Is suicide always a selfish act?

Sylvia Plath tried all the anti-depressants and treatments and nothing worked. She made a rational choice to die
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Seven years ago, I wanted to die. Not consistently, not every moment of every day; but I was suffering from clinical depression and I knew I could not bear to feel like that any longer. The best description of how it feels to be trapped in a morbid, protracted depression can be found in a throw-away joke by the late manic depressive Spike Milligan. After hearing a woman scream in childbirth, he said: "She was howling in agony. Fortunately, it is a language I speak fluently."

Seven years ago, I wanted to die. Not consistently, not every moment of every day; but I was suffering from clinical depression and I knew I could not bear to feel like that any longer. The best description of how it feels to be trapped in a morbid, protracted depression can be found in a throw-away joke by the late manic depressive Spike Milligan. After hearing a woman scream in childbirth, he said: "She was howling in agony. Fortunately, it is a language I speak fluently."

I was lucky. I managed to find medication that stopped the agony. If I had not, I might have killed myself. It would have been a reasonable choice. Sylvia Plath and the late playwright Sarah Kane tried all the anti-depressants and treatments they could, and none of them worked. They made a rational decision to die. Individuals forced to choose between unbearable pain and death should not be condemned for choosing death; it can be the kindest thing to both themselves and to their families. To dismiss them as "selfish" is a failure of empathy.

Over the past week, I have noticed a small, insidious tremor of condemnation recurring in our public discourse on this subject. The British attitude towards suicide has been slowly, steadily moving in a softer, more sane direction for over a century. As recently as 1961, if you killed yourself on British soil, you were posthumously punished. Your estate was seized by the government and your relatives were stripped of their inheritance. Your family would not only be bankrupted but shunned; the churches would refuse to bury you on "consecrated ground". We were coming to a more subtle understanding of suicide, and beginning to accept that sometimes it is a decent choice.

Yet Brian Drysdale's death - the event that caused the Berkshire train crash last weekend - has given an opportunity to those who want to revive the stigma around suicide. A gaggle of bishops and Catholic pontificators like Mary Kenny have used the tragedy to expound their view that suicide is always, invariably wrong and must be condemned. I disagree. Drysdale was horribly, disgustingly wrong to take seven people with him, including two children - but if he wanted to kill himself, assuming he was not completely insane, we should respect his decision.

When it comes to allowing people to choose death, Western societies are in the middle of a painful ethical transition. We are moving from a Judaeo-Christian belief in the sanctity of life to a more nuanced understanding that quality of life can be more important. The debate about whether people should kill themselves might seem obtuse; who, after all, can stop people doing it? But it matters because any conclusions we reach about suicide inevitably affect our conclusions about assisted suicide.

The important question underlying both debates is: do you own your own life, and do you have a right to end it if you want to? If we believe you do, then it cannot reasonably be denied to people too infirm, physically incapacitated or just plain cowardly to perform the physical act. A willing doctor handing a patient the medical equivalent of hemlock - or delivering a lethal injection - is simply delivering suicide by other means. The ethical difference between me killing myself and a willing doctor helping me seems slight, and it is often exaggerated by the opponents of euthanasia.

These are particularly important questions at the moment because, as part of the Mental Capacity Bill currently before Parliament, the Government is proposing to introduce legally binding "living wills". Already in place in most European countries, this new law will give you the right to stipulate circumstances in which you would prefer death to life. The most common scenarios are if you are mentally incapacitated, or if you could only survive in extreme physical pain. This Bill is a little-noticed tipping point, a moment when we should be forced to look at our slowly evolving moralities and realise how far they have shifted. Iain Duncan Smith has condemned the Bill as "government-sanctioned suicide" and "euthanasia by the back door". These are pretty accurate descriptions. The Government should stop ducking the debate and denying the obvious euthanasia implications. They should argue back against IDS and defend your right to choose the time of your own death.

IDS, like most opponents of euthanasia, argues that all lives - no matter how unwilling or miserable - are worth preserving equally. This sounds attractive at first. Yet almost nobody, not even the Vatican, believes that the "sanctity of life" ethic (to use the philosophical label) can be consistently followed any more. Look at Anthony Bland, one of the victims of the Hillsborough disaster. He was left in a persistent vegetative state, and kept alive for four years by medical technology. He had no more self-awareness than a cabbage, and no cure was ever going to be possible. But he was undoubtedly alive; if you believe in souls, then he presumably still had one.

If you really believed in the sanctity of life at all costs - irrespective of quality of life - then you would have to argue against switching off the machines and killing him, which was finally done in 1993. Hardly anybody did. This was an admission that sometimes quality of life can be so poor that it overrides the sanctity of life and makes death preferable. Once you make this admission, we are simply haggling over how bad life can get before allowing (or helping) a person to die is justified.

This is slowly being understood by the British public, but many people feel understandably uncomfortable that the old ethic is dying away without a clear replacement. We need to craft an alternative - a legally protected right to choose the timing of your own death, if you wish to exercise it. This should not be restricted to the terminally ill, even though they are almost always the focus of this debate. While they are obviously the most sympathetic candidates for the cause - they have the most emotionally blackmailing case - the vast majority of people who want to die are suffering from no physical illnesses except life itself. If these are firmly resolved to do it and they have pursued reasonable medical treatments and found them ineffective, they should be given medical help to end their lives.

Dignitas, the voluntary euthanasia society, has helped four people with a history of severe depression travel to Switzerland to be helped to die over the past three years. This has attracted a great deal of condemnation. But, given that these patients had exhausted the medical options and were in unbearable psychological pain, I think it was a compassionate act to help them leave life in a dignified way of their own choosing.

If I had been born just a decade earlier - before the creation of SSRIs, anti-depressants that actually work - I might have chosen the same route for myself. The small minority of British people who find life too painful to endure should be given this option - and the Mental Capacity Bill is a very small, faltering step in that direction. It provides us with an opportunity to move away from the rotting carcass of Judaeo-Christian ethics and acknowledge that sometimes - just sometimes - death is the least bad option.

j.hari@independent.co.uk

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