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How Do You Want Your Death to Be? Finding Common Ground with Non-Suicides

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Each one of us will die. What do you want your death to be like?

What do you want to happen when you die? Do you want to live as long as possible? How long would be ideal? Do you want to die in a hospital, or at home? If you were dying of pancreatic cancer, would you want complete pain relief, even if it meant that you might die from a morphine overdose? Or would you want to live as long as possible, even if in pain? Would you want doctors to introduce a feeding tube? What if the feeding tube gave you severe, constant diarrhea? If you had lived with Alzheimer’s for a decade and could no longer recognize anyone and didn’t know where you were, and you came down with pneumonia, would you want to be treated for it and cured of the pneumonia? Or would you want to die naturally of pneumonia, even though it is a treatable condition? Do you want to continue living as long as you are conscious? As long as you are able to have meaningful interactions? As long as you are able to maintain your activities of daily living? As long as you can hold your grandchildren? As long as you are, technically, alive? Do you want the ability to control the manner of your death?

There is no right answer to any of the questions above. People’s wishes for their own deaths are idiosyncratic, and should be: people’s wishes for their lives, and definitions of a good life, are certainly diverse; why should the same not be true of death? The question is: once you have though about your own death and decided what you want, do you want to deny another person his “good death”? Or do you want people to be free to have lives, and deaths, as close to their ideals as possible?

Admitting that death is a natural part of life, and thinking about how we want our own deaths to be, is, I think, an important part of being a mature human being. However, some authors, like Thomas Joiner, think that irrational, visceral fear of death is not only healthy, but that it is pathological to lose this fear of death:

. . . the erosion of fear and the attendant ability to tolerate and engage in lethal self-injury may set into motion still other psychological processes that are important in suicidality; namely, the merging of death with themes of vitality and nurturance. Only when people have lost the usual fear and loathing of death do they become capable of construing it in terms related, ironically, to effectiveness and belongingness. Only those who desire death and have come not to fear it can believe that through death, their need to belong and to be effective will be met. [Why People Die By Suicide, by Thomas Joiner. Harvard University Press, 2005, p. 226.]

But it is far from clear that the “usual fear and loathing” of an inevitable, natural, well-understood process is healthy and in the interests of human flourishing. Such a fear prevents honest and productive reflection on one’s own death.

This is not to say that dislike of death, or a strong preference against death, is a problem. A strong preference against death might be an important value held by a person, based upon which the person may make rational decisions. But, except in terms of crude survival, an irrational “fear and loathing” of death is not warranted, nor should it be encouraged.

There are many obstacles to having a mature conversation, as citizens, about death. The irrational fear of death (as opposed to a love of life) is one of these obstacles. But there are other obstacles. One, I think, is the tendency for some in the anti-suicide community to emotional overreaction to any reference to suicide in the wider culture that is not both deadly serious and in accord with their beliefs.

For instance, this week, someone calling himself an “internet safety campaigner” for the British anti-suicide group PAPYRUS, is calling for the “removal” of a computer game called Billy Suicide, in which players try to prevent a character from committing suicide by maintaining his caffeine and antidepressant levels, among other things. (One can only imagine he hasn’t heard of Karoshi Suicide Salaryman, in which each level’s puzzle calls for the player to help a cute, energetic salaryman commit suicide.) Says the “internet safety campaigner” (in the Telegraph):

This game is completely irresponsible and the people who made the game should realise the damage that it can incur in the terms of somebody taking their (sic) own life

A “spokesperson for the Samaritans” agrees that culture-wide discussions of suicide should never, ever happen with any lightheartedness, based on a credulous acceptance of the poorly understood and controversial phenomenon of suicide contagion:

Suicide is not a light-hearted subject and is (sic) should always be taken seriously.

Certain types of suicide portrayal can act as a catalyst to influence the behaviour of people who are already vulnerable, particularly young people, and result in an overall increase in suicide and/ or an increase in uses of particular methods.

I think that, in the interest of greater cultural maturity on the issues of death and suicide, all conversations about death and suicide should be encouraged – even seemingly immature conversations, and conversations that take place via marginalized art forms like computer games. Good faith should be presumed, rather than malice. It is not pathological, but crucial that we lose our cultural fear of death.

An old family friend used to joke that, when he got so old as to be helpless, he wanted his sons to roll him out into the woods he’d hunted in for years, in his wheelchair, and hang strips of raw bacon over his ears so that the bears would eat him. This was his way, I think, of introducing the somewhat tabooed topic of death control – telling people that he didn’t want to die, helpless and intubated, in a hospital. I don’t think he was wrong to make such a remark.

A person who does not fear death is not a monster or mentally ill. He is free to pursue his values as he sees them – including, often, a love for life and a desire to avoid death. He may be courageous in the face of death or danger, able to realize that some things are more important than preserving his own life at any cost. He need not be a suicide; usually, he is probably not a suicide. He is not the slave of his genes. He is not a slave at all.

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Written by Sister Y

November 13, 2008 at 9:14 pm

7 Responses

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  1. “<>An old family friend used to joke that, when he got so old as to be helpless, he wanted his sons to roll him out into the woods he’d hunted in for years, in his wheelchair, and hang strips of raw bacon over his ears so that the bears would eat him.<>“This kind of joking is totally uncalled for. For one thing, the bear could get trichinosis!

