In Ancient Rome and other cultures, suicide was regarded as a rational choice in the face of dishonor. Only three candidates were barred from exercising this choice in Ancient Rome: those accused of capital crimes, soldiers, and slaves. The reason behind all three was that the state determined it was uneconomic to let these people choose to die. As for accused criminals facing capital punishment, the state would lose the right to seize the accuseds’ property if they were allowed to kill themselves before being executed. As for soldiers, suicide was deemed to be a form of desertion. And, finally, as to slaves, obviously, as far as the state was concerned, slaves did not own their own lives so they were not allowed to take them.
We’ve come a long way. Suicide is now widely viewed as a fatal disease, which I think is the most sophisticated and scientifically advanced understanding of the phenomenon. As such, very few of us think it would ever be fair or right to blame family members for a suicide. But is it right to assign blame physicians and care-givers?
If one embraces the idea of suicide as a disease, it would seem most appropriate to hold doctors and hospitals liable if their treatment if it falls below professional standards. We bring our ailing friends and family to hospitals and we entrust them to their care.
In a recent decision of the Minnesota Court of Appeals in Pfeiffer v. Allina Health Systems, the Court of Appeals reversed a decision by the Ramsey County District Court that threw out a malpractice claim that arose in the context of a suicide.
The case has some important analysis of court rules and procedural issues. But I cannot shake the feeling that possibly the trial court judge was influenced by the extraordinarily complex question of blame (and liability) for suicide. It might seem that there is something paradoxical, perhaps even intolerable, in finding one person blameless for an intentional act and another blameworthy for acts (or omissions) that are so plainly negligent, at worst.