In her recent post at City Journal Kay Hymowitz sees the spike in suicides, particularly among middle-aged and elderly white men, much as I do:
cholars sometimes refer to the domestic earthquake that first rumbled through wealthy countries like the U.S. in the mid-twentieth century as the Second Demographic Transition. (The first transition occurred around the time of the Industrial Revolution, as the high death and birth rates that had been humanity’s default condition since the Neanderthals declined dramatically, leading to rapid population growth.) Mostly associated with the Belgian demographer Ron Lesthaeghe, the SDT (the unfortunately evocative acronym) is a useful framework for understanding the dramatic rupture between the Ozzie and Harriet and Sex and the City eras.
The SDT began emerging in the West after World War II. As societies became richer and goods cheaper and more plentiful, people no longer had to rely on traditional families to afford basic needs like food and shelter. They could look up the Maslovian ladder toward “post-material†goods: self-fulfillment, exotic and erotic experiences, expressive work, education. Values changed to facilitate these goals. People in wealthy countries became more antiauthoritarian, more critical of traditional rules and roles, and more dedicated to individual expression and choice. With the help of the birth-control pill, “non-conventional household formation†(divorce, remarriage, cohabitation, and single parenthood) went from uncommon—for some, even shameful—to mundane. Lesthaeghe predicted that low fertility would also be part of the SDT package, as families grew less central. And low fertility, he suggested, would have thorny repercussions for nation-states: he was one of the first to guess that developed countries would turn to immigrants to restock their aging populations, as native-born young adults found more fulfilling things to do than clean up after babies or cook dinner for sullen adolescents.
Read the whole thing. The concurrent spike in drug abuse doesn’t refute those observations but corroborates them. As I’ve said before, we’re doing something wrong.
I don’t have any solid prescriptions for changing the course of events. All I can say is teach your children well. Don’t encourage them to fall into the same self-destructive patterns we have let ourselves fall into even though the entire world is pushing them that way. They may not see it now but they may in thirty or forty years.
Large families were the result of an agricultural economy and no birth control. We arent going back that way so I think that smaller families are here to stay. Smaller families mean more people ending up isolated. We have fewer and smaller churches, so dont see much help there. (Drug abuse is sometimes a way of treating depression and other psychiatric issues.)
Steve
@steve, the fall in total fertility was primarily a 19th century phenomena: 7.04 in 1800; 3.56 in 1900; 2.05 in 2000. And to the extent, the group we’re looking at today are Boomers, they likely grew up in larger households than the generations before and after.
I presume you’re right. But that means we need to find another alternative. There are many. There’s plenty of evidence that people actually want more children but are having problems affording them. There could be heightened responsibility for the children who are born and grow to adulthood. Extended families could be more the norm. Non-family private institutions could take up the slack (the opposite is the case now).
Or the state could undertake more responsibilities. But what we are doing is not working.
Just a little anecdotal evidence. I have four younger siblings. That was pretty much the norm when I was growing up. My siblings have two children each. It’s too soon to tell what my nephews and nieces will do.
I had a cousin who killed himself last year. He apparently struggled with depression, but had a supportive wife and kids. I’m not aware of any drugs or alcohol issues, just that he worked in construction in an area declining from a major manufacturer locating to Mexico. My ruminations about this tend towards changes in male employment.
My personal opinion is that income is not a substitute for employment. The remedies being proposed are for income. I think that Peter Drucker pointed out that once you’ve reached a pretty basic level of subsistence income there are other factors that become important fast—things like job satisfaction and feeling that you’re part of something important.
A 17 year old Dutch girl was legally killed because she was depressed, and Maine is waiting for the governor to sign the law to make it legal there as well.
I understand PTSD, depression, and suicide. I do not endorse or condone Robin Williams committing suicide rather than face Parkinson’s on top of bi-polar, but I understand why. I can understand why Michael J. Fox would rather fight.
I do not endorse or condone somebody in the late stages of an especially painful or debilitating disease committing suicide, but I can understand why. I can understand why somebody would rather fight.
