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Rawls, Suicide and Self-Respect
Categorised in:
Originally written 2004
‘…the parties in the original position would wish to avoid at almost any cost the social conditions that undermine self-respect.’ (Rawls 1999: 386)
Abstract
Rawls identifies self-respect as a fundamental feature of his theory of justice, but diffuses it of political significance by arguing that it is essentially a by-product of other primary goods. This assertion can be questioned by taking suicide as an indicator of a catastrophic collapse of self-respect and considering the social factors which help produce this collapse. Pre-eminent amongst these factors is a lack of social integration, something which is largely independent of Rawls’ primary social goods. Therefore a new dimension must be added to the Rawlsian vision which has implications for the wider liberal agenda. Liberty and equality are not enough; they are worthless without fraternity.
Introduction
After his death at the age of 81 in 2002, John Rawls was described in his obituaries as the leading philosopher of the English-speaking world (Rogers 2002) and credited with producing ‘the 20th Century’s most complete philosophical defence’ of liberal democracy’ (Lovin 2002). His classic work, A Theory of Justice, reflects the concerns of most contemporary liberal activists, politicians and fellow philosophers in its focus upon the appropriate distribution of wealth and liberties. Yet, as the title quote shows, Rawls also attached great importance to the abstract personal quality of self-respect. This essay will consider the implications of taking Rawls’ emphasis on self-respect seriously.
Section 1 will examine the place of self-respect in Rawls’ political theory: its definition, importance and the contention that it is determined by the distribution of other primary goods. Section 2 will consider whether self-respect might not be influenced by factors other than the primary social goods. Sections 2.1 to 2.3 will give the reasons for using suicide as an indicator of low self-respect, and the problems with doing so; sections 2.4 to 2.7 will examine the causes of suicide and section 3 will consider ways in which a Rawlsian political programme might engage with these findings.
1 The place of self-respect in A Theory of Justice
1.1 A summary of Rawls’ theory
Rawls proposes that the principles guiding ‘the proper distribution of the benefits and burdens of social cooperation’ (Rawls 1999: 5) should be those chosen in an ‘original position’ where everyone is under a ‘veil of ignorance, such that nobody knows what position they will occupy in society, nor what conception of the good they will hold’ (ibid.: 118). In order to secure their wellbeing whoever they turn out to be, the parties of the original position will devise principles which ‘a person would choose for the design of a society in which his enemy is to assign him his place’ (ibid.: 133), arranging benefits and duties in order that they ‘work as part of a scheme which improves the expectations of the least advantaged members of society’ (ibid.: 65).
This scenario is not envisaged as a practical possibility, but as an intellectual ‘device for teasing out the implications of certain moral premises’ (Kymlicka 2001: 61). By thinking in terms of this ‘purely hypothetical situation’ (Rawls 1999: 11) we will arrive at principles of justice which embody the ‘the right of each individual to equal concern and respect’ (Daniels 1975: xxi) regardless of differences which should be irrelevant to justice.
Since they are ignorant of their ambitions, beliefs and personality, the parties in the original position will want to secure access to ‘things which it is supposed a rational man wants whatever else he wants’, what Rawls calls ‘primary goods’ (Rawls 1999: 79). For the sake of simplicity, Rawls restricts his discussion to the primary social goods – that is, goods which are directly controlled by the basic structure of society*, which he lists as ‘rights, liberties, and opportunities, and income and wealth’ (ibid.: 54). The only other primary good discussed in A Theory of Justice is self-respect.
1.2 Rawls’ definition of self-respect
In defining this good, Rawls reveals a very particular conception of self-respect:
In other words, a person has self-respect when she believes in the worthiness of her aims and is aware of her full potential and ability with regard to these aims. This conception of self-respect has been criticised as incomplete since it allows for a clearly illiberal society of masters and unquestioning servants, so long as the servants are convinced their servitude is inevitable and worthwhile (Massey 1983: 260).
To solve this problem, McKinnon (2002: 68) proposes that a self-respecting person be additionally defined as someone who would not ‘judge as illegitimate any expectation of hers that others offer her justifying reasons why she should perform actions which she is expected by them to perform’. Since Rawls considered his principles to ‘best express [people’s] nature as free and equal rational beings’, and since the parties of the original position would surely wish to avoid being duped into a lifetime of unquestioning servility to another’s arbitrary whims, we can be confident that had he addressed the issue, Rawls would have amended his definition in a similar way.
1.3 Self-respect as a fundamental primary social good
Rawls describes self-respect as ‘perhaps the most important primary good’ (Rawls 1999: 386, 440). In his later work, Political Liberalism, Rawls reaffirms self-respect’s ‘fundamental importance’ (Rawls 1993: 76). Considering that he defines self-respect essentially as a sense that one’s life has meaning, Rawls’ emphasis is not surprising:
When we feel that our plans are of little value, we cannot pursue them with pleasure or take delight in their execution. Nor plagued by failure and self-doubt can we continue in our endeavours… All desire and activity becomes empty and vain, and we sink into apathy and cynicism. (Rawls 1999: 386).
