Sample Research Proposal on The Moral Justification of Suicide

Suicide – the ending of one's own life. This observable, enigmatic and perplexing experience and fact was rampant even during the earlier times. As a result of this occurrence, there were various thoughts – mostly philosophical that are instigated by different philosophers and scholars with the purposes of providing a clear description and the full understanding of the principles underlying it. As an ancient practice, suicide possesses important views in terms of its acceptability and application. The question on whether or not suicide is justified could still be a controversial topic to several perspectives of this modern living. Today, suicide is an object of multidisciplinary scientific study, with sociology, anthropology, psychology, and psychiatry each providing important insights into suicide (Cholbi 2004). With the onset of globalised manner of thinking, it could be said that there are still different beliefs that refer to the totality of suicide – may it be rational and irrational in nature. But then again, suicide must be viewed in terms of applicability and perspective to fully understand its ethical dimensions. Still, thoughts on suicide are appropriate to understand especially during these contemporary times where uncertainty and ambivalence prevail. This paper aims to discuss the moral justification of suicide. Included on this reports are significant concepts of this particular subject varying to all areas concern like psychology and the Kantian view of suicide. Further, euthanasia as an example of justified suicide will serve as an example and will constitute most part of the paper. Another reason on why euthanasia will be used in the discussion is the goal to further illustrate the justification of the said phenomenon.   What is suicide?             The dictionary provides a definition that is constricted only on the manifested facts relation to the phenomenon. The American Heritage Dictionary describes suicide as "the act or an instance of intentionally killing oneself", the destruction or ruin of one's own interests", and "one who commits suicide". Traditionally, people think of suicide as connected with a negative connotation and often misjudge as an evil deed. Not considering the mysteries and other reasons behind this observable occurrence, suicide traverses different aspects of individual human life. There are unknown and undiscovered things that need to be exposed to fully clarify the elemental nature of suicide. Then, what is suicide?             As stated by Cholbi (2004), suicide is an enigmatic and disconcerting phenomenon. He also qualified the different views connected with the said practice in relation to history, religions, legal and social (such as cultural) systems of the world. With these considerations, understanding the nature of suicide will then be bounded on the specific perspectives and reasons of the incidence. On the other hand, suicidal acts are complex human behaviours that involve many aspects of an individual's personality, state of health, and life circumstances (Tondo and Baldessarini 2001a). Since ancient times, many philosophers and clinicians have been intrigued to factors leading to suicide although these modern times, explanations of suicidal behaviour have largely shifted from moral philosophy to medical biology, psychology, and sociology (Tondo and Baldessarini 2001a). Meanwhile, a widely held view is that being suicidal is itself a psychopathological condition or is a strong indication of mental illness (Tondo and Baldessarini 2001b). In terms of risk factors, psychopathological problems are the most prevalent reasons, specifically depressive disorders and substance abuse disorders (Otsuki 2002). Certainly, a person contemplating suicide is in a depressed mood, sometimes in reaction to adverse circumstances, but this state of mind does not necessarily represent a psychiatric disorder; typically, an operational distinction is drawn between suicide as a consequence of pre-existing psychiatric illness, and suicide as a resolution of an existential dilemma or a response to a precipitating experience in the absence of a history of psychiatric disturbance (Tondo and Baldessarini 2001b).  In reference to statistical figures, 12% of youths had actually died because of suicide (Grunbaum et al 2004). But these cases are inclined with the use of drugs and other risk behaviours that contributed to the actual suicide case and other causes of youth premature death (Grunbaum et al, 2004). A past report of World Health Organization (1996) regarding the rate of suicide in terms of gender in the global setting generally showed that there were higher suicide rates in males in 1994 than females. Among the countries that have high suicide rates in males are: Russian Federation (48.9); Lithuania (45.6); Finland (45.5); and Latvia (40.0). On the other hand, countries that have high rate of suicide among females are: China (39.4); Lithuania (12.0); Kazakhstan (11.2); and Singapore (10.2) (WHO 1996). Andrews and Lewinsohn (1991) conducted a study and examined data from 1,710 adolescents attending nine high schools in five communities to determine the prevalence of suicide attempts and the lethality and intent of the attempts. The results showed approximately 6.8% of the adolescents had attempted suicide in their lifetime; while significantly greater proportion of girls (9.8%) as compared to boys (3.5%) had attempted suicide. Generally, rates of attempts were higher among those diagnosed with major depression, substance use disorder, or disruptive behaviour disorder. In relation to this report, the aforementioned discussion may serve as the traditional notion of suicide. Realistically, the subsequent parts of this paper will now focus on it real intent – to provide a justification of the said phenomenon. To Szasz (1999), suicide is morally problematic and ought to be problematic. The reason provided is the fact that it entails the deliberate killing of a human being. He added that there is a need for suicide to be judged. In judging suicide as a moral dilemma, there are two options presented. One option is to condemn it out of hand where the common laws of the land will preside. Another is to treat it as we treat other types of killings namely, by examining the context in which the act occurs, the actor's motives, and the consequences of his act. With the usage of these options, the justification of suicide is identified.   