SUICIDE WILLIAM A. COX, M.D.

FORENSIC PATHOLOGIST/NEUROPATHOLOGIST November 24, 2009 On occasion the determination of suicide as a manner of death can prove to be most disturbing to the family and thus potentially give rise to adverse media representation as to the determination by the medical examiner or coroner. It may prove to be beneficial if we explore from a historical, cultural, religious and legal perspective the issue of suicide. General Information Suicide is the intentional taking of one life. Presently in western society it is considered a mental health issue in which psychological stress either due to depression, fear, a sense of hopelessness because of devastating debilitating disease such as Alzheimers, terminal cancer, etc., a sense of worthlessness, economic loss or other psychiatric disorders the person chooses to take their own life. It is estimated that over 1 million people per year commit suicide. It is one of the leading causes of death among teenagers and young adults (under age of 35). In the United States the number of deaths due to suicides is twice that of homicides, being, the 11 th leading cause of death in this country. Some statistics indicate that the annual rate of suicide in the United States is approximately 25,000. Some believe however, the actual figure is much higher in light of the fact many cases of suicide are classified as accident, with the actual number of suicides being closer to 100,000. It is believed most of these are due to depression. For every actual suicide, it is believed there are ten unsuccessful attempts. One of the problems with determining the actual number of suicides is the modification of the scene by members of the family or close friends. It is estimated when family members or close friends come upon the suicide, they will modify the scene 80% of the time Asia has the most suicides, accounting for approximately 60% worldwide. In western society males commit more suicides than females, although females attempt suicide more frequently. This is primarily a reflection of the methods employed by men vs. women. Men tend to use methods which are irreversible once placed in motion, i.e. shooting

themselves, etc. Women are more apt to use methods such as sleeping pills, cutting their wrist, etc. It is believed that over 52% of suicides in the United States are due to firearms. Asphyxiation methods, including hanging, and poisoning or drug overdose account for approximately 40% of suicides in the United States. The incidence of mental disorders in those who commit suicide ranges from 87 to 98% with mood disorders and substance abuse being most common. Mood disorders are divided into two broad categories, which represent two emotional extremes, the intense energy of mania and the despair and lethargy of depression. Mania can be mild to extreme, individual is unusually talkative, is in constant motion, moves from one thought to the next, incessantly busy, loses normal social inhibitions, formulate grandiose concepts, which have a tenuous, at best, +- pragmatic foundation, express intense irritations with any perceived frustration and sleep little. They often require medication to decrease the intensity of the mania. There are several causes including drug abuse and brain tumors, but it is most often associated with bipolar disorder, where episodes of mania alternate with episodes of major depression. It is during the periods of depression that suicide becomes a major concern. Depression is the polar opposite of mania. The person has a sense of utter despair, hopelessness, losses interest in all that surrounds them including people and a feeling of worthlessness. Both their thought process and actions slow down to a minimal level of activity. In severe cases they can experience delusions or even hallucinations. They can manifest physical symptoms in the form of loss of appetite, weakness, fatigue, poor bowel function, disturbance in sleep and little if any interest in sex. If severe, depression can prove to be lethal, for within the canopy of mental anguish the person begins to think of the peace of death through suicide. The actual greatest risk for a depressed person to commit suicide is not at their deepest or darkest moment, but rather when they are beginning to come out of their depression. Suicide rates are greatest during weekend leaves from the hospital or shortly after discharge. As indicated above mood disorders can be substance abuse based. The essential feature of Substance-Induced Mood Disorder is a prominent and persistent disturbance in mood that is due to the direct physiological effects of a substance (i.e., drugs of abuse, a

medication, other somatic treatment for depression [electroconvulsive therapy or light therapy] or toxin exposure. Substance-Induced Mood Disorders may manifest itself with depressive features, manic features or mixed features. For example, amphetamines, methamphetamines, and cocaine can induce any of these features. Steroids, L-dopa and antidepressants can induce manic-like mood disturbances. Alpha-methyldopa (an

