Why don’t more people kill themselves?

by Emrys Westacott

Imagine you are given the following choice:Hosptial-mexico-patients

Option A: You live 34,748 days. Your final four weeks are spent in and out of hospital, alternating between discomfort and semi-consciousness, entirely dependent on family members and health care providers for assistance with every basic function.
You die in hospital or in a nursing home. The cost of home care, hospital services, and medications over this period depletes your estate by thousands of dollars.

Option B: You live 34,720 days–that is, 28 days less. The 28 days you give up are those last four weeks just described. You die at home. The money you save helps put a grandchild (or great grandchild) through college.

To my mind, this is a no-brainer. Option B is clearly preferable. In both cases you live until you are 95, a good long life. Everything significant that you were able to enjoy or accomplish will have happened. All you miss out on if you choose Option B is a few days of humiliation, discomfort (occasionally rising to out-and-out pain), guilt about the burden you are imposing on others, and anxiety about how your final pitiable condition might affect the way you are remembered. I assume most people will share my view that B is the better option. So the question arises: Why do the final days of so many people resemble Option A rather than Option B?

This question was prompted by two very good bestselling books that I read during the recent holidays: Atul Gawande's Being Mortal, and Roz Chast's Can't we talk about something more pleasant? GawandeGawande, a physician, addresses an increasingly important problem. Due to the tremendous progress made in medicine over the last century, dying is often a much more complex and protracted process than it used to be. Doctors today have the know-how and the technology to keep us alive a lot longer after we are stricken with illness or old age. Unfortunately, says Gawande, doctors, other care-providers, and family members, often unthinkingly opt for whatever will prolong life without considering sufficiently whether what is being prolonged is really worth living from the perspective of the person who has to live it.

Our worst nursing homes are luxury hotels compared to the old workhouses and almshouses where people used to spend their final days, but they are nevertheless dreaded. Innovative assisted living arrangements make an honest attempt to eliminate some of most objectionable aspects of nursing homes, particularly the lack of independence granted to the residents. But all the same, loss of autonomy, and the blighting of even small pleasures by continual discomfort, seems to be the fate that awaits many of us if we take our time shuffling off our mortal coil.

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Removing the Blades from Hume’s Guillotine

by Tauriq Moosa

David-Hume-Scotland-17111776-289536 Hume’s Guillotine: “One cannot derive an “ought” from an “is”. This thesis, which comes from a famous passage in Hume's Treatise [says]: there is a class of statements of fact which is logically distinct from a class of statements of value. No set of statements of fact by themselves entails any statement of value. Put in more contemporary terminology, no set of descriptive statements can entail an evaluative statement without the addition of at least one evaluative premise. To believe otherwise is to commit what has been called the naturalistic fallacy.”

– John Searle, ‘How to Derive an “Ought” from an “Is”’, The Philosophical Review, 1964

Beware, people. This is a long piece. Even I’m uncertain about it. Here we go then.


Major ethicists like Immanuel Kant and indeed – to an extent – Thomas Aquinas sought to establish a rational basis for deriving moral considerations. Why rationality above other justifications? Consider: one and one is two. This is a statement that appears to hold true regardless of the state of the world, whether we’re dreaming or awake (as Descartes famously pointed out in his Meditations), whether we’re in pain, and so on. However there is an implicit assumption being made here, too: that if we do agree that one and one is two, we who agree to this statement are rational agents; that is, beings who accept the constraints and rules of logic and rationality.

This appears to only beg the question: Why should anyone accept that one and one is two? (This problem so vexed the young Bertrand Russell, that he nearly mentally destroyed himself as an adult trying to establish conclusively that one and one is two.) As Sam Harris has said, how do you convince a person not interested in rationality to use rationality? As soon as you start making rational arguments, you’ve already lost.

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