Kantian View on Suicide From the point of view of contemporary philosophy, suicide raises the following distinct questions (Donnelly 1998): whether a person who commits suicide (assuming that there is suicide if and only if there is intentional termination of one's own life) is morally blameworthy, reprehensible, sinful in all circumstances; whether suicide is objectively right or wrong, and in what circumstances it is right or wrong from a moral point of view; and whether, or in which circumstances, suicide is the best or the rational thing to do from the point of view of the agent's personal welfare. Indeed, the morality of committing suicide has existed in classical philosophies such that of Immanuel Kant. In his writings, Kant emphasized the autonomy of human beings as the ultimate impetus in all humans- ranking even higher than life. The essence of life thus is the ability of humans to answer for their existence and take control of what they have. Suicide according to Kantian philosophy ultimately reduces human autonomy to nothing. This point of view has been dealt accordingly by Kant in the 18th century where he is generally seen as an opponent of suicide (ASB 2003). When deliberating over the morality of suicide, it is necessary to also bring into the discussion those cases in which death is a highly possible risk, but not an intention, and the question of intervention, psychopathology and autonomy. However, Kant's Formula of the End in Itself can allow, or sometimes provide the reasons for, suicide in certain conditions. Kant discusses suicide in the Fundamental Principles of the Metaphysics of Morals and disapproves of it as a general rule of conduct (cited in ASB 2003): "A man reduced to despair by a series of misfortunes feels wearied of life, but is still so far in possession of his reason that he can ask himself whether it would not be contrary to his duty to himself to take his own life. Now he inquires whether the maxim of his action could become a universal law of nature. His maxim is: From self - love I adopt it as a principle to shorten my life when its longer duration is likely to bring more evil than satisfaction. It is asked then simply whether this principle founded on self - love can become a universal law of nature. Now we see at once that a system of nature of which it should be a law to destroy life by means of the very feeling whose special nature it is to impel to the improvement of life would contradict itself, and therefore could not exist as a system of nature; hence that maxim cannot possibly exist as a universal law of nature, and consequently would be wholly inconsistent with the supreme principle of all duty". (Kant, 1948)   In his essay Suicide, Kant argues that suicide is wrong because it degrades our inner worth below that of animals. Kant considers two common justifications of suicide, and rejects them both. First, some may argue that suicide is permissible as a matter of freedom, so long as it does not violate the rights of others. In response Kant says self-preservation is our highest duty to ourselves and we may treat our body as we please, so long as our actions arise from motives of self-preservation. Some also might give examples from history that imply that suicide is sometimes virtuous. For example, in Roman history, Cato, who was a symbol of resistance against Caesar, found he could no longer resist Caesar; to continue living a compromised life would disillusion advocates of freedom. Kant argues that this is the only example of this sort and thus cannot be used as a general rule in defense of suicide. Kant's main argument against suicide is that people are entrusted with their lives, which have a uniquely inherent value. By killing oneself, a person dispenses with his humanity and makes himself into a thing to be treated like a beast. Kant also argues on more consequentialist grounds that if a person is capable of suicide, then he is capable of any crime. For Kant, he who does not respect his life even in principle cannot be restrained from the most dreadful vices. These noble deaths, such as Captain Oates's, are just as much suicide as the adolescent (successfully) slitting her wrists. The intention is to end one's own life and whatever the causes, and however "noble" the motives, it is still an act carried out with the intention of self-termination. On these grounds, an intention-based or rule-based morality can not separate them, whereas consequentialist accounts may still. Suicide is often seen as the act of a desperate or mentally unstable person, which seems a little harsh. Suicide can be entered into in a completely rational frame of mind, but, more importantly, what is sane? Is sanity simply agreement with those around you, or societal convention? Kant's argument, writes Wood (1999), is "progressive," with the later formulations constituting ever more "adequate expressions of the supreme principle of morality" (p. 110). To "insure the unity of the principle he is seeking," Kant formulates the "moral law first in terms of a certain kind of principle (a categorical principle or universal law), then in terms of a value to be esteemed, respected, and furthered (humanity as an end in itself)," then "in terms of its ground in the rational will which legislates universally, recognizing no authority except its own autonomy," and finally as the "allness or totality of the system" of ends expressed in the formula of the realm of ends (pp. 183, 185). In terms of this framework, and by filling in the "intermediate premises," Wood rereads the arguments in Kant's familiar examples (suicide, false promises and converted deposits, rusting talents, refusing to help). However, Kant is appealing to instinctive self-preservation because we cannot know that this