CONCLUSION

CAN THE SUICIDAL SUBJECT SPEAK?

Suicidal People’s Voices as Microresistance

MY FRIEND CASSANDRA¹ called me from her car the day I had begun to write this conclusion. “Vincent,” she told me, referring to her son in his twenties, “just found Julia dead in her apartment. I’m on my way there to support him.” Everyone was in shock. Julia was part of their family and, being Cassandra’s close friend for more than twenty years, I had met Julia on a few occasions. When talking to Cassandra the following week, I learned that Julia had carefully prepared her death. She wrote a will and arranged for an automatic email to be sent to Vincent the day after her death, with information about her will and computer passwords. She had meticulously planned her act, ordering a helium tank and preparing letters and souvenir packages for all her loved ones, letters that she stuck on the outer door of the locked bedroom where she died, alone, in her closet. She did not want Vincent to discover her body, so the letters stuck to the door acted as a warning signal. In the days before her death, she posted lifetime memories and photos on Instagram and called some friends and family members. Even Vincent, who suspected that Julia would likely die by suicide one day, was not informed that she was going to proceed that day. In her last conversations with everyone, Julia was not able to speak about her suicide.

Julia most likely wanted what many people want during their last moments: to speak with her loved ones about what was on her mind. She had messages to deliver, as attested by the suicide letters she left; yet she did not feel that she could deliver these messages while still alive because of the suicidist context in which we live. If she had spoken, her plans would have been scuttled. Her wish for death would have been destroyed. She would have been subjugated to multiple forms of suicidist violence. Saying “I want to die and I will do it” would have led to involuntary commitment, restraints, forced treatments, violations of her rights, and the delegitimization of her desire for death, agency, and voice. Like the subaltern who cannot speak or be heard under colonialism and imperialism, as Gayatri Chakravorty Spivak reminds us, Julia—who was oppressed but not a subaltern—could not speak her truth. The only way to deliver her message was through her suicide and the testimonials in her letters, her private journal, and the instructions in her will, which she left behind.

While talking with Cassandra, I felt enraged and deeply sad. I was angry and heartbroken, not only because Julia, a wonderful person, had left the world but because she had had to do it in such a violent and lonely way. This experience resonated with my deepest fears and concerns regarding suicide. “I cannot believe that she had to prepare all this by herself, concealing what was most important to her in all her last conversations, and that she had to die alone,” I said to Cassandra.² I felt Julia’s pain. Her loneliness. Her despair. Her anger at being forced to go through these hurdles alone. Like many of the suicidal people interviewed by Susan Stefan (2016) who had to lie to escape forms of institutionalization and incarceration, Julia also had to lie and tell people what they wanted to hear, just to make sure that she could carry out her plan. Julia had to censor herself to avoid pervasive forms of invalidation because everyone around her would have had the authority to decide what was best for her in such context. Her epistemic authority and agency would have been denied and invalidated, based on her suicidality. She was, as I have articulated throughout this book regarding suicidal people in general, silenced.

