The public debate.  And what is “suicide”?

Written by on July 5, 2014 in Blog with 0 Comments


One cannot give much thought about self deliverance without delving into the social and legal issues involved.  Dr. Chabot does so in his book, Taking Control of Your Death, which is about stopping eating and drinking (SED). * 

Chabot says, “The idea of parting from life by keeping one’s mouth closed to food and drink was well known in antiquity.”   He cites Democritus.   Democritus was a pre-Socratic Greek philosopher and scientist noted for his atomic theory of the universe (not our current knowledge of atoms).  While in the middle of SED, he was implored to interrupt his fast so that he could attend a feast, which he did.

SED’s re- emergence didn’t come until late in the 20th century, when some hospice doctors noted how calmly some patients died after declining food and drink.

Should physicians tell patients about the SED option?  This was proposed in 1993 and met much opposition.  The debate rages today, with some physicians doing so, others denouncing it. Ethicists and moralists weigh in on both sides.   My philosophy is that knowledge seldom harms and usually helps, so my answer is emphatically YES.    I go so far as to argue that doctors have a moral duty, if not a legal one, to tell patients about SED, especially those patients suffering greatly near the end.

I won’t go into the arguments, except one, discussed below.  I think they boil down to this one issue:  Do you believe that you have an inherent right to die, that is, to choose your final exit, or not?  My personal belief is again emphatically YES.   And the law in the U.S. recognizes this right.  Flowing from my belief is my secondary view that people should know and understand all the alternatives they have, and then make an informed, personal choice.  This might be no more than seeking a natural death, without self-deliverance.  My website,, and my blogs are designed for my readers to learn and consider these options.**

Chabot points out that SED may be preferable to the other two self-deliverance options because with helium or lethal drugs other people are likely to be deeply involved, exposing them to prosecution for assisting suicide.  This has certainly been true for the Final Exit Network (FEN) and its “exit guides” who counsel people on the use of helium.  But FEN has generally been successful defending a series of law suits, arguing that its exit guides don’t buy any of the equipment, don’t help assemble it, don’t turn the valve, or otherwise directly assist the patient.  The successful legal theory is that FEN and its guides have a right to give information because their speech is protected by the U.S. Constitution (and many state constitutions).   Assisting people who choose the lethal drug option have the same potential for being prosecuted for assisting.***

I have read of no physician or other attendant in a SED situation that has been prosecuted.  Apparently Dr. Chabot hasn’t either, and Dr. Terman tells me the same.  (But see the discussion in my next blog.)

Dr. Chabot discusses one major aspect of the debate I cannot ignore.   Is SED a natural death or a suicide?  He points that there is no widely accepted definition of “suicide,” citing a World Health Organization (WHO) group of experts.   Therein lies the root of this issue.  We all understand that a violent intentional death by a depressed person, via shooting one’s self, hanging, jumping from a height, or breathing car exhaust, is suicide.  So the question becomes when self-taking of life, by someone who is not depressed but is in great pain, or is elderly and suffers incurable disease or disabilities, or is otherwise clearly in the process of dying, suicide?

Chabot says it is not suicide, and gives these distinguishing differences.  Suicide is always an irrational, lonely act, taken by a depressed person, usually impulsively. Typically the body is broken, even mutilated.

A person taking advantage of self-deliverance via SED is none of these, but has chosen to die:

1.  After considerable thought.  Chabot notes that SED is superior to helium or Rx drugs, as it is reversible at any point in time.

2.  With family present, and others such as friends, doctors and nurses.

3.  Peacefully.   There is no violence and the body is not mutilated.

4.  With full mental and legal competence. It is not done in extreme depression.

If not suicide, what is it then?  We need a good word for it, but, in English anyway, we don’t have one.   “Self-deliverance,” “self-directed death,”  “physician aid in dying,” “final exit” and other such descriptions really don’t get us there.  How about ____________?  You fill in the bank, preferably with one made-up word.  Let me know.  For example, “death-by-right” – perhaps too long though; if you like or dislike “death-by-right” let me know that too.

Bill Simmons

* This is the fourth blog arising out of this book and the unique SED process of dying.  The first three were posted 6/12, 6/23 and 6/29.  On the blog page of my website,  you can scroll down through them.  There will be one more in the series, coming in a week or so.  A second book by Chabot, to be published soon, will cover the helium and lethal drug methods.  I can’t wait to get my hands on it, and talk about it.

* As covered in my first (6/12) blog, these are:  apply all effort to keep me alive; let me die a natural death, and choosing you own exit (self deliverance) via SED, the helium method, or lethal drugs.

**Read The Last Good Nights by attorney John West, who secretly helped both his parents take lethal drugs knowing full well he might be prosecuted for assisting either suicide if found out. He never was prosecuted, even after going public about what he did, and writing the book.  His parents lived in Los Angeles County; in other, more conservative, jurisdictions this scot-free result might well be different.

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