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Should we intervene to prevent suicide?
by Graeme J. Davidson,
27 March 2010

Because someone’s suffering drives them to want to end it all doesn’t mean they’ve lost their marbles and are incapable of making a sensible decision.

Margaret Page had a brain haemorrhage 20 years ago. She has spent the last four years at Wellington’s St John of God care home and is now starving herself to death. Her pro-death choice raises an ethical dilemma. Should we allow individuals to take their own life? Or should we try to keep them alive? After all, their decision affects others, especially their loved ones.

I’ve counselled suicidal people in a similar situation to Mrs Page. Most decided to grin and bear their appalling situation rather than end their lives. They didn’t want to burden their family with feelings of sadness and guilt. Mrs Page’s family agrees with her decision, but not her former husband. Is his continued interest in her welfare 12 years after they’ve split sufficient reason for her to hang on in there? Hardly. Surely, the views of her nearest and dearest are of greater consequence.

Fifty years ago, we used to treat folk who attempted suicide as criminals. This became an incentive for them to succeed on their first attempt. Our Crimes Act still regards suicide as something we should prevent. Section 41 says, “Every one is justified in using such force as may be reasonably necessary in order to prevent the commission of suicide”.

Prisoners at risk have belts, shoelaces and any other likely means of killing themselves removed. People who suffer from some psychiatric conditions or aren’t capable of making a rational decision may also be restrained under the Mental Health Act to prevent them doing harm to others or themselves, including attempting suicide. This wouldn’t apply to Mrs Page. Psychiatrists say she is lucid and competent.

Because someone’s suffering drives them to want to end it all doesn’t mean they’ve lost their marbles and are incapable of making a sensible decision. Admittedly, they may be under enormous strain, pain or loss, or face ridicule and shame from the community. Yet we allow individuals the right to decide whether to face the surgeon’s knife when they are in agony. So why not the decision to die?

Should Margaret Page’s doctors intervene in accordance with Section 41 and force-feed her against her will? The medical profession usually ducks the issue by claiming that food and water are necessities of life, not a medical treatment. Therefore, they shouldn’t intervene.

That’s a lame excuse. Doctors constantly recommend diets; prescribe diet supplement pills and glucose, electrolytes and other life-sustaining intravenous drips. If a doctor did ignore Mrs Page’s determination to die and intervened to keep her alive, as well as justifying it under Section 41 he or she could also claim to be acting in accordance with their Hippocratic Oath to save human life.

When the British suffragettes of nearly 100 years ago went on hunger strikes in prison, they were at first force-fed to avoid their self-destruction. Despite protests from doctors all round the world, the US military has force-fed hunger-striking prisoners at Guantanamo Bay to keep them alive, and the War Crimes Tribunal in the Hague agreed to force-feeding Serbian politician Vojislav Šešelj so he could stand trial.

Nevertheless, most of us are right to recoil at the thought of forcing someone to stay alive against their will. Instead, we prefer less invasive methods such as counselling them to make an informed decision, or trying to reason and persuade them not to pull the plug on their lives. We usually tell them it really is worth sticking it out through the dark patch they are going through, as there’s light at the end of the tunnel – even if there isn’t. We emphasise how devastated we’ll be and how much they mean to us, which sometimes translates to how we don’t want to feel morally responsible for their death.

Some of us might even counsel the opposite for personal gain or because we find it difficult to be around such a depressed person.

I’ve watched a crowd in Berlin screaming “jump” – for their own macabre entertainment – to a suicidal person on a tall building. Recall those who jumped from the Twin Towers on 9/11. What’s the difference? The man in Berlin may have been convinced to change his mind; the Twin Towers suicides only had the choice of how to die. And if we were in one of those doomed towers, the last thing we would want to hear is someone bleating the mantra that it is wrong to take our own life. Or worse, some public-spirited individual forcibly trying to stop us from taking our destiny into our own hands. Margaret Page, and many like her, are in a similar situation.

In the end suicide is the taking of one’s own life, which means the decision is the individual’s. Margaret Page has thought long and hard and come to a dignified decision that deserves respect.



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