Ambivalence and Paternalistic Suicide Prevention

That suicidal persons often appear ambivalent about ending their lives seems to speak in favor of paternalistic suicide prevention. For in preventing the death via suicide of someone whose behavior suggests ambivalence on their part, third parties thereby act to prevent them from ending their lives when suicidal persons have an unsettled will regarding whether they stand to benefit from dying prematurely. Here I critically scrutinize this reasoning and propose that ambivalence’s role in suicide prevention is in fact more equivocal. (1) Ambivalence is easily confused with difficulty, and suicide is likely to present as a difficult choice regarding which individuals are understandably ‘torn.’ But difficult choices can nevertheless be sufficiently rational to ward off paternalism, and a fortiori, difficult choices involving clashing considerations are precisely those where deference to a person’s judgment is most called for. (2) Ambivalence need not indicate any defect in rational judgment. (3) The strongest rationale for suicide prevention in cases of ambivalence is epistemic: that suicidal individuals cannot access, or often fail to give adequate consideration, to reasons to continue to live (because, for example, they are suffering from depression). Preventing suicide in these cases thus serves as a ‘speed bump,’ designed to slow the person’s deliberation and to afford them additional time by which to access evidence that would resolve their suicidal ambivalence. In this respect, prevention would be justified not because ambivalence as such is irrational but because the person’s consent to their own suicide would be substantially misinformed. I conclude with four hesitations about this rationale.