I cannot understand killing a 17 year old with or without PTSD. What is next? Should we screen combat vets for PTSD and euthanize them? Why are wee wasting money on suicide prevention hotline? Why not have a suicide tip line?
Anybody who thinks this is a good idea is a monster, but I still would not endorse or condone your suicide. Get help, immediately!
There is not a great deal of distance between that and a girl’s relatives killing her if she is raped.
Enlightend social advancement is beginning to look retrograde.
I’ve known several people who killed themselves, two I new well.
– One was a long-time friend from grade school who had abusive parents and never seemed to find his way in life.
– My brother-in-law essentially committed suicide via alcoholism. Always a drinker, he went over the edge after his business failed – he hit rock bottom and died there despite lots of help, support and interventions from family and friends.
– One of the guys I served and deployed with got into an argument with his wife, something tripped, and he went into the bedroom and blew his brains out.
They are all men – that is the only clear commonality I can find.
But there is certainly increasing atomization in our society which brings a lot of negative effects. I don’t see how to turn the ship in a more positive direction – all I can do, really, is focus on those around me and my own community.
“There is not a great deal of distance between that and a girl’s relatives killing her if she is raped.”
This was reported as assisted suicide when it was not.
https://reason.com/2019/06/05/everyone-got-the-dutch-teen-euthanasia-story-wrong/
This is not even remotely close to family killing their own child because they are angry with them.
Steve
Full disclosure: My cousin’s father killed himself messy after being diagnosed with a brain tumor. I agree with TastyBits about understanding, but not endorsing or condoning. such acts. I’m not omnipotent, so there is no way to know how how one suicide influenced another, but the stoic, manly desire not to be a burden on others doesn’t always work out that way.
@steve
I am not sure that allowing a 17 year old to starve herself is better. It would have been more humane to smother her with a pillow or use helium and a plastic bag.
I understand it is hard, but that is why we have psychiatric facilities.
Except for the most extreme cases, assisted suicide is barbaric. It is human sacrifice disguised as altruism, and it is just as vile no matter the setting – a hospital bed or a stone altar.
Thumbs up for TastyBits. 👍
You won’t condone but you have no trouble being judgmental, even when you dont know what really happened. No empathy or compassion for a family making a difficult decision.
You should know that anorexia has a high mortality rate. We arent especially good at treating it. Force feeding is controversial and it is not clear that it has long term success. It is clear that it is brutal if the person being force fed resists. (Having nearly killed someone we were force feeding I can tell you it is also not without risks. There are photos of her with an OG tube so it seems likely they had tried feeding via that route.)
In this case as far as we can tell the girl had received lots of appropriate care. Her parents cared and participated in that care. This was according to everything written a tough decision. However, only they can know how much she was suffering and how committed she was to dying. Does it concern me that she was only 17? Yes. If the person in this story was 27 I would feel better about this story.
“Except for the most extreme cases, assisted suicide is barbaric.”
Who defines “most extreme”? Should we use your standards. The fact is that in places where it is legally sanctioned it has to meet pretty strict criteria. I have listed the Dutch criteria below. We arent talking about someone having a bad day then getting euthanized. We are talking about people suffering for months or years with no chance of improvement.
be satisfied that the patient’s request is voluntary and well-considered;
be satisfied that the patient’s suffering is unbearable, with no prospect of improvement;
have informed the patient about his situation and his prognosis;
have come to the conclusion, together with the patient, that there is no reasonable alternative in the patient’s situation;
have consulted at least one other, independent physician, who must see the patient and give a written opinion on whether the due care criteria set out in (a) to (d) have been fulfilled;
exercise due medical care and attention in terminating the patient’s life or assisting in his suicide.
Steve
Large families are still a plus. We are not farmers, and we don’t need child labor. But we get old, and in our declining years we need our children to look out for us. Minimum wage brown and black immigrants working in nursing homes will abuse their white patients. They do now.
My 98 year-old mother died Easter day. She was living with a daughter who was an RN with long experience in elder care. Another sister and two nieces were also present, and they were RNs, too.
