A Philosophical Perspective on Euthanasia, Suicide, and Assisted Suicide

SECOND THOUGHTS

Name no man glad earlier than he’s useless, however solely fortunate.

—Solon, historical Greek lawmaker, one of many Seven Sages of Greece

Not too long ago, Psychiatric Instances columnist H. Steven Moffic, MD, shared his ideas about deciding easy methods to die to which Mark S. Komrad, MD, who’s concerned within the psychiatric elements of physician-assisted suicide, replied, adopted by a rejoinder and clarification by Dr Moffic. I want to handle Dr Moffic’s query with a philosophical perspective on dying. We are going to look at Socrates’ option to die (and different examples of suicide which go by completely different names), in addition to what is supposed by a “good dying,” which is the literal that means of euthanasia, from the Greek, εὐθανασία.

Why philosophy, the reader could ask? German psychiatrist-philosopher Karl Jaspers, MD, who launched the phenomenological methodology in psychiatry and have become one of many main philosophers of postwar Germany, put it very clearly¹:

If anybody thinks he can exclude philosophy and depart it apart as ineffective, he shall be finally defeated by it in some obscure kind or one other.

Half I: A Philosophical Perspective

Euthanasia, suicide, and physician-assisted suicide are matters which have stirred appreciable debate in modern society. These practices increase profound questions concerning the worth of life, the morality of dying, and the function of particular person autonomy in choices regarding one’s existence. Within the realm of philosophy, these points usually are not new; they’ve been contemplated by thinkers all through historical past. Some of the well-known circumstances that resonate with the philosophical discourse on this matter is the selection made by Socrates to finish his life by means of suicide. This essay explores euthanasia, suicide, and physician-assisted suicide from a philosophical standpoint, with a specific deal with Socrates’ alternative and its implications for modern moral views.

Philosophical Foundations of Euthanasia and Assisted Suicide

Philosophy offers a framework for understanding and evaluating the ethical dimensions of euthanasia and physician-assisted suicide. These practices could be examined by means of varied moral theories, together with utilitarianism, deontology, and advantage ethics.

From a utilitarian viewpoint, the morality of euthanasia and physician-assisted suicide is set by the results of the actions. Utilitarianism, championed by British philosophers Jeremy Bentham and John Stuart Mill, asserts that the very best motion is the one which maximizes total happiness and minimizes struggling. On this context, euthanasia and assisted suicide could be seen as morally permissible in the event that they alleviate insufferable ache and struggling, thereby enhancing the general well-being of the people concerned.

Deontological ethics, notably these espoused by German thinker Immanuel Kant, deal with the adherence to ethical guidelines and duties. From a deontological standpoint, the act of euthanasia or physician-assisted suicide could battle with the obligation to protect life. Kantian ethics emphasize the intrinsic worth of human life and the ethical obligation to respect it. Due to this fact, these practices could also be deemed morally unacceptable in the event that they violate the precept of treating people as ends in themselves relatively than means to an finish.

Advantage ethics, rooted within the historical Greek philosophy of Aristotle, emphasizes the event of ethical character and the pursuit of advantage. Within the context of euthanasia and physician-assisted suicide, advantage ethics would take into account the intentions and ethical character of the people concerned. If the choice to finish life is made with compassion, braveness, and a real want to alleviate struggling, it might be thought to be a virtuous act. Conversely, if the choice stems from egocentric motives or an absence of respect for all times, it might be deemed morally problematic.

Socrates’ Selection: A Good Demise

The trial and dying of Socrates represent one of many nice ethical occasions of antiquity, certainly of historical past …

—Paul Johnson²

Euthanasia, from the Greek, εὐθανασία, actually means “good dying.” Socrates, probably the most influential philosophers in Western historical past, confronted a state of affairs that has been interpreted by many as a type of assisted suicide. Was it a very good dying?

Condemned to dying by the Athenian court docket for impiety and corrupting the youth, Socrates selected to drink a cup of hemlock relatively than escape into exile or attraction his sentence. His resolution has profound philosophical implications and provides worthwhile insights into the discourse on euthanasia, the character of suicide, and the ethics of physician-assisted suicide.