antihypertensive agent) can induce depressive disorders. Birth-control pills can also induce depression. Alcohol abuse is associated with the development of depression, with high suicide rates. Chronic use of benzodiazepines is associated with the development of depression. Major depression can also occur as part of benzodiazepine withdrawal syndrome, which can last up to 6 to 12 months following withdrawal. As is the case with alcohol, the depression associated with benzodiazepines is believed to be the result of decreased levels of serotonin and norepinephrine. Historical Perspectives of Suicide Historically how suicide was viewed was influenced by that cultures position toward religion, honor and the meaning of life. In the pagan world of the Romans and Greeks there was a degree of ambivalence toward suicide. There were some exceptions. In ancient Athens, before a person could commit suicide they had to have approval of the state. For example Titus Livy (59 BC-17 AD), a Roman historian, recorded that the citizens of Massilia, which was a Greek colonization, were required to apply to the Senate for permission to commit suicide. If the Senate agreed with the request, the Senate would provide hemlock free of charge. Hemlock contains the piperidine alkaloids coniine, which acts like curare by blocking the neuromuscular junction, hence the person experiences an ascending muscular paralysis, which culminates in paralysis of the respiratory muscles. If such approval was not obtained, the person had to be buried on the outskirts of the city without a headstone or marker. In Rome suicide was never regarded as an offense against the state, however, they did have a pragmatic or if you will an economic view on suicide. The Roman Senate would not allow suicide in three types of cases: those accused of a capital crime, solders and slaves. The underlying reason for their objection was economic. If the accused killed

themselves prior to their trial and conviction then the state lost their right to seize their property. A soldier who committed suicide was viewed in the same fashion as if he had deserted the military. However, if the soldier was defeated in battle, suicide was

acceptable rather than being captured with possible torture or becoming a slave. If a slave killed themselves within 6 months of purchase, the owner could claim full refund from the former owner. The entire ancient world was not all ambivalent toward suicide. Pythagoras (575 BCE to 595 BCE), Greek philosopher, scientist, and religious teacher, developed a school of thought that accepted the passage of the soul into another body and established many influential mathematical and philosophical theories. Pythagoras was opposed to suicide. The foundation of his opposition was not based on morals but rather mathematical grounds. He believed there was only a finite number of souls for use in the world, and that the sudden and unplanned departure of one soul upset a delicate balance. Socrates (469 BCE to 399 BCE) was fundamentally against suicide basing his opposition on the concept .the gods are our keepers, and we men are one of their possessions. He also believed the gods are very good masters and being their possession, it would be morally wrong for an individual to take leave from their rightful and benevolent masters through an act of suicide, barring some divine necessity or compulsion. What Socrates meant by compulsion or divine necessity was the individual was morally justified in committing suicide if he had an incurable debilitating disease, an incurable debilitating disablement or if he is about to be captured by an enemy. It is interesting to note that there are some aspects to Socrates objection to suicide that are similar to the early Churchs position on suicide and some would say up to 1997 with the publication of the revised Catechism. This will be discussed later on in this article. Plato (428/427 BCE to 348/347 BCE) believed suicide was wrong for it represented a willful act in which the person was releasing his soul from his body, in which the gods have placed it as a form of punishment; hence it was a disgraceful act. However, Plato recognized four exceptions: when ones mind is morally corrupted and ones character can therefore not be salvaged, when the killing of ones self is by judicial order as in the case of Socrates, when the commission of suicide is due to extreme and unavoidable

personal misfortune and when self-killing results from shame or having participated in grossly unjust actions. Aristotle (384 BCE to 322 BCE) was also against suicide, but again his opposition was not based on moral grounds, but on pragmatic grounds in that the person who committed suicide was denying the community his services. It was not until the advent of Christianity that suicide was condemned, which occurred at the Council of Arles in 452 AD. Christian doctrine looked upon suicide, as morally wrong, although there is no passage in scripture, which unequivocally states suicide is wrong. It is interesting to note that neither the Theodosian Code nor the Justinian Code contains a single law, which confirms the Christian view of suicide. The Theodosian Code was a collection of Roman constitutions extending from Emperor Constantine (306 to 337 AD) to Theodosius II (408 to 450 AD). It was promulgated in 438 in the eastern half of the Roman Empire and in the western half in 439 AD. The Theodosian Code contains no prohibition for suicide. The Justinian Code was a revision of the Theodosian Code. Justinian I, Eastern Roman Emperor, issued it from 529 to 534 AD. The Justinian Code treated suicide with the same indifference of Roman law. Under Roman law suicide was permissible for the following specified reasons: Disgust with Life; impatience of sickness or bodily pain; grief caused by loss of relatives or loved ones; disgrace consequent of insolvency; desire of posthumous fame; fury and madness. When suicide was due to anyone of these causes, his goods were passed to his heirs. However, suicide was not legal if done without appreciable cause, as a consequence of remorse for a criminal deed, or done to escape sentence. Should suicide be committed under these circumstances his goods were confiscated by the state. What is of interest is that although the Code and Digest of Roman law were united under a Christian Emperor to form the Justinian Code, they were pagan. The lawyers charged to collate them, never modified them to conform to the Churchs position on suicide. Despite the Churchs position, suicide was not considered a sin under the Justinian Code. In 533 the Church determined that those who had committed suicide while accused of a crime were denied Christian burial, which in some respects is a reflection of an early pagan position under Roman law as sited above. In 562, the Church expanded its position on suicides, decreeing that all those who committed suicide were denied a