    Michael Drake

    November 14, 2008 at 3:37 am

  2. < HREF="http://www.epi.alaska.gov/bulletins/docs/b2000_18.htm" REL="nofollow">Poetic justice.<>Anyway trichinosis is not a light-hearted subject and should always be taken seriously!

    Sister Y

    November 14, 2008 at 6:35 am

  3. “Poetic justice.”Well, how do you think those bears caught trichinosis in the first place? Just goes to show old folks shouldn’t venture out into the wilderness wearing raw bacon on their ears. No good can come of it.

    Michael Drake

    November 14, 2008 at 6:28 pm

  4. I’d like to see more fleshing on the question of what constitutes an “irrational” fear and loathing of death. For one who desires and embraces their life, the prospect of dying presents a singular and profoundly confounding problem, and I’m not at all sure that it is self-evidently irrational for such a person to abominate this reality, even in the most violent and visceral terms. I certainly wouldn’t characterize a walking suicide’s fear and hatred of life as irrational (though I would allow that there may be conditions that mark such a predisposition as irrational, or perhaps extra-rational). And if the promise of technology embraced and tested by edging transhumanists cannot be dismissed out of hand, a hostile stance toward death may even serve a calculable and desired end, at least to the extent that research is motivated by such hostility, as I believe it is. I suspect that many lab oncologists would scoff at the notion that their work is driven by an irrational fear and loathing of cancer. Because their hatred is pure, and grounded. Like the science that emerges, however slowly.Perhaps a relevant distinction hinges on whether one’s hatred is overly generalized? The immortalist who declares that “death is unacceptable,” seems perfectly rational insofar as he speaks for himself or for those who share his longing for life eternal. It is only when his driving sentiment assumes a more catholic reach — such that it excludes the subjective value of conflicting sentiments, including those of the suicide — that the mark of irrationality seems, arguably, apposite. This may be where Thomas Joiner is led astray.Incidentally, this post is interesting to read against the case of Susan Sontag, who, for all her seated pessimism, warred against her own death with abiding ferocity, and ultimately against all reasonable hope. Read “Swimming in a Sea of Death,” by her son, David Rieff. Was Sontag irrational? I don’t ask rhetorically.

    Chip

    November 15, 2008 at 7:56 am

  5. First, Chip, I have an irrational fear and loathing of memoirs, but one of these days you’re going to get me to actually read that damn Reiff book.I think I’m pointing in a different direction than idiosyncrasy/generality in my idea of what constitutes an irrational fear.We have values, but it can be difficult to tell what those values are – partially because we often act <>against<> our values. We may act in a way that we later regret and feel shame over – that’s a sign that there was a value that got put second to an irrational fear, I think (a la <>Huis Clos<>. Often we chalk up our bad actions to, specifically, cowardice.Given that we have some really important values, an irrational fear might be anything that prevents us from acting on them. A “hatred” of death – “death is unacceptable” – can be, I think, a genuine <>value<>. But that other thing – that animal need to survive at all costs, that can outweigh our other values – we need not dignify as a “value.” (Notice I’m using a completely subjective, or at least idiosyncratic, idea of what is rational here – an irrational fear is something that causes you to act against <>your<> values.)A person living with end-stage cancer is better off for not having this sort of “fear” of death. If her genuine value is to live as long as possible, fine – go for it. But if, on the most authentic plane, there are things more important to her that might be harmed by clinging to life, then if she has no <>animal fear<> of death, she can do what her most genuine values dictate, rather than sell out her genuine values because of cowardice.

    Sister Y

    November 15, 2008 at 7:40 pm

  6. To put it differently: Person A has a core value of <>autonomy<> and an irrational animal fear of death. Person B has a core value of <>long life<>, with an irrational fear of helplessness. Both need to overcome their fears in order to realize their highest values. When they do overcome their fears, their actions will be different from each other (Person A will opt for different medical interventions from Person B), but both will be rational.

    Sister Y

    November 15, 2008 at 8:30 pm

  7. The concept of cowardice is immensely helpful, actually. Irrationality comes after a blinding effect.On another point, I’m stuck on the passage that you cite by Joiner:<>the erosion of fear and the attendant ability to tolerate and engage in lethal self-injury may set into motion still other psychological processes that are important in suicidality; namely, the merging of death with themes of vitality and nurturance. Only when people have lost the usual fear and loathing of death do they become capable of construing it in terms related, ironically, to effectiveness and belongingness. Only those who desire death and have come not to fear it can believe that through death, their need to belong and to be effective will be met.<>This idea of construing death in terms of “vitality” — it seems like a bit of a straw man, no? Like a way of sidestepping a would-be suicide’s sincere longing for cessation and release. Does Joiner cite evidence that suicidal thinking is commonly bound with such “themes of vitality and nurturance” (other than in the obvious context of a religious belief in an afterlife)? And does he fashion an answer to currents of suicidal ideation that are not weighted by such confusion? — The undeceived view tracing to a more personal intolerance for vitality, or the mindset that seeks merely to escape suffering? I share your general distaste for memoirs. But Rieff’s book is very focused and reads like a novel. As deeply as he is affected (and tormented), he approaches the hard questions with admirable clarity and distance.

    Chip

    November 16, 2008 at 7:32 pm


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