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Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law
When should we try to prevent suicide? Should it be facilitated for some people, in some circumstances? For the last forty years, law and policy on suicide have followed two separate and distinct laws aimed at preventing suicide and, increasingly, laws aimed at facilitating it.
In Rational Suicide, Irrational Laws legal scholar Susan Stefan argues that these laws co-exist because they are based on two radically disparate conceptions of the would-be suicide. This is the first book that unifies policies and laws, including constitutional law, criminal law, malpractice law, and civil commitment law, toward people who want to end their lives. Based on the author's expert understanding of mental health and legal systems, analysis of related national and international laws and policy, and surveys and interviews with more than 300 suicide-attempt survivors, doctors, lawyers, and mental health professionals, Rational Suicide, Irrational Laws exposes the counterproductive nature of current policies and laws about suicide. Stefan proposes and defends specific reforms, including increased protection of mental health professionals from liability, increased protection of suicidal people from coercive interventions, reframing medical involvement in assisted suicide, and
focusing on approaches to suicidal people that help them rather than assuming suicidality is always a symptom of mental illness. Stefan compares policies and laws in different states in the U.S. and examines the policies and laws of other countries in Europe, Asia, and the Americas, including the 2015 legalization of assisted suicide in Canada. The book includes model statutes, seven in-depth studies of people whose cases presented profound ethical, legal, and policy dilemmas, and over a thousand cases interpreting rights and responsibilities relating to suicide, especially in the area of psychiatric malpractice.
In Rational Suicide, Irrational Laws legal scholar Susan Stefan argues that these laws co-exist because they are based on two radically disparate conceptions of the would-be suicide. This is the first book that unifies policies and laws, including constitutional law, criminal law, malpractice law, and civil commitment law, toward people who want to end their lives. Based on the author's expert understanding of mental health and legal systems, analysis of related national and international laws and policy, and surveys and interviews with more than 300 suicide-attempt survivors, doctors, lawyers, and mental health professionals, Rational Suicide, Irrational Laws exposes the counterproductive nature of current policies and laws about suicide. Stefan proposes and defends specific reforms, including increased protection of mental health professionals from liability, increased protection of suicidal people from coercive interventions, reframing medical involvement in assisted suicide, and
focusing on approaches to suicidal people that help them rather than assuming suicidality is always a symptom of mental illness. Stefan compares policies and laws in different states in the U.S. and examines the policies and laws of other countries in Europe, Asia, and the Americas, including the 2015 legalization of assisted suicide in Canada. The book includes model statutes, seven in-depth studies of people whose cases presented profound ethical, legal, and policy dilemmas, and over a thousand cases interpreting rights and responsibilities relating to suicide, especially in the area of psychiatric malpractice.
584 pages, Paperback
Published March 24, 2016
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Displaying 1 - 6 of 6 reviews
August 13, 2020
This book is about the difficult subject of suicide (with a special consideration of assisted suicide) from legal, medical, psychiatric, and social policy standpoints. The author skillfully and quite comprehensively examines these aspects with the seriousness, empathy, and criticism they deserve, and provides a myriad of compelling policy changes to deal with the fact that many human beings kill themselves or wish to do so. The author surveyed 240 people who have attempted suicide, and some of their stories and viewpoints are mentioned throughout. A substantial part of the book is dedicated to analysing high-profile suicide-related lawsuits which have shaped the current laws and policies mostly in the US, but also European countries.
The book did become a bit repetitive at times, but overall, I found it an intriguing read and it held my interest in the subject throughout, especially with the occasional, refreshing, perfectly-placed wry humor of the author. Being interested in the field of psychiatry, my favourite thing about the book was the author's well-reasoned and brilliantly-navigated insistence on the just treatment of, as well as due empathy towards, people with psychiatric diagnoses who happen to be suicidal, who are frequently discriminated against in society and the legal system and are at times, sadly, not helped by the healthcare system.
