Every Cradle Is a Grave by Sarah Perry

This post originally appeared on I Read Odd Books

Book:  Every Cradle Is a Grave:  Rethinking the Ethics of Birth and Suicide

Author:  Sarah Perry

Type of Book:  Non-fiction, philosophy

Why Do I Consider This Book Odd:  Pretty self-explanatory.

Availability:  Published by Nine Banded Books, you can get a copy here:

You can also order a copy directly from the publisher.

Comments:  Sarah Perry wrote this book from a place of philosophical intellectualism and factual integrity.  She exhaustively researched the hows and whys of suicide and procreation and makes a very compelling case for making suicide accessible for people who do not want to live and for considering whether or not it is ethical to continue to create new humans whose lives may be more a burden to them than a gift.  As she deftly picks apart the arguments against suicide and antinatalism, she bestows upon mankind a dignity and respect for self that anti-suicide and pro-birth crusaders deny us as we are asked to suffer and to mindlessly recreate ourselves because of tyrannies of tradition and religious mores.

I very much want to discuss this book in a bloodless manner because the subject matter is so fraught with emotional reaction, much of it knee-jerk, that makes the topic hard to discuss in an intelligent way.  When you speak to people whose loved ones killed themselves, you hear them speak of the cowardice and selfishness of suicide.  When you talk of people who did not have children, you all too often hear others dismiss ethical childlessness as selfish, or insist that if only one had a child, one would know, really know, what true love means.  To approach a counter to such topics with emotion is pissing in the wind because the very basis for avoiding suicide and encouraging procreation is steeped in emotion.

But given my personal history and recent events in my life, I can only approach these topics – especially suicide – from a place of emotion and personal anecdote.  I hope that as I write from my id I do this topic justice.  This book really is a paradigm changer, and you don’t have to adopt an antinatalist world view for that to happen.  It is a book that argues against some of the most deeply ingrained habits of human existence – to remain living at all costs and to spread one’s seed far and wide – and it makes the case that our reason and self-awareness are not entirely a great gift and that possession of them should permit us to control how we decide to die rather than be used as a manipulative tool to keep us living.

And there is no way to discuss the entirety of this book.  Know that I will be unable to discuss large amounts of this book and that you need to read it yourself.  All I can do is discuss what I experienced when reading this book and how it relates to my life.

Perry begins her treatise with an analysis of Bryan Caplan’s theory of “free disposal.” Caplan, an economist, through analyzing current trends in suicide, makes a facile case for how it is that the mass of people consider life a great gift.  Caplan states that since it is so easy to end one’s life, that there are so many options available to the suicidal person, the fact that so few people avail themselves of suicide proves in itself that life is valuable to us all.  For Caplan, because there are so many tall buildings one can leap from, and because one doesn’t have to worry about cleaning up the mess one leaves behind, that proves, economically, that even though the “cost” of suicide is cheap, people choose not to commit suicide not because it is hard to do but because we as human beings really value living at all costs.

Without the rancor that would accompany my own dismissal of such an argument, Perry neatly tears apart Caplan’s economic view of cheap suicide.  The costs of suicide are steep, Perry explains. People are not free to do with themselves what they want.  The very nature of the secrecy of planning suicide proves that one is not free to take one’s life because the secrecy is necessary to prevent people from stopping you from dying.  You have to plan to die in secret because it is illegal for anyone to help you and if you fail you may find yourself locked up in a psych ward, your will thwarted and your future in the hands of people you do not know.

But Perry goes beyond just the basic economic analysis Caplan offers.  Suicide is hardly a situation of “free disposal” because anyone who thinks about committing suicide knows full well the social burden suicide brings with it.  Someone will have to find your body and it’s appalling to think of a family member or friend encountering such a thing unprepared.  Suicide with drugs is risky and prone to failure but more effective methods are messy and one does not want to think of one’s mother or husband cleaning brain matter off the wall.  Then we have to face the knowledge that our loved ones will feel utterly betrayed because we crept around behind their backs in order to die and they are left holding the bag, second guessing themselves, wondering if they could have saved us, wondering what they did wrong.  Did they miss the signs?  Could they have gotten us help?  Or worse, they may be angry at us for being cowardly, for not fighting to stay alive at all costs.  There is nothing free about suicide in this world.  If it costs us nothing when our bodies hit the floor, the loneliness of planning a covert suicide and the reactions of those surviving us have a cost that many find too dear to pay.

Most interesting to me was Perry’s analysis to support the notion that most suicides are not caused by a person feeling out of options or that life is too hard.  Temporary despair seldom fuels suicide. Most suicides are committed by people who feel like they lack connections to others, or are tired of being burdens or fear becoming a burden.  Virginia Woolf did not drown herself because she could not endure another depressive episode.  She drowned herself because she could not see putting her family through the effects of another depressive episode.  It is in this moment when the self-awareness that is supposedly a gift to human-kind is most evident, a realization of one’s limitations and endurance and our impact on others.  In order to work around that self-awareness, we’ve imbued suffering with meaning, a religiosity that guilts us into remaining alive and to creating more living beings, ensuring that no amount of personal or inflicted misery can ever be seen as a legitimate reason for dying because our suffering evidently ennobles us.  It teaches us lessons.  It gives us meaning that makes the suffering seem worth enduring.