I have felt silenced countless times regarding my own suicidality and my discourses on (assisted) suicide. Even in the process of publishing this manuscript, I have felt silenced. Throughout the journey of publishing this book, a number of scholars and people in the publishing industry who are otherwise open to cutting-edge scholarship have expressed concern about the controversial nature of my arguments. I highlight these reactions because they tell a common story when it comes to work that critiques dominant epistemologies. Such critical work is often dismissed, considered unscholarly, or, worse, ignored or rejected precisely because it troubles dominant ways of thinking, even among radical and progressive people. As Patricia Hill Collins (2000, 253) reminds us, “Scholars, publishers, and other experts represent specific interests.” In her discussion of Black feminist epistemology, Hill Collins illustrates how knowledge and “knowledge validation processes” (253) are controlled by people in dominant positions, such as White men. The same could be said of nonsuicidal people, who dominate the publishing world, scholarship, social movements, and intervention. Discourses such as mine, which challenge not only mainstream conceptualizations of suicide promoted by the medical model of suicidality but also conceptualizations produced by social and social justice models of suicidality, are discredited, disbelieved, and silenced. Hill Collins (2000, 271) says, “The existence of a self-defined Black women’s standpoint using Black feminist epistemology calls into question the content of what currently passes as truth and simultaneously challenges the process of arriving at that truth.” I hope that the suicidal epistemological standpoint put forth in this book calls into question current knowledge on (assisted) suicide and the ways it is created and gatekept by health practitioners and scholars with individualistic and pathologizing views on suicide. I also hope that the book challenges the discourses of some proponents of the social justice model on suicidality, be they critical suicidologists or queer, trans, disability/crip/Mad activists/scholars, as discussed in Chapters 1, 2, and 3. I also hope that the book challenges the discourses of those who advocate for a right to die, as discussed in Chapter 4. Indeed, despite their radical differences, all those discourses on (assisted) suicide represent somatechnologies of life designed to construct and preserve the lives of suicidal subjects. As I have shown throughout this book, some radical and alternative discourses, mostly in trans and critical suicidology circles, have started to question the deleterious effects of the suicidist preventionist script that aims to save lives at all costs. But, despite these growing critiques, I have never thus far heard, read, or encountered, even among these activists, scholars, and organizations, support for assisted suicide for suicidal people, as I propose in Chapter 5 with my queercrip model of (assisted) suicide and a suicide-affirmative approach. In informal discussions, many people have told me privately that they agree with my vision. Are these people also silenced in academic and activist circles? Would asserting a position such as mine cost them their credibility, legitimacy, relationships with colleagues, reputation, or career? Do they think that expressing ideas such as those endorsed in this book would be too controversial?

As I have shown in Chapter 3, a majority of activists/scholars in disability/crip/Mad studies are fiercely opposed to assisted suicide. For example, changes in 2021 to the Canadian medical assistance in dying (MAID) law removing the requirement of reasonably foreseeable death have allowed various disabled/sick/ill people who are not at the end of their lives to access MAID. Before the official revisions of MAID through Bill C-7, disability/crip/Mad activists/scholars tried to push back on its expansion. A February 2021 webinar titled “Death by Coercion: A Panel on the Impacts of Changes to Medical Assistance in Dying (MAID) on Black Indigenous Queer Sick and Poor Communities,” organized and supported by several key Canadian disability organizations and featuring disability justice activists, firmly opposed MAID and any potential modifications. While I agree with many of the panelists’ arguments and concur that MAID is founded on a logic of disposability with respect to marginalized people in society (Chapter 4), as a suicidal person, I felt that there was a lack of discussion about suicidal people’s potential usage of MAID. Discussion of the hurdles, discrimination, and violence faced by suicidal people was also totally absent. The only person on the panel in favor of the law’s revisions agreed to participate anonymously. This disabled person clearly did not feel safe expressing their opinions among disability activists. As a trans and disabled man, I know that I did not feel comfortable sharing my thoughts during the Q&A (not because of the panelists but because of the dominant position against MAID in disability circles), and I do not feel safe expressing myself on this topic in numerous anti-oppression circles. At the time of revising this book for its eventual publication, I fear the backlash that might come from my people, some queer, trans, disability/crip/Mad activists/scholars who might refuse to even consider the possibility of discussing potential forms of assistance when it comes to suicidality and who automatically equate assisted suicide with an endorsement of the culture of disposability.

