It is slowly becoming accepted that people with terminal illnesses who are suffering physically and mentally from the illness have the moral and legal right to choose suicide and, in some jurisdictions, they have the ability to obtain assistance from others in accomplishing their suicide. Physician-assisted suicide is legal in Oregon and other regions of the USA and in some countries such as Switzerland. However, the presence of a psychiatric disorder in the individual usually makes it illegal for a physician to assist individuals (by prescribing a lethal dose of medication) in dying by suicide. What if the person does not have a terminal illness? Does this mean that their choice of suicide cannot be a rational decision? What if the person can be diagnosed with a psychiatric disorder? Does their psychiatric disorder eliminate the possibility of rational thought? Typically, today, the answer to both of these questions is Yes . In this book, David Lester, a renowned scholar in the field of suicide, argues that the answer to both questions should be No.
In August 2013, Martin Manley chose to die by suicide and left a website in which he had written his thoughts for the previous year and a half. Lester analyses Manley’s writing, and relevant psychological research, to argue that Manley’s decision was the result of rational thinking despite the fact that Manley did not have a terminal illness. The book also examines the notion that people with a psychiatric disorder cannot think rationally or make rational decisions. Lester first criticises psychiatry for being scientifically unsound and then presents evidence that those labelled by psychiatrists as having a mental illness can make rational decisions. Lester also presents the case of Jo Roman who was suffering from terminal cancer, who refused further treatment and arranged to die by suicide supported by her husband and large circle of friends. Lester concludes that deaths by suicide may be rational more often than we commonly believe and that these deaths may be appropriate ways of dying.