Christian burial. In 693, not only was a successful suicide an ecclesiastical crime but so was an attempt at suicide even though unsuccessful, which was punished by excommunication and civil consequences. It was St. Augustine (354 to 430 AD) who was the first to lay the foundation for the Churchs position that suicide was wrong basing it on the fifth commandment Thou shall not kill. St. Thomas Aquinas (1225 to 1274 AD) further refined St. Augustines position. St. Thomas believed suicide was contrary to natural self love, whose aim is to preserve us, it injures the community of which an individual is a part and it violates out duty to God because God has given us life as a gift and in taking our life we violate His right to determine the duration of our earthly existence. The intellectuals of the Renaissance period (cultural movement that spanned roughly the 14th to the 17th century) in general affirmed the Churchs position on suicide. The prominent figures of the Protestant Reformation (Martin Luther [1483 to 1546], Huldreich Zwingli [1484 to 1531], John Calvin [1509 to 1564], John Knox [1513 to 1572] and Henry VIII [1491 to 1547]), in general also condemned suicide, however, they held out the possibility of God treating suicide mercifully and permitting repentance. The first noteworthy defense of suicide was by John Donnes, Anglican priest, in Biathanatos 1608. In this publication he argues that Christian doctrine should not hold that suicide is necessarily sinful. His critique is in effect internal; drawing upon the logic of Christian thought itself to suggest that suicide is not contrary to laws of nature, of reason, or of God. Where it contrary to the law of nature mandating self-preservation, all acts of self-denial or privation would be similarly unlawful. Moreover, there may be circumstances in which reason might recommend suicide. Finally, Donne observes, not only does Biblical Scripture lack a clear condemnation of suicide, Christian doctrine has permitted other forms of killing such as martyrdom, capital punishment and killing in wartime. Donnes casuistically treatise was an early example of the liberalized Enlightenment attitudes of the 1700s. In 1755 David Hume (1711 to 1776), Scottish philosopher, published a book of essays entitled Five Dissertation. Two of these essays On Suicide and The Immortality of the Soul drew such controversy in the pre-release copies of Five Dissertations that

they were removed from the printed copies. The two essays were published in 1783, well after Humes death in 1776. In the essay On Suicide Hume assaults the Thomastic natural-law view on suicide. In contradistinction to David Hume, Immanuel Kant (1724 to 1804), a German philosopher and the last noteworthy philosopher of the modern European era, opposed suicide. Kants arguments, though partially based on natural law arguments, emanated from his view of moral value arising from the autonomous rational wills of each individual. In Kants mind, our rational wills are the foundation of our moral duty, thus it would be anathema for a rational will to destroy itself. The nineteenth and early twentieth centuries saw the evolution of three lines of thought, which ultimately shaped our viewpoint on suicides. The first was a romantic idealized script in which suicide was depicted as a consequence of a misunderstood and anguished person who has been a failure at love and considered a pariah by society. Such a perception of suicide appeared in novels written by Rousseau, Goethe, and Flaubert. The second was the evolution of the medical specialty of psychiatry, which could diagnose and treat those conditions, which formed the foundation of suicide. The last was the work of sociologists such as Durkheim and Laplace who viewed suicide as a social ill reflecting alienation, anomie and attitudinal issues of a modern society. In many

European countries the rising suicide rates were regarded as evidence of cultural decline. It was the evolution of these lines of thought which gave rise to bureaucratic and medical movements to address suicide as a consequence of social and psychological forces rather than something that is innate or predisposed (predetermined) to that person. In the latter half of the twentieth century there was a decline of traditional religion and a rise of individualism in some of the European countries, most notably the Netherlands, creating an open-mined society whose views on suicide began to diverge from the Christian view. The viewpoint in the Netherlands culture at the turn of the millennium was just as everyone has the right to live so do they have the right to die, hence there was an acceptance of the right of an individual to commit suicide. Other Cultural Views of Suicide In ancient Egypt suicide was considered an acceptable way to escape intolerable conditions.