I want to be very clear and reiterate here, as I have throughout this book and in previous work (Baril 2017, 2018, 2020a, 2020c, 2022), that current laws on assisted suicide, including MAID, are founded on ableism/sanism/ageism/suicidism, among other -isms. Ideally, these laws would be eradicated and replaced by assisted suicide laws and policies providing support to people who want to die, including suicidal people, regardless of their health status. I support revolutionary and abolitionist perspectives, and I advocate for current laws to be dismantled rather than reformed to be more inclusive of various categories of people based on a logic of disposability. To be coherent, such perspectives should not endorse reforms to MAID, a fundamentally violent law. The anti-psychiatry movement provides an example to better understand the abolitionist position. Authors/activists such as Bonnie Burstow have shown that, while we may understand the desire of marginalized communities to reform the psychiatric system to improve services and diminish the impact of racism, cisgenderism, and other oppressions in psychiatric settings, these reformist initiatives have not lead to the abolition of psychiatry. Burstow (2014, 49) concludes, “As such, campaigns for such [inclusive and more equitable] services are at odds with psychiatry abolition and arguably hazardous for the communities in question.” In an ideal world, in the spirit of Burstow, I would simply condemn any kind of reform related to MAID. In the ideal world I envision, where the queercrip model of (assisted) suicide and the suicide-affirmative approach would be embraced (Chapter 5), the current ableist/sanist/ageist/suicidist laws on assisted suicide would be eradicated, and new laws and services on assisted suicide would be offered to everyone, including suicidal people. But we do not live in an ideal world. Most importantly, debates continue regarding the implementation of abolitionist perspectives. Liat Ben-Moshe (2013, 139) reminds us that some people “suggest conceptualizing the long-term goal of prison abolition as a chain for shorter campaigns around specific issues—like jail diversion, restitution programs, or the move of those released to community placements. Such strategic use of abolition and reform can also be applied to the context of abolishing psychiatric confinement and forced medical treatments [ . . . ].” Following Angela Y. Davis, Ben-Moshe (2013, 139) provides examples of strategies and actions, that, at first glance, might be interpreted as reformist but are compatible with the long-term goal of abolition: “For instance, fighting for health care for prisoners is something activists should support, as integral to abolitionist and decarcerating strategies.” I contend the same is true regarding the incarceration of suicidal people, suicidism, and MAID. The abolition of MAID is unlikely to happen in the next few years (even decades), and suicide-affirmative health care is not going to be established any time soon. Meanwhile, suicidal people continue to be left to fend for themselves. Like prisoners who still need health care until prisons are abolished, suicidal people need health care and support until my queercrip model of (assisted) suicide and my suicide-affirmative approach are adopted. Therefore, in the current, imperfect world, assisted suicide legislation reform aiming to be inclusive of nonterminally ill people, such as mentally ill people, while problematic from a long-term abolitionist perspective, is probably in the short term one of the “best” options for many suicidal people. For these reasons, I endorse a pragmatic posture in which I hold, simultaneously, the goals of pursuing the abolition of assisted suicide laws, founded on a logic of disposability toward disabled/sick/ill/old people, and better access to current assisted suicide services for suicidal people. In other words, we can fight to dismantle those violent laws in the long term while supporting suicidal people in the short term as the revolution happens.

I believe that a strict abolitionist agenda regarding MAID that excludes any strategic use of the current laws to offer support to suicidal people does not constitute an accountable response toward suicidal people. Revolutionary/abolitionist goals and pragmatic strategies in the here and now are not antithetical or mutually exclusive. Indeed, we can work toward an eventual abolition of psychiatry, prisons, and assisted suicide laws and simultaneously seek, in the here and now, better psychiatric services for marginalized groups, better incarceration conditions for prisoners (e.g., access to health care), and more inclusive assisted suicide laws for suicidal people. In other words, while unmasking the outrageous ableist/sanist/ageist/suicidist roots of assisted suicide laws in various countries and working toward their abolition are crucial, we may also temporarily transform these laws in less damaging ways for marginalized groups, including for suicidal people. When I think about the possibility that MAID in Canada may be extended to people whose request is based solely on mental suffering (whose exclusion from the current law is supposed to be reevaluated in 2023), I cannot help but think that, despite being unjust, violent, and problematic, as I have shown in Chapter 4, the extension of the law for people with mental illness would nonetheless be a gain for people like me, who potentially wish to die by suicide, but not in a lonely and violent way. Indeed, while profoundly imperfect, MAID’s potential future inclusion of mentally ill/Mad people would still provide a more humane death process to some people. Slowly but surely, the expansion of MAID’s criteria to include suicidal individuals could drastically change the ways they interact with suicide intervention services, the health care system, and even their relatives and friends. These kinds of gradual changes might be one way to carve the path toward a total abolition of MAID and the embracing of a suicide-affirmative approach.

