Some say that the difference between active voluntary euthanasia and assisted suicide is merely that the very last act is performed by someone else. Suicide is then employed without a connotation, merely meaning intentional self-killing or voluntary intentional self-killing. However, if 'suicide' is disapproved of by people, they will only call an act of self-killing "suicide" when it incurs their disapproval. It then depends, for example, on the reason or motive for taking one's own life intentionally (or voluntarily and intentionally) whether it is called "suicidal" or "sacrificial". It has been suggested that an act of self-killing is a 'suicide' if it is self-regarding, that is, performed to relieve oneself, and a 'sacrifice' if other-regarding, that is, performed to relieve others. Altho such a difference could be created by stipulative definition, it would not be one in moral status, for in itself there is nothing wrong in relieving oneself --on the contrary. (There may be something wrong in relieving oneself in spite of the harm done to others, but it is then the harm done to others which is wrong, not relieving oneself. ) In order to prevent all confusion and question-begging it is probably better not to use the term suicide at all, and only to speak of "the different forms of self-killing". A very important aspect of self-killing is indeed the reason or motive for causing one's own death, but relieving others is just one kind of reason which may be legitimate. (Assuming that relieving is not used in an overextended, self-defeating sense. It cannot be applied, for example, to the grief of those who would be terribly distressed, if a widow did not kill herself so that she might be cremated with her husband's body; this to show her religious devotion to him.)

Given that one causes one's own death of one's own free will, there is no significant difference with allowing one's death. Since we hold the view that a person owns the body 'e has --as explained in section 9.4.1 of the Book of Instruments-- causing the death of this body makes no difference on the metadoctrinal level with allowing to die. It is only when one does not own a personal body that there is an important difference. Even on the neutralistic, doctrinal level there is no difference in principle, because in the event of an omission, the death is caused by certain changes anyhow.

Causing death is only a limiting case of risking it, and in this sense the difference between self-killing and risking death is merely gradual. Self-killing is an act in which a person drastically shortens 'er life, but there are numerous other ways in which people less drastically shorten their lives, the most notorious ways being, probably, the addictive use of tobacco, alcohol and other drugs, hard drugs in particular. Yet, not only the addictive use, any (more than minimal?) use of artificial aids, and just eating too much while exercising too little, will shorten a person's life on the average. There are also those who participate in dangerous sports or take on dangerous jobs. Are they not self-killers because they are not sure that their sport or job will kill them? Moreover, there are people (called "suicides" too by some) who only attempt to kill themselves without making it absolutely certain that they will die. There is a whole range of acts on the border of self-killing which are attempts at self-killing and which do not succeed. In all these cases it does not seem to be in the first place the probability of death which counts. The question is therefore whether it is, perhaps, the intention or the motive of the act or omission which makes the difference.

When an apparent attempt at self-killing is not intended to succeed, it is not an attempt at self-killing but a cry for help. Or --as has been pointed out-- the situation may also be a mixed one in which 'a gamble is taken with some risk of death and some chance of survival followed by help'. Gambling with their own lives (if not other people's lives as well) is what many people do, however, who would never be called "suicides": those partaking in a war or revolution, those off on a dangerous job, those playing a perilous game, those on hard drugs, those driving under the influence of alcohol, and so on and so forth. All of them may kill themselves, or be killed, yet none of them presumably have the intention of killing themselves or of being killed. The reason for risking death may be to defend or overthrow a government, to save (other) lives, to amass wealth or to get high; the reason may be to escape boredom, to find a way out for their aggressions and frustrations, or to liberate themselves from the shackles of an exclusionist milieu. In practise several of such reasons may play a role at the same time, possibly in addition to increasing the risk of death itself. It is not 'er death which is the motive of a person who aspires to a better society, for instance; that is not even the motive of a person who wants to destroy it.

But are the reasons or motives of those risking their own deaths fundamentally different from those causing them? People kill themselves also to escape suffering when they cannot improve their situation in another way, and because they do not want to be a burden on society or on people they know. So the reasons of a person choosing 'er own death may be much more praiseworthy than those of a person only risking 'er own death. To be sure, it may be the other way round too. The normative significant difference is accordingly not really between causing and risking one's own death when one's life is on balance worth living but rather between taking and not taking too high a risk. (Compare the difference between taking a risk when driving, and taking too high a risk when speeding or being intoxicated.)

Taking too high a risk with respect to one's own life, for whatever reason or lack of reason, is everyone's right of personhood, if, and insofar as, one does not risk another person's life (and assuming that one does not take this risk while using another person's property without 'er permission). Yet, as regards taking the 'risk of certainty' it has been claimed by one philosopher that 'man has duties to himself as an animal being' and that 'he cannot renounce his personality so long as he is a subject of duty, hence so long as he lives'. However, if a man or other animal being may never kill himself so long as he lives, then he may never kill himself. And indeed, killing oneself was self-murder on this construction, surpassed in its 'viciousness' perhaps solely by masturbation or some such 'unnatural vice of carnal self-defilement'. (It is historically not justifiable to conclude that self-killing was believed to be as innocent as, or even more innocent than, masturbation in the eyes of the theoretician concerned.) Even 'depriving oneself of an integral organic part' was professed to be an instance of 'partial self-murder', unless the organ was already dead or diseased, or unless the bodily 'part' was not an organ. (Cutting one's hair, fortunately, was not partial self-murder, except when done to sell it.) This hilarious ethical theory of 'perfect duties to oneself' has one important thing going for it, namely that it is true that every person is 'a subject of duty' and that 'to dispose of oneself as a mere means to an arbitrary end is to abase' personhood (not 'humanity') 'in one's own person'. But it is, then, intrinsic duty one is talking about. So far as a person's relationship to 'er own body is concerned, it is intrinsic duty to oneself as a happiness-catenal and living being.

It is everyone's right as a person (not as a happiness-catenal, animal or living being) to do with 'er life as 'e pleases, even to use 'imself, that is, 'er own body, as a mere means to an arbitrary end. On the metadoctrinal model the major problem is not self-killing but the criminalization of self-killing and 'suicide' intervention. Those pleading for intervention are but too ready to assume that 'an attempt to commit suicide is the act of a mentally sick person' and that 'suicidal persons are under the strain of temporary crises or under the influence of drugs' and 'beset with considerable ambivalence'. This would be the equivalent of assuming that loving a nonnatural god and/or hating a nonnatural demon is a mental illness, and that theodemonists are often under the strain of extreme or queer emotions while constantly being beset by existential anxieties. It may all be true, but merely believing that it is, does not make it so, and relevance requires that it not be equally true of nonmembers of the class in question.

When people are asleep or temporarily unconscious their bodies may be protected for their own good. Similarly, when they do act under the strain of a temporary crisis, or are under the influence of alcohol or other drugs (without having decided beforehand that they wanted to die), their bodies may also be protected, supposedly for their own good. Both when people are temporarily unconscious and when they are temporarily under stress, not taking the risk of interfering with their autonomy at that moment might indicate a serious lack of concern. The interference must not be permanent tho, but may only be temporary. The person concerned must be able to undo it at any point in time, for example, by giving reasons for 'er conduct. And if those reasons are not good or consistent ones, this is no sign of absence of personhood. It is only with respect to one's own life that terminating it requires reasons which are good and consistent from the standpoint of one's own normative convictions.

If the reasons in favor of one's own life outweigh those against it, then one should stay alive, or save one's life, and then one is allowed to do so. On the other hand, if the reasons against one's own life outweigh those in favor of it, then one should take the risk of death, altho one is not obliged to do so. But it is implicit in a person's posing the question whether 'e should or should not risk 'er life, that 'e has already chosen.