*****

I now know there are ways you can tell a person is getting ready to die.  Gradually failing appetite.  Distaste for being touched.  Mood changes.  Agitation. Much of what marks a person beginning to die can also be markers for depression except for one:  seeing and speaking to dead loved ones.

My mother confused me for her mother on the phone a couple of times before she died in January of this year.  My grandmother died in 1981.  She was also convinced my grandfather was in her home, pacing the hallways, looking over her.  He died in 1994, and he indeed haunted her.

My grandfather shot himself in the head, dying in a hospital when life support was removed.  He shot himself because he was 78 years old and his health was beginning to fail him. I don’t know the details but he wasn’t fatally ill.  He was just an old man who did not like being an old man because he had been so strong in his youth and middle-age.  His family was long-lived and he was the baby of his family.  His own mother, a vile Irish hag, lived with him and my grandmother when she was old.  She more or less turned my aunt into a nervous wreck and wreaked havoc on my very sensitive grandmother.  My mother claimed the evil old woman didn’t bother her much but Mom never copped to any mental or emotional weakness, at least not around me.

My grandmother suffered for decades before she died in her early 60s and my grandfather was her primary care-taker, even as he worked as a rancher.  He loved her dearly and did not resent his role but it is undeniable that my grandmother’s severe illness changed their marriage.  He was unable to save much money, he spent much of his life caring for his elderly mother and then his sick wife, and it all left a mark. My grandfather married a widow after my grandmother died and lived in her home because he had been a sharecropper (share-rancher is more accurate) and owned nothing but his truck. My mother thought my grandfather remarried because he didn’t want to be a burden for her or my aunt, but either would have loved to have had him come live with them.  But he didn’t want any of that.  He’d seen how that worked out for him, his wife, his children.

My grandfather had spoken of his older brother Tom, who in his 90s was a dementia patient in diapers.  He could see years and years of failing health with indignity after indignity heaped upon him.

He didn’t want to be a burden on anyone.  He hated not having financial independence.  He didn’t want to sit by idly as his body failed and his mind left him.  He didn’t want to wait around for the worst to happen.  So he took care of it himself.

It shocked everyone.  My grandfather was a deacon in his Baptist church.  He had strong ties to his community and was in his way a pillar of the community. He was quite literally the last person anyone would think would kill himself.  Well, he was until you looked at it logically.

In the last year of her life my mother was so bitter towards her father.  She told me many times she planned to confront him in Heaven, to tell him off for what he did and demand an explanation.  She said he could have lived 20 more years had he not killed himself.  I asked her why, as a Christian, she could not forgive him.  I asked her why she wanted him to stay on Earth in a body that was failing, in an emotional state that hurt him.  She would look away when I asked her these questions, never answering.

I know the answers now.  She couldn’t forgive him because he planned it and no one knew.  She was angry because she could not prepare.  She was angry because she could not say goodbye before he left.  She felt abandoned by him, like he had made a craven choice to leave her behind without a single word of warning.

So she was haunted and spent the last year of her life in misery because she didn’t understand and felt angry.  I wonder if at the end she began to understand why he did it.  I know I do now.

And I wonder how different her last year would have been had my grandfather lived in a culture where impoverished, elderly men who were tired of life and rightfully afraid of what was to come could end their lives in the presence of those who loved them, preparing people for the end rather than planning covertly, going in quiet dignity rather than blowing their brains out in their backyards.  She would have had more peace as her own body failed her.  She would have been able to remember how wonderful a man her father had been.  She could have planned to meet him again with an open heart rather than angry demands for answers.  She would not have been haunted by him pacing the hallway, nervously awaiting her arrival.

*****

One of the elements of Perry’s analysis that stuck with me the most is the notion that we human beings exchange suffering for meaning.

Rather than eschewing all suffering, individuals frequently accept some degree of suffering in pursuit of other rewards – either in the form of meaning or in the form of pleasure.  The mountain climber or medical student affirmatively chooses to suffer for the purpose of future experiences, pleasurable or meaningful.  Others, looking back on times of suffering, say they are glad to have had such experiences.  When making decisions for ourselves, there is no moral problem with trading off suffering for pleasure or meaning; it appears to be a social fact that people do not minimize suffering in their own lives.

She goes on to make note of the fact that even though acceptance of suffering is evidently a part of human decision calculus, we really don’t have the right to actively inflict suffering on others so that they can later interpret it as a meaningful experience.  This is an element of thought important in creating new human beings – when we have children we are effectively asking these beings who had no say about coming into existence to participate in this exchange of misery for meaning, and Perry questions whether or not we have the right to do this.