Socrates’ alternative have to be understood throughout the broader context of his philosophical beliefs and the societal norms of historical Athens. Socrates valued the pursuit of fact and advantage above all else. He believed that residing a life in accordance with one’s rules was extra necessary than bodily survival. His resolution to just accept the dying sentence relatively than flee was an illustration of his dedication to his beliefs and his respect for the legal guidelines of the state.

Philosophical Implications

Socrates in jail, about to die for the fitting to specific his opinions, is a picture of philosophy forever.

—Paul Johnson²

And certainly this picture is captured poignantly by French artist Jacques Louis David in his neoclassical portray, “The Demise of Socrates” (1787), on view at The Metropolitan Museum of Artwork in New York. I don’t assume it’s an excessive amount of to make a parallel with the Final Supper of Jesus Christ. In each circumstances, we now have a tragic determine in his last Earthly moments surrounded by his closest disciples, going through a dying foretold with equanimity.

Socrates’ dying raises a number of philosophical questions concerning autonomy, morality, and the character of dying. By selecting to finish his life, Socrates exercised his autonomy in a way constant together with his beliefs. This act could be interpreted as a type of dignified dying, the place Socrates took management of his destiny and embraced dying as a pure a part of life. His alternative underscores the significance of particular person autonomy in making end-of-life choices.

Furthermore, Socrates’ alternative displays a profound understanding of the character of dying. He seen dying not as an evil to be feared however as a transition to a different state of existence. This attitude challenges the traditional view of dying as an final hurt and means that the moral analysis of euthanasia and assisted suicide should take into account the person’s angle in direction of dying.

Recall Sophocles’ phrases after being supplied hemlock in a cup, “I can nonetheless pray that my departure from this world shall be beneficent. So do I pray, and I hope my prayer shall be granted.” After consuming the hemlock, his buddies started to weep. “What a manner for males to behave!” he remonstrated with them, “I despatched away my womenfolk to stop this type of scene. I plan to die in a reverent silence, and now your tears are forcing me to joke! Pray, be calm, and courageous.”¹ With that, his legs already heavy from the poison, he lay down. Taken for useless, a fabric overlaying his face, Socrates all of a sudden eliminated the duvet and pronounced his last phrases to his rich good friend and confidant: “Crito, we owe a cock to Asclepius. Accomplish that and don’t overlook.”¹

Antigone’s Suicide: Affective Bonds vs the State

One other related instance from historical Greek literature is the suicide of Antigone, a personality in Sophocles’ play. Antigone defies the order of King Creon by burying her brother Polynices, who was thought of a traitor. As punishment, Creon condemns her to be entombed alive. Confronted with an agonizing dying, Antigone chooses to hold herself, asserting her autonomy even in her last moments. Antigone’s alternative highlights themes of particular person autonomy, resistance towards unjust authority, and the acceptance of dying on one’s personal phrases.

Her dying, very similar to that of Socrates, serves as a poignant instance of the complexities surrounding suicide in philosophical discourse. Slovenian crucial theorist, Slavoj Žižek, “probably the most harmful thinker within the West,” has given us a brand new translation of Antigone’s tragedy with a minimum of 3 different endings—Sophocles’ personal and a pair of Žižekian twists. This restaging forces us to confront what we’re to make of the unique message of the play at present.³

Antigone is, in my studying as a social thinker and household therapist, a foundational textual content about affective bonds and attachment versus society. Beneath regular circumstances, we comfortably steadiness the 2. But, when state energy or social conventions undermine the dignity of human and social relations, the stress can grow to be insufferable. Recall that in the course of the top of the COVID-19 syndemic, relations couldn’t go to their family members dying in hospital and couldn’t bury them. This triggered a deep-seated revulsion, feeding misunderstanding and distrust of public insurance policies of confinement and isolation.

Jewish Prisoners in Nazi Focus Camps

A very harrowing instance of people selecting suicide is discovered amongst Jewish prisoners in Nazi focus and dying camps throughout World Warfare II. Claude Lanzmann’s documentary “Shoah” offers a haunting exploration of life and dying in Nazi dying camps.⁴ Among the many many atrocities, it sheds mild on the suicides of prisoners who, confronted with the unimaginable horrors of torture, hunger, and the knowledge of a brutal dying by the hands of their captors, selected to finish their lives relatively than endure additional torment.