This then is why self-respect stands above other primary goods – if we do not find our pursuits worthwhile, the resources and the freedoms which allow us to pursue them are meaningless.
1.4 Wider relevance of Rawlsian self-respect
Rawls’ theory has had such an immense impact on political philosophy because it is so clearly based on the fundamental tenets of liberalism – ‘the equality of all men under the law’ (von Mises 2002: 28) and ‘toleration of all opinions’ (ibid.: 56). Many regard A Theory of Justice as ‘the paradigmatic statement of contemporary liberalism’ (Mulhall 1996: xv). At the very least Rawls is the central philosopher of contemporary ‘social’ liberalism**. The commitment to providing all citizens, so far as possible, with primary goods – the means necessary to pursue the goals they have chosen – is central to social liberalism as a whole, not just Rawls’ particular theory. Thus if Rawls succeeds in showing that self-respect is an essential primary good (and as seen in the previous section, it is difficult to see how one could argue otherwise) then it has vital relevance to all social liberal political programs, not just a Rawlsian one.
It is therefore unsurprising to find that Rawls is not alone in giving self-respect a central place in a liberal philosophy. Bedau (1968: 571) asserts that a list of ‘natural or human rights’ can only be derived from ‘a prior inventory of… what men need… in order to be free and self-respecting persons’. Feinberg (1970: 252) reverses this statement in arguing that the value of human rights is dependent on the possession of a self-respecting character – ‘that minimal self-respect that is necessary to be worthy of the love and esteem of others’. What Rawls, Bedau and Feinberg share is the conviction that freedom and equality enshrined in political rights are not in themselves enough to secure the full liberty desired by all social liberals. Rather they require the desire and confidence to uphold and make use of these rights – qualities which these philosophers term self-respect.
1.5 Rawls’ account of the social bases of self-respect
Clearly, the acceptance of self-respect as an essential primary good has ‘important implications for our assessment of social, political, and economic institutions’ (Massey 1983: 259). Although, as an abstract personal quality, self-respect cannot be secured for people directly, the state can ‘provide persons with opportunity to develop… self-respect’ (McKinnon 2002: 125).
What are these social bases? Firstly, there is the underlying ethos of the society. In a just society, founded on precepts of equality and pluralism, ‘persons express their respect for one another in the very constitution of their society’ (ibid.: 156) ensuring widespread self-respect (ibid.) and a ‘democracy in judging each other’s aims’ (ibid.: 388).
Self-respect is also facilitated by the ‘full and diverse internal life of the many free communities of interests that equal liberty allows’ (ibid.: 477). Thus, in the pluralist society which Rawls’ principles give rise to, all kinds of interests and goals are catered for. Associations provide recognition, in the form of fellow enthusiasts who appreciate one’s aims and interests, and resources in the form of equipment and facilities ‘necessary for associates’ pursuit of their individual criteria of excellence’ (McKinnon 2002: 127). Through membership of one more of such associations ‘we acquire a sense that what we do in everyday life is worthwhile’ (Rawls 1999: 387).
Importantly, Rawls claims that self-respect ultimately results from the distribution of other primary goods:
This explains why he produces ‘no principle of justice which directly addresses the distribution of the social bases of self-respect’ (McKinnon 2002: 78). Since he conceives of self-respect as a by-product of the arrangement of freedoms and economic opportunities ‘any difference between people in terms of their access to the social bases of self-respect is to be explained by differences between them in terms of their basic rights and liberties, their freedom of movement and free choice of occupation, and their income and wealth’ (ibid.: 78). The idea is that if you get these primary social goods rights, self-respect will flourish without any need for direct political policies on this issue.
Can this contention be supported? It is this question which section 2 will seek to answer.
2 Suicide rates: assessing the social bases of the absence of self-respect
2.1 Suicide as an indicator of chronically low self-respect
Suicide is an appropriate indicator of low self-respect for two reasons. Firstly, the parties of the original position prioritise above all else the welfare of the least-advantaged (see section 1.1). Since suicide is nearly always an indication of a complete absence of self-respect (see section 2.2) it follows that the suicidal are the least-advantaged in terms of self-respect. Secondly, suicide is convenient for research. Self-respect in itself is an abstract mental quality and as such any attempt to measure it and find correlations with social conditions is fraught with difficulties. In contrast, suicide is a distinct event the incidence of which has long been recorded by governments (although see section 2.3).
Suicide can be defined as an act which successfully results in the intended outcome: the perpetrator’s own death (Maris, Berman & Silverman 2000: 30-31). This essay will not be concerned with attempted suicide, both because there is much less data available and because many suicidologists consider most attempted suicides to be cries for help rather than genuine attempts at self-annihilation (Eglin 1988: 7). Indeed the social and psychological profiles of suicide attempters and suicide completers differ significantly (Pritchard 1995: 30) – e.g. in nearly all countries, men are much more likely to complete suicide while women are much more likely to attempt suicide (Kerkhof 2000: 55-56).
