Fatal Freedom: The Ethics and Politics of Suicide [Paperback]

Dr. Szasz does not admit the existence of mental illness unlike Dr. Kay Jamison who, in her book NIGHT FALLS FAST, assumes in the suicide its "almost ubiquitous presence." She discounts the will as a vital force in determining behavior; he emphasizes it as follows: Suicide is not a disease but a deed and as such, poses a moral, not a medical, problem. To allow medical experts to pathologize it is indicative of our willingness not to think, but to be thought for. More, these agents of our ever-expanding "therapeutic state" seem unable to call things by their right names. For example: Why say suicide is an unnatural act when they mean it is a wrongful one? Or misname medical intervention for the dying as medical treatment? Szasz deplores imprecise language because it rigor-mortises thought and begs significant questions. How can we, for example, without empirical evidence, accept the idea that mental illness is like any other illness?

Dr. Jamison reminds us that suicide among the young has tripled in the last forty-five years; Dr. Szasz asks whether suicide prevention in its present form does not increase its likelihood. Her study echoes the latest orthodox belief in biologically-based mood disorders. He, on the other hand, takes issue with our tendency to pathologize socially unacceptable behavior: Only yesterday we believed masturbation and homosexuality cause insanity. Today insanity causes suicide. To call the subject ill and to incarcerate him "for his own good" not only presupposes his act unjustified, it relieves him of responsibility for it;-and because it is more blessèd to forgive than to blame, relieves us of responsibility too.

Szasz goes further: If we have birth control, why not death control? If we allow justifiable homicide on grounds of self defense, why not justifiable suicide? The question gives one pause.

Death is the final indignity imposed by time; it is, paradoxically, our only refuge from it. "One loves ultimately one's own desires," writes Nietszche, "not the thing desired." And when desires fade from old age or debilitating illness, are we not sometimes obliged to relieve our loved ones and ourselves of further agony? Yes, says Szasz. For suicide is not only an act of will, it may be a moral responsibility.

I think of the Myth of Sisyphus, its corollary in our lives: Sisyphus, whose punishment was to push a boulder up a mountain that must always roll down again, could not choose but submit. Can free will have taught us that unless we find joy in our struggles we had best not struggle at all? Shall we all lie down and sleep in the shadow of the rock? Yes, if we choose, says Szasz! Yet he does not advocate suicide, only its option: Who but we should control how and when we die? he asks. But to sanction such a choice for every adult?

Running rampant among the young today is the infectious disease of despair that breeds on the fallacy that things difficult are necessarily impossible, and what is largely true is wholly true. And symptomatic of this disease is the alarming insistence that there is nothing to prevent the pendulum from swinging us all into annihilation. Statistics don't lie. These are parlous times.

And our suicide-prevention programs are failing. Should we abolish them then? No, says Szasz, we should abolish coercive suicide prevention, and instead practice verbal persuasion as do the Samaritans in England. They, in respecting the suicide's wishes, more often than not dissuade him from the act.

I don't remember the last time I talked back to a book. FATAL FREEDOM is an exciting read, a tonic breath of fresh air. I recommend it highly for lay people and medical professionals alike.