The book did become a bit repetitive at times, but overall, I found it an intriguing read and it held my interest in the subject throughout, especially with the occasional, refreshing, perfectly-placed wry humor of the author. Being interested in the field of psychiatry, my favourite thing about the book was the author's well-reasoned and brilliantly-navigated insistence on the just treatment of, as well as due empathy towards, people with psychiatric diagnoses who happen to be suicidal, who are frequently discriminated against in society and the legal system and are at times, sadly, not helped by the healthcare system.
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October 1, 2025I was sitting in a semi-rural county’s sheriff’s training center on the third day of a Crisis Intervention Team (CIT) training. I was wondering what the standard was for an officer to detain and transport a person for psychiatric evaluation before a judge was to teach the officers – and me as the only community member – what the standard was. Had I read Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law, I wouldn’t have been so surprised at what I was about to hear. What I expected to be clear rules and consistent rulings turned out to be a morass of confusing and conflicting laws, decisions, and opinions.
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September 9, 2024
why’d she kinda cook w this!!
#bellaisoutjan152029
it low key shows that both ppl w mental illnesses and terminal illnesses both have a right to decide when to end their lives!!
the physician assisted suicide bout to go crazy after they hear about this one
#bellaisoutjan152029
it low key shows that both ppl w mental illnesses and terminal illnesses both have a right to decide when to end their lives!!
the physician assisted suicide bout to go crazy after they hear about this one
July 2, 2016
"Stefan’s book is valuable [for] its clear and comprehensive overview and critical evaluation of the law relating to suicide in general, decision-making competence, refusal of life-sustaining treatment, and assisted death. But it is much more than that.
… her thought-provoking and carefully argued book, Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law ... documents how the law and psychiatric practice fail to respect the autonomy rights of suicidal individuals and to offer them effective treatment.
Stefan … discusses ways in which prevention and treatment can be improved. Her analysis devotes fresh thinking about key questions …
Juxtaposing the way in which contemporary society responds to life-ending decisions of the terminally ill with attitudes and practices relating to suicidality in general sheds light on both.
… regardless of whether they agree with the author … those who go the distance on the journey will be challenged and rewarded …."
Franklin G. Miller, Ph.D.
Professor of Medical Ethics in Medicine, Weill Cornell Medical College
[excerpt above,
from Franklin G. Miller, Ph.D., Book Forum Review, American Journal of Psychiatry
Am J Psychiatry 2016; 173:736–737; doi: 10.1176/appi.ajp.2016.16040488]
________________
From the Publisher, Oxford University Press:
"Rational Suicide, Irrational Laws" is a nuanced, subtle, and thoroughgoing look at suicide and assisted suicide. ...
"Stefan debunks the idea that all suicide is a symptom of mental illness enacted by incompetent people. Stefan also proposes recommendations as to how we should respond to a suicidal person and the phenomenon of suicide generally. An important theme running through this book is that there is so much more we could be doing to help the patient want to live.
"All in all, a must-read for anyone interested in the phenomenon of suicide and assisted suicide--a masterful account."
--Elyn Saks, JD, PhD, Orrin B. Evans Professor of Law, Psychology, and Psychiatry and the Behavioral Sciences, USC Gould School of Law
"This is a landmark book written about thorny issues pertaining to suicide, mental health care, and mental health-related laws and policies within contemporary culture.
"Susan Stefan has an uncanny ability to point out when the 'emperor has no clothes' as she poignantly explores suicidal human suffering in the face of existing conventional mental health care that too often 'treats' suicidal people through control, coercion, and shame that is fostered and supported by existing policies and laws.
"This important book makes one think deeply about the topic of suicide, human suffering, truly compassionate care, personal liberty, and mental health-related policy and laws in novel and important ways."
--David A. Jobes, PhD, Professor of Psychology, The Catholic University of America
(as posted, at http://www.madinamerica.com/2016/04/7...