This question also comes up for me when a person is no longer possessing higher consciousness.  We imbue suffering with meaning because of our higher consciousness and self-awareness but how moral is it to ask a person stripped of any sort of sentience to continue to suffer when such a personal exchange is no longer possible?  Well, we tell ourselves that life is sacred and we cannot deprive anyone of life, no matter how little they experience life or how quickly they know they will be facing the end of their natural life.  Life has assumed the role of an ultimate good and because we cannot inflict suffering on others we cannot help them achieve a pleasant death, even if refusing that death is itself the infliction of suffering.  Worse is the use of other people’s suffering for our own interpretation of meaning.  We tell ourselves that terrible things happen for a reason and that if we learn a lesson, then it was all worth it in the end, and that’s a very callous way to process suffering that we don’t have to experience first-hand.

All of this has led us to a very sorry end. What do we do when we know suffering no longer has any experience-value for the person suffering?  The answer is:  not much.

*****

For close to fifteen years my mother had suffered and the last year of her life was spent in complete misery as her conditions became terminal.  I can’t even begin to describe what happened to her and the last six months she was alive were torture, the sort I know I simply could not have endured. She had many things going wrong with her body, all of them painful, all of them complex.  But of all the things we thought would kill her, a brain hemorrhage was not on the list.

She was already in the hospital for a fall brought on by hepatic encephalopathy and suffered the hemorrhage in the middle of the night, and because the hepatic encephalopathy made her sleep heavily, the nurses didn’t notice anything was wrong until she had already lost all her higher brain function. It was not until late the following morning on January 2, 2015 that a scan showed she had suffered complete death of her cerebral cortex and her cerebellum.  Had the doctors detected the bleed the moment it happened there would have been nothing they could have done – her blood was unable to clot so surgery was not an option.  We just had to wait for her to die on her own as the swelling in her brain reached her brain stem.

The hospital, which had no facility for hospice care, didn’t bother to arrange hospice transfer immediately because they were so sure she would die quickly.  They eventually put her in a room on the sixth floor and the vigil began.  The doctors said my mother could feel no pain so no genuine palliative care was offered – they called what they did “comfort care” and very little of it seemed comforting.  She was given anti-seizure meds, which we later learned didn’t prevent seizures but rather prevented the seizure from manifesting physically and upsetting us.  She also was given an anti-inflammatory drug that would help slow the swelling in her brain.

We were waiting for the swelling to reach her brain stem so she could finally die. Why did they give her anti-inflammatory drugs via IV?  That inexplicable action prevented her brain stem from herniating and she could potentially have stayed in a coma for years.  However, my mother had refused a feeding tube before the hemorrhage, so even though her heart kept pumping and her lungs kept breathing unassisted, eventually death would come in the form of dehydration and starvation.

And that was okay, in a perverse way, because if her cerebral cortex and her cerebellum were completely dead, as we had been told, she wouldn’t need morphine.  The hospital didn’t really take care of her much – they unhooked her from all monitors and didn’t bathe her until she had been in her coma for six days and my aunt and I told the nurses we could smell an infection in her skin.  But she didn’t feel any of it.

But then a nurse told my mother’s husband that she could probably hear us, spoke of a pamphlet  (that never materialized) that she promised would prove that hearing was the last sense a person suffering brain death lost and we should talk to her and hopefully she would respond.  I came into the hospital room one day to see her husband asking her to squeeze his hand if she was okay with elements of her funeral planning.  I know now that people who are dying who seem unresponsive often can hear everything around them, but my mother was not temporarily unresponsive while dying.  She had suffered complete death of all higher brain function.

I said, “If she can hear us and can respond via grunts or hand movements, then she can probably feel being unclean, she can feel herself starving, she can feel thirst, and she can feel pain.  If they are telling us to talk to her, then they need to give her plenty of morphine.”  That didn’t happen but suddenly the posturing common to brain damage patients seemed like communication with a still sentient, self-aware human being. I know my aunt and my mother’s husband needed to think she could hear them and I spoke to her as well. Otherwise I was sitting in a dark, fetid room watching what was left of my mother refuse to die.

But I also needed to believe she lost all higher brain function and could sense nothing because otherwise I stood by and did nothing as my mother was starved to death, as she felt pain and fear.

When my mother’s carcass didn’t shuffle off this mortal coil fast enough, Baylor Irving finally decided to force her husband to either take her home to die, which was impossible since there would be no way to afford the nursing care, or to pick a hospice, any hospice, pick it now or else, and no, she might not survive the transfer but since she’s pretty much a corpse anyway who cares, right? Besides, my mother was taking up a valuable bed, one of the two pieces of shit masquerading as social workers told us.  She was taking too long to die and they needed the bed and they said this at the foot of that bed while my mother was still in it.