This act of defiance towards the Nazis’ dehumanizing regime was a method to train the final vestiges of their autonomy and to reclaim some measure of management over their destiny. These acts are a stark reflection of the human situation underneath excessive duress, elevating questions on company, dignity, and the boundaries of human endurance. Lanzmann’s work underscores the despair and lack of hope skilled by victims, presenting suicide as a tragic consequence of oppression. The dialogue about suicide comes after a 9-and-a-half-hour movie marathon. When requested why he would finish “Shoah” on such a unfavourable word, Lanzmann defended suicide as a constructive affirmation, a last assertion of management in an in any other case powerless existence.³

Simone Weil’s Passive Suicide by Self-Hunger

Simone Weil, a French thinker, mystic, and activist, is commonly cited for instance of passive suicide by means of self-starvation. Weil, recognized for her unwavering empathy and solidarity with the oppressed, intentionally restricted her meals consumption throughout World Warfare II. Her well being deteriorated as she sought to align herself with these affected by starvation underneath Nazi occupation. Her dying raises profound moral and philosophical questions on sacrifice, autonomy, and the intersection of non-public perception with the realities of struggling.

Bobby Sands and Political Suicide

Bobby Sands, an Irish member of the Provisional IRA, is a notable instance of political suicide. Whereas imprisoned in a British jail in 1981, Sands led a starvation strike to protest the British authorities’s refusal to grant political prisoner standing to IRA detainees. He finally died after 66 days of hunger, sparking worldwide consideration and debate. Sands’ starvation strike exemplifies the usage of self-inflicted dying as a type of political resistance, elevating questions on company, sacrifice, and the function of particular person acts in broader societal actions. His dying resonated deeply in Eire and past, highlighting the intersection of non-public autonomy and collective battle.

Mohamed Bouazizi and the Arab Spring

Mohamed Bouazizi, a Tunisian road vendor, ignited the Arab Spring by means of his tragic act of self-immolation in December 2010. Bouazizi’s suicide was a determined response to systemic oppression and humiliation after authorities officers confiscated his items and allegedly assaulted him. His dying turned a strong image of resistance towards injustice, sparking protests that led to the overthrow of Tunisia’s authorities and impressed uprisings throughout the Arab world. Bouazizi’s act underscores the profound connection between particular person autonomy and collective actions, illustrating how a single tragic occasion can catalyze societal change.

Fashionable Moral Views and Socrates’ Legacy

Socrates’ alternative has enduring relevance for modern debates on euthanasia and assisted suicide. His legacy invitations us to rethink the moral foundations of those practices and to strategy them with a nuanced understanding of particular person autonomy and the character of dying.

One of many key rules in fashionable bioethics is respect for autonomy. Socrates’ alternative exemplifies the train of autonomy in a profound manner. As we speak, this precept is central to arguments in favor of euthanasia and physician-assisted suicide. People ought to have the fitting to make choices about their very own our bodies and lives, together with the selection to finish their struggling by means of euthanasia or physician-assisted suicide.

Socrates’ alternative additionally highlights the significance of compassion in moral decision-making. Fashionable advocates of euthanasia and physician-assisted suicide stress the function of compassion in assuaging insufferable struggling. Socrates’ acceptance of dying as a method to flee the struggling imposed by his sentence resonates with the compassionate rationale behind these practices.²

Socrates’ perspective on dying challenges the traditional view of it as an final hurt. His philosophical strategy encourages us to rethink the character of dying and to contemplate it as a transition relatively than an finish. This understanding can inform modern moral discussions on euthanasia as a “good dying” and assisted suicide as a compassionate response to struggling, suggesting that these practices could also be morally permissible in the event that they align with the person’s understanding and acceptance of dying.

