Introduction
In this essay,
my focus on suicide in the Graeco-Roman world will begin with the Hippocratic
Oath and then turn to Greek drama (briefly) and philosophy. Special attention will be given to Stoic
views on suicide. I will also draw out
contrasts to early Christian writings.
Hippocratic Oath
and Assisted Suicide
The Hippocratic
Oath is the oldest known and longest lasting oath among medical
practiioners. First for our interests,
the oath has them pledge:
I will use those dietary regimens which will benefit my patients
according to my greatest ability and judgement, and I will do no harm or
injustice to them (Hippocratic Oath
1).[1]
Hippocrates
elsewhere calls on practitioners ‘to help, or at least not do harm’ (Epidemiae 1.11).[2] Another ancient author, Apuleius, attests to
this practice among physicians in his fictional work, Metamorphoses: a physician says that practitioners of medicine
were not to be responsible for anyone’s death or destruction (X.11).
Second, Hippocrates
proscribed two harmful practices in the oath that caused harm:
I will not give a lethal drug to anyone if I am asked, nor will I
advise such a plan; and similarly I will not give a woman a pessary to cause an
abortion.
The first proscribed
practice, giving a lethal drug to anyone, could be understood as aiding someone
in poisoning someone else, or it could be understood as aiding someone in
suicide. No distinction is made between
these alternatives, though, because the point is that a doctor was not to use
his knowledge of drugs to kill someone.
He was to do no harm.[3]
The second
practice is, more literally, not to give a woman a ‘harmful pessary’—the Greek[4]
has no reference to abortion, as in the quoted English translation. However, ‘harmful pessary’ would refer to abortion. Anthony M. Vintzileos
has argued that the pessary reference is to contraception.[5] While pessaries could be used for
contraception, they were also used to purge the uterus after birth or of a
child that died in the womb. A ‘harmful
pessary’, however, only fits the use of pessaries to abort the child. Both the first and second examples refer to
harmful practices in medicine and are examples of causing death.
Suicide and
Greek Drama: Honour
The plot of Sophocles
play, Ajax, advances as the Greek
hero tries to live nobly despite the fate of the gods. If fate is unavoidable, suicide allows one still
to maintain one’s honour. The notion
that suicide may be honourable in certain situations is a key theme in Greek
and Roman cultures. Sophocles presents the story of a Greek victor,
Ajax, in the battle against Troy. Having
lost the greatest honour for the battle to Odysseus, Ajax goes temporarily mad
and disgraces himself. Thinking he was
killing the Greek generals for insulting him, he instead slew the army’s
livestock. Having returned to his
senses, he says, ‘The
options for a noble man are only two: either live with honor, or make a quick
and honorable death’ (Ajax 480).[6] He then considers
suicide. His wife, Tecmessa, says that
fate decreed by the gods determine the events in one’s life: ‘Ajax, my lord, the fortune that humans are compelled to endure is
their gravest evil’ (485). The chorus
says that Ajax shares ‘his tent with a madness of divine origin’
(609-610). Ajax says, ‘And so hereafter
I shall, first, know how to yield to the gods, and, second, learn to revere the
Atreidae [the sons of Atreus, king of Mycenae]. They are rulers, so we must
submit’ (666-668).
Suicide and
Philosophy in Antiquity
The oath not to
administer a lethal drug to anyone if asked is a prohibition against assisted
suicide. In both of these, one can see
the importance of divine authority rather than civil law establishing
accountability: no authority can contradict divine authority in the matter of
when one departs this life. If we were
to consider this today, we would see the problems created in our day as
legislators debate bills for assisted suicide and abortion. In this, they overstep their authority both
in meddling with medical practice—about which one might well argue that they
are not adequately trained for such oversight—and in assuming a role in life
and death that belongs to God alone.
Pliny the Younger comments about a friend’s request for suicide that the
doctors hold that the gods have laid down the plan of life and death (Letters 1.22). The medical practitioner’s oath under divine
oversight recognizes that God gives and takes life, not the doctor.
