that the morally correct action is the one that produces the best outcome for all people affected by the action. Effectively stating that if one considers suicide then they should also consider that whether it brings the best outcome for those who would be affected by it. According to utilitarianism, a good action is one that results in an increase and positive effect, and the best action is one that results in that effect for the greatest number.

Applied ethics focuses on what a person is obligated (or permitted) to do in a specific situation or a particular domain of action i.e. applying ethical theory to real-life situations. Applied ethics is used in some aspects of determining public policy, as well as by individuals facing difficult decisions. Applied ethics asks the questions “is the act of suicide immoral”, “Is condoning suicide right or wrong.” Without questions like these, there is no clear fulcrum on which to balance law, politics, and the practice of arbitration—in fact, no common assumptions of all participants—so the ability to formulate the questions are prior to rights balancing.

And it has not only been shown that people consider the character of the moral agent (i.e. a principle implied in virtue ethics), the deed of the action (i.e. a principle implied in deontology), and the consequences of the action (i.e. a principle implied in utilitarianism) when formulating moral judgments, but moreover that the effect of each of these three components depends on the value of each component.

Although there was shift in the general consensus there was still the moral question that needed answers. In moral and political philosophy there exists a theory or model that originated during the Age of Enlightenment called the social contract. It usually concerns the legitimacy of the authority of the state over the individual and it arguments typically posit that individuals have consented, either explicitly or implicitly, to surrender some of their freedoms and submit to the authority (of the ruler, or to the decision of a majority) in exchange for protection of their remaining rights or maintenance of the social order.

The philosopher Thomas Hobbes famously said that in a 'state of nature', human life would be 'solitary, poor, nasty, brutish and short'. In the absence of political order and law, everyone would have unlimited natural freedoms, including the 'right to all things' and thus the freedom to plunder, rape and murder; there would be an endless 'war of all against all'. To avoid this, free men contract with each other to establish political community (civil society) through a social contract in which they all gain security in return for subjecting themselves to an absolute sovereign, one man or an assembly of men. Though the sovereign's edicts may well be arbitrary and tyrannical, Hobbes saw absolute government as the only alternative to the terrifying anarchy of a state of nature. Hobbes asserted that humans consent to abdicate their rights in favor of the absolute authority of government (whether monarchical or parliamentary).

Obviously, answers to any one of these four questions will bear on how the other three ought to be answered. 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.

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.

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.

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. “Any person who, with intent to take his own life, commits upon himself any act dangerous to human life”, a statement formerly used in describing the criminal act of suicide under former Oklahoma law, Okla. Stat. Ann. tit. 21, § 812 (1958) (repealed 1976).

Whoever attempts to commit suicide is guilty of a misdemeanor, and whoever abets the commission of suicide by any person shall, whether or not the suicide be actually committed, be liable to imprisonment for fifteen years.

General rules for punishment

1. Where a crime is declared by this Code, or by any other statute to be a felony, and the punishment for it is not specified, a person convicted thereof shall be liable to imprisonment for four years, or to a fine of seven thousand dollars, or to both.
2. Where a crime is declared by this Code or by any other statute, to be a misdemeanor and the punishment for it is not specified, a person convicted thereof shall be liable to imprisonment for two years, or to a fine of four thousand dollars, or to both.

Every year close to 800 000 people take their own life and there are many more people who attempt suicide. Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind. Suicide occurs throughout the lifespan and was the second leading cause of death among 15-29 year-olds globally in 2016.

Suicide does not just occur in high-income countries, but is a global phenomenon in all regions of the world. In fact, over 79% of global suicides occurred in low- and middle-income countries in 2016. Suicide is a serious public health problem; however, suicides are preventable with timely, evidence-based and often low-cost interventions. For national responses to be effective, a comprehensive multisectoral suicide prevention strategy is needed.

Mental illness, also called mental health disorders, refers to a wide range of mental health conditions — disorders that affect your mood, thinking and behavior. Examples of mental illness include depression, anxiety disorders, schizophrenia, eating disorders and addictive behaviors. Many people have mental health concerns from time to time. But a mental health concern becomes a mental illness when ongoing signs and symptoms cause frequent stress and affect your ability to function.

A mental illness can make you miserable and can cause problems in your daily life, such as at school or work or in relationships. In most cases, symptoms can be managed with a combination of medications and talk therapy (psychotherapy).

Suicide directly involving only the deceased person is not by itself a criminal offence under Scots Law and has not been in recent history. However, attempting suicide might be a Breach of the peace if it is not done as a private act; this is routinely reported in the case of persons threatening suicide in areas frequented by the public. The Suicide Act 1961 applies only to England and Wales but under Scots Law a person who assists a suicide might be charged with murder, culpable homicide, or no offence depending upon the facts of each case. Despite not being a criminal offence, consequential liability upon the person attempting suicide (or if successful, his/her estate) might arise under civil law where it parallels the civil liabilities recognised in the (English Law) Reeves case mentioned above.