Julia’s situation might have been different if a suicide-affirmative approach and suicide-affirmative health care were available. She could have reached out to such services to help her prepare for her death. This preparation would have allowed her to connect with her significant others and tell them that she was planning to leave this world and to have been accompanied by them and by professionals in her reflections and her passage from life to death. Through this caring process, maybe she would have connected with them in a transformative way, which would have given her the desire to continue living, as Vivek Shraya (2017) recounts in I Want to Kill Myself. But even if Julia had still chosen to die by assisted suicide, at least she would not have died violently. She would have been surrounded by love. She would have been able to speak to her loved ones, and this process would have saved them the excruciating task of finding her body and the complex mourning process characterized by all the questions we ask ourselves when someone completes suicide without having had an opportunity to talk to them: Why? Could I have done something to better support them before they died?

In the spirit of scholars who insist on the importance of an epistemology of resistance, on epistemic resistance, and on forms of microresistance (Medina 2012; Mills 2014; Tuana 2017), as well as authors who acknowledge that some reformist strategies, despite their major flaws, may sometimes improve the daily lives of members of marginalized groups (Dolmage 2017; Price 2011), I believe that we must engage in microresistance against the somatechnologies of life described in this book. Assisted suicide laws, such as MAID, and their retrofit logic of extending the right to die to some “specific populations” will always remain haunted by their inaccessibility to those who need them most, as explained in Chapter 4. However, this inaccessibility does not mean that those laws cannot currently be used to improve the life, and death, of suicidal people. As Margaret Price (2011, 86) highlights in her work on disability and accessibility, what she calls “microrebellions” sometimes have more to offer than revolutionary initiatives that “provide little of use in day-to-day survival.” This approach may also be true of assisted suicide laws in various countries, including Canada. For the day-to-day survival and death of suicidal people, microchanges to the current legislation on assisted suicide may be a viable option in the short and medium terms while we continue, in the long term, through various other forms of microresistance and concerted revolutionary/abolitionist visions, to dismantle the oppressive systems underlying these laws. Through small increments and changes brought about through microresistance, these laws may be trans-figured and eventually emptied of their ableist/sanist/ageist/suicidist logic. In sum, the pragmatic thanatopolitics I propose in Chapter 5, while intended to revolutionize the way we conceptualize (assisted) suicide, must remain sensitive to the need of many people to mobilize the currently available tools to reach their end, particularly when this end is the end. As José Medina (2012, 2017) reminds us, while microresistances are not enough to combat systemic oppression, they may certainly play a crucial role in the multiple strategies used to strike back against racist ideologies and structures. The same is true for suicidist ideologies and structures. Taken together, all forms of microresistance could lead to bigger and deeper transformations.

Suicidal people’s forms of microresistance and dissident voices, such as mine and those of others offered in Undoing Suicidism, could be considered to be “epistemic disobedience” tools to deconstruct suicidist epistemic oppression, to reuse a notion mobilized by Medina (2012). Suicide notes and letters, such as those of Julia, also constitute micropractices of resistance and microrebellions that offer alternative views of suicide to the one dominated by the suicidist preventionist script. Their messages, as scholars such as Isabelle Perreault (Perreault, Corriveau, and Cauchie 2016) and Patrice Corriveau (Corriveau et al. 2016; Corriveau et al. 2021) rightly point out, have much to teach us, and they challenge our visions of suicide. My invitation in this book to create a new social movement—the anti-suicidist movement—builds on and expands the crucial work of these scholars who focus on the voices of suicidal people by attempting to give visibility to their voices while the authors of those potential suicide notes and letters are still alive. Indeed, suicidal people have crucial messages to convey, which may transform (assisted) suicide discourses and interventions. But they cannot speak, or, when they do speak, their voices are overridden. More precisely, their messages are not heard except from a suicidist preventionist script. Just as critical race studies scholars, such as Charles W. Mills (1997) and José Medina (2012), have shown in relation to racism, groups in power embrace a willful ignorance to avoid troubling their dominant racial conceptualizations. Nonsuicidal people who refuse to view suicidal people as agents and who dismiss their discourses on life and death exercise forms of willful ignorance regarding compulsory aliveness and the injunction to live and to futurity. As I have demonstrated throughout this book, the desire to die itself cannot be heard for what it is: It can only be perceived through the very logic of prevention that seeks to thwart it. Allowing safer spaces to emerge in which to talk about the desire to die, using a queercrip model of (assisted) suicide, therefore constitutes a form of “epistemic activism” (Hamraie 2017, 132) that resists the dominant imaginations of suicidality. It opens up the possibility for suicidal “epistemic communities” (Tuana 2017, 130) to emerge and refuses to allow social movements, in the name of hope and futurity, to postpone offering the support and help suicidal people need here and now.