In antiquity,
both suicide and abortion were regular and legal practices. According to the Hippocratic Oath, neither
was to be performed by a doctor.[7] Moreover, philosophical schools offered
distinctions in suicide that provided some basis for accepting it. Among these, the Pythagorean school clearly
demurred.[8] Socrates, agreeing with the Pythagorean,
Philolaus, claimed that anyone worthy of philosophy would not take his own
life, as this is not permitted (Phaedo 61c-d).[9] Socrates’ reason for opposing suicide was
that humans are the chattels of the gods and have no right to kill themselves
by their own design.
Quite possibly,
the Epicureans agreed. Affirming the
view that one should pursue pleasure and virtue in life, one might have
expected them to allow suicide in certain instances. Yet, according to Diogenes Laertius, Epicurus
wrote (the work has not survived) that the Sage (one living the good life
described by his philosophy) should hold himself worthy of life even if he
loses his sight (The Lives and Opinions
of Eminent Philosophers X.X).[10] Indeed, he says that Epicurus wrote on the
last day of his life, though suffering immensely from a strangury (painful
urination) and dysentery, that it was a blissful day as he contemplated past
conversations rather than his afflictions (The
Lives and Opinions of Eminent Philosophers X.X; cf. Seneca, Letters to Lucilius 66.47).
Socrates, Plato,
and Aristotle on Suicide
Plato wrote
several short works to do with Socrates’ trial and death: Euthephro, Apology, Crito, and
Phaedo. In 399 BC, Socrates stood trial on the
charges of impiety and corrupting the youth of Athens. Since the manner of his execution was by
means of drinking hemlock, the question of enforced suicide arises. He did not
put up the defence that he might have, perhaps because the charges were
politically motivated. Socrates says in
Plato’s Apology: ‘But, gentlemen, it
is not hard to escape death; it is much harder to escape wickedness, for that
runs faster than death’ (Apology 39a).[11] Much of his reasoning to accept the verdict of
the court has to do with not fearing death and what happens to the soul
afterwards.
In Phaedo, Socrates explains why suicide is
wrong: ‘Yet I too believe that the gods are our guardians, and that we are a
possession of theirs.... Then, if we look at the matter thus, there may be
reason in saying that a man should wait, and not take his own life until God
summons him, as he is now summoning me.’
Yet, his view of the afterlife and of the soul led him to say that, when
faced with death, one must not hold back.[12]
David Ebrey lists four arguments in Phaedo for the proposition that the soul
is immortal:[13]
1.
The Cyclical Argument: as the
body dies, its opposite, the soul, must not die. [Socrates believed in
reincarnation.]
2.
The Recollecting Argument:
since people seem to know some things apart from being shown the evidence, they
must be recollecting this knowledge. If
so, the soul existed before birth.
3.
The Kinship Argument: things are
either incorporeal or corporeal.
Incorporeal things are invisible and immortal, and the soul is not
corporeal but incorporeal.
4.
The Final Argument: since
particulars (e.g., a beautiful thing) participate in the universals, i.e.,
eternal forms (Beauty per se), and
the soul participates in the universal forms of life, it must be eternal.
Plato’s (or
Socrates’) view of death is that it frees the eternal soul from being pulled
down and confused in the world of particulars (cf. Phaedrus 245c-249d) that keep it from seeing the forms themselves
purely. The soul, freed from the body,
can ascend to gaze upon pure forms such as the Good, Justice, Beauty, and so
forth. He says,
the body is constantly breaking in upon our
studies and disturbing us with noise and confusion, so that it prevents our
beholding the truth, and in fact we perceive that, if we are ever to know
anything absolutely, we must be free from the body and must behold [66e] the actual realities with the eye of the soul alone.
And then, as our argument shows, when we are dead we are likely to possess the
wisdom which we desire and claim to be enamored of, but not while we live. For,
if pure knowledge is impossible while the body is with us, one of two thing
must follow, either it cannot be acquired at all or only when we are dead; for
then the soul [67a] will be by itself apart from the
body, but not before. And while we live, we shall, I think, be nearest to
knowledge when we avoid, so far as possible, intercourse and communion with the
body, except what is absolutely necessary, and are not filled with its nature,
but keep ourselves pure from it until God himself sets us free. And in this
way, freeing ourselves from the foolishness of the body and being pure, we
shall, I think, be with the pure and shall know of ourselves all that is
pure... (Phaedo 66d-67a).[14]
In his Laws, Plato discusses the matter of
where to bury a person who has committed suicide and makes distinctions between
persons’ motivations. The person who
does so simply for reasons of sloth or unmanly cowardice is to be buried in an
unmarked grave, apart from others, and in barren and nameless districts of no
note. The exceptions noted are when the
death is ordered by the State or when it is the result of ‘some disgrace that
is beyond remedy or endurance’ (9.873).[15]
Aristotle also
delineated types of suicide that were shameful.