Finally my mother did make it to hospice on January 9.  She was taken care of by an excellent end-of-life staff.  They noticed my mother was making facial expressions as though she was experiencing pain so they gave her morphine.  She died not long after her second bag on the 10th.  I know deep in my heart what happened – the morphine depressed her nervous system so that her body could die along with her brain.  She had had no fluids outside of IV-bags of meds, she had received no food for nine days and the morphine helped end it.

But the hospice could not say this.  They could not say, “This has gone on too long.  She has been gone for over a week – the woman you loved is no longer in this body.  This is killing all of you.  This has to stop, so we are going to give her morphine until she dies.”  That is illegal in Texas.  So they had to tell my mother’s husband she was in pain, that it was possible she was in pain the whole time, in order to do what can only be called the most ethical thing.  And no matter how much I know that my mother was gone, really gone from her world of pain and misery as of January 2, I am still afraid she suffered.  That she was in pain.  That the woo-slinging nurse was right and she could hear, that the excellent hospice wasn’t reacting to brain stem grimaces so that they could ease her out of life.  That she felt, heard, smelled and experienced every goddamned minute of it.

Why is it death is so feared that even the most hardened atheist and humanist slips into magical thinking when faced with it.  We tell ourselves a brain stem medically prevented from herniating is a sign of a sick old woman’s stubbornness and willingness to fight, to rage, rage against the dying of the light, as if that’s a good thing, to suffer and suffer because to die is far worse.  Even Christians who believe in the celestial kingdom of eternal life after death mindlessly fight against the mechanism that sends them to their Lord.  We see death as worse than suffering, and we give our suffering human attributes of spunk, of strength, of sanctity, because we are too chickenshit to face the reality that sometimes death is better than life.

And since we are too afraid to face death, how the hell can we speak openly and honestly about how suicide can so often be better than continuing to live.  Sarah Perry was unspeakably brave to write this book.

I finished a pre-publication version of this book right before my mother began her final spiral in November and it changed how I processed my mother’s death.  I had little patience for any of it because I could not justify the suffering my mother may have endured and that we, her family and friends, endured.  In a sane world, when a terminally ill woman suffers complete higher brain death, we don’t ask what remains of her to starve to death.  We let her go and we let her go quickly and we do what is needed to help her leave.

You don’t have to subscribe completely to the notion of antinatalism to realize that our modern beliefs that life is the ultimate good in every situation infantilizes us and forces us to engage in cruelty in the name of life, even if we know the life is untenable.  I don’t know exactly where I stand on the subject of antinatalism but I can say this: There is no moral force in this world that can ever convince me that a suicide entered into sanely is somehow more immoral or irrational than what happened to my mother.

People have told me that I learned something from this, that I am stronger for having endured it.  They can go fuck themselves because my mother’s death was not mine to learn from.  The only thing I walked away from that experience knowing is that if I ever become that ill, I will not wait for the inevitable end.  I will not ask anyone to grow from the experience of watching me die.

*****

I am focusing so much on the suicide part of this book because aside from some maternal rumblings when I graduated from college, I never really wanted a baby.  I couldn’t have had one even had I wanted one, so it all seemed very neatly put together – lack of desire coupled with physical inability. I thought about foster care a few times and even that seemed a bad idea.  I suffer from cyclical but major depressive episodes and there was no way then and no way now to justify putting a child through it. Suicide and death are what I know.  Babies and regeneration are not a part of my world.

Because I am a depressive, I seem to know all too well the burdens of being alive but I also know the burden that my own suicide attempt had on those who love me.  Sarah Perry discusses this carefully in the book as she flays Bryan Caplan’s insistence that we have a “free disposal” society where suicide is concerned.  Our ties to others often makes suicide difficult, if not impossible, even for those with a strong will to die.

…people do not exist as individual units separate from human relationships and groups.  A great deal of the cost of committing suicide faced by a person wanting to die is social and empathetic: it is resonant in the loneliness and grief that his death will cause, or at least hasten, among parents, children, siblings, a spouse, or friends.  As social creatures, we begin forming bonds at least as soon as we are born; these bonds, while often no more voluntarily chosen than our own births, are powerful motivations.

[…]

The suicide of a close associate is usually regarded as much more than the event of such a person moving across the country and losing touch, even though the deprivation is similar in either case.

Some social costs are artifacts of the prohibition.  The suicide must act in secret, sneaking and hiding to avoid detection and unwanted rescue.  But who will discover his dead body?  It will be especially traumatic for a relative or close friend to happen upon the dead body of a suicide.

But for me the most interesting prohibition for those seeking death that Perry discusses is the threat of intervention before death and its repercussions.  If you survive a violent attempt at suicide, you will be left in a wrecked body with even less quality of life than you had before you attempted suicide.  If they find you before the drugs stop your heart, they will bring you back to consciousness and you will likely find yourself in a mental hospital for a time determined by people who do not know you and for whom the reality of your life will never be clear because they have a single mission: to make your mind better so you won’t attempt such a thing again.

And then you have to face everyone who suffered because of your actions.

