Re: Suicide (was PCA statement on end of life decisions)

From: Freeman, Louise Margaret <>
Date: Mon Apr 04 2005 - 17:13:59 EDT

I can certainly empathsize with anyone in that position, as my family had to
make that decision for my father a year ago. He had advanced Alzheimers.

If by operate you mean inserting a feeding tube, and if a reference to
medical research helps, there are two recent articles (New England Journal
of Medicine 342:206-210 and Journal of the American Medical Association
282(14) 1365-70) that did an extensive lit review and found
1) no evidence that feeding tubes significantly prolong the life of advanced
dementia patients, compared to continuing hand feeding
2) no evidence that tube feedings reduce, and some evidence that they may
actually increase aspiration of stomach contents or saliva, and the
associated pneumonia.
3) no evidence that feeding tubes reduce discomfort, and some evidence that
they may actually increase it.
4) most dementia patients on feeding tubes have to be restrained to keep
them from pulling them out, and this restraint seems to cause agitation and

Both articles concluded that the harm caused often outweighs the benefits
and recommended against the routine use of feeding tubes in such patients.
These articles were not commenting on Terry Schiavo like cases, were the
tubes clearly do prolong life.

I think a Biblical case can be made for making dying people as comfortable
as possible (ie Proverbs 31's instruction to give wine to the dying). I
have little doubt that in Biblical times, giving wine to the critically ill
did shorten their lives, and I think the same reasoning could apply to
morphine drips and to rejecting a feeding tube or other surgical procedure
that would cause pain or distress.

-----Original Message-----
From: "Michael Roberts" <>
To: "Iain Strachan" <>, <>
Date: Mon, 4 Apr 2005 21:09:26 +0100
Subject: Re: Suicide (was PCA statement on end of life decisions)

The two worst funerals to take are suicides and children. What do you say to
a family whose 28 yr son has just hanged himself, without any indications of
problems? I also conducted the funeral of a young soldier found with a
bullet in his head at Deepcut Barracks - where 6 recruits have been found
dead with bullets in their head in the last 10 years. These funerals still
haunt me and are the only ones which do. They were totally devoid of joy,
and far more numbing than that of a child. The pain is far worse than either
cancer or a car crash. The worst was a friend who drank paraquat on the
anniversary of her father's suicide. Could one say that suicide not only
kills oneself but one's family as well. It causes guilt on those left far
more than any other death.I see the pain whenever I meet the suicide's
I think I can "understand" suicide but it cannot be seen as right. It raises
a few questions about the ethics of many groups like the Samaritans. But how
can one support the death penalty but not abortion and euthanasia?
On euthansia is there a difference between active killing and passive
killing e.g. giving more morphine to reduce pain knowing that it will
shorten what time is left, or withdrawing life support systems? One morning
at 7 o'clock a parishoner rang up and asked what to do about her 95 yr old
mother in hospital. The doctors had given her a choice as she could not
swallow; either let her die in a few days or operate and prolong her life
(delay her death) for a few weeks. I had to find a way of assuring her that
whatever she told the doctors she was morally right and a loving daughter.
----- Original Message -----
From: Iain Strachan
Sent: Monday, April 04, 2005 7:39 PM
Subject: Fwd: Suicide (was PCA statement on end of life decisions)

Oops, sent this one just to Jack and was intended for the whole list :-(

---------- Forwarded message ----------
From: Iain Strachan <>
Date: Apr 4, 2005 7:37 PM
Subject: Suicide (was PCA statement on end of life decisions)
To: jack syme <>

I wonder if I might solicit list members' views on the following (hope it's
not considered to be too far off-topic). I found the following clause in
the web-link that Jack posted ...

9. Euthanasia, or "mercy-killing" of a patient by a physician or by anyone
else, including the patient himself (suicide) is murder. To withhold or to
withdraw medical treatment, as is being discussed here, does not constitute
euthanasia and should not be placed into the same category with it.

I deliberately searched for "suicide" in this article on "end of life
decisions", as it's a subject of interest to me because of my involvement
with the Samaritans movement. I had been a volunteer from 1982 to 1989, and
decided to rejoin the movement in 2003 following the death by suicide of an
email acquaintance that I knew from another email list I was on. (In the
past Samaritans were advised to be secretive about the fact that they were
involved, but nowadays, they are encouraged to be more open about it).

The following is from the "Mission Vision and Values" statements from the
Samaritans website (

Samaritans' vision
Samaritans' vision is for a society in which:
Fewer people die by suicide
People are able to explore their feelings
People are able to acknowledge and respect the feelings of others
Samaritans' values
Samaritans' values are based on these beliefs:
The importance of having the opportunity to explore difficult feelings
That being listened to, in confidence and accepted without prejudice, can
alleviate despair and suicidal feelings
That everyone has the right to make fundamental decisions about their own
life, including the decision to die by suicide

So while the organization wants to see less people die by suicide, they also
(indicated by the last bullet point), support fully the right to end your
own life by suicide, clearly NOT condemning it as a form of murder, as the
clause in the PCA statement indicates.

This point came up in my selection interview. I was asked "Do you think
people have a right to commit suicide?". (They had already ascertained I
was a Christian, and wanted to be certain I wasn't going to start preaching
at callers about the wrongness of suicide). I was pretty flummoxed by the
question, and kind of got out of it by saying that I didn't think *I* had a
right to commit suicide, because of my beliefs, but equally I didn't have
the right to force my opinions down other peoples' throats who might not be
of the same persuasion.

Then I had an interesting email discussion with a friend from my
Shostakovich email list, who was a Buddhist. We were discussing the suicide
of the person I mentioned above, whose death prompted my return to
Samaritans. My Buddhist friend was of the opinion that suicide was a very
bad thing to do, and that "all major religions agree" that suicide is an
instant ticket to hell (apparently it is regarded as such in Buddhism -
somthing to do with Karma). I disputed this, and said actually having
thought about it, that in Christianity, although suicide is clearly a sin,
we all die with unconfessed sin, but the key was that if we believe in Jesus
Christ (John 3:16) we shall not perish but have everlasting life. I'm
afraid he wasn't convinced!

I've often spoken to Catholic callers, who, on asked about suicide will say
that their religion forbids it, but they'd love to just go to sleep and not
wake up. It is well-known that the Catholic church regards suicide as a
mortal sin, but even they apparently now say that it is not a mortal sin in
the case of the patient being mentally ill.

There was a recent horrific death by suicide in the UK that made the
national newspapers, where a man drove his car on a level crossing and
waited for the train. The train was derailed and many people were killed.
There was much from the press condemning the man and saying how selfish it
was. Then a national spokesperson for the Samaritans pointed out in the
press that people who are suicidal develop a kind of "tunnel vision" where
they are simply incapable of thinking about anything but themselves, and
their desire to end their lives. Maybe this falls into the category of
"mentally ill"?

I wonder what list-members views are on this?

Parting thought .. If a caller said to me (Matt 26:38) "My soul is
overwhelmed with sorrow to the point of death", I would ask them if they
were suicidal - on the face of it, it sounds very like someone in such
despair that all they want to do is die.

Guess the science/faith link is tenuous here ... possibly about mental
states, which has overlap with the Schiavo discussion.


On Apr 4, 2005 12:10 PM, jack syme <> wrote:

Morning all. I had been looking for this and finally found it.

My views are very much the same as this statement for the most part. The
language used is old, and the statement itself probably needs to be
upgraded. But everything I have been saying is consistent with the PCA

There are 3 types of people in the world.
Those who can count and those who can't.
There are 3 types of people in the world.
Those who can count and those who can't.
Received on Mon Apr 4 17:16:27 2005

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