Discussing the virtue of courage, the virtue lying between the vices of
cowardice and rashness, Aristotle says,
to seek death in order to escape from poverty, or the pangs of love,
or from pain or sorrow, is not the act of a courageous man, but rather of a
coward; for it is weakness to fly from troubles, and the suicide does not
endure death because it is noble to do so, but to escape evil (Nicomachean Ethics 1116a).[16]
Stoicism and
Suicide: Quality of Life, Freedom, Self-Sufficiency, and Honour
The topic of
suicide received particular consideration from Stoics—especially Seneca. While not all supported it (such as
Epictetus), the general argument was was favourable to suicide in certain
circumstances. Particular virtues, as
interpreted by the Stoics, leant their support: freedom, self-sufficiency,
honour (or nobleness), and quality of life.
Chrysippus
compares knowing when to commit suicide to knowing when to leave a party. He offers five reasons:[17]
Reasonable departures from life take place in the same five ways: 1)
because a pressing matter turns up, as in the case of someone commanded by the
Pythia [the oracle of Apollo at Delphi] to slit his throat to save his own
city, on the brink of destruction. Or 2) because tyrants rush in, forcing
us to do shameful deeds or say forbidden things; or 3) because a serious
illness prevents the soul from using the body as an instrument for a long
time. For this reason Plato too does not approve of the dietetic part of
medicine, because of its effect of moderating the disease and turning it into a
chronic condition, but approves of the surgical and the pharmaceutical parts,
to which Archigenes, the army doctor, resorted. So Sophocles too says:
It will not
become a good doctor
To chant incantations over a malady calling for the knife (Ajax, 582).
Or 4) because of poverty, as Theognis says well: “…Escaping from
poverty, it is necessary to…” Or 5) because of dementedness. For
just as drunken stupor would break up a party there, so here too can one have
oneself depart from life because of dementedness. For being demented is
nothing but natural intoxication, and intoxication, nothing but self-induced
dementia. The same consideration applies here.
Epictetus, a
later Stoic philosopher in the 1st c. AD, argued against
suicide. He says that one should
... wait for God, till he shall give the
signal and dismiss you from this service; then return to him. For the present,
be content to remain at this post where he has placed you. The time of your
abode here is short and easy to such as are disposed like you; for what tyrant,
what robber, what thief, or what court can be formidable to those who thus
count for nothing the body and its possessions. Stay, nor foolishly depart
(Epictetus, Discourses I.9).[18]
Not all Stoics held Epictetus’ aversion to suicide,
but they did agree with his view of indifference to one’s circumstances. Such indifference could, however, lead one to
commit suicide when one’s quality of life was hopelessly diminished. A century earlier, Cato the Younger (1st
c. BC), who would go on to commit suicide some time later, argued
When a man's circumstances contain a preponderance of things in
accordance with nature, it is appropriate for him to remain alive; when he
possesses or sees in prospect a majority of the contrary things, it is
appropriate for him to depart from life (as stated in Cicero, De Finibus Bonorum et Malorum III.18.60).[19]
In the 1st c. AD, the Stoic writer,
Seneca, had much to say on the subject.
He says of suicide,
The best thing which eternal law ever ordained
was that it allowed to us one entrance into life, but many exits. 15. Must I await the cruelty
either of disease or of man, when I can depart through the midst of torture,
and shake off my troubles? (Letters LXX,
14-15, ‘On the Proper Time to Slip the Cable’).[20]
I shall not avoid illness by seeking death, as
long as the illness is curable and does not impede my soul. I shall not lay
violent hands upon myself just because I am in pain; for death under such
circumstances is defeat. But if I find out that the pain must always be
endured, I shall depart, not because of the pain but because it will be a
hindrance to me as regards all my reasons for living. He who dies just because
he is in pain is a weakling, a coward; but he who lives merely to brave out
this pain, is a fool (Epistle LVIII,
36, ‘On Being’).
You wish to live; well, do you know how to
live? You are afraid to die. But come now: is this life of yours anything but death?...