instinct has been given to man as part of nature's perfection and that to go against it is going against nature. Survival instinct is very strong and it a lot more difficult to commit suicide that people might at first think. However, we are not talking about the survival instinct in a biological sense, but how it fits in with Kant's philosophy and whether one can appeal to it to formulate duties and universal laws. Whether Kant actually intended this argument as a general prohibition of suicide is unclear. Perhaps his concern was to prevent any tyrant from coercing one of his subjects to commit suicide. Fact is, the above argument only proves that there cannot be any universal duty to commit suicide. In short, we shouldn't force people to kill themselves. A person who commits suicide sins thus not against God (Kant was by no means a religious dogmatic), but against their own freedom. A suicider disposes of his humanity (i.e., his freedom) as a means and not as an end, since he wants to be free only so long as this procures him a pleasant state. In this sense, committing suicide is similar to selling yourself into slavery: in both cases, one gives up one's free will, one treats oneself as a beast or a thing.   Euthanasia: Physician Assisted Suicide Due to the sufferings that many people with fatal illnesses are experiencing, many people opted to die than live with their painful sickness.  Because of this, there emerges many arguments had been made on whether euthanasia is good or not. Countless discussions have been performed to address the issues concerning the right to life and the right to death. However, thousands still tread over the specific ethical issues surrounding it. With the advancement of knowledge and the modernization of medical treatments, questions revolving around the persuasive powers of physicians over their patients and the trust these patients are willing to give their doctors have increased considerably, especially with the growing alertness of the public concerning the principles and morals that surrounds this issue. The case of euthanasia as a justified suicide is worthy of discussion in this research. As an example, the physician assisted suicide (PAS) will be specifically used. Generally, euthanasia is defined as "the act or practice of allowing a hopelessly sick or injured patient to die by taking less than complete medical measures to prolong life called also mercy killing" (Merriam-Webster 1996). Further, Lundberg (1988) defines euthanasia as an easy death or means of inducing one, or the act or practice of painlessly putting to death a person suffering from incurable conditions or diseases. Euthanasia can be divided into two kinds: passive euthanasia (allowing patients to die without taking an active role in assisting their deaths or by withdrawing medical treatment) versus active euthanasia (allowing patients to die through the use of medical treatments or instruments in order to assist their deaths), and voluntary euthanasia (the patient requests for death or it is administered with their knowledge, usually since the suffering is too great) and involuntary euthanasia (the patient has no idea of the decision made and it is the physician who decides for the patient; usually when the patient is in comatose). Is euthanasia justified or not? The main argument why there are people who considers the use of euthanasia is based on the principle of autonomy or the right to self-determination (Arras 1982; Smith 1989; Callahan 1989).  According to this principle, each individual has vale and is worthy of respect and each person is the bearer of fundamental freedoms and rights, and is the final determination of his or her destiny (Gula 1990).  Proponents of euthanasia argue that an individual who has a decision-making capacity had the right to control his or her own body and should be able to know when or how he or she die without interfering with the freedom and rights of others.  It is human self-determination, the capability of individuals to choose and pursue their particular life-plan, which is said to give persons their special moral status (Rawls 1980) and is an important component of the dignity that attaches to rational personhood.             Furthermore, proponents argue that maintenance of the present legal prohibition on euthanasia is an unjustifiable infringement of the liberty of those persons who would choose to be killed. It has been argued that to deny euthanasia is a form of tyranny; an attempt to control the life of a people who have their own autonomous view about how that life should go, and that this constitutes an ultimate denial of respect for persons (Harris 1995). According to proponents of euthanasia, in order to uphold the patient's interest in self-determination, doctors should be free to act upon the request of an informed and mentally capable patient for active voluntary euthanasia without fear of criminal liability. If the principle of self-determination is accepted as the appropriate foundation for the legalization of active voluntary euthanasia there would be no need objectively to examine quality of life considerations--indeed, it would be quite inappropriate to do so. Any attempt to impose a qualitative assess merit of the patient's life as a basis for active euthanasia would be a violation of the requirement of justice (Grisez & Boyle 1979) and would be completely contrary to the principle of patient autonomy. Different patients will inevitably have different goals and values which can best be respected by giving effect to the patient's interest in self-determination and allowing the patient to make decisions based on his or her quality of life assessment. Thus, subject to any requirements of enabling legislation, the sole consideration should be the patient's choice, based on the patient's subjective assessment of his or her circumstances whether motivated by a fear of pain, suffering, dependency, or other causes.  