During the Napoleonic era (1799 to 1815) in both France and Europe in general, suicide was considered an acceptable way to save ones honor and that of their family from what they regarded as a shameful circumstance such as bankruptcy. In Chinese culture, suicide has and is an accepted aspect of society. It is frequently used as a means to escape tragedy and shame. It is especially common among women, usually as the result of oppression or misfortune, such as family members looking upon them with distain. This typically occurs among poorly educated rural women. Ritual suicide, especially as a form of political protest is relatively common. As an example, during the Cultural Revolution in China (1966 to 1976), many public figures, especially intellectuals and writers committed suicide. What is of interest is that within Chinese society there are moral disciplines, such as Buddhism and Confucianism, which are against suicide, although, even within these disciplines exceptions were made. Like the Chinese, Japanese culture is relatively tolerant of suicide. As in China, suicide is looked upon as a means of maintaining honor, of avoiding shame upon their family. On the average, approximately 30,000 Japanese commit suicide every year. In 2007, 274 Japanese school children took their own lives because of pressures put on them by their parents. Indian culture, like the cultures in China and Japan, has historically had an ambivalent view toward suicide. Philosophical Aspects of Suicide As discussed, in many respects the Greeks and Romans both condemned and defended suicide. The Epicureans, who considered pleasure and peace of mind the highest human good, argued that it was better to kill oneself than endure life if it had become more painful than pleasurable or peaceful. Epicureanism is a system of philosophy based on the teachings of Epicurus (341 to 270 BCE), founded around 307 BCE. Epicurus believed the greatest good was to seek modest pleasures in order to attain a state of tranquility and freedom from fear (ataraxia) as well as absence of bodily pain (aponia) through knowledge of the workings of the world and the limits of our desires. The combination of these two states is supposed to constitute happiness in its highest form. It flourished through the Hellenistic period (death of Alexander the Great in 323 BCE to the final conquest of Greece by Rome in

146 BCE or the defeat of the last remaining successor-state of Alexanders empire, the Ptolemaic Kingdom of Egypt in 31/30 BCE) and the Roman period (146 BCE or 31/30 BCE to as early as 330 AD, and as late as 480 AD) coming to an end around the same time the Roman period concluded. The Stoics believed that virtue or self-control was the highest good, argued that it was permissible to kill oneself if suffering or torture might force one to lose self-control or act ignobly, or where a choice had to be made to perish in a shameful way or die with dignity. Stoicism was a school of Hellenistic philosophy founded in Athens by Zeno of Citium around 301 BCE. Fundamentally stoics considered destructive emotions to be errors in judgment, and a person of moral and intellectual perfection, would not undergo such emotions. They believed in the virtuosity of maintaining a will that was in accord with nature. It persisted throughout Greece and the Roman Empire until the closing of all of its philosophy schools in 529 AD by order of Emperor Justinian I, who perceived their pagan character antagonistic to his Christian faith. The Dualists, Agnostics, and Manicheans taught the soul, which is the real person, is burdened by the body in this life or in many reincarnations; thus suicide might be justified as a release from this burden. Moral dualism believes there are two moral opposites at work, or if you will, a conflict between good and evil. Some equate dualism with bitheism or ditheism. Although bitheism/ditheism implies moral dualism, they are not equivalent: bitheism/ditheism implies at least two gods, while moral dualism does not imply any god. Agnosticism had its origin in the form of skepticism in ancient Greece. Its proponents included Protagoras, Pyrroh, and Carneades. These thinkers rejected the idea that certainty was possible. Thomas Henry Huxely used the term Agnostic in 1860 to describe his philosophy, which rejects all claims of spiritual or mystical knowledge. Early Christian Church used the Greek word gnosis (knowledge) to describe Spiritual Knowledge. Agnosticism should not be confused with religious views opposing the religious movement of Gnosticism. As such, the term agnostic does not necessarily imply a particular view about religion or God.

