Ask Faye 9: Moirai, or the Allotter, the Spinner, and the Inflexible

By Scott Douglas Jacobsen

Faye Girsh is the Founder and the Past President of the Hemlock Society of San Diego. She was the President of the National Hemlock Society (Defunct) and the World Federation of RTD Societies (Extant). Currently, she is on the Advisory Board of the Final Exit Network and the Euthanasia Research and Guidance Organization. Here we talk about death, dying, and image versus reality.

Scott Douglas Jacobsen: What comes to mind when people who have outwardly good lives kill themselves?

Faye Girsh: When a person seems to have everything to live for: health, love, money, stability, an interesting life. Anthony Bourdain comes to mind. His death seemed to be a tragedy. So did Robin Williams’ death until his Lewy Body Dementia came to light and then it was easy to understand how he must have been suffering from confusion, brain fog, and depersonalization.

His brand of quick humour must have been impossible to continue. He apparently never discussed it with anyone nor did he belong to a right to die organization that could have informed him of a “better” way to die. I have two good friends who killed themselves, one by jumping off our tallest bridge and one by shooting himself in the head.

Both were attractive, bright people in what seemed like perfect marriages and loving families. One in the care of a very capable psychiatrist. It may be that Robin Williams’ case illustrates how little we know about what goes on in people’s heads and hearts and how much suffering they have endured before making the decision.

We use the term “unbearable suffering” as the criterion for eligibility to get an assisted death (in most countries, not the US) but I would have to imagine that these people, like Robin Williams, did find their lives unbearable.

They had the idea that there was no way out and no treatment or solution other than death. These, to me, are suicides that don’t make sense and are tragic — but I must reserve judgment since it is easy for me to say.

I also had a friend who killed himself and his demented wife for whom he was the caregiver, somehow that seems rational and understandable, though terribly sad and a waste. Two other older friends killed themselves because they were so deeply in debt — as we later found out — that they would have been evicted and homeless.

Another couple wanted to leave a large sum to their church, so they ended their lives. These deaths seem “elective” and do not, on the surface, make sense to most people but then some people put a higher priority on other things than living.

Jacobsen: How can different circumstances and groups suffer from suicidality differentially?

Girsh: This recent year where all of us were isolated was not good for mental health, whether children’s or old people’s. We caused one public health crisis in the service of preventing another. Losing your job and not being able to feed or house your family is another situation leading to despair.

We know in India when crops were failing many farmers drank fertilizer and died. The latest stimulus bill in the US had the express purpose of preventing a public health crisis of depression and suicide. Another group at high risk of suicide are people with gender dysphoria who see themselves at odds with their families and society.

When attitudes change and they can be comfortable with who they are they are no longer at risk. In the past few years, the stigma of homosexuality was lifted probably resulting in many lives being saved. In some other countries such is not the case.

Veterans in the US have a high suicide rate and it does appear to lower when their health, housing, and vocational needs are addressed.

Jacobsen: Some fear mass suicides or increases in suicides if legalization of dying with dignity moves forward. Does the evidence support this claim?

Girsh: We do see an increasing use of assisted dying in places like Canada or the Benelux countries but these are people who would have died a natural and difficult death or people who would have “committed” suicide because of long-standing psychological problems.

When the book Final Exit came out, with explanations of methods of humane “self-deliverance”, the author, Derek Humphry, said that the number of suicides did not increase but the number of violent, lonely deaths went down.

In countries like Japan where suicide is an acceptable, if not honorable, way to die the rate is fairly high and is lower in Catholic countries where it is a sin.

Jacobsen: Thank you, Faye, for the opportunity and your time.

Scott Douglas Jacobsen is the Founder of In-Sight: Independent Interview-Based Journal and In-Sight Publishing. He authored/co-authored some e-booksfree or low-cost. If you want to contact Scott: Scott.D.Jacobsen@Gmail.com.

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