ABSTRACT
Even if it is agreed that circumstances can occur in which it is understandable to prefer death to survival, it is possible that ‘rational’ (well-considered) suicides occur only rarely, if at all, because the decisional capacity of people who want to end their own lives is (nearly) always compromised by mental illness. This is still the dominant view in suicidology. In the Netherlands, however, patients’ requests for euthanasia are granted in 7000 cases a year, and in all these cases, at least two doctors have confirmed the patient's competence. The combination of these two findings is puzzling.
But we should distinguish between two types of suicide, with clustering characteristics. In cases of the first type the agent doesn't carefully plan his action, doesn't communicate about his plans with his relatives and others, and uses violent, i.e. disfiguring and painful, means. In such cases it is reasonable to presume a lack of competence. The other type has the opposite characteristics. The most plausible explanation of our puzzling finding is that suicides of the second kind tend not to be registered as suicides at all. We should, therefore, not say that most suicides are ‘irrational’, but only that most registered suicides probably are.