A queering, transing, cripping, and maddening of (assisted) suicide, which I have proposed in this book, can help us emerge not only from the dominant medical narratives that cast suicidality as an individual problem to cure but also from some newer dominant narratives in queer, trans, disability/crip/Mad circles and in critical suicidology, which interpret suicidality only through the lens of alienation, oppression, mutilation, destruction, or structural violence turned against the self. Kai Cheng Thom believes that not doing everything we can to prevent suicides in our marginalized communities comes from a distorted understanding of love. She says (2019, 43; emphasis in the original), “The idea that we need to support trans women’s decisions to die—in other words, let them die—comes from the ways we understand and feel about love.” Thom believes that we need to keep reaching out to the suicidal person and keep fighting to improve their living conditions, even when they say they do not want our help (45). I wholeheartedly concur with Thom when she says that we need to do everything possible to end the oppressions that make people suicidal in the first place. I also agree that our position on (assisted) suicide depends on how we define love, support, and care, but I disagree with her definition of those terms. Thom believes that the ultimate act of care, support, and love is to prevent someone from completing suicide, even if that person has expressed this wish repeatedly and even if they have reflected seriously and explored all their options. She clearly states that no support whatsoever should be offered to the suicidal person that validates their decision to die.

In addition to doing everything we can to transform our world to make it more hospitable and livable for all marginalized groups, what if the ultimate act of care, support, and love is to accept that someone does not want, for various reasons, to live anymore, or cannot live anymore, or will not live anymore, as Julia decided? What if loving someone means accompanying them in that messy, complex decision-making process regarding life and death, helping them prepare for that frightening passage, and caring for them throughout that process, despite the fact that their decision tears our hearts apart and leaves us with an empty space filled with their memories? What if loving someone means accepting that sometimes that person needs to leave us and leave the world?

For me and for many suicidal people I know (as well as those cited in this book and those who shared their thoughts with me throughout the years), care, support, and love mean accepting our decision to leave this world and to end the suffering we are experiencing. We are not duped, naïve, alienated, or delusional. There are no good or bad reasons for wanting to die: There are just reasons, a multitude of reasons, all valid, all legitimate, and all relevant, as long as they have been acknowledged and considered from different angles when making a truly informed decision about death. This is exactly where the current approaches to (assisted) suicide fail suicidal people: No space allows honest conversations about suicide, which would let us discuss, on multiple occasions and with various people, the fatal decision we were about to carry out. When people cannot reach out, they are denied the option of making a truly informed decision. In my definition, this denial does not constitute care, support, or love. As a suicidal person, my hope is not only to find a miraculous medical or sociopolitical solution to cure my suicidality but also to be able to articulate my thoughts to an open-minded audience and to see concrete changes in suicide intervention, policies, laws, institutions, and representations that would be more supportive of my reality, needs, and claims.

I have often thought and articulated to a few individuals who share my perspectives on suicide that I would most likely die by suicide one day. I just hope that when that day arrives, I will not be alone in my closet like Julia, without having had the chance to say good-bye to the people I love. I hope that the people I love, and who love me, will be there to support my decision, to hold me physically and emotionally in the scariest moment of my life, and to accompany me until my last breath. This profound acceptance of my departure and their accompaniment throughout that process would symbolize, for me, the power of love. But for them to be able to do so, a radical reconceptualization of (assisted) suicide and the care for suicidal people needs to happen. Starting this revolution and pushing this agenda have given me a reason to live until now. One more day, one more week, one more year, or maybe many more.