"Rational Suicide, Irrational Laws, [from] Oxford University Press and renowned scholar Susan Stefan ... There is much in this book that makes me want to stand up and cheer.
"A ground-breaking, brilliant, indeed courageous book ... a compassionate and an intelligent book, written by a researcher who listens intently.
"My invitation? Pick up the book, engage with it.
"Where you find yourself agreeing, ask yourself why.
Similarly, when you find yourself disagreeing, continue thinking about the issues raised."
-- Bonnie Burstow, Ph.D.; Dr. Burstow is a faculty member at University of Toronto"
… her thought-provoking and carefully argued book, Rational Suicide, Irrational Laws: Examining Current Approaches to Suicide in Policy and Law ... documents how the law and psychiatric practice fail to respect the autonomy rights of suicidal individuals and to offer them effective treatment.
Stefan … discusses ways in which prevention and treatment can be improved. Her analysis devotes fresh thinking about key questions …
Juxtaposing the way in which contemporary society responds to life-ending decisions of the terminally ill with attitudes and practices relating to suicidality in general sheds light on both.
… regardless of whether they agree with the author … those who go the distance on the journey will be challenged and rewarded …."
Franklin G. Miller, Ph.D.
Professor of Medical Ethics in Medicine, Weill Cornell Medical College
[excerpt above,
from Franklin G. Miller, Ph.D., Book Forum Review, American Journal of Psychiatry
Am J Psychiatry 2016; 173:736–737; doi: 10.1176/appi.ajp.2016.16040488]
________________
From the Publisher, Oxford University Press:
"Rational Suicide, Irrational Laws" is a nuanced, subtle, and thoroughgoing look at suicide and assisted suicide. ...
"Stefan debunks the idea that all suicide is a symptom of mental illness enacted by incompetent people. Stefan also proposes recommendations as to how we should respond to a suicidal person and the phenomenon of suicide generally. An important theme running through this book is that there is so much more we could be doing to help the patient want to live.
"All in all, a must-read for anyone interested in the phenomenon of suicide and assisted suicide--a masterful account."
--Elyn Saks, JD, PhD, Orrin B. Evans Professor of Law, Psychology, and Psychiatry and the Behavioral Sciences, USC Gould School of Law
"This is a landmark book written about thorny issues pertaining to suicide, mental health care, and mental health-related laws and policies within contemporary culture.
"Susan Stefan has an uncanny ability to point out when the 'emperor has no clothes' as she poignantly explores suicidal human suffering in the face of existing conventional mental health care that too often 'treats' suicidal people through control, coercion, and shame that is fostered and supported by existing policies and laws.
"This important book makes one think deeply about the topic of suicide, human suffering, truly compassionate care, personal liberty, and mental health-related policy and laws in novel and important ways."
--David A. Jobes, PhD, Professor of Psychology, The Catholic University of America
(as posted, at http://www.madinamerica.com/2016/04/7...
"Rational Suicide, Irrational Laws, [from] Oxford University Press and renowned scholar Susan Stefan ... There is much in this book that makes me want to stand up and cheer.
"A ground-breaking, brilliant, indeed courageous book ... a compassionate and an intelligent book, written by a researcher who listens intently.
"My invitation? Pick up the book, engage with it.
"Where you find yourself agreeing, ask yourself why.
Similarly, when you find yourself disagreeing, continue thinking about the issues raised."
-- Bonnie Burstow, Ph.D.; Dr. Burstow is a faculty member at University of Toronto"
April 17, 2016
IF I were seeking a lawyer to represent me, I would want someone like this book's author, Susan Stefan. It is not just her intellect and knowledge on display in her latest book, but her passion for truly helping legal clients. This is just the latest extremely well-researched and written book by Stefan, a national expert on disability and mental health law.
However, this is the first time to my knowledge that a prominent legal writer has reached out to those who are the real "survivors" of suicide and not just family members, other legal scholars and other academics, to write about this most profound of personal issues. She interviewed over 175 persons who have made suicide attempts, and she weaves many of their cases and their stories seamlessly into explanations of case law.