It is with life as it is with a play, –
it matters not how long the action is spun out, but how good the acting is. It
makes no difference at what point you stop. Stop whenever you choose; only see
to it that the closing period is well turned’ (Letter LXXVII, 18).
Such evils, that which appears at first to be the lightest of all
misfortunes, namely, poverty, is naturally calculated to produce, when it is
the result of the vengeance of God; for even though cold, and thirst, and want
of food may be terrible, still they might at times be objects worth being
prayed for, if they only produced instantaneous death without any delay. But
when they last a long time and waste away both body and soul, then they are
calculated to reproduce the very greatest of the calamities recorded by the
tragic poets, which appear to me to be described in a spirit of fabulous
exaggeration (Rewards 136).
The idea that
one should end one’s life when circumstances become too burdensome for one
reason or another is rejected in the New Testament. James says,
Count it all joy, my brothers, when you meet trials of various
kinds, 3 for you know that the testing of your faith produces steadfastness. 4
And let steadfastness have its full effect, that you may be perfect and
complete, lacking in nothing (James 1.2-4).
Also, Paul tells
slaves remain in the state in which they were called by God to be
Christians. He says, that one who was
called while in the state of slavery is actually God’s freedman, and one who
was called as a free person
is actually God’s slave (1 Corinthians 7.23).
He concludes, ‘So, brothers, in whatever condition each was called,
there let him remain with God’ (7.24).
Peter, speaking to slaves unjustly treated by their masters, says, ‘For
this is a gracious thing, when, mindful of God, one endures sorrows while
suffering unjustly’ (1 Peter.1.19).
Furthermore, he sets before them the example of Jesus:
For to this you have been called, because Christ also
suffered for you, leaving you an example, so that you might follow in his
steps. 22 He
committed no sin, neither was deceit found in his mouth. 23 When he was reviled, he did
not revile in return; when he suffered, he did not threaten, but continued
entrusting himself to him who judges justly. 24 He himself bore our sins in his body on the tree, that we
might die to sin and live to righteousness. By his wounds you have been healed.
25 For you were
straying like sheep, but have now returned to the Shepherd and Overseer of your
souls.
Indeed, the suffering of the righteous is a theme running throughout the
Old Testament. The lament form of a
psalm is the most common in the book of Psalms.
The narrative of Israel is a narrative of a people’s suffering
(sometimes as punishment). This theme
culminates in Jesus’ death on the cross.
People shaped by such a powerful narrative are going to approach matters
very differently from the Stoic teaching just outlined. Paul, for example, can set before the
Corinthian church his suffering as a positive thing. He boasts:
far greater labors, far more imprisonments, with
countless beatings, and often near death. 24 Five times I received at the hands of the Jews the forty
lashes less one. 25
Three times I was beaten with rods. Once I was stoned. Three times I was shipwrecked;
a night and a day I was adrift at sea; 26 on frequent journeys, in danger from rivers, danger from
robbers, danger from my own people, danger from Gentiles, danger in the city,
danger in the wilderness, danger at sea, danger from false brothers; 27 in toil and hardship, through
many a sleepless night, in hunger and thirst, often without food, in cold and
exposure. 28 And,
apart from other things, there is the daily pressure on me of my anxiety for
all the churches. 29
Who is weak, and I am not weak? Who is made to fall, and I am not indignant? (2
Corinthians 11.23-29).
Paul’s reason for boast in such hardships is that the Lord told him, ‘My
grace is sufficient for you, for my power is made perfect in weakness’ (2
Corinthians 12.9).
The Christian tradition leads to a different ethic than suicide, and it
lays a challenge before those who know a troubled person. This we see in the 2nd c. AD
writing, the Shepherd of Hermas:
Tell all who are able to do right not to stop; to work at
good works is beneficial to them. Moreover, I say that every person ought to be
rescued from distress, for one who is in need and suffers distress in daily
life is in great anguish and hardship. 3 So whoever rescues such a
person from misery wins great joy for himself. For the one who is troubled by
distress of this sort is afflicted with the same anguish as one who is in
chains. For many people, because of afflictions of this kind, commit suicide
when they can no longer endure them. Therefore, whoever knows about the misery
of someone like this and does not rescue that person commits a great sin and
becomes guilty of that person’s blood (114: 2).
