Part 3 - Ethics, morals & perceptions attributed to death by suicide, by Robert Glenton

Can suicide ever be deemed as morally, culturally, or ethically, right? There has always been people who take their own life, for reasons that matter to them. Is it really suicide if a person with an eating disorder dies due to lack of nutrition? Are there times when religious or cultural beliefs sanctify taking your own life.

Seppuku also known as Hara Kiri is the ritual of ending your own life by disembowelment. Seppuku is the honourable method of taking one's own life practised by men of the samurai class in feudal Japan. The word hara-kiri translates roughly as, "belly-cutting". This term is widely known to foreigners, but is rarely used by Japanese, who prefer the term seppuku, written in Japanese with the same two Chinese characters but in reverse order. Japan, whilst being connected with meditative and ritualistic practices, still has a very significant issue with death by suicide. Nowhere is this more prevalent than in Aokigahara Forest at the foot of Mount Fuiji, where it is estimated 100 people die by suicide each year. The methods may have changed, but pressures around honour remain.

Suicide Bombers and other forms of self-destruction that are employed as military, guerrilla, or terrorist tactics, are often seen as an honourable death which will be rewarded in the afterlife and/or bestow blessings on their families. There is a long history of this form of self-destruction that can be seen in recent history with Kamikaze attacks in the World War Two, through to al-Qaeda, and suicide bombings in the conflicts in Israel, Palestine, Iraq, and elsewhere.

Suicide for political reasons stretches back through history, right up to modern times. Some see this as an appropriate sacrifice to raise awareness of their cause. Examples range from hunger strikes by political prisoners to self-immolation (setting oneself on fire).

Martyrdom or dying by suicide in the name of religion. There have always been people who ended their own life in the name of religion. Often the stories of their deaths are immortalised in songs and stories.

Something that often blurs the boundaries of people's thoughts around death by suicide is a person's death as a result an eating disorder. The individual may be fully aware of the consequences of their actions and whilst they may not want to die, they feel compelled to continue. Many people view this cause of death in a less judgemental and sympathetic manner. The person was "ill and could not help themselves"

In Western cultures suicide has come to be seen by the public, health professionals, and government policy makers as primarily a matter of mental illness, social stressors, and the result of depression or other, often treatable, diseases—'a tragedy to be prevented'. The discussion about suicide in contemporary Western culture has concerned whether access to psychotherapy, improved suicide-prevention programs, or more effective antidepressant medications are the best lines of discourse. The exception to these discussions about suicide are those debates about euthanasia; - "assisted dying".

Assisted dying or euthanasia, can be explained as a medical professional ending the person's life, usually by injection or tablet. Assisted dying is fast becoming a dark form of big business, from "Death Tourism" where people travel to another country to end their life, through to companies vying for people to end for people to purchase their deaths from their company. Which company offers the least painful way to go, from injections to tablets to small gas chambers, the choice of methods is increasing and so are the financial implications to those who are ending their own life.

If a person has a life-limiting illness or significant health issue, can they choose to end their life in a supported and dignified manner? With this, there are questions of who deems the person to have the capacity to decide their death. For me this was brought into question when a 29-year-old Dutch person was allowed to end her life due to having "a lot of mental health issues. I suffer unbearably and hopelessly. Every breath I take is torture". (BBC News 2018). In the Netherlands it is allowed if a doctor is satisfied a patient's suffering is "unbearable with no prospect of improvement" and if there is "no reasonable alternative in the patient's situation". (BBC News 2018). Was her death wish a direct result of her psychiatric illness or a product of the trauma she experienced? If the death wish is caused by her psychiatric illness, does she have full capacity to decide her own fate? Evidence suggests many people with complex mental health needs experience prolonged periods of feeling suicidal, however, these feelings do fluctuate over time and with appropriate treatment the quality of the person's life can improve. For me, this felt like the doctors had washed their hands of trying to help her and given up. As such, does this set a precedence for ending treatment for people with complex mental health needs? Does this mean that when I am very low, as I have my own distinct mental health needs doctors would be willing to euthanise me, instead offering treatment and support that matches my need?

My friend's death by suicide did not fulfil the criteria of an honourable death by suicide, however, she had ongoing mental health needs. Does that make her death any less important, or evoke greater understanding? In my opinion, every death is important and relevant. Everyone's life touches people both in good and bad ways. Whilst we live in a society that measures success in materialistic wealth and power, in death, I believe the measure of our life is in the hearts and thoughts of those people we love. I am not saying that in death we should whitewash the dead person's life, but that we should celebrate the whole person, recognising the good and the bad. My friend certainly had difficulties where she would say hurtful things, but these were more of a reflection of her pain rather than out of a desire to hurt anyone. To me she brought hope and kindness and something I will try to hold on to.

In the fourth instalment of my blog, I will discuss the "personal impact on me, of being bereaved by suicide".

USEFUL ORGANISATIONS

AMPARO

Support for those affected by someone's death by suicide

Referral Line Call: 0330 088 9255

https://amparo.org.uk

CALM

Helpline: 0800 585 858 (national) Every day 17.00 – midnight

thecalmzone.net

PAPYRUS

Prevention of young suicide

Call: 0800 068 4141 Open 24 hours every day

Text: 88247

Papyrus UK Suicide Prevention | Prevention of Young Suicide (papyrus-uk.org)

SAMARITANS

Call: 116 123 Open 24 hours every day

Samaritans | Every life lost to suicide is a tragedy | Here to listen

SHOUT

Text: 85258 Open 24 hours every day

Shout: the UK's free, confidential and 24/7 mental health text service for crisis support | Shout 85258 (giveusashout.org)

STAY ALIVE

App based Plans to help keep safe

StayAlive - Essential suicide prevention for everyday life