2.2 Theoretical problems with using suicide
Is suicide really an outcome of low self-respect? As established in section 1.2, to have Rawlsian self-respect, a person must have a sense that ‘his conception of his good, his plan of life, is worth carrying out’ and confidence in his ‘ability, so far as it is within one’s power, to fulfil [his] intentions’ (Rawls 1999: 386). Intuitively it seems obvious that someone who has determined to end his own life has ceased to have any sense that his chosen endeavours are worthwhile and/or has lost faith in his ability to successfully pursue them.
However, suicide encompasses a wide variety of actions, many of which do not fit our initial assumptions about motivations for suicide (Eglin 1988: 6-7). The Buddhist monks who set themselves on fire in protest at the Vietnam War, the Palestinian suicide bombers who have died believing they will receive a heavenly reward for their sacrifice and the 914 Jonestown cult members who died in a collective act of ‘revolutionary suicide’ in Guyana all committed suicide according to the definition given in section 2.1. Yet these deaths did not entail the despairing abandonment of the perpetrators’ plan of life, but rather its fulfilment.
However, these types of suicide are anomalous. The psychiatric research on suicidal behaviour shows that the vast majority of suicides are motivated by a desire to escape ‘intolerable psychological or mental pain, perturbation and pressure’ (Shneidman 1993: 293), what Shneidman terms ‘psychache’. This ‘introspective experience of negative emotions’ is a necessary condition for non-anomalous suicide (ibid.: 287). Holden et al. studied the association between Schneidman’s Psychache Scale and suicide ideation, previous suicide attempts and the likelihood of future suicide attempts and found that ‘current data support the validity of the Psychache Scale and provide support for Shneidman's theory of suicide’ (Holden et al. 2001: 231).
A key feature of the suicidal person’s mental pain is hopelessness. That is, she can see no solution to her troubles and ‘anticipates dire outcomes to… her problems’ (Beck et al. 1990: 190). Clinical hopelessness epitomises the absence of Rawlsian self-respect – the hopeless person can see no point in attempting to carry out her plan of life.
Moreover, it is a defining aspect of suicide. In a 10 year study of 207 suicide attempters Beck et al. (1985) found that while depression did not differentiate the suicide ideators who ultimately committed suicide from those who didn’t, hopelessness was a characteristic of 91% of the eventual suicides. Similarly, Young et al. (1996) found that hopeless subjects attempted suicide even between episodes of depression and that when feelings of hopelessness subsided, so did suicidal behaviour. Likewise, Rifai et al. (1994) found an association between post-depression feelings of hopelessness and a history of suicidal behaviour. People only resort to suicide when it seems impossible to achieve even their most basic concept of the good – they appear trapped in their unhappiness:
However, the suicide rate should not be conceived of as exactly equivalent to the incidence of very low self-respect. One factor affecting the suicide rate is the availability of the means necessary to commit suicide. For example, Kreitman (1980) argues that the main cause of Britain’s anomalously declining suicide rate between 1961 and 1977 was the gradual reduction of the carbon monoxide content in British domestic gas during the 1960s, making it much less dangerous. This is evidenced by the sharp decline in the rate of suicide by domestic gas poisoning and slight rise in suicide by other means during this period of detoxification. Likewise, a person may have very low self-respect but still choose not to resort to suicide, perhaps because the emotional experience of this low self-respect is not sufficiently painful, or because, maybe for religious reasons, suicide is completely unacceptable. So while (excepting anomalous ideologically-motivated suicides) all suicides are caused by a state of chronically low self-respect, the incidence of very low self-respect being translated into suicide is affected by other factors. Nevertheless, the suicide rate is still a useful, if imperfect indicator of low levels of self-respect.
2.3 Empirical problems with using suicide
For most of its history, sociological study of suicide has followed the quantitative tenets established by its founding father, Emile Durkheim (Eglin 1988: 3, see section 2.5 for Durkheim’s theory of sucide). However, in the mid-1960s newly emerging approaches to sociology began a radical assault on the foundations of Durkheim’s positivist perspective. Ethnomethodologist Jack D. Douglas brought attention to the fallibility of the methods by which suicide statistics are produced. He attacks the fatal ‘assumption that “suicidal actions” have a necessary and sufficient, unidimensional meaning throughout the Western world’ (Douglas 1967: 229). Rather coroners and medical examiners utilise unstated and diverse criteria and are subject to myriad pressures and prejudices as they seek to establish a cause of death. Douglas turns Durkheim’s finding that social integration is inversely related to the suicide rate (see section 2.5) on its head and asserts that ‘the more integrated the deceased individual is… the more [officials] responsible for deciding what the cause of death is will be… favourably influenced… by the preferences of the deceased and his significant others’ (ibid.: 213). He concludes that ‘official statistics cannot be expected to have any significant value in constructing or testing sociological theories of suicide’ (ibid.: 247) and advises suicidologists to concentrate instead on the ‘intensive observation, description, and analysis of individual cases’ (ibid.: 231).