Early in the book the Stefan quotes Albert Camus. She talks of the “most basic of philosophical issues,” which is whether or not one should even exist--or not. Hence, about taking one’s own life. Hamlet’s question: “To be or not to be.”
We in the Western hemisphere have turned any human problem into a medical one in the last 30-40 years, and nowhere is this more apparent than in the medicalizing of melancholy or loss of hope. Stefan frequently points out in her commentary on legal decisions or changes in law in both the US and Great Britain how in the courtroom juries displayed more wisdom than the laws themselves. She eloquently states her case on the irony and the bad consequences of our existing set of laws against suicide and/or suicide attempts.
One of the most telling contrasts she presents is the case of the state of Virginia, where Thomas Jefferson first proposed decriminalizing suicide in the 18th century. But the state's present law still criminalizes those whose most drastic health or life decisions lead them to attempt to kill themselves. Her books notes our increasing reliance on the courts to penalize professionals who do not force treatment on those who are suicidal, which just makes no sense to me.
I think her commentary of the lack of reliable psychiatric prediction of who will or will not attempt suicide will be an eye opener for many--not just the general public and the media, but policy makers and academics. The deprivation of self-determination and choice for those with psychiatric diagnoses based on "so-called" predictions is common today under law. This needs to change.
I hope my state and national elected representatives and the media read this book. It is well worth the time to read it. Stefan’s book speaks both to me and for me. We who know the mental darkness that leads to suicide attempts deserve a say in this policy issue.
However, this is the first time to my knowledge that a prominent legal writer has reached out to those who are the real "survivors" of suicide and not just family members, other legal scholars and other academics, to write about this most profound of personal issues. She interviewed over 175 persons who have made suicide attempts, and she weaves many of their cases and their stories seamlessly into explanations of case law.
Early in the book the Stefan quotes Albert Camus. She talks of the “most basic of philosophical issues,” which is whether or not one should even exist--or not. Hence, about taking one’s own life. Hamlet’s question: “To be or not to be.”
We in the Western hemisphere have turned any human problem into a medical one in the last 30-40 years, and nowhere is this more apparent than in the medicalizing of melancholy or loss of hope. Stefan frequently points out in her commentary on legal decisions or changes in law in both the US and Great Britain how in the courtroom juries displayed more wisdom than the laws themselves. She eloquently states her case on the irony and the bad consequences of our existing set of laws against suicide and/or suicide attempts.
One of the most telling contrasts she presents is the case of the state of Virginia, where Thomas Jefferson first proposed decriminalizing suicide in the 18th century. But the state's present law still criminalizes those whose most drastic health or life decisions lead them to attempt to kill themselves. Her books notes our increasing reliance on the courts to penalize professionals who do not force treatment on those who are suicidal, which just makes no sense to me.
I think her commentary of the lack of reliable psychiatric prediction of who will or will not attempt suicide will be an eye opener for many--not just the general public and the media, but policy makers and academics. The deprivation of self-determination and choice for those with psychiatric diagnoses based on "so-called" predictions is common today under law. This needs to change.
I hope my state and national elected representatives and the media read this book. It is well worth the time to read it. Stefan’s book speaks both to me and for me. We who know the mental darkness that leads to suicide attempts deserve a say in this policy issue.
April 9, 2017
This book should be required reading for anyone working in mental health care, suicide prevention, or law and ethics. Stefan's writing is highly readable, and even wryly funny at times, despite the heartbreaking and sometimes infuriating subject matter. What I particularly like is that she includes the voices of 175 suicide attempt survivors, and fully admits that she found it difficult to be "objective" in the face of their bravery and what they had suffered. Frankly, we need more of this sort of bias. I sincerely hope this book is read and utilized by policy makers- she gives some excellent proposals for model policies in regards to mental health and suicide care.
Displaying 1 - 6 of 6 reviews