Any way you read it, suicide
is a sad and sensitive topic. Whether it is the death of a
celebrity like Ernest Hemingway or Sylvia Plath, a relative,
a dear friend or of someone you barely know, it is a tragedy.
Of late the issue of suicide
has been gaining more and more attention. Forcing the issue
into the face of the American public, Jack Kevorkian, otherwise
known as "Doctor Death," claims to have helped more
than 130 people kill themselves. For one of these assisted
suicides, he now stands convicted of second-degree murder.
Another genre - mass suicides
- became big news with Jim Jones and his 900 followers in
Jonestown in 1978. More recently it was the Heaven's Gate
followers in California, who killed themselves believing that
their deaths would get them on board the Hale Bop comet for
a ride into the future. Then it was the 52 Solar Temple members
who died in a series of suicides in Canada and in Switzerland.
Now forecasters are warning of an upsurge in suicides around
the western world as the millennium approaches.
Perhaps it is this growing paranoia
that recently prompted Tipper Gore, the U.S. vice-president's
wife, and U.S. Surgeon General David Satcher to declare suicide
"a national tragedy and a public health problem demanding
national leadership." "Let's talk about the reality
of suicide in our national life," said Gore. "Let's
encourage all Americans to get the help they need."
All Americans? Has Tipper been
tipped off about an impending national suicide? Or is she
oblivious to the fact that suicide is way down on the list
of causes of death. The top three - cancer, strokes and heart
disease - account for more than 60 per cent of all deaths.
Add pneumonia, diabetes and accidents and you've described
how most of us might expect to die. The suicide rate, at 1.3
per cent, has been on the decline for years.
And what help is Tipper offering?
On close examination her recommendations are about as powerless
as those applied by other administrations to previous "wars,"
such as Reagan's war on drugs (remember "Just say No!")
and Johnson's war on poverty.
"We want coaches, we want
school teachers, we want hairdressers, we want people who
interact with the community," said Damon Thompson, Satcher's
spokesman. "It's going to take outreach, it's going to
take training. It's going to take communities to realize it's
got to be a priority."
What are all these people supposed
to do? Ah, there's the rub! While "prevention" may
be their buzz word, research suggests that it's an illusion.
In reviewing 14 studies that assessed the preventive effects
on suicide rates, David Lester of the Center for the Study
of Suicide in New Jersey found that only half even hinted
that they might be effective. Of the remaining half, six were
ineffective and one seemed to increase the number of suicides.
And researchers at Arizona State University looking at a youth
suicide preventions methods concluded that none were useful.
Such findings are not, it seems,
influencing politicians or tempering the enthusiasm of those
who offer up such enterprising solutions as "suicide
prevention by e-mail."
Such ideas may capture the public
imagination, but the sober conclusion, as Columbia University
researchers Shaffer and Craft put it, is that "the most
effective (prevention) is a systematic procedure that has
a high potential for institutionalization." In common
language that means locking up anyone who utters a suicidal
Critical psychiatrist Thomas
Szasz writes that suicide "is our ultimate, fatal freedom."
But that's not how Gore and Satcher see it. They believe that
no one in his right mind kills himself, that suicide is a
mental-health problem that can be prevented like other health
"Imagine a world free of
suicide" is the slogan of one enthusiastic Texas lawyer.
He is on the cutting edge of a new legal specialty - suing
doctors or therapists whose patients kill themselves. His
logic is simple if suicide is preventable then, whenever a
person suicides, someone is responsible and that person should
Perhaps mental-health workers
ought to have second thoughts about endorsing treatments and
giving the impression that they hold the key to suicide prevention.
In this instance, such a pretense could be costly.
"Suicide is an event that
is a part of human nature," wrote Goethe 200 years ago.
"However much may have been said and done about it in
the past, every person must confront it for himself anew,
and every age must come to its own terms with it."
Dying voluntarily is a choice
intrinsic to human existence; sometimes impulsive, sometimes
rational, rarely preventable, and always tragic.