Views of Psychiatrists in Canada, the US, and Europe

The views of psychiatrists in Canada and the US add one other dimension to the talk on euthanasia and physician-assisted suicide. In each international locations, there’s a recognition of the significance of psychological well being and the function of psychological struggling in choices associated to end-of-life care.

Canadian psychiatrists emphasize the necessity for complete psychological well being assessments earlier than contemplating euthanasia or physician-assisted suicide. They advocate for thorough evaluations to make sure that sufferers don’t make choices based mostly solely on treatable psychological well being circumstances equivalent to despair or anxiousness. Moreover, Canadian psychiatrists spotlight the significance of palliative care and assist programs to handle the psychological and emotional elements of terminal sickness.

Within the US, psychiatrists additionally stress the importance of psychological well being evaluations within the context of euthanasia and physician-assisted suicide. They argue that sufferers must be supplied with satisfactory psychological well being assist and counseling to discover all doable choices for assuaging struggling. American psychiatrists are involved concerning the potential dangers of coercion and the necessity to safeguard weak populations, making certain that choices are made with full autonomy and knowledgeable consent.

In lots of European international locations, there’s a nuanced strategy to those practices, deeply rooted in each moral concerns and the excellent understanding of psychological well being. European psychiatrists emphasize the significance of holistic psychological well being assessments, making an allowance for not solely the psychological state but additionally the socio-cultural context of the affected person. They advocate for a multi-disciplinary strategy, involving varied well being care professionals to make sure that all elements of the affected person’s well-being are thought of. European psychiatrists are notably involved with safeguarding the autonomy of sufferers whereas additionally addressing the potential for vulnerability and coercion. They stress the need of knowledgeable consent and the significance of palliative care choices to assist sufferers of their end-of-life choices.

Conclusions

Euthanasia, suicide, and assisted suicide are advanced and contentious points that require cautious philosophical consideration. Socrates’ alternative to finish his life by consuming hemlock provides worthwhile insights into the moral dimensions of those practices. His legacy underscores the significance of particular person autonomy, compassion, and a nuanced understanding of dying in making moral choices about end-of-life care.

The views of psychiatrists in Canada, the US, and Europe additional illuminate the significance of psychological well being assessments and assist programs in these choices. By analyzing these practices by means of the lens of philosophy, Socrates’ instance, and psychiatric views, we are able to achieve a deeper understanding of the ethical rules that ought to information our strategy to euthanasia and assisted suicide.

Lastly, the teachings that stay from Socrates’ alternative not solely apply to philosophy as a lifetime of apply however for the apply of psychiatric medication. As a matter of precept, I’m not for suicide, assisted or in any other case, by no matter time period or definition of this we undertake, utilized to no matter circumstances. But, it’s laborious to dismiss the intense and profound examples raised right here, starting with Socrates’ alternative, adopted by Antigone’s suicide, Simone Weil’s gradual suicide by self-starvation in solidarity with victims of conflict, Jewish suicides within the Nazi dying camps, political suicide by the likes of IRA prisoner Bobby Sands in a British jail, and Mohamed Bouazizi whose suicide triggered the Arab Spring, and naturally, Franco-Algerian existentialist Albert Camus on suicide in The Delusion of Sisyphus.⁵

Socrates’ Selection as an Occasion. Socrates’ alternative is probably the most vital single occasion within the historical past of Western philosophy. We might go as far as to say it’s the defining occasion of its start and its legacy—a veritable philosophical occasion within the full sense of the phrase. An occasion, as outlined by French thinker Alain Badiou, marks a earlier than and an after and, by means of a radical constancy to its that means, completely modifications one to the purpose that one turns into a brand new topic.⁶ With Socrates’ dying, we now have the dual start of philosophy as a apply and the start of the human being as an conscious and moral topic. 

Recall as soon as extra Socrates’ final phrases: “Crito, we owe a cock to Asclepius. Accomplish that and don’t overlook.” A lot has been written as to the that means of this gnomic farewell. Recall too that in Socrates’ Athens, Asclepius was a physician-god of therapeutic with the ability of life, even elevating the useless. Temples to Asclepius have been erected throughout Greece and Asia Minor, but the Athenian Asclepion was constructed privately with out state sanction.