Caplan’s attempt to apply free market economics to suicide is actually one of the stupidest things I’ve ever read, now that I think hard about it.  Only a man who has never heard the song could so effectively mangle the tune.

*****

After reading this book, I went back and reread sections of my old blog wherein I discussed the before and after of my own suicide attempt.  I went psychotic due to really inappropriately prescribed pharmacology and ended up in a mental ward on Halloween of 2008.  It was bizarre reading those entries because even though I can barely remember much of that time, I also know that what I wrote in my blog were hardly the words of someone completely in the throes of psychosis.  I asked Mr Oddbooks about it and he explained that there were long stretches in late September and October when I was completely lucid.  Then a light would switch off and I would become incoherent and violent.

But as I read my account of the hospital, I was struck by how distant I was in my recounting of it.  It was horrible.  It was far worse than the suicide attempt on both of us, my husband and me.  I was completely deprived of will and so was he.  A doctor whose own diagnosis of me was completely off the mark was responsible for determining when I could leave and, once I knew that, I marched to her tune and did and said what I had to do to get out, including submitting to a pharmacological regimen far worse than the one that had landed me there in the first place.  Initially the drugs seemed to help but eventually I developed something called toxic psychosis from being on Wellbutrin, Prozac, Klonopin, Valium, Xanax, Trazedone, Ambien and Provigil.  I was on all of these at once, after having been prescribed the anti-psychotic that landed me in the hospital in the first place.

I’ve talked about my suicide attempt on this site before.  But I seldom discuss the aftermath of the hospitalization.  I was fucking insane.  I attempted suicide at least two more times and both times Mr Oddbooks did what he had to do to both save me and keep me out of the hospital because the hospital had made it all so much worse.  I am often scared to share this element of my recovery because I fear that someone who is suffering who may not have a genuine will to die may read this and think that not seeking help is in their best interests.  But the fact remains that most forms of help available to me during that time invariably made everything so much worse.  Nothing got better until I detoxed from all those drugs I was on.  And I was too scared to go to rehab to get off those drugs (and insurance denied it anyway), given my experiences in the loony bin.  From September 2008 through the end of September 2009  I lived in hell and my husband did, too.

But here’s what I want people who read this to understand:  drug-induced psychosis is not a valid will to die.  Now that I am drug and alcohol-free, my life is strange to me at times but I am very glad I am alive.  But my happiness to still be here is not proof that suicide is a great moral harm.  It just means that what happened to me is not universal.  Once I was drug-free I never attempted suicide again and never again had a definite and clear urge to die.  It would have been very regrettable had any of my attempts succeeded.

But that is the caprice of life, is it not?  We regret a lot of things.  And due to that potential for regret we’ve decided that we can dictate to a cancer patient in terrible pain, a brain tumor patient who does not want to bankrupt her family in exchange for a few months of life, a person with MDD who simply cannot face another episode, that the possibility of someone somewhere making a bad decision means they cannot make a decision.  Your regret, my regret, your best friend’s brother’s regret are not everyone’s regrets.  The potential for regret doesn’t prevent gun sales.  It doesn’t prevent divorce.  It doesn’t prevent the purchase of mid-life crisis Corvettes that get wrapped around utility poles.  It is puritanical and disingenuous concern that causes our potential regrets to condemn this specific choice.  Concern trolling, as it were.

That doesn’t mean that you don’t want to help a fifteen-year-old kid who is facing turmoil due to transgender status or terrible home life.  Such a being is not in clear mind – that person needs intervention, as I did as I was not in my clear mind when I tried to die, even if the help was not particularly helpful.

What you should do is stop using the worst case scenario – a young person making a bad decision or a middle-aged woman in a psychotic haze making a mad decision – and using it to make public policy to prevent people whose lives are a misery to them and will never improve from exercising their will to die.

But it has to be said:  though I recall very little of that year of my life, I do know that if I ever, for any reason, decide to take my life, I won’t attempt an overdose.  I will use a far more more violent and effective method because the aftermath of suicide was far worse for me than the act itself.  I know for a fact that Caplan is wrong.  There are many, many costs to disposal.

*****

Ultimately, at heart, I am not an antinatalist.  Part of my reluctance to adopt such a philosophy is that I don’t know how self-aware and conscious many people are, how much their life is dictated by reason and how much is dictated by instinct.  We are animals, albeit animals with a bit more strategic capacity.  I think I am too pessimistic about the human condition to be an antinatalist because I just don’t think that the mass of humanity really think through their life choices.  And I’m not patting myself on the back here – had we not suffered from infertility there is every chance Mr Oddbooks and I could have brought a child into the world based on whim, tradition, a misplaced desire to make someone else happy, a belief that a shiny new person could heal old scars.  The will that guides me is not always what happens.  Human beings are remarkably preprogrammed in many ways.  At its heart, despite the innate pessimism in seeing mankind’s self-awareness and advanced consciousness as a curse, antinatalism is a philosophy that if made active requires optimism, hoping that human beings can put their higher consciousness to work in a manner that eliminates current and future suffering.  I don’t think we all have such nobility of character.  I’m just not that hopeful.

