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Tuesday, April 2, 2013

Suicide [L. sui, of ones self + cida, to cut or kill]

While recently grieving the loss of a highly respected professional friend and colleague who committed suicide, I recalled something I had written for our denomination's paper, the Gospel Herald, in 1991, after the self-inflicted death of another friend. It was also in response to a highly controversial book that had just published on the subject.

Here it is, from the archives:

FINAL EXIT, FINAL ANGER                             

"O Lord, how long shall I cry for help,
and you will not listen?
Or cry to you "Violence!"
and you will not save?"
(Habakkuk 1:2 NRSV)

Runaway sales of Derek Humphry's FINAL EXIT, a "user's guide to suicide," have more than a few people worried.  My own concerns about the issues of suicide and euthanasia led me to check on the availability of the book at a local bookstore.  "Completely sold out," I was told, but I could be on a waiting list for my very own copy of this little $16.95 "nuts and bolts book about how to end your life." I decided to pass.

While the book is described as covering "various forms of self-deliverance and assisted suicide for the dying," many fear it will become a handbook for emotionally disturbed but otherwise healthy people seeking the ultimate escape. 

National statistics on suicide and euthanasia are sobering.  The line between the two may sometimes be hard to draw, although most of us see a useful distinction between the use of heroic measures to prolong life as over against simply prolonging death.  As James Wall writes in a Christian Century editorial (August 21-28, 1991), "It is important to distinguish between the comatose patient being kept alive by mechanical means and the person still able to make decisions.  When consciousness disappears permanently, a decision to die becomes the responsibility of others, who may reach the judgment that for  all practical purposes life for an individual has concluded and that therefore artificial supports need not be maintained."

But the use of medical or other means to induce a premature death is another matter.  The decision to take ones own life, Wall points out, is the ultimate result of modern individualism.   "If...  the individual is supreme, then our responsibility is only to ourselves, since there is no God who gave us life or who awaits us in death."

By far the majority of cases of suicide, even among the elderly, where suicide rates are now the highest of any age group, result from feelings of simply not being able to cope.  According to a recent study by David C.  Clark, psychologist at Rush-Presbyterian-St. Luke's Medical Center in Chicago, 65% of elderly victims whose cases he studied suffered from serious depression, a mental illness, not a financial  or medical crisis or the recent loss of a loved one, and 19% were alcoholic.  Few had received professional help.  Unfortunately, the instructions in FINAL EXIT  are as effective and final for someone who is simply depressed as for the person facing incurable cancer.
 
Or as ineffective.

One of the myths perpetuated by a book like Humphry's is that suicide can be easy, painless or even noble--a swift, sure solution.  Popular films like "Dead Poet's Society" tend to romanticize suicide or portray it as inevitable when things get too bad.  As the lyrics of the theme to M*A*S*H* suggest, "Suicide is painless..."

Fortunately most suicides are "successful" only as desperate cries for help, but they are never painless.  And whether successful or not, the emotional suffering experienced by concerned friends and family in the aftermath is incalculable.

The pain which suicide (or an attempted suicide) inflicts on others may be intentional. Since a desperately depressed person has borne enormous emotional suffering, it can seem like a form of justice to have some of that hurt passed on to others.  In that sense, suicide is often an act of anger, even an alternative to murder (Since I cannot destroy those who have hurt me, I will destroy myself).  In any case, suicide is an act of violence, as much as homicide or genocide.

Lionel Tiger, author of OPTIMISM: THE BIOLOGY OF HOPE, writes, "Suicide is a violent challenge to our general complacency about the extraordinary value of life.  To be sure, suicide is not only violent against the community but also against the survivors." Even Humphry is concerned about proper etiquette in this regard, suggesting that those who feel compelled to use a hotel room should leave a note "apologizing for the shock and inconvenience"--along with a big tip.

The physical risks and consequences for individuals who attempt suicide are also seldom given the attention they deserve. Gayle Rosellina and Mark Worden in their book on depression, HERE COMES THE SUN, graphically describe suicide as leaving "a legacy of a broken, battered, blood-and excrement-soaked body drowning in vomit, clinging to life in spite of all the good intentions about a sensitized and uncomplicated self-deliverance."

The authors go on to give examples of how ineffective and potentially devastating most of the commonly tried methods of suicide are.  As an example, they cite a pharmacologist who describes aspirin as "one of the messiest, most complicated overdoses you ever hope to see." Other studies show that people who jump from high buildings or bridges may fall a hundred feet or more and still manage to survive, while of course suffering terrible injury and/or paralysis in the process.

Suicide needs to be de-mythologized.  Like any form of death, it is hard to look in the eye; we prefer to cloak tragedy in euphemisms.  However, if we want to fully describe the reality of suicide, we must recognize it as an expression of rage as well as despair, an expression of violence as well as a cry of hopelessness.  Facing the issue honestly may help prevent what someone has called "a permanent solution to what is often a temporary problem."

Thus as a church committed to peace, we must condemn suicide in the same way we do other forms of violence.  But even more importantly, we need to show  compassion for those who experience the despair that leads to it.  This means placing a high value on human life, but making the message of grace an equally high priority.  We recognize that at the point of carrying out the suicidal act, individuals may no longer have any rational control over their actions,  as David Halley writes in a recent article in The Journal of Religious Ethics, "A theist might judge almost all cases of self-inflicted death to be wrong and yet think that emotional distress, ignorance or other mitigating factors make blame very rarely appropriate." But Halley adds, "To think of life as a gift is to be predisposed to look for its good qualities and ways of gratefully using it.  When we conceive of something as a gift, we do not typically think of how we can be rid of it."

Followers of Jesus clearly affirm life.  We are called to enhance the quality of life for everyone, and to work in whatever ways possible to prevent the needless tragedy of self-inflicted homicide.  Individuals who are seriously depressed need professional and congregational help.  Dying and suffering people need the same kind of intense support and care.  It is the feeling of being isolated in pain, of being in denial of ones pain, of going it alone, that makes the depressed person's continued existence seem unbearable.

All of us can help.  According, to the Los Angeles Suicide Prevention Center, the more acute and severe the suicidal crisis is, the less one needs to be trained professionally to help manage it effectively.  Among the steps we can take are:

1) Encourage the suicidal person to continue talking as long as necessary while giving as much emotional support as possible.
 2) Insist on taking suicide threats (or attempts) seriously, not allowing them to be minimized or kept  secret.
 3) Stay with the person until a clear commitment is made not carry out the threat and to get needed help. 
4) Follow up to make sure the distressed person makes contact with others who are able to give further help--friends, family members, pastors, counselors, etc.  If they refuse, make such contacts yourself.

Suicide doesn't have to be accepted.  It doesn't have to  happen.  Together we can help individuals in distress begin making changes in their lives rather than destroying them.

"My God, my God, why have you forsaken me?
Why are you so far from helping me, from the words of my groaning?

Yet it was you who took me from the womb;
...on you I was cast from my birth...

To (God), indeed, shall those who sleep in the earth bow down;
and I shall live for him."
(Psalm 22:1, 10,  29 NRSV)
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