FATAL FREEDOM

Szasz (Emeritus, Psychiatry/SUNY Syracuse; The Meaning of Mind, 1996, etc.) has produced an intelligent critique of the cultural misunderstanding of suicide without providing a positive description that might give readers a reason to let suicidal loved ones alone. Contemporary Western culture, Szasz contends, has stigmatized suicide in ways that surely are not historically universal, and may not be instinctive. The sense that suicide is wrong is a religious-philosophical position articulated by Plato and adopted by the Christian Church. Saint Augustine formulated what is known as the —double effect— theory of sin: When an act has one beneficial and one malicious consequence, only the intent of the actor is liable to ethical judgment. This theory, in Szasz’s view, laid the foundation for later Western ethics to characterize the act of suicide as symptomatic of something else—most often, insanity. Anyone who commits suicide is divided into the component who receives the lethal wound and the (insane) component who inflicts it. This confusion of moral agency, moral consequence, and the nature of the self leads to a dozen legal and ethical contradictions, and Szasz is particularly persuasive in hacking through the thicket of medical ethics in —right-to-die— circumstances. How can it enhance patients— rights, he asks, to have death induced by a doctor alone, when a genuine right would leave access to suicide unrestricted? Szasz waxes impatient with our refusal to acknowledge the integrity of suicide, and recommends the ’suicidal— be left alone. Although he admits some suicides may be symptoms of something else, he offers no way to distinguish the acid tripper flying off a rooftop from the philosopher who contemplatively decides to end her life. Szasz cogently argues that we are wrong to call all suicides —victims— of something else. But until we can tell the reasonable self-extinction from the ghastly mistake, we—ll probably continue to err on the side of caution.