Manichaeism was one of the major Iranian Gnostic religions, originating in Sassanid Persia, founded by the prophet Mani (216 to 276 AD). It was one of the most widespread religions in the world reaching its height between the third and seventh centuries. It extended from China to the Roman Empire. Manichaeism appears to have faded away after the 14th century in China. Manichaeism is dualistic in regards to good and evil. A keystone of Manichaeism is there is no omnipotent good power. It denies the infinite perfection of God and postulated two equal and opposite powers, good and evil. There are many philosophical arguments that contend that suicide is immoral and unethical. As an example, the philosophy of Absurdism developed by Albert Camus, felt that suicide was the rejection of freedom. He believed that fleeing from the absurdity of reality into illusions, religion or death is not the way out. Instead of fleeing the absurd meaninglessness of life, we should embrace life passionately, The absurd man will not commit suicide; he wants to live, without relinquishing any of his certainty, without a future, without hope, without illusionsand without resignation either. He stares at death with passionate attention and this fascination liberates him. He experiences the divine irresponsibility of the condemned man. Christian-inspired philosophy as represented by G.K. Chesterton calls suicide the ultimate and absolute evil, the refusal to take an interest in existence. He argues that a person, who kills himself, as far as he is concerned, destroys the entire world. John Stuart Mill represented the view point of Classical Liberalism in his essay On Liberty, that since the sine qua non of liberty is the power of the individual to make choices, any choice that one might make that would deprive one of the ability to make further choices should be prevented. Thus, for Mill, selling oneself into slavery or killing oneself should be prevented in order to avoid precluding the ability to make further choices. However, Mill also believes the

individual to be the best guardian of their interest. He uses the example of a man about to cross a broken bridge: we can forcibly stop that person and warn him of the danger, but ultimately should not prevent him from crossing the bridge. Thus, if an individual views their life as unlivable, it would appear well within their rights to end it. Immanuel Kant, considered to be the father of deontologism, argues against suicide in Fundamental Principles of the Metaphysic of Morals. Kant argues that, He who contemplates

suicide should ask himself whether his action can be consistent with the idea of humanity

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as an end in itself. He than states, You would then have to think whether you would be willing to universalize the act: to claim everyone should behave that way. Kant further argues that if a person chooses to commit suicide, that is using themselves as a means to satisfy themselves, but a person cannot be usedmerely as means, but must in all actions always be considered as an end in himself. Therefore, it is unethical to commit suicide to satisfy oneself. David Hume, whose view point on suicide I have previously discussed, believes that suicide can be compared to retiring from society and becoming a total recluse, which is not normally considered to be immoral, although the comparison would not seem to justify a suicide that leaves in its wake children or dependants who are thereby rendered vulnerable. As for duty to self, Hume takes it to be obvious that there can be times when suicide is desirable, though he also thinks it ridiculous that anyone would consider suicide unless they first considered every other option. Evolution of the Churchs position on suicide The Churchs position on suicide from early Christianity to about 1997 was founded in the concept that each of us is created in Gods image, hence we belong to God; to destroy that life is in essence a statement that that which was created in Gods image has become greater than the creator; thus, suicide was looked upon by the Church as a serious sin (mortal sin). The Catechism of the Catholic Church up to 1997 states in section 2281 Suicide contradicts the natural inclination of the human being to preserve and perpetuate life. It is gravely contrary to the just love of self. It likewise offends love of neighbor because it unjustly breaks the ties of solidarity with family, nation, and other human societies to which we continue to have obligations (which is a reflection of the pagan thought process-Aristotle was against suicide basing his position on the grounds that the person who committed suicide was denying the community his services). Suicide is contrary to love for the living God. In section 2325 Suicide is seriously contrary to justice, hope, and charity. It is forbidden by the fifth commandment (this was first raised by St. Augustine). In 1997 the revised Catechism reflected a change in the Churchs position on suicide. It indicated that the person who committed suicide may not always be fully right in their mind; and thus not one-hundred-percent morally culpable. Grave psychological

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disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide. The Catholic Church prays for those who have committed suicide, knowing that Christ shall judge the deceased fairly and justly. The Church also prays for the close relations of the deceased, that the loving and healing touch of God will comfort those torn apart by the impact of the suicide. Evolution of Protestant thought on suicide The conservative Protestants (Evangelicals, Charismatics and Pentecostals) believe suicide is analogous to self-murder and is no different than if another person murdered that person, thus it is a sin. However, the more liberal Protestants believe because Jesus Christ took the punishment for the sins of mankind, and suicide is a sin; the sin of committing suicide is covered by Christs death on the cross. Some liberal Protestants believe assisted suicide is morally acceptable. Jewish views on suicide Judaism regards the commission of suicide as a serious sin and is forbidden under Jewish law. Assisted suicide and the mere fact of requesting such assistance is also a sin and are forbidden under Jewish law. However, throughout history there have been