2.
Freedom
We
shall not condole with such a chain-gang of prisoners so wretched, we shall not
urge them to submit to the commands of their butchers; we shall show that in
any kind of servitude the way lies open to liberty'. If the soul is sick and
because of its own imperfection unhappy, a man may end its sorrows and at the
same time himself. To him to whom chance has given a king that aims his shafts
at the breasts of his friends, to him who has a master that gorges fathers with
the flesh of their children, I would say: ‘Madman, why do you moan? Why do you
wait for some enemy to avenge you by the destruction of your nation, or for a
mighty king from afar to fly to your rescue? In whatever direction you may turn
your eyes, there lies the means to end your woes. See you that precipice? Down
that is the way to liberty. See you that sea, that river, that well? There sits
liberty — at the bottom. See you that tree, stunted, blighted, and barren? Yet
from its branches hangs liberty. See you that throat of yours, your gullet,
your heart? They are ways of escape from servitude. Are the ways of egress I
show you too toilsome, do they require too much courage and strength? Do you
ask what is the highway to liberty? Any vein in your body!’ (III.15.3-4).[21]
Conquered people often faced the choice of suicide or enslavement. Seneca suggests that suicide is the way to freedom in this or any other impossible situation.
3.
Self-Sufficiency and Freedom
Within Stoicism, virtue is determined
according to one's being satisfied and self‑sufficient (autarkeia and autarkes
mean both) with one's position in the divinely ordained universe. Stoic determinism necessitates an ethic of
inward satisfaction that is not dependent on one's situation. Thus, Epictetus writes:
"He
is free, whom none can hinder, the man who can deal with things as he
wishes. But the man who can be hindered
or compelled or fettered or driven into anything against his will, is a
slave. And who is he whom none can
hinder? The man who fixes his aim on
nothing that is not his own. And what
does `not his own' mean? All that it
does not lie in our power to have or not to have, or to have of a particular
quality or under particular conditions...." (Discourses IV, i.70‑76).
Efface
the opinion, I am harmed, and at once the feeling of being harmed disappears;
efface the feeling, and the harm disappears at once (To Himself iv.7).
An expedition will be incomplete if one stops
half-way, or anywhere on this side of one's destination; but life is not
incomplete if it is honourable. At whatever point you leave off living,
provided you leave off nobly, your life is a whole. Often, however, one must
leave off bravely, and our reasons therefore need not be momentous; for neither
are the reasons momentous which hold us here (Letter LXXVII, 4, ‘On
Taking One’s Own Life’).
always carrying in the body the death of Jesus, so that the life of Jesus also may be manifested in our bodies. 11 For we who live are always being given over to death for Jesus’ sake, so that the life of Jesus also may be manifested in our mortal flesh. 12 So death is at work in us, but life in you.... 16 So we do not lose heart. Though our outer self4 is wasting away, our inner self is being renewed day by day. 17 For this light momentary affliction is preparing for us an eternal weight of glory beyond all comparison, 18 as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal (4.10-18).
Thus, the Christian lives life for Christ and conquers death with Christ. Life in Christ, a purpose for living, and the hope of the resurrection provide a certain, Christian perspective that opposes suicide and assisted suicide.
The hope of life with
Christ after death and of the resurrection body also means for the Christian that
holding onto this life as though it is all we have is unchristian. We live out this life with its suffering and challenges
to fulfill the purposes of God, but we do not advocate expensive medical care, especially
late life and other circumstances, simply to live another day—in front of the television
with a respirator. As Paul says about death,
‘we do not grieve as others do who have no hope’ (1 Thessalonians 4.13). We do not take our lives in suicide, but we also
do not value this life as though it is all we have.
Previously: Assisted Suicide: What Sort of Society Do We Wish to Be?
[1] Hippocrates, Hippocratic Oath,
trans. Michael North (National Library of Medicine, 2002); online: Hippocrates,
Hippocratic Oath, Hippocratic Oath (accessed 3 December, 2024).
[2] Hippocratic Opera, ed. H.
Kuehlewein, I (1894), p. 190.
[3] Philo calls for the execution of someone administering a lethal
medication or one that does not kill but disables a person, such as leaving him
or her mentally incapacitated. See Philo,
Laws 3:98-99.