However, although a consensus exists that there is widespread underreporting of suicide (Taylor 1982: 43-50), studies have found that this misreporting ‘has little effect on the relationship between suicide rates and indicators of concepts in sociological theories of suicide’ (Pescosolido & Mendelsohn 1986: 94) and in fact ‘rather than explaining all variation in official rates from one area to another, actually masks the true variation’ leading to the underestimation of the importance of social factors (ibid.: 95).
So accepting that empirical studies of suicide are worthwhile, what do they tell us?
2.4 Suicide and the economy
If Rawls’ claim that self-respect is a derivative of his primary social goods is correct, we would expect to find the suicide rate to be inversely correlated with indicators of economic wellbeing. This is certainly the case with the most obvious indicator of economic distress: unemployment. Unemployment has been identified as a key predictor of suicide in a range of countries: in an Austrian study, Schony and Grausgruber (1987) found an unemployed suicide rate of 98.3 compared to the local population’s rate of 24; in a British study the equivalent figures were 73.4 and 14.1 (Platt 1984); in an Italian study 3.2 and 2.1 (Platt 1992) and in Indianpolis 13.7 and 19.2 (Sholders 1981).
What about other indicators? Although several studies have found that suicide rates increase with SES*** (Sainsbury 1971: 251), most recent research has found a reverse pattern (Boxer, Burnett & Swanson 1995). Again, this finding has been reproduced in a number of countries: in Austria, Schony & Grausgraber (1987) found a suicide rate of 17.9 for white-collar workers compared to 35.5 for blue-collar workers; in Australia, Burnley (1995) recorded a suicide rate of 32.5 for male manual workers, 20.5 for male technical workers and 19.4 for male clerical and sales workers while in England and Wales, Kreitman, Carstairs and Duffy (1991) found that the suicide rate for working age males was highest for those with the lowest SES.
However, in interpreting these correlations it must be considered that they ‘do not factor out the influence of the covariates of lower SES’ (Stack 2000: 196). Kposowa, Breault and Singh (1995) found that when seven other variables were taken into account, the relationship between the suicide rate and SES was insignificant. Similarly, is the unemployed status of suicidal persons a result of economic factors or of ‘psychological problems [which] prevent them from being productive workers’ (Platt 1984: 95)? Studies which attempt to answer this question have produced mixed results – pending further research we cannot be sure of unemployment’s role (Stack 2000: 197, 199).
A less ambiguous finding is that the suicide rate rises in times of economic recession and falls in times of prosperity (Henry 1964: 42). Although Durkheim claimed the opposite to be true, ‘the great bulk of the evidence’ is against him on this matter (Stack 2000: 207). Since the kind of doubts surrounding the role of SES and employment obviously do not apply here, this is one case where an economic factor clearly has independent influence on suicide risk. However, it should be noted that it is the most socially dominant group – white males of high SES – whose propensity to commit to suicide increases the most during an economic downturn (Henry 1964: 41). So even this finding provides no evidence of a simple inverse association between prosperity and suicide.
It is also worth noting that some prestigious high-income occupations are amongst the most suicide-prone. For example, Stack (1996) found that, even after controls for associated covariates, dentists are 6.64 times more likely than the general populace to commit suicide.
2.5 Suicide and social relations
2.5.1 Social integration
So if suicide research does not point to economics as the main influence on suicide rates, what key factors can be identified? Overshadowing all later suicidology is the work of Durkheim. Durkheim sought to explain human behaviour through the influences of external social forces on naturally un-socialised individuals (Maris 1969: 26-28). In the case of suicide, while Durkheim accepted that individual motives such as relationship breakdowns and sickness play a part, he contended that such mishaps occur at the same frequency everywhere, whereas social influences vary, so that only social forces were relevant to explaining variations in the suicide rate (Durkheim 1962: 213-214).
The key variable for Durkheim is social integration – the degree of interaction, collective identity and sense of allegiance an individual experiences with regards to a group. Forms of social integration include religious belief, political activism and membership of an intimate interdependent community such as a family. His central claim was that ‘suicide varies inversely with the degree of integration of the social groups of which the individual forms a part’ (Durkheim 1962: 209)†.
While many criticisms have been levied against Durkheim and his claims, the central contention that suicide varies inversely with social integration has largely been borne out:
Social isolation has been found to be strongly associated with suicide:
In a study of suicides in Chicago, Maris (1981: 113-115) found that 49% of suicide victims had zero close friends, frequently having no informant to help fill out a suicide death certificate, or even no-one to identify the body, compared to 29% for natural deaths. Similarly 50% of suicide victims did not belong to any social organisation compared to 30% for natural deaths. Likewise unmarried, widowed and divorced status are all associated with a higher suicide risk (Retterstøl 1993: 79-80).