This represents the stress between Socrates’ beliefs and people of the state, which will get to the center of the accusation of impiety towards him that led to his trial and conviction. Recall too that these tensions between the convictions of the person and the ability of the state are at stake in Antigone’s suicide and within the extra modern examples reviewed beforehand.

Now, what concerning the sacrifice of a cock to Asclepius? A cock crows the hopeful promise of a brand new day, symbolizing rebirth and afterlife to the Athenians. In his final request to sacrifice a cock to Asclepius, in calming his weeping buddies and reaching for a reverential silence at his dying, Socrates bequeathed us an eloquent paean to life and to the nice dying.

Pharmakos and Skándalon. As if this weren’t sufficient, the ultimate key to unlock this puzzle of Socrates’ final phrases is the polysemic Greek time period φαρμακός, pharmakos, that means each poison and treatment.⁷ Furthermore, the oldest that means of pharmakos is scapegoat, the innocent sufferer that’s sacrificed to expiate the sins of unhealthy others to hold illness and pestilence away from the neighborhood.⁸ The Biblical model of this within the Koine Greek translation of the Hebrew phrase מִכְשׁוֹל, miksol, within the New Testomony was σκανδαλον, skándalon, actually a “snare or stumbling block,” that means to trigger somebody to sin. Together with the cost of impiety, Socrates was the scapegoat accused of inflicting the youth of Athens to stumble. Quite the opposite, Socrates as a skándalon unmasks the corruption and tensions of his society. For us, these phrases carry starker fashionable meanings, and Socrates’ dying unmasks the scandal of Athens and his dying is a scandal within the historical past of our civilization.

In administering the hemlock to the scapegoat Socrates, it turned each a poison to hold out the dying sentence of the Athenian court docket and a treatment for his advantage. The pharmakos was the therapeutic liberation from the false society of Athens and an affirmation and apotheosis of the lifetime of fact to which Socrates in his life and philosophy for eternity have given start. We could properly and really conclude, with Solon, that Socrates had a very good dying (the unique Greek that means of εὐθανασία, euthanasia) and that he lived a cheerful life.

Right here is an appreciation of Socrates’ alternative and virtues by James Bailey, MD, a up to date doctor⁸:

Socrates’s final phrases thwart Athenian authorities’ makes an attempt to silence him, challenge a name for Asklepian beliefs to prevail within the metropolis of Athens, and establish the selfless caring for others exemplified by Asklepios as the best obligation for all people. Socrates calls us from the previous to recollect timeless Asklepian doctor duties to self, sufferers, and neighborhood.

Half II: A Psychiatric Doctor’s Observe

Could I by no means see within the affected person something however a fellow creature in ache.

—Moses Maimonides⁹

As a training psychiatric doctor, knowledgeable by philosophy and social psychiatry, I want to define my occupation of rules on euthanasia, suicide, and physician-assisted suicide, the latter of which matches by the identify of Medical Help in Dying (MAiD) in Canada.

1. Differentiate euthanasia from physician-assisted suicide (known as MAiD in Canada):

• Euthanasia is the intentional act of ending an individual’s life to alleviate intractable ache or struggling, often carried out by a doctor or well being care skilled.
• Euthanasia is additional divided into 2 varieties:
  • Energetic euthanasia: Includes direct motion, equivalent to administering a deadly injection, to trigger the affected person’s dying.
  • Passive euthanasia: Happens when life-sustaining remedy is withheld or withdrawn, permitting the affected person to die naturally.
• Doctor-assisted suicide (PAS), alternatively, happens when a physician offers a affected person with the means—mostly a prescription for a deadly dose of remedy—to finish their very own life. The crucial distinction between lively euthanasia and PAS lies in who administers the life-ending motion: in PAS, the affected person takes the ultimate step.

2. Differentiate 3 varieties of suicide:

• On account of psychological sickness and despair
• On account of bodily sickness and infirmity
• As a response to socio-political circumstances

I’ve compassion and empathy for all 3 predicaments. And but, prescription does

not all the time observe description; to know isn’t essentially to just accept or approve. As a doctor, I cannot help and abet anybody’s dying besides within the passive sense of not actively intervening to maintain life as in “no resuscitation” orders. I do consider, nonetheless, that we now have an lively obligation to alleviate struggling by means of accompaniment, psychological, relational, and social care, and the medical reduction of ache. I might add that we should always do all we are able to to respect the dignity of others and protect our personal.