circumstances, albeit most would regard as extreme, that despite Jewish law, Jews have committed suicide and sometimes in mass. As an example in the southern district of Israel is a rock plateau, on the eastern edge of the Judean Desert, overlooking the Dead Sea called the Masada. Following the first Jewish-Roman War (66 to 73 AD) and the fall of Jerusalem in 70 AD, Lucius Flavius Silva, the new military governor of Judea, laid siege to Masada, the last Jewish stronghold, in the fall of 72 AD. The Romans were finally able to assail its walls in 73 AD only to fine the 967 Sicarii defenders had committed suicide rather than face Roman enslavement. In 1010 Alduin, Bishop of Limoges France, gave the Jews an ultimatum, either accept baptism or be exiled. It is said only three or four Jews accepted baptism, the others escaped to other cities in France or committed suicide. In March of 1190 a fire broke out in the City of York during which Richard de Malbis, who was in debt to a prominent Jewish banker, Aaron of Lincoln, used this opportunity to incite a mob to attack the Jews of the community. Some 150 Jews took refuge in York

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Castle to escape the mob.

On March 16, the tower caught fire; rather than give

themselves up to the mob many of the Jews chose to commit suicide. Despite the Jewish prohibition against suicide, within the Jewish liturgy is a prayer for when the knife is at the throat, for those dying to sanctify Gods Name. All of the above examples have received different reactions by Jewish authorities. Some have regarded these examples as being representative of martyrdom, while others say that it was wrong for them to take their own lives in anticipation of martyrdom. Islamic views on suicide Like the other Abrahamic religions, Islam considers suicide an offense towards God due to the underlying religious belief in the sanctity of life. Within the fourth chapter of the Quran is a verse in which An-Nisaa (The Women) instructs; And do not kill yourselves, surely God is most merciful to you. (4:29) Most Muslim scholars and clerics consider suicide to be strictly forbidden (Haraam or Haram). In Islam Haraam is used to refer to anything that is prohibited by faith. Haraam also applies to suicide bombings for it is a direct violation of the above-mentioned verse from the Quran. The prohibition against suicide also appears in the hadith, which are oral traditions relating to the words and deeds of the Islamic prophet Muhammad; He who commits suicide by throttling shall keep on throttling himself in Fire (Hell), and he who commits suicide by stabbing himself, he shall keep stabbing himself in the Fire (Hell). The hadith collection reflects the words and deeds of Muhammad, which determine how Muslims should live their lives (Sunnah). Buddhisms views on suicide A fundamental principle of Buddhism is to abstain from destroying life, including oneself. If differs however from the Abrahamic religions in that it does not condemn suicide, it does however take note of the reasons for suicide. Intimately connected with this line of thought is the belief in honor suicide. This is in concert with the ancient Asian ideology of seppuku, which is a form of ritual suicide by disembowelment. The samurai, who rather than suffer the shame of defeat, would choose to end their lifepracticed seppuku. This was a common practice in the Warring State Period (Era of Warring States, 476 BCE to the unification of China by the Qin dynasty in 221 BCE) and the Edo Period of Japan (division of Japanese history extending from 1603 to 1863).

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An example of a Buddhists committing an honor suicide was Thich Quang Ducs suicide by self-immolation to protest the government of Ngo Dinh Diem. Hindus views on suicide The commission of suicide in the Hindu religion is considered a sin, the seriousness of which is no different than murdering someone. Hindu scripture states that if one commits suicide they will become part of the spirit world in which they will wander the earth until such time they would have died had they not committed suicide. Legal concepts on suicide Suicide and assisted suicide is regarded in many parts of the world as a crime; there are some exceptions in physician-assisted suicide. As has been previously noted in ancient Athens, a person who committed suicide without approval of the State was denied the honors of a normal burial. They were instead buried alone, on the outskirts of the city, without a headstone or marker. In ancient Rome, Feudal Japan and China it was expected for a soldier defeated in battle to commit suicide. In France during the reign of Louis XIV the body of a person who committed suicide was dragged through the streets, face down, and then hung or thrown into the garbage; all of their personal possessions, including property, were seized by the State. In England and Wales suicide as well as attempted suicide was illegal under English law and remained so until 1961 when the Suicide Act was passed. In the State of Victoria of Australia it is a crime to encourage, aid or abet a person to commit suicide. Suicide itself, however, is no longer considered a crime, however, a survivor of suicide pact can be charged with manslaughter. In Ireland, suicide or an attempt to commit suicide is not considered a crime, however, assisted suicide and euthanasia are. In Scotland neither suicide nor an attempt of suicide is considered a crime. Those who assist a person to commit suicide may be charged with murder, culpable homicide or be charged with nothing depending upon the facts. In the Netherlands it is a crime to participate in a suicide with the possible exception of euthanasia. However, it is not a crime to give moral support or to be present when a suicide is committed.