Religion also offers a protection against suicide. However, whereas Durkheim claimed that Protestants were at greater suicide risk than Catholics, more recent research has found that membership of the relatively integrated evangelical Protestant and Roman Catholic congregations does protect against suicide, whereas membership of the more impersonal institutional Protestant churches (e.g. Episcopal, Congregational) does not, suggesting, in line with Durkheim’s central argument, that it is the degree of social support offered by a church which determines suicide risk (Pescosolido 1994: 274).
Support for the Durkheimian hypothesis also comes from studies of differing suicide rates within urban areas. Various US studies found that suicide rates were highest in areas of ‘social disorganisation’ - ‘neighbourhoods, normally situated near the city centre, where there is great deal of lateral mobility, a high immigrant ratio… a large proportion of the population lives alone in lodgings or flats [and where] social life is generally unstable in character, and lacking in a coherent set of norms’ (Giddens 1971: 243). However such neighbourhoods were also the areas of greatest poverty, so that it proved difficult to distinguish the role of economic factors from that of social disorganisation (Sainsbury 1971: 247). This problem did not affect Sainsbury’s 1955 study of London since here ‘the prosperous north-western boroughs [had] the highest rates of mobility, isolation and social disorganisation [while] the poor eastern boroughs [had] the lowest’ (ibid.: 247). Sainsbury’s finding that it was the wealthy but socially disorganized boroughs which had the highest suicide rates and the poor but socially organised boroughs which had the lowest ‘unequivocally supports the view that social disorganization, not poverty, is the paramount factor’ (ibid.: 247).
A sense of the potency of social integration even in situations of impoverishment can be found in Jonathan Sacks’ description of his childhood community:
2.5.2 Suicide in Scandinavia
Further evidence of the importance of social relations comes from an assessment of suicide rates in Norway, Sweden and Denmark. In terms of political and economic social structure (the key determinant of self-respect according to Rawls), they have moved in parallel and in a decidedly Rawlsian direction††, and yet their suicide rates have differed markedly. Although the rates have converged in recent years, Norway has traditionally enjoyed a low suicide rate, while Sweden and Denmark have suffered high rates (see figure 1). Surely if Rawls’ account of the social bases of self-respect is adequate, we would expect to see similar rates for all three countries. What accounts for the differences?
Returning to the issues raised in section 2.3, one explanation is that Norway simply has less stringent procedures for recording suicide than its neighbours (Giertsen 2000). However, in 1977, the Scandinavian countries and Finland set up the Nordic Planning Group for Suicide Research (Juel-Nielsen, Retterstøl & Bille-Brahe 1987) which later set up a sub-project specifically to study the role of differing registration procedures in influencing suicide rates. Although the data for all four nations were judged to have underestimated the true rate, they were found to have the same degree of reliability. Reviewing this and other studies on the issue, Giertsen (2000) concludes that ‘it appears reasonable to conclude that changes in suicide rates in Norway in recent decades reflect genuine changes’.
What social factors might account for the variation? Hendin (1964) and Farber (1977), on the basis of interviews and anecdotal observations, both attributed the differences to child-rearing styles. Hendin claimed that while ‘the Norwegian child is not required to excel in order to win his mother’s affection’ (Hendin 1964: 112) and openness and independence are encouraged, Swedish mothers are neglectful (Hendin 1964: 50) and Danish mothers encourage over-dependence (Hendin 1964: 30). Farber argued that Norwegian families are more affectionate and warm and that the Norwegian father is ‘a figure of strength’ (Farber 1977: 54).
While such generalisations are always problematic, empirical support for a link between suicide and family is provided by Allardt’s (1975) study of social variables in Nordic countries. He found group cohesion to be strongest in Norway - a sense of belonging, a feeling of identity with the nation, a general degree of satisfaction and, in particular, family solidarity, were all highest in Norway. Similarly, Fuchs, Gaspari and Millendorfer (1977) studied several Western European nations and found that the two which were rated most highly with regard to data on the quality of family life, the Netherlands and Norway, were also countries with a noticeably low suicide rate. Likewise Narrol (1983) found that close family groups and smaller communities offered the best form of protection against socially deviant behaviour, including suicide, and in a comparison of twelve developed nations, declared Norway a ‘model country’.
More recently, the Nordic Planning Group for Suicide Research (Juel-Nielsen, Retterstøl & Bille-Brahe 1987) found that levels of social integration were considerably lower in Denmark than in Norway, particularly for women. Norway’s high level of integration stemmed ‘partly from family contact and relations to friends, partly from the Norwegians’ engagement in community life, particularly in respect of their local community’ (Juel-Nielsen, Retterstøl & Bille-Brahe 1987: 59). In line with Durkheim’s hypothesis, social integration was found to be lowest amongst high-suicide groups such as 50-65 year old Danish women and 20-29 year old Norwegian men.