But Christ this book made me think.  It’s extraordinarily well-written, well-researched and well-reasoned.  It was elegant at times.  And it helped me deal with the death of my mother in a way I had not expected.  I didn’t have to dwell in platitudes.  I didn’t have to deny what was happening to us all watching her slowly starve to death.  I could say that what was happening was morally wrong, and I was surprised when a few others agreed with me.  I am very grateful to Sarah Perry for that.

Highly recommended.

14 thoughts on “Every Cradle Is a Grave by Sarah Perry

  1. I haven’t finished reading your discussion yet, but so far I’m finding it very, very moving and thought-provoking.

    One thing I don’t understand about Perry’s rebuttal of Caplan. If one of the problems with suicide as it is treated now in America is that the suicidal person has to conceal their plans from their loved ones — because of expected resistance, thwarting of their plans, emotional upset — what difference would it make if assisted suicide became legal here? If I wanted to end my life, would it make any difference to my loved ones if I wanted to end it with pills or a gun, or at a hospital? Would their response be significantly different? Would the effect on my loved ones differ other than that I’d spare them the trauma of finding my body?

    1. Well, on some level we would need a titanic shift in how we view suicide in order to keep loved ones from being betrayed or deeply unhappy when someone decides to die.

      But if people could go to family members and say, “I no longer want to live, I have approached this sanely and have made my decision and I plan to kill myself in a week.” In a society wherein suicide is not seen as a selfish waste of life or a sign of deep mental illness, provisions could be made for loved ones to be there to comfort the suicide. Provisions could be made for a funeral director to come and get the body after death. There could be so many different ways to avoid the betrayal that comes from sneaking and the body-burdens that happen when a loved one finds you dead unexpectedly.

      And I think it would have a different effect on your loved ones. I think if you can plan openly, if it isn’t a surprise, if the family isn’t asked to engage in difficult activities like cleaning up after a violent suicide, it can make it not too much different than what people experience when they lose a loved one after an illness. It will be painful but it will be less tainted by betrayal, shock and a sense of helplessness and second-guessing.

      1. My friend Scott committed suicide in 2002. My feelings about his death have shifted around a bit over the years, from anger/betrayal to acceptance and finally to something complicated I can’t begin to articulate.

        I’m one who believes assisted suicide should be legal everywhere, and that humans’ rights should be honored along with women’s reproductive rights. Yet, Scott’s decision to end his life troubled me deeply, because I couldn’t — and still can’t — see any reason why I would have accepted that decision. He wasn’t physically ill, and he wasn’t in a life situation that necessarily caused him any suffering. He may have been severely depressed, but that, to me, is not a valid justification. Certainly if he’d come to me and said that he wasn’t ill in any way and simply wanted to end his life, I’d have argued against it and tried to stop him.

        We are social animals, so much so that humans who are socially isolated have been shown to die sooner than those who are connected. In a sense, we don’t truly belong to ourselves because we are socially integrated with others, via family relationships, friendships, and romantic partnerships. For one member of our social organism to die out is naturally a traumatic event, and noting short of divine intervention or genetic manipulation will remove our sensitivity to part of our larger “selves” being destroyed.

        We will necessarily tolerate and accept death when it happens due to circumstances outside of our control, but for someone to voluntarily choose to rip themselves away from our social organism? I think we’re hard wired to reject this. To assert that this could somehow change on any kind of significant scale seems utopian to me.

        Someone outside my social circle? Sure. I don’t have an opinion because I have no skin in the game. Someone socially connected to me? Never going to accept suicide that isn’t a response to old age, terminal illness, or some other suffering that only death can bring an end to.

        1. Especially in regards to this book, all philosophical approaches to the meaning of life are going to be difficult to apply directly to all of life’s experiences and reactions. And when you have a strong aversion to suicide because of a suicide that seems inexplicable, I don’t know that you need to make that reaction fit this philosophy. The personal reaction is still very valid and not anything you need to defend – I am still a bit stricken by my own grandfather’s suicide, no matter how much I understand it and accept it.

          What happened for me when I read Every Cradle is that I found myself with a new way to look at this topic, a new framework for understanding that which seems inexplicable.

          Sarah doesn’t argue that suicide will not be traumatic to the social units we live in, even if we all become antinatalists. She does, however, ask if those of us in the social unit have the right to ask anyone who is suffering enough to want to die to stay with us and continue that misery because we, the social unit, prefer to have that person alive. Do the ties that people have to family and the community trump a person’s right to terminate a miserable life? Perry would say that when a person decides to bring a child into the world, that person loses the right to end their life because they made a conscious choice to bring an innocent soul into being and therefore must not heap misery upon that innocent soul. But beyond that, she asks if the community really has a right to ask a miserable person to stay alive on the basis of those community ties.