My mother got the best care possible anytime anywhere. I will die alone in some ratty nursing home. I had two daughters, but neither had children. They will die miserable deaths.
If you are young, make sure you have four or five children.
Everywhere, the people in advanced countries have below replacement birth rates. Their populations are declining, in some case by half each generation. In Darwinian terms, we are living in an environment to which we are not adapted. And we are dying out. The dinosaurs went quicker, but advanced populations are going extinct.
@steve, I agree with TastyBits, she should have been committed to psychiatric institute. The main thing your link countered was TastyBit’s assertion that it was done through a legal system, when it appears to have been handled within the family.
You can’t believe that the family gets to decide her fate. The family might be nearly as tired, exhausted and unhinged by her struggles as she. Some families feel deep humiliation and shame from mental illness. Outsiders have to be involved.
Agree with your concern that the U.S. doesn’t handle end-of-life issues well, but she’s just a kid.
PD- I said my only reservation was her age. Even at that it sounds like she had multiple commitments already. Wait until she is 18, and then let her go? Having worked with anorexics, plus one of our OR nurses is anorexic (one of the nicest, hard working people you would want to meet) I find it really hard to condemn these people. This is the kind of stuff I think that those of us who dont know the full story on should stay out of rather than try to score political points.
Steve
@steve
I could easily pass the test, and if I were in the Netherlands, I probably would. I know exactly what it is like, and the day I go into the ground cannot come soon enough. I know what it is like to go to bed at night knowing that the next day will be worse than today, and if I am lucky, tomorrow will be no worse than today.
Even though I understand, I do not endorse or condone it, and yes, I am judgemental. In most of the US, we have psychiatric institutions to treat people with extreme mental illness. It is not always successful, but we try.
You know or should know that she would have been given lithium, thorazine, or some other drug and zombified. If needed she would have been force-fed, but more than likely, she would have been so drugged up she would have done what she was told. Then, they would work to de-zombify her.
Half my family has mental issues. The other half has to deal with us, and it is difficult on them. I am trying not to judge her family, but something is rotten in the Netherlands. Apparently, the Dutch need to catch up to the 21st century.
What if she had decided that instead of dying she just wanted her legs amputated. Is that OK? What about gangbangers. Most of them are planning on a short life. If they only kill themselves, is that OK?
For anybody who has not dealt with “crazy” people, everything you see as irrational is completely rational inside the head of somebody with a mental illness.
If you have a plan, means, and intention, you have a high chance of success. You are just going to have to trust me on this, but if you really want to kill yourself, starving to death is not a good plan. A gun is much better. By the time that you realize that it was a bad idea, the bullet is bouncing around in your head. With starvation, you can have a snack and re-think the decision.
I am going to stop now.
I had two cousins from a violently abusive home, (I witnessed it). Who did themselves in . The man, at about age fifty, by automobile, for financial reasons. His sister, a little younger, used a revolver in the garage. She didn’t leave a note, but she hosted a blog on fibromyalgia support.
Anorexia is sure something else, in line at the grocery the other day, I was behind a woman shopper with all the characteristics.
I wish I had a copy of her receipt, right at fifty dollars and no solid food. All liquids. I’m not judging, just amazed.
TB- In the Navy I was a psychiatric technician, which meant I worked on the psych ward, so I did inpatient psych care for 3 1/2 years. I worked my way through undergrad and med school working in psychiatric emergency units. Then in med school, Penn’s inpatient unit at that time was devoted to the treatment of anorexia. There probably isn’t a lot of mental illness I have not seen, with the caveat that it was long ago. (Mental illness also-rans in the family. Mother was institutionalized for most of my teens. I raised the younger kids.)
As I said above, the psychiatric illness with the highest mortality rate is anorexia. Unfortunately, it is a pretty effective way to die. Force feeding is done through either an OG tube or PEG. Either are pretty easily pulled out if the pt wants to do so. If they dont want the tube placed it can be a battle to place it. I am assuming that they already went through the drugged up and zombified stage.