Linked to this latter finding is the fact that Norway’s rising suicide rate mainly reflects the phenomenal recent rise in youth suicide (Retterstøl 1993: 27). This is thought to reflect the greater influence of characteristically modern, socially disintegrative, forces on the young:
…the same development that reached the other countries earlier is now occurring in Norway. (ibid.: 74)
2.5.3 The modern malaise†††
What is it about modern society that engenders social disintegration? For the purpose of explaining suicide, we can divide the anomie of modernity into two aspects. In exploring the first aspect, we can look at the way in which a closely integrated social framework works to supports a person’s identity as a necessary part of a meaningful social entity. Philosopher Alisdair MacIntyre cogently argues that a coherent identity can only be founded upon a sense of the social ‘stories’ of which we find ourselves a part (MacIntyre 1985.: 216). Through relationships with others and through performing necessary functions within institutions, we know who we are and who we should be – our lives are given direction and meaning. The more these social roles engage and challenge us and the more they are based on interdependent, personal and long-lasting social relations the more supportive of identity they will tend to be.
As Durkheim and many others have observed, the nature of modern society is such that it tends to undermine the development of meaningful social relations. Sandel identifies a pervasive ‘sense that, from family to neighbourhood to nation, the moral fabric of community is unravelling around us’ (Sandel 1996: 3) as a defining anxiety of our era. Capitalism has reduced the social relations of the archetypal workplace to contracts of supply and demand. From the employer’s viewpoint, the employee is a tool – he is there because a machine cannot yet do the same work more cost-effectively. From the employee’s viewpoint, work is a means to the ends of money and status.
Outside of work, people are increasingly disconnected from their neighbours. Slum clearances, greater mobility and the power of the market have combined to uproot established communities. Meanwhile, the political community consists of the state – an enormous impersonal bureaucracy over which the individual has influence only as an insignificant component of a massive collective. Conflating all of this is modernity’s tendency to partition ‘life into a variety of segments, each with its own norms and modes of behaviour’ (MacIntyre 1985: 204), such that it is difficult to see how one’s life forms a coherent whole. In contrast, the pre-modern social relations of work, family, political and social life were interwoven, each reinforcing the significance of the other.
The other aspect to the importance of social relations is the quality of those social relations. Social relations can be highly effective in giving identity and meaning while still being of no or even negative value in terms of emotional support. Good social relations act as source of comfort and support in times of distress. But these aspects of social relations are also undermined by modern life. Where there is greater migration, less contact with neighbours and greater general anonymity there is less opportunity to develop supportive intimate relationships which might protect against suicide.
2.6 Other factors
Needless to say, poor social relations and economic difficulties are not the only contributors to a person’s decision to commit suicide. However space considerations allow only a brief summary of other factors. Alcohol and drug abuse is one particularly common precursor to suicide – 25-55% of suicide victims practice substance abuse (Murphy 2000: 135). However:
Psychological autopsy studies suggest depression is present in 29-88% of suicides (Lönnqvist 2000: 107). But this finding in itself is unhelpful – the question simply shifts from ‘what causes suicide?’ to ‘what causes mental illness?’ Many studies suggest that biology plays a large role - suicide appears to be related to decreased activity in the brain’s serotenergic system, resulting in ‘impaired inhibition and a greater propensity to act on powerful feelings such as suicidal or aggressive feelings’ (Mann 1998: 26). However, once again this does not in itself tell us much since our internal chemistry is profoundly affected by our environment – merely glancing at an attractive face is enough to spark measurable changes in the brain (Muir 2001). Nevertheless, our propensity to chemical imbalance in the brain is at least partly independent of our environment – as shown by a study which found that adopted children display a greater likelihood of developing bipolar depression if their biological parents suffered mood disorders (Faraone, Tsuang & Tsuang 1999: 40).
An entirely different kind of cause is the build-up of undesirable life events and stresses over long periods of time. These include ‘blows to self-esteem, guilt, legal problems, economic strain, interpersonal discord, loss of important social relationships, threat of jail or imprisonment, loss of social status, just being repeatedly overworked, and so forth’ (Maris, Berman & Silverman 2000: 83). Suicide is frequently associated with life transitions – e.g. from middle-age to retirement, from marriage to divorce (ibid.: 261-262).
As suggested in section 2.5.2, a person’s upbringing also has a significant influence. Most studies have focussed on the family’s impact on suicidal children and adolescents. Of those studying the link with adult suicide, Maris (1981: 122) found that, compared to those dying of natural causes, suicide completers were much less close to their fathers, and four times more likely to have received mainly physical discipline from their fathers as children. Other studies suggest early separation from one’s mother for long periods, physical, sexual and emotional abuse by one’s parents, young adult promiscuity and frequent changes of residence in childhood are all related to suicide in adulthood (Maris, Berman & Silverman 2000: 83). Many psychologists view the quality of one’s childhood as the main root of problems in adulthood:
2.7 Bringing the findings together
So far the causes of suicide have been considered as a list of contributing factors, an approach which in itself does not amount to a full explanation:
Instead, factors must be ‘organized into a comprehensive picture of suicidal dynamics that takes into account the dynamic interaction among various factors’ (Weinberg 2000: 606). What might this picture look like?
