Suicide

Like, the concept of "euthanasia," the concept of "suicide" carries with it a lot of ambiguity and social baggage. The word "suicide" is used (both legally and morally) to signify the "act of killing oneself," as distinct from being "euthanized by others." On the surface, suicide appears to be a purely self-regarding act, protected by the liberty principle. However, historically, other moral principles such as utility, beneficence, non-maleficence, and justice have been invoked. Libertarians such as J.S. Mill have argued, that rational competent adults "own their bodies" and therefore have the right to end their lives without interference from others. However, there is often disagreement over whether any given person is rational/competent and/or whether any given decision by a seemingly rational/competent person is, in fact, rational/competent. Some philosophers have sought to identify the various context whereby a rational/competent adult might justifiably kill themselves for either self-regarding and/or other-regarding reasons. 

Most egoistic utilitarians agree that the "good life" is marked by a positive ratio of pleasure over pain. Therefore, a rational/competent adult whose life consists of an intractable imbalance of excruciating pain over pleasure, has a right to kill himself. Two self-regarding problems emerge: At what point does extreme pain become objectively excruciating?" And, in light of modern medicine, at what point does temporarily intractable become permanently intractable? Pain and suffering is, obviously, subject to greater and lesser degrees of magnitude; and some individuals adapt to pain and suffering better than others. For better or worse, we also distinguish between "physical" and "psychological" pain. Both are invoked in the context of the justification of self-regarding suicide and/or suicide prevention.

Philosophers disagree over the justification of suicide. Kantians, argue that suicide is an abuse of freedom, and that we have a negative duty to refrain from killing ourselves, regardless of the presence of overwhelmingly negative pain-pleasure ratios.
Most libertarians, in the J.S. Mill tradition  agree that young children are neither rational nor competent, however they also acknowledge that cultures disagree as to when children become rational and competent varies... anywhere from 14 to 21 years. In the US, legal adulthood is contextual (and occasionally comicalL), with laws dictating at what point should children be allowed to drink, smoke, drive automobiles, vote, refuse medical treatment, or commit suicide? Unfortunately, many children commit suicide every year over minor, temporary psychological harms such as breaking up with boyfriends/girlfriends or bullying in school. Many young gays, lesbians, and transsexuals are also vulnerable.  While we all agree that we have individual and collective duties to prevent teenage suicides, disagree over exactly who is responsible for intervening and how to intervene.  Do teenage suicides signal parental and/or institutional neglect of that duty to prevent suicides? How much time, energy, and resources must beneficent parents expend paying for psychologists, psychiatrists, anti-psychotic drugs, and/or institutionalization of suicidal children? Should local, state, and/or federal governments contribute? If so, how much?

Age alone is does not, necessarily, signify rationality or competence; as many adults lack rationality due to the presence of short-term and long-term diseases that affect the human brain. Thus, many adults are over 21, but irrational and/or incompetent to perform various acts. In general I am a rational competent adult, but I am an incompetent airplane pilot.

The intractability of excruciating pain is relative to time and place. Since the early 20th century, opiates (and other drugs) have been successfully used to minimize pain and suffering. In China, Japan, and India other techniques have been developed to help those suffering from chronic pain learn to adapt to a  life of pain. Today, many people commit suicide without trying a variety of pain relieving drugs, or ancient techniques such as yoga, transcendental meditation, or the various marshal arts. Thus, the question emerges: What do we do as beneficent individuals and/or as societies to prevent irrational/incompetent adults from needlessly killing themselves?

Not all rational/competent suicides are for self-regarding reasons. Other-regarding reasons for suicide include the desire to spare family, friends, and or society the emotional and/or financial harms that result from remaining alive. From both self-regarding and other-regarding perspectives, there are better and worse ways to kill oneself. Shooting oneself in the head, is very efficient and painless self-regarding way to kill oneself, but it leaves behind a mess that others have to see and/or clean up. Some of us attempt to kill ourselves via automobile wrecks, but inadvertently kill or injure others in the process. Others attempt suicide via drug overdoses, without knowing how many to take, and end up surviving the overdose, and having to live with drug induced disabilities, including persistent vegetative state. Sometimes surviving a suicide attempt ultimately subjects individuals, families, friends and society to even greater costs.

To the extent that at least some suicides are rational and competent, the ultimate  question is whether the rest of us have either a positive right or a positive duty to assist or prevent others in committing suicide? If so, how much assistance is justifiable? At what point does suicide-assistance become euthanasia? Based on beneficence, do we have a paternalistic duty prevent all or some self-regarding and/or other-regarding suicides? At what point does paternalistic suicide prevention by family, friends, and or government undermine personal liberty?