          Another small framework to process suicide, especially in the one you are describing (and I am so sorry you lost a friend), is the rejection of Caplan’s free disposal theory. On the surface, my grandfather seemed like a man who had no reason to die – good health for his age, relatively good marriage, large supportive family, religious ties to community, no history of deep depression, and on and on.

          However, if you favor Perry’s view on the ridiculousness of the free disposal theory, as I do, you suddenly realize that killing one’s self is full of costs, costs that dissuade many from even attempting suicide. When a person becomes willing to pay that cost – hurting loved ones, risking not succeeding and the fallout from that, lonely planning in secret, the loneliness of dying alone – and it becomes clear that while we may not understand the motives, we can rest assured that if a person was willing to pay those costs, then the person was in fact suffering and we need to try to cope with the notion that it may be terribly cruel to ask a person to remain in such misery.

          But say antinatalism takes hold and we stop reproducing and stop preventing suicides willing to pay the cost of disposal, it will never cease to be horribly painful when those we love choose to die. For me the philosophy in the book helped me understand the unthinkable and give it a framework that allowed me to understand why my pain and loss may not matter as much as I thought they did.

          This is such a hard topic. I can intellectualize all I want but the pain will always be there when those we love leave us, by choice or not. And I don’t know if intellectualizing suicide is ultimately in my best interests but at the end of the book a lot of the anger and dread I used to feel faded a bit. Mileage, as always, varies.

          1. So, it seems like the issue boils down to the extent of the responsibility that an individual has to their community. Like how a common justification for having children is that someone needs to bear the responsibility of maintaining and moving society forward, so anyone who can have children and doesn’t is shirking societal duty. Does a person have exclusive rights to their own survival, or must they respect the needs of their loved ones?

          2. A distinction between obligations might be useful. If you have a child, it could reasonably be argued that you inhere an obligation to see to that person’s needs and thus forfeit your self-interests to some degree. Such forfeited interests might include an interest in ending your own life. I don’t think this works in reverse, nor with friendship, nor with mutually entered contracts. Having children is sui generis.

            Unless you’re a certain kind of egoist, the questions that follow will be very difficult. If nothing else, the difficulty itself might serve as reason not to take a dismissive stance toward suicide rights and antinatalist ethics.

  2. Edward,

    I think there are good reasons to imagine that the suicide prohibition makes the interpersonal dimension of suicide worse by enforcing concealment and by promoting more traumatic psychic sequelae for those who discover bodies and live with loss, but Sarah’s point contra Caplan is simply that suicide is costly and difficult (rather than cheap and easy). One aspect of the cost and difficulty that Caplan neglects to consider is the psychological burden of knowing that one’s act of self-destruction will hurt others. Her thought experiment where she tries to envision a world of truly “free” disposal is ironic inasmuch as it shows that such a world would probably be incompatible with human nature. This, I believe, illustrates the reflexive flippancy of Caplan’s view (which is shared by many).

    By the way, I’m glad that Anita’s discussion focuses on this aspect of the book because Caplan’s argument — which he has since cited many times without revision — was originally intended as an “obvious” rebuttal (or refutation) of antinatalism. Full circle.

    1. I guess I’d need to read Perry’s argument to really understand what she’s advocating. Is it merely legalization of suicide? Because that would only address a few of the problems inherent in how suicide is dealt with today. Or is she arguing against the cultural revulsion of suicide? If that’s the case, then, well, good luck with that. We don’t need to look back as far as the Holocaust to witness the extremes of suffering humans will endure in order to survive or to prevent the deaths of others. Suicide for reasons other than terminal illness or extreme disability is unlikely to ever be deemed acceptable by the majority of humans. But again, I’m interested to read her own words on this.

      1. Because I reacted to this book in such a visceral and emotional manner, I think I didn’t do the book the justice it deserves. When you read this, read it in the same vein you would read any philosophical treatise. Perry is less creating a direct advocacy for suicide than she is analyzing the pros of an antinatalist view and the cons of our current anti-suicide and pro-birth world. It’s a philosophic analysis of world views with a suggestion that perhaps the aberration of human consciousness and self-awareness lead to suffering and that refusal to continue to exist in a state of suffering or to create more people to suffer is a superior approach to handling such suffering.

      2. I was responding more narrowly to try to further contextualize Caplan’s position and Sarah’s response. It’s a small part of the book that provides necessary groundwork for what follows, which isn’t so much a work of “advocacy” as it is a kind of light-handed exposition on how to “rethink” bioethical subjects enshrouded in the thick smoke of sacredness. The fact that so many intelligent people flippantly insist that suicide is “easy” or “cowardly” or even that it is predominantly caused by depression (empirically not true) suggests that there is something curiously amiss in our thinking. This is also true of the seldom-examined assertion that “life is a gift.” Sarah’s book asks why we find it difficult to think clearly about starting and stopping lives, and I think she provides a way of getting past the prevailing cultural stop signs and meaning-bound narratives and on to more difficult terrain. To my biased mind, this is a more interesting project than merely arguing against legal and moral constraints on human autonomy, though Sarah’s stance on such matters is made clear enough.