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In Russia, inciting one to commit suicide through threats, ill treatment or continual degradation is considered a crime for which a person can receive up to 5 years imprisonment. In India suicide is prohibited and attempted suicide can give rise to a prison term of up to one year or a fine. In Singapore, a person who attempts suicide can receive a prison term up to one year. In the United States many states regarded the commission of a suicide a criminal offense, which remained in effect until the early 1990s when only two states still listed suicide a crime, both of which since have removed suicide as a crime. There are some states however, that still consider suicide a common law crime. In essence what this means is that the family of the suicide victim can be barred from recovery in a lawsuit unless the person who committed suicide can be proven to be of unsound mind. In other words, for the family of the suicide victim to collect monetary damages, they must prove the act of the suicide was an involuntary act and not a voluntary act in which the person develops a plan to commit suicide and carries it through in a thoughtful fashion. Summation As shown above, the monotheistic religions of Judaism, Christianity, and Islam have always apposed suicide, because they regard life as Gods gift, which we being made in his image, his children, are to use as his faithful children. There is also another very fundamental point, which comes into play here, and that is in the monotheistic religions, eternal life is not survival of a disembodied soul or endless reincarnation, but resurrected life with God. Thus, Christians cannot evade Gods gift of life and its incumbent stewardship of the bodies He has given us nor can they reject the body which will always be a part of them. This foundation of the monotheistic religions view on suicide is very similar to that of the Greek philosopher Plato, who argued that suicide is a rejection of duty to ones body, to the community of which the person is a part, and to God who gave the person life. As discussed above, Kant, another philosopher, argued that suicide is the greatest of crimes because it is a person rejection of morality itself, since a person must be his or her own moral lawgiver. The classical stand of Plato, the monotheistic religions, Kant and others has been challenged. As an example, the Protestant moralist Joseph Fetcher stated, The real issue

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is whether we can morally justify taking it into our own hands to hasten death for ourselves (suicide) or for others (mercy killing) out of reasons of compassion. Fletcher was an Episcopal priest who developed a form of ethics called Situationism. Situational ethics state that sometimes other moral positions, such as the classical position of the monotheistic religions, can be put aside in certain situations if love is best served. The love Fletcher is referring to is Agape love, which is an absolute, universal, unchanging and unconditioned love for all people. Fletcher believed that in forming an ethical system based on love, he was best advocating one of the fundamental concepts taught by Jesus Christ, Love thy neighbor. It was Fletchers belief that there are no absolute laws other than Agape love, thus all other laws are only guidelines to how to achieve this love, consequently, they can be broken if the other course of action would result in more love. Thus, Fletcher answers his own question by using his situational ethics and its fundamental principal that the only command of God is to act lovingly. Consequently, it appears to him that there are many situations in which the person can will his own death for the good of others, such as a prisoner of war who fears torture that would cause him to reveal the hiding place of others. Although Catholic theologians in general rejected situationism, there are some who in believing in the Principle of Proportion (Things are well when they move together, not in isolation. If in order to achieve a particular goal we harm our health, sacrifice our loved ones, or are unconcerned with other values, accidents may happen that will keep us from reaching our goal. In other cases, we may reach our desired goal but we wont have the good health to enjoy it, or loved ones to share it with. Life is a whole that requires overall-not partial-equilibrium and development). The Principle of Proportion was developed by the German Jesuit theologian Peter Knauer and others, who argued that the moral law against suicide and euthanasia admits exceptions. Knauers ethical theory, which allows for euthanasia, suicide, or abortion, is founded on the principle that it is commensurate reason, which counts. Commensurate reason, is not just any reason, rather a reason is commensurate if the value realizable at that moment in time by measures involving physical evil in a premoral sense is not in the long run undermined and contradicted by these measures but supported and maximized. Thus, if the reason of