Firstly, an individual may, probably as a result of both genetic inheritance and a troubled childhood, possess one or more psychological traits, such as a predisposition to depression or a weak sense of identity, which make her more vulnerable to the loneliness and psychic disorientation resulting from the anomic social environment described in section 2.5.3. Psychological problems may also inhibit the vulnerable individual’s ability to form satisfying, lasting social relations. Without this social support, the tragedies, disappointments and general stresses of life, will be particularly painful and difficult to deal with. The problem of the loss of important identity-affirming statuses and relationships will also be exaggerated in the context of an anomic modern social environment in which the role of community-member is of little significance. Thus the end of working life or physical fitness and the death or departure of children and spouses will often leave a void – a lack of purpose and connection to the world. Without such reasons-for-living, we can understand how a troubled person might choose to end the struggle through suicide:
The individual can no longer go on being with an identity that he has achieved or can no longer maintain. The narrative stops. Hopelessness is when there is no story to go on with. (Aldridge 1998: 39-40)
3 A new agenda
The account of suicide established in the previous sections, reveals it to be a result of forces largely independent of wealth and liberty. In particular, the key social factor, social integration, can exist amidst both wealth and poverty, and varies significantly within identical or similar political-legal frameworks. Therefore, since suicide is equivalent to very low self-respect, Rawls’ assertion that the social bases of self-respect are adequately supplied through the primary social goods of freedoms and economic wellbeing is wrong.
This is not to say that they are irrelevant to self-respect. As section 2.4 showed, economic difficulties do seem to play some role. Moreover, in raising self-respect beyond the bare minimum, Rawls’ primary social goods are certainly crucial – they facilitate the pursuit of the diverse interests which contribute to a person’s sense of her life as worthwhile (McKinnon 2002: 132-139).
However, the social bases of the minimal level of self-respect are not secured by money and rights. If Rawls’ theory and the sociology of suicide are to be taken seriously, political programmes must be developed specifically to support social integration. This section will consider what these programmes might look like. It should be noted that, within the context of Rawls’ theory, not all social integration is good integration – it cannot come at the price of liberty, nor can it engender relations of unthinking subservience (see section 1.2).
First of all, a new attitude to politics is required. Political commentators have tended to judge a government’s success in terms of what can be easily measured – e.g. the distribution of wealth, the performance of the health service, the efficiency of the transport system. Without denying the importance of these matters, it is necessary to recognise that none of them matter if people lack a basic sense that life is worthwhile. We must ‘realise that the story of man-the-political-and-economic-animal is only half of the truth of our human situation’ (Sacks 2000: 268). The fact that growing numbers of people in the developed world are losing that sense, to the extent of resorting to suicide‡, should, if we take the Rawlsian concern for the least-advantaged seriously, be our most pressing concern.
While governments are not oblivious to the importance of mental health, the issue is very far from occupying the primary place on the agenda where it belongs. Why, when traffic mortality rates have been decreasing and suicide rates sharply increasing over the last two decades, do the resources for tackling suicidal behaviour constitute only a tiny fraction of what is available for the prevention of motor traffic deaths (Diekstra 1996: 2)?
Secondly, greater imagination is required. The UK government has set itself the target of reducing the suicide rate by 20% by 2010 (Great Britain, Dept. of Health 2002: 5). However, its intended strategy, while not inconsequential, focuses only on short-term risk reduction and awareness-raising. For example, frontline clinical staff are to receive improved ‘risk management skills’ (ibid.: 19-20) while the NHS will see the addition of new ‘clinical teams providing assertive outreach, early intervention and crisis resolution’ for people with a history of mental illness (ibid.: 17). There no recognition that suicide and mental illness are the results of particular personal histories and particular social contexts which are in turn shaped by forces over which the government has some measure of control.
Despite our current emphasis on medical diagnoses, sophisticated technology, economic cutbacks and ‘quick fixes’, what patients need most in the midst of this health care maze is sensitive and caring individuals who are willing to enter into interpersonal relationships that foster hope and prevent hopelessness. (Peplau 1995: x)
While this can be partly rectified through the funding and resourcing of the many volunteers, social workers and therapists who are willing to enter into such relationships, it would obviously be far better if suicidal people did not suffer negative or absent social relations in the first place.
Retterstol (1993: 212) notes that while ‘training is required for most professions… no training is required to enter one of the most demanding areas of society we have – marriage’ and advises that if we expect marriages to be mutually supportive and long-lived, we should be willing to invest in widely available marriage guidance, including giving the subject a place in the school curriculum. To help troubled adolescents, Bird & Faulkner (2000: 14) propose ‘school programmes for equipping young people with effective problem-solving skills’ and help for school staff in dealing with ‘at risk’ students. Perhaps most crucially, it would be helpful to improve the relations between parents and their children. DeMause (1998) declares that rather than contenting ourselves with ‘endless repair work on damaged adults, with more jails and police and therapists and political movements’ we should directly address what in his view is the underlying cause of the damage and create a new profession of ‘child helpers’, giving parenting classes and performing home visits, as the logical sequel to universal education. He cites a pioneering parenting centre in Boulder, Colorado which, on the evidence of careful follow-up studies and reduced police reports and hospital entrance rates, has measurably reduced child abuse.