The talk in Canada has now polarized across the first kind of physician-assisted suicide for psychological sickness. And it hinges on the notion of rights and equal entry. I discover it incongruent bordering on absurd that I dedicate a lot power coping with suicidal youth and our makes an attempt as companions with youth, their households, and well being and social care providers to stop their repetition whereas colleagues in my very own division are selling physician-assisted suicide with no consideration for psychological sufferers.

3. Distinguish between empathy and sympathy:

• As I put it in my evaluation of polarization, distinguish between description and prescription (see additionally Gordon Friesen’s article).
• Description: It’s one factor to have therapeutic empathy for a predicament such because the ache and struggling related to extreme and power sickness, and to explain it precisely and to know it.
• Prescription: It’s fairly one other to sympathize with it and assist it and actively prescribe suicide as a medical answer, whether or not voluntary (a private alternative), nonvoluntary (the particular person can’t select or make their needs recognized) or involuntary (a reliable particular person doesn’t consent).

This isn’t solely the notorious “slippery slope” that Karandeep Sonu Gaind, MD, in Canada and Mark S. Komrad, MD, within the US have warned us about however a trenchant reframing of the stakes and the class errors made in our serious about physician-assisted suicide (MAiD in Canada) which legitimizes its medical apply. A class mistake happens after we current one thing from one class as if it belongs to a different. Description (what’s, factually) and prescription (what should be, in worth phrases) are separate and distinct classes.

Talking for myself, I took the Hippocratic Oath¹⁰ upon graduating from McMaster Medical Faculty, together with the Oath or Prayer of Maimonides.⁹ Each of those historical prescriptions for moral medical apply encourage beneficence concerning human struggling and humility within the face of our all-too-human limitations. Hippocrates’ Oath additional calls for that the doctor trigger no hurt when therapeutic the sick and enjoins towards assisted suicide and abortion¹⁰:

With regard to therapeutic the sick, I’ll devise and order for them the very best weight loss program, in line with my judgment and means; and I’ll take care that they endure no harm or harm. Nor shall any man’s entreaty prevail upon me to manage poison to anybody; neither will I counsel any man to take action. Furthermore, I’ll give no type of medication to any pregnant girl, with a view to destroy the kid.

Assets

Listed below are some important texts on Socrates, Antigone, suicide, and the Shoah:

• Paul Johnson, Socrates: A Man for Our Instances. Viking; 2011.² This biography by a British journalist with a compelling account of Socrates’ alternative is each scholarly and accessible to non-philosophers. Extremely advisable.
• Slavoj Žižek, Antigone. Bloomsbury; 2016.³ Slovenian thinker Žižek’s retelling of Antigone’s story provides Sophocles’ authentic ending and two different endings that Žižek provides to resolve her predicament otherwise with out resorting to suicide.
• Claude Lanzmann, Shoah: An Oral Historical past of the Holocaust. The Full Textual content of the Movie. Pantheon Books; 1985.⁴ French filmmaker Lanzmann’s highly effective testomony to the horrors of the Holocaust advised completely by means of interviews with these concerned on either side—prisoners and guards. Antek Zuckerman, who fought within the Warsaw Ghetto Rebellion, spits out: “For those who might lick my coronary heart, it might poison you.”
• Albert Camus, The Delusion of Sisyphus and Different Essays. Alfred A. Knopf; 1955.⁵ The Franco-Algerian Nobelist’s most well-known assertion of his philosophy of the absurd, famously specializing in suicide as “the one really critical philosophical drawback.”
• Al Alvarez, The Savage God: A Research of Suicide. Random Home; 1972.¹¹ British poet and literary critic Alvarez provides one thing completely different: a private digest about suicide by means of poetry, sociology, psychology, and historical past from his perspective as a good friend of the poet Sylvia Plath who accomplished suicide and reflections on his personal try.
• William Styron, Sophie’s Selection: A Novel. Random Home; 1979.¹² This poignant American novel poignant impressed this essay. In it, Sophie, a Polish Catholic survivor of Auschwitz, was compelled to decide on which of her 2 youngsters would dwell when she arrived on the camp.