[4] It reads: ‘οὐδὲ γυναικὶ πεσσὸν φθόριον
δώσω’.
[5] Anthony
M. Vintzileos, ‘Revisiting the evolution of the Hippocratic Oath in obstetrics
and gynecology,’ American Journal of
Obstetrics & Gynecology, Volume 230, Issue 5 (May 2024), pp. 469.e1 - 469.e5;
online: Revisiting the
evolution of the Hippocratic Oath in obstetrics and gynecology - American
Journal of Obstetrics & Gynecology (accessed 3 December, 2024).
[6] Sophocles, The Ajax
of Sophocles. Ed. Sir Richard Jebb (Cambridge: Cambridge University Press.
1893).
[7] Soranus’s Gynecology (I.XIX)
lists many of the contraceptives and abortifacient remedies used by people at
the time. He does not describe the use
of instruments for abortion as he rejects such methods. Tertullian, De Anima 25.5-6 describes a blunt barb that dismembers the child
and a bronze needle or embryo knife that cuts the baby’s throat in the womb.
[8] See the discussion in Ludwig Edelstein, The Hippocratic Oath, Text, Translation and Interpretation (Baltimore,
MD: Johns Hopkins University Press, 1943), pp. 14-17; online: The
Hippocratic oath, text, translation and interpretation : Edelstein, Ludwig,
1902-1965 : Free Download, Borrow, and Streaming : Internet Archive
(accessed 2 December, 2024). Edelstein
argued that the proscription against suicide in the Oath and in the Pythagorean
school suggests that the Oath originally came from that philosophical school.
[9] This dialogue takes place after Socrates had been condemned to
death by suicide from a drink of hemlock.
In Roman times, too, a person could be ordered to commit suicide.
[10] C. D. Yonge translation, online: https://www.gutenberg.org/files/57342/57342-h/57342-h.htm#BOOK_X
(accessed 11 January, 2025).
[11] Plato, Plato in Twelve
Volumes, Vol. 1, trans. Harold North Fowler (Cambridge, MA: Harvard
University Press, 1966).
[12] Elsewhere, Plato rejects
the idea that people considered whatever life after death might involve when
committing suicide. In The Republic, Socrates asks: ‘How about
belief in the underworld and its horrors? Do you think that makes people
fearless in the face of death, makes them choose death in preference to defeat
or slavery?’ And the answer to the
question was: ‘Of course not’ (386b).
Plato, The Republic, trans.
Tom Griffith (Cambridge: Cambridge University Press, 2000); online: Plato
The Republic (Cambridge, Tom Griffith).pdf.
[13] David Ebrey, Plato’s Phaedo:
Forms, Death, and the Philosophical Life
(Cambridge: Cambridge University Press, 2023).
[14] Plato, Plato in
Twelve Volumes, Vol. 1, trans. Harold North Fowler (Cambridge, MA: Harvard University
Press, 1966).
[15] Plato, Plato in
Twelve Volumes, Vols. 10 & 11, trans. R.G. Bury (Cambridge, MA: Harvard
University Press, 1967 & 1968).
[16] Aristotle, Aristotle
in 23 Volumes, Vol. 19, trans. H. Rackham (Cambridge, MA: Harvard
University Press, 1934).
[17] Ioannes ab Arnim, ed., Stoicorum Veterum Fragmenta, Vol. 3, paragraph
768 (Stuttgart: B. G. Teubner, 1903), pp. 190-191, tr. Yukio Kachi; online: CHRYSIPPUS(c. 280-c. 206
B.C.)The Stoics’ Five Reasons for Suicide | The Ethics of Suicide Digital
Archive
(accessed 26 December, 2024).
[18] Epictetus, The Discourses of Epictetus, with the Encheridion and Fragments, trans. George Long (London: George Bell and Sons, 1890).
[19] Cicero, On Ends, trans.
H. Rackham (Loeb Classical Library; Cambridge, MA: Harvard University Press,
1931).
[20] Moral Letters to Lucilius,
Vol. 2, trans. Richard Mott Gummere (Loeb Classical Library; London: William
Heinemann, 1920). This translation is
used here of other letters of Seneca.
[21] Lucius Annaeus Seneca, ‘On Anger,’ in Moral Essays, trans. John W. Basore (London: Heinemann, 1928).
Comments