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an action is commensurate, it alone determines the end, consequently, the act is morally good, i.e., and the end justifies the means. Another Catholic Moral Theologian, Daniel Maguire, believes that the termination of life can be either moral or immoral according to the circumstances that give it moral meaning. He also believes that the traditional argument that suicide violates Gods dominion over human life is not persuasive, since if God gives us share in His dominion over our life in most matters, why not over out death as well? In general, these Christian thinkers believe that to make an absolute rule against suicide is, under some circumstances, to fail to respond compassionately to useless human suffering or to accept Christs own teaching against the Pharisaic legalistic mentality. In general, Humanists, emphasize the autonomy of the individual, thus they favor the right of all persons to determine when their own life shall end. Some regard the justification of suicide as being determined by a balance between the advantages and disadvantages for suicide. For example the advantages would be: 1. Suicide gives the human person full autonomy since he or she can choose to live or die, to be part of society or reject it. 2. Suicide enables a person to leave life with dignity, instead of enduring useless suffering, being a burden to others, and so forth, or suffering mental disease or unjustified disgrace and dishonor. 3. Suicide may enable one to avoid temptation to treacherous or ignoble acts that destroy ones personal integrity or that may be harmful to others, such as the revelation of secrets under torture. 4. Suicide relieves ones family, and also society, of burdens, so that their resources can be used for something better. 5. Suicide can be an act of heroic sacrifice for others, such as the kamikaze pilots in World War II. 6. Suicide can be a protest against social injustice, such as the Buddhist monks who burned themselves in protest against tyranny in Vietnam or the Irish Catholic hunger strikers. The disadvantages that are often used:

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1. Suicide is an intrinsic evil for a person to reject living out life to its full, since there is opportunity for personal growth as long as conscious suffering or conscious endurance is possible. 2. Suicide is contradictory to the very basis of morality, since by this act the person gives up all other moral responsibilities. 3. Suicide is not a road to immortal life; since that life is mysterious, and whether this is the proper way to enter it is not known. 4. By suicide the individual withdraws himself or herself from the community that has given him or her life and deprives it of a unique member. 5. Suicide is a rejection of God because it is a rejection of Gods gift of life. 6. Suicide deeply hurts a persons loved ones and discourages them in their own task of living. From a pragmatic standpoint, although one can weigh advantages vs. disadvantages of committing suicide, the justification for suicide in each individual case is often founded in either social or personal reasons. From the social perspective the individual may believe they have a moral responsibility to kill themselves for the good of others. However, it is generally accepted that society has no right to require any of its members to directly sacrifice their life for others, although it can require they perform some positive action for the common good, which may involve the risk or even the certainty that they may incur death. Consequently, those who kill themselves because they believe this will benefit others are following an exaggerated sense of moral obligation, while at the same time they are failing to fulfill their social obligation to continue to participate in the life of the community. From a personal perspective, people commit suicide because there is no other way out. Thus, the question that needs to be ask, is this really true? There is no question that many who commit suicide believe at that moment in time, this is true. However, many argue that since we are intrinsically oriented toward the future, as long as there is hope for the future, suicide is unreasonable. This of course assumes that the person who is

contemplating suicide still has the ability to use appropriate cognizant thought, thus reaching appropriate conclusions as viewed by those who are antagonistic to suicide. Unfortunately, many who have reached the decision to commit suicide, often believe for

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them it is the only rational thing to do, even though the underlying thought process may be chaotic as viewed by others who are not in the throws of mental anguish. Approaching this from the classical Christian perspective, it is hope in God, which grounds our future, thus this hope in God, using rational thought, should allow us to endure even the most painful situations, for they allow us to complete our existence on earth as God would will it. If you will, as Christians we should wait on God who gave us life, since it is He who knows best how to prepare us for eternal life with Him. With these foundations, the classical Christian position on suicide was that it is intrinsically and always wrong, since in all circumstances it constituted an abdication of ones responsibility to live out life in community with other persons and with God. As to the argument that if God shares with us a stewardship over life, why not over death, the classical Christian response was that our stewardship over life presupposes that we preserve life, not destroy it. Thus, suicide is a rejection of Gods gift of life and therefore of God the giver, it also does not constitute a use of life as God had intended. Although, the line of theological thought used by the Classical Christian Theologians is clear in its foundation and thus the reached conclusions, it is difficult to believe that one who is enveloped in the canopy of crushing despair has consciously or even has the capacity to follow this line of thought. It is perhaps with this in mind the Catholic Church changed its position on suicide in 1997. Presently the Church believes that the person who committed suicide may not always be fully right in their mind; and thus not one-hundredpercent morally culpable. Grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture can diminish the responsibility of the one committing suicide. The Catholic Church prays for those who have committed suicide, knowing that Christ shall judge the deceased fairly and justly. The Church also prays for the close relations of the deceased, that the loving and healing touch of God will comfort those torn apart by the impact of the suicide.

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