Death with Dignity v. Death by Suicide

I am easily triggered lately with the 2^nd anniversary of Noah’s suicide approaching. My tears burst from a full-face grimace. I see a young quadriplegic on TV fighting to regain his strength and I think, why didn’t Noah fight for his life? Instead of moaning like an injured animal, I emit howls and growls of protest. I am back to fixating on “this did not have to be.”

I hear a segment on NPR about a “good death” and the death with dignity movement. I remember my mother's death at home from cancer at age 47 and am relieved to hear physician/writer Atul Gawande concede that there’s really no good death since it nearly always entails indignities, decline, discomfort, and loss, if not pain. I have been a lifelong believer in death with dignity, home hospice, and palliative care for the terminally ill. But talk of a good death right now gets me howling. As a mother who lost her young adult son to suicide, I’m too close to the worst kind of death.

Death with dignity can be a rational choice made by a terminally ill person after getting second opinions and exhausting medical remedies. Death by suicide, some say, is also a choice made by desperate people who can see no alternative. But if it is a decision made by a disturbed and distorted mind—especially a not yet fully developed young person’s brain--is it truly a choice? 

Death with dignity can ease the pain and passing of a terminally ill person, ideally in the company of their family and friends and with supportive end-of-life care. Death by suicide ends the pain of the suffering person and passes it on to their family and friends, denying us a chance to help or say good bye. It forces survivors to look directly into the face of death and despair and to recognize not only our lack of control over the actions of others but our limited understanding of their minds.  

Death by suicide does violence to the body of one person and to the soul of many, leaving a trail of destruction and doubt. It puts the health, happiness, well-being and sometimes lives of survivors at risk. It is a violation of trust with our loved ones, yes, and it is a tragedy. But it is also a violation of the social and natural order—a small-scale crime against humanity. It scares me to be so blunt, but that’s what it amounts to when we consider the collateral damage. No wonder suicide has been so widely forbidden and punished across time and cultures.

I will always try to understand my son’s suicide and suicide generally. I will try to be compassionate with those who take their lives and with those who suffer with (or without) mental illness. I will continue to join survivors and others who call for breaking the silence and advancing research and services around mental illness and suicide. 

But I will not make excuses for my son or others who kill themselves. I am too hurt and angry. I miss Noah too much. I hate suicide too much. I will continue to rail and howl against the violence he did to himself, to everyone who loved him, and to our world.

To my fellow survivors and others who find this harsh, I'm sorry. This is how it feels today; I trust I will not always feel this way. I know our loved ones were not criminals who intended to hurt us or our world; they were lost in terrible pain. But I am howling against their actions right now. This did not have to be.