Further, it must be understood that strict adherence to the notion of self- determination necessarily dispels any reliance upon utilitarian principles as a basis for active euthanasia. The arguments of some proponents for the legalization of active euthanasia rest on a form of utilitarian humanism which demands the decriminalization of certain acts of euthanasia and suicide. On pure utilitarian principles, active euthanasia would be justified in circumstances where the patient and persons involved in the care of the patient, are suffering a balance of pain over pleasure and where the killing of the patient would, on utilitarian calculations, produce the greatest good for the greatest number. However, this reveals a fundamental weakness in utilitarian arguments as a basis for strictly voluntary euthanasia, in that they apply with equal force to cases of involuntary euthanasia--a practice which must be unequivocally deplored. According to utilitarian principles, provided there is a balance of pain over pleasure, active euthanasia would be justified if it could maximize benefits overall, regardless of whether the patient can or would give consent. Thus, the interests of the individual patient are subordinated to the interests of the majority. Because of this possible manipulation of utilitarian arguments towards non- voluntary and involuntary euthanasia, utilitarianism ought to be rejected as a moral theory justifying active voluntary euthanasia (Rachels 1986). In contrast, however, the autonomy-based principle of self-determination, essentially anti-utilitarian in nature, is not susceptible to the same arguments for extension to non voluntary or involuntary forms of killing, and therefore constitutes the only acceptable basis for the legalization of active voluntary euthanasia. Moreover, in spite of being one of the most conventional topic euthanasia have been considered as a means for patients to escape pain and fear of dying slow and painful way.  Due to the notion that euthanasia can be attached to the concept of mercy killing, there is a consensus for other people who know the dying patient since they feel that they are prolonging the agony of such individual.  Many Christian scientists are being involved in practicing euthanasia mainly because of the rigorous exercises of maintaining medical care that would help lengthen the suffering of a patient's life. In addition, these scientists has an intense feeling that God has given an individual some illness with a certain reason and that the medical practices to alleviate the suffering of such person goes to oppose God's willing (Simons & Stuart 2000).  In addition, they perceive that sickness may only be cured by means and the power of prayer as only God knows what best for His people. Because of this notion, Christian scientists are considered to be one of the proponents of euthanasia. In can be noted that many individuals believed that physicians must use able to use each and every ways to maintain the life of a certain person as long as possible, but there are also some people who proposed that patients who are dying and their respective physicians have the right to select on whether they would continue the life-sustaining medication or thy would consider the concept of euthanasia. And some also feel that the decision on whether euthanasia should be done should be left to the family and the patient's physician if the victim is incapable of deciding for what he or she wants or not (Fulton 1989). There have been many significant studies concerning euthanasia and physician-assisted suicide and deaths. The Hippocratic Oath, a pledge ritually taken by newly-appointed doctors in order to assert their intentions to prevent sickness and to heal, has continually been questioned and reevaluated. Over the course of time, the pledge has gradually been modified to suit the modern ethics called for at present. Along with this, government laws that address policies regarding the prohibition as well as legalization of euthanasia continuously change based on the ever-changing needs of a country. This undeniably reflects that the ethical choices of people are influenced by their social upbringing and their current conditions based on cultural views.             With the world becoming more concerned with the right of life to continue, physicians themselves are becoming more active in promoting their beliefs concerning this issue. Doctors have begun to debate on the bioethics that all physicians must have a stand on this issue, and some have given arguments that will help in the decision-making (Lewis 2001). Physicians, health-related experts, ethicist, and legal administrators, however, should not be the only ones allowed to influence the decisions concerning physician-assisted deaths (PADs); people from different sectors, social class, and ethnic backgrounds must also be allowed to take part in the decision-making (Shannon 1996) and thus everyone must give their opinions concerning the matter as the end result will primarily affect everyone. Thus, people continue to address issues such as euthanasia, have commented on both its affirmative side as well as its negative side. Questions concerning the intentions of the physicians are proliferating and are also being argued about (Lund 1997). Emphasis has been given on the relationship between culture, death, and mourning (Hoefler & Kamoie 1994) while medical anthropologists have studied the bioethics of many practices which includes euthanasia (Johnson & Sargent 1996). With the presence of past studies and researches that made an attempt to establish a connection between culture, society, bioethics, and euthanasia, there is the need for more studies to more clearly understand this controversial issue.             As many countries continue to debate over the importance of life and the right to die, attempts to link social status—especially those who are in the lower-class—and the choice to allow euthanasia are made as many countries plunge into economic despair. If no answers are given soon, a worst case scenario may be that a country succumbs to laws that may fumble over this controversial issue, without thought for the possible actions that their citizens may turn to, and a possibility of morality and ethics being discussed only when the damage has been done.