  3. This was a hell of a heavy read.

    I’ve read some of Caplan’s arguments against Antinatalism, but I don’t remember coming across this “cheap suicide” idea. It’s such a silly idea, I can’t believe someone would seriously propose it. His other comments on the subject were pretty bad too. Whenever he talks about this subject, he really comes across like he has no idea what he was talking about.

    Antinatalism is something I agree with on a philosophical level, but I pretty much agree with you that people’s desire to have kids isn’t going to go away any time soon.

    Suicide ethics is something I haven’t really considered much, and the discussion here gave me a lot to chew on. When the book was announced, I got the impression it was going to be more of an antinatalism book. All the more reason to pick it up.

  4. I found this book really troubling. I held off commenting about it because I was going to write about it on my seldom up-kept book blog, but I haven’t done that yet and Satan knows whether I ever will. It was a very interesting reading experience for me, because I’m generally sympathetic to antinatalist perspectives and am very skeptical about my own reproduction, yet this book did the opposite of what it sets out to do and made me question whether I can continue to hold those of my views that are closest to Perry’s.

    I didn’t find Perry’s arguments about suicide terribly coherent, though I’m broadly in agreement that the taboo around it is counter-productive. At different points in the book she seems to give wholly different reasons for why people most often choose to die – initially arguing against the idea that economic circumstances are to blame, and later dedicating a whole chapter to arguing exactly the opposite. She also states often that people don’t usually want to die because of mental illness, but I know from both personal and professional experience that the truth is more complicated that this, and psychosis, which is real and terrifying, can directly influence a person’s decision to try to die.

    Towards the end of this book, when Perry started advocating human intervention to bring an end to all conscious life, I started feeling ill. Not that I believe nature is inherently good or anything such, but I find the worldview that holds mankind both capable of and right to consider bringing about an end to all life so warped and limited as to be fundamentally wrong. It strikes me as a supreme arrogance – a weird form of anthropocentric thinking that seems in thrall to religious ideas of where humans fit into God’s plan, except that God isn’t in the picture anymore and “logic” has replaced him. This, despite the analytical philosophy Perry promises at the start of the book never making much of an appearance.

    The universe is indeed vast and indifferent, and any advanced neutering program humanity could carry out to bring an end to potential suffering in nature could only ever be partial on the planet earth, let alone in relation to the myriad forms of consciousness that matter doubtless arranges itself into far away from our grasp or understanding. What Perry is arguing at the end of the book is Quixotic to say the least and reminded my of nobody more than Valarie Solanas (who I love, incidentally – a lot of what sounds like criticism here isn’t that at all. A book that makes me feel ill like this one did is a rare creature).

    I have a problem with the way the arguments in this book proceed, basically setting up a saint-like moral position about suffering and then arguing for the death of all things as a result. It makes antinatalism seem so self-righteous to me, and this kind of extreme moral utilitarianism seems arid and unappealing. What’s more, a lot of other arguments that would apparently follow from this kind of extreme anti-suffering perspective, such as state intervention in health and welfare, free dentistry etc. are dismissed by Perry from what seems implicitly to be a libertarian ideological position, but without evidence or discussion, with declarative statements claiming, for example, that attempts at organized help usually make life worse. Also, vegetarianism would seem to be pretty high on a list of active steps to reduce the suffering of conscious beings, and though this is important to other moral utilitarians like Singer, is not even mentioned in passing by Perry. I doubt it would fit her oh-so-dark libertarian agenda. (Being more generous, maybe it’s just outside the scope of the brief?)

    When it came to Perry’s afterword, where she gets into the personal feelings that lie behind some of her arguments, I could finally relate to what she was saying. It is lonely to want to die in a world that won’t talk about suicide. It is horrifying to feel that your life has no meaning or narrative. When she says science has told us that our narratives are false, though, I would suggest that science doesn’t say anything much at all about the subject. I would also suggest that the end of the grand narratives is just another grand narrative, albeit an unusually depressing one.

    I found Perry’s book inspiring in some ways, because I was continually frustrated and bemused by the way she went about making a case for things I thought I agreed with. I’m glad to have read it, but not at all for the reasons I thought I would be.

    I know this was long, and I know I probably should have planned it out and written it properly on my own blog, but hopefully this wasn’t a total misfire.

    Congrats on the new blog, Anita.

    V.

    1. Wow, this is a great comment, Vince. Don’t ever worry about comments being too long. I’m under the gun at the moment but will come back to this and reply in depth when the smoke clears. At the moment I can say that a friend told me I need to reread this book now that I am no longer in the middle of my own chaos narrative because he has a similar view point as you. But he also hails from a decidedly socialist country wherein health care is expansive and free and the societal infrastructure so different than that in America that life here would seem savage to him were he to try to live here. Though antinatalism is far from an American concept, I wonder if the way of life and social expectations the USA can make the idea more palatable.

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