Etyczne aspekty zapobiegania i udzielania pomocy w samobójstwie

Abstract

Whereas traditional ethical discussions of suicide have primarily dealt with questions relating to the moral rightness or wrongness of suicidal acts, the problem of which moral criteria should govern acts of preventing, admitting and aiding suicide has rarely been discussed systematically. In the present paper it is argued (1) that suicide is morally neutral in all cases in which it does not constitute grave damage, material or psychological, to others (e.g. near relatives), (2) that this does not imply that non-prevention, in the same range of cases, is morally neutral as well. Moral criteria for suicide prevention are formulated by making use of the Rawlsian device of a fictitious “veil of ignorance” behind which moral rules are decided on from merely self-regarding motives. It is argued that decision behind the veil would be of a principle of “restricted paternalism” that minimizes both the risk of not being prevented from committing suicide in cases in which this is clearly irrational in view of the enduring preferences of the suicidal person himself, as well as the complementary risk of being subjected to compulsory detention or treatment in cases in which suicide is the option conforming most, on a realistic view of the case, to the enduring preferences of the person. The practical rules translating the principle into concrete practice comprise a rule demanding compulsory prevention of all imminent suicides by persons not intimately known to the potential preventer, a prohibition of pre-emptive compulsory measures, and a general temporal limitation on detention. Finally, a similar, if more tentative, derivation of practical rules is attempted for cases in which aiding a suicide might seem to another person to be in the best interest of the suicidal person concerned.