Dr Di Nicola is a toddler psychiatrist, household psychotherapist, and thinker in Montreal, Quebec, Canada, the place he’s professor of psychiatry & dependancy medication on the College of Montreal. He’s additionally scientific professor of psychiatry & behavioral well being at The George Washington College and president of the World Affiliation of Social Psychiatry (WASP). Dr Di Nicola has acquired quite a few nationwide and worldwide awards, honorary professorships, and fellowships. Of word, Dr Di Nicola was elected a Fellow of the Canadian Academy of Well being Sciences (FCAHS), given the Distinguished Service Award of the American Psychiatric Affiliation (APA), and is a Fellow of the American Faculty of Psychiatrists (FACPsych). His work straddles psychiatry and psychotherapy on one aspect and philosophy and poetry on the opposite. Dr Di Nicola’s publications embody: A Stranger within the Household: Tradition, Households and Remedy (WW Norton, 1997), Letters to a Younger Therapist (Atropos Press, 2011, winner of a prize from the Quebec Psychiatric Affiliation), and Psychiatry in Disaster: On the Crossroads of Social Sciences, the Humanities, and Neuroscience (with D. Stoyanov; Springer Nature, 2021).

Acknowledgements

H. Steven Moffic, MD, is a fellow Psychiatric Instances columnist and each Karandeep Sonu Gaind, MD, and Mark S. Komrad, MD, DFAPA, are outstanding voices within the physician-assisted suicide debate. All 3 are revered psychiatric colleagues in and expensive buddies. My title consciously echoes the title of William Styron’s poignant however controversial novel, Sophie’s Selection (1979)¹² which gained the Nationwide E book Award. In his essay, Dr Komrad cites the lengthy historical past and custom of medical ethics beginning with Hippocrates, whose oath I’ve taken. Nonetheless, as Socrates’ alternative instructs, even philosophy which purports to be “the Queen of the sciences,” providing sober second ideas on society, doesn’t in some way float above society ensconced in an ivory tower however is essentially and forcibly embedded in that very same society, as Karl Jaspers, MD, reminded us.¹

References

1. Jaspers Okay. Common Psychopathology. Hoenig J, Hamilton MW, trans. Manchester College Press; 1963:769-770.

2. Johnson P. Socrates: A Man for Our Instances. Viking; 2011.

3. Žižek S. Antigone. Bloomsbury; 2016.

4. Lanzmann C. Shoah: An Oral Historical past of the Holocaust. The Full Textual content of the Movie. Pantheon Books, 1985.

5. Camus A. The Delusion of Sisyphus and Different Essays. Alfred A. Knopf; 1955.

6. Di Nicola V. Badiou, the occasion, and psychiatry, half 2: psychiatry of the occasion. Weblog of the American Philosophical Affiliation. November 30, 2017. Accessed April 25, 2025. https://weblog.apaonline.org/2017/11/30/badiou-the-event-and-psychiatry-part-2-psychiatry-of-the-event/

7. Derrida J. Plato’s pharmacy. In: Johnson B, trans. Dissemination. College of Chicago Press; 1982.

8. Bailey JE. Socrates’s final phrases to the doctor god Asklepios: an historical name for a therapeutic ethos in civic life. Cureus. 2018;10(12):e3789.

9. Oath of Maimonides. Wikipedia. Accessed April 25, 2025. https://en.wikipedia.org/wiki/Oath_of_Maimonides

10. Practo Weblog for Medical doctors. The Hippocratic Oath: The Authentic and Revised Model. Accessed April 25, 2025. https://medical doctors.practo.com/the-hippocratic-oath-the-original-and-revised-version/

11. Alvarez A. The Savage God: A Research of Suicide. Random Home; 1972.

12. Styron W. Sophie’s Selection: A Novel. Random Home; 1979.