So I come from two different places than you on this. I know that sometimes there are medical and psychiatric problems we just dont know how to fix. Second, I think there are worse things than death. However, I understand that some people think that is not the case. Some people want to live as long as possible, even if it is in excruciating physical pain and in the absence of friends and family. Some people want life maintained in a vegetative state as long as possible until they die.
So if that family and there girl just made a last second decision with no outside input then think this was awful, but that is not the sense I get here. It sounds like they had lots of input from professionals and take dit over as a family. Only they knew how much she was suffering and they hopefully had good advice and ideas about the probability of successful treatment.
Steve
@steve
From a professional perspective, you might be right, or it could be a way to cope. I am sure that non-professional people should be horrified. I realize that all people cannot be saved, but assisted suicide is murder. If a person really wants to commit suicide, they should do it alone.
People with eating disorders have mental issues about their body. They may be slowly killing themselves, but again, starvation is a really ineffective way to kill yourself. An effective plan should be as escape proof as possible.
The only exception would be people whose body is failing. If they want stop eating, refusing medications, or a DNR, I do not like it, but I can understand. For anything else, you are on your own.
If you want to hang yourself, you had better do it right, or it will be slow and painful. If you intend to have the police kill you, do not threaten them with a plastic knife.
Having a lot of professional experience with mental illness, you should know that anybody who intends to kill themself will pass the checklist. People who are hopeful do not want to kill themselves, usually. People who do not feel helpless do not want to kill themselves, usually.
Again, should there be assisted amputation?
It is easy to rationalize dehumanizing people. Like it or not, your limits are arbitrary, and what you think is too far will not be for somebody else.
If you want to live in a world where human life is no different than plant life, so be it. You can have it.
From the American Journal of Psychiatry:
and
“Again, should there be assisted amputation?”
I did miss that, sorry. I think that if a limb, lets say leg just to make this easier, had intractable pain with no possibility of improvement and that the leg was no longer usable, an amputation would be OK. Cutting off a leg just for funnies would not be OK.
Steve
@steve
… amputation …
Elective amputation of a healthy limb because a person wants to be an amputee. Rephrased:
Should there be assisted amputation for elective amputation?
Just as we dont have assisted suicide for no reason, we should not have elective amputation for no reason. Healthy, happy people should not have assisted suicide, and they dont. I thought I already answered this.
“Cutting off a leg just for funnies would not be OK.”
(Should have said funsies.)
Steve
@steve
Healthy, happy people do not want to assist killing other people.
There is a reason why executioners wear a hood and are not welcome in polite society.
So we have jumped from the agency of people choosing how they want to end their life, to those who assist. My impression is different than yours. While I dont know anyone in Oregon or the Netherlands who does official assisted suicide, I know several palliative care docs and some geriatricians. (Spouses of people I have hired.) To put the following in context remember that terminal patients who go into palliative care actually live longer and are happier with their care, as are their families.
They often reach a point where they have nothing to offer a pt and the pain is hard to control. They make the decision, along with family, chaplains, pastor, whoever to turn up the morphine until the pt is comfortable, knowing this will probably end the person’s life. Really, assisted suicide, just not called that. Physicians have done this forever. These docs dont wear hoods and are highly valued in the community. When we go out to dinner they seem pretty normal and happy. Maybe they are secretly conducting Satanic rituals at night, but I doubt it.
Steve
@steve
It is always about those who assist. There is a difference between an end of life decision and a life ending decision.
In my first comment, I specified:
Except for the most extreme cases, assisted suicide is barbaric.
Extreme cases do not include depression, “psychic suffering”, dementia, Alzheimer’s, or anticipated painful suffering.
I am baffled by the voluntary requirement. Why leave an important decision up to the individual? If a person’s life is so horrible that killing them is justified, why wait until they realize it?
Many of the mass shooting killers want to kill as many people as possible before killing themselves. Why hope that they will voluntarily seek assisted suicide? We should assist them anyway.
There are likely many people who do not realize that they qualify. Why hope that they will voluntarily seek assisted suicide? We should assist them anyway.