However, the social relations relevant to mental health are not just familial ones – none of the above addresses the anomie described in section 2.5.3. In considering what his native Norway can do to reverse the trend of recent years and reduce the suicide rate, Retterstøl (1993: 74) advises the protection of those small, rural communities where social cohesion is still strong through a programme of decentralisation. However such efforts can only have a very limited impact – small, closely-knit rural communities developed as a result of a particular economic and technological framework. The forces of modernity push inexorably in the opposite direction – towards a society of highly mobile urban individuals. It is the economic framework which must be altered if the shape of society is to change.
One possible solution lies in the co-operative movement. The co-operative ethos of democratic member-ownership, allows for co-operative businesses to become socially integrated communities rather than simply machines for making money for an impersonal body of shareholders. Thus in a co-operative organisation, employees are not simply means for somebody else’s end, and there is a greater likelihood that work becomes more than a means to the worker’s end of earning a wage. Because of their ‘people before profit’ ethics, co-operatives are also far more likely than standard businesses to risk employing the mentally ill and other disadvantaged people – i.e. those most at risk of losing their self-respect. The co-operative movement is a solution which seeks to reform the forces of modernity, rather than attempting to turn the clocks back and return to a bygone era. We should also note that the socially integrated communities of yesteryear were no bastions of liberal principles – social integration tended to go hand in hand with arbitrary hierarchy and rigid social roles. In contrast, while they are, to a greater extent even than ‘traditional’ communities, based on shared interests and a single shared project, co-operatives are firmly founded upon principles of equality and tolerance‡.
Needless to say, this section is far from comprehensive. It is intended only as an exploration of the kind of discussions and ideas which might be generated were the fundamental relevancy of self-respect and its relationship to social integration embraced by liberal politics.
Conclusion
Rawls is right to emphasise the critical importance of self-respect. Without it, wealth and freedom amount to nothing. But if we are to take the Rawlsian commitment to the least-advantaged seriously, we must acknowledge that the findings of sociology and psychology expose Rawls’ plan for guaranteeing self-respect as inadequate. Underlying the despair of those who have entirely lost their self-respect is not economic injustice or authoritarian law books, but the impossibility of coping with the strains, tragedies and confusion of life in a context of loneliness and alienation. Unless it develops a response to this context, a Rawlsian political agenda cannot live up to the compassion and humanitarianism at the heart of Rawls’ justice.
Bibliography
Footnotes
* ‘…the way in which the major social institutions distribute fundamental rights and duties and determine the division of advantages from social cooperation’ (Rawls 1999: 6).
** Liberalism can be divided into two main schools – classical liberalism and social, or new, liberalism (Vincent 1992: 27). Both are founded upon the citizen’s right to equal liberty but differ in their conception of that liberty. Classical liberalism advocates a negative conception of liberty (e.g. ‘the state in which a man is not subject to coercion by the arbitrary will of another’ (Hayek 1960: 11)) and hence a minimal state. Social liberalism propounds a positive conception of liberty (e.g. ‘…to enjoy liberty means… to have the capacities… to be able to pursue different courses of action’ (Held 1996: 263)) and hence an interventionist state.
*** Socioeconomic status
† Durkheim’s actually conceived of four categories of suicide: egoistic and altruistic, resulting from lack and excess of integration respectively, and anomic and fatalistic, resulting from lack and excess of regulation respectively. But Durkheim frequently conflated the two forces, integration and regulation, referring to egoistic and anomic suicides as ‘two different aspects of one social state’ (Durkheim 1962: 179) – namely a lack of social integration (Travis 1990: 225-226). Likewise, altruistic and fatalistic suicide were not considered by Durkheim to be generally relevant to modern society (Breault 1986: 628) – they are the anomalous suicides described in section 2.2.
†† The Scandinavian states are all liberal parliamentarian democracies headed by constitutional monarchs, have relatively regulated capitalist market economies, are characterised by close relations between organised interests and government and share the distinctive ‘Scandinavian welfare model’ (Ervik & Kuhnle 1996: 88-89).
††† Space considerations preclude a full account of the issues summarised in this section.
‡ In 1998, there were 5,905 suicides in the UK – sixteen suicides for every day of the year (Office for National Statistics 1998), in British men under 35, suicide is the leading cause of death (Great Britain, Dept. of Health 2002: 7) and for every completed suicide there are an estimated 10-15 attempted suicides (Retterstøl 1993: ix).
‡‡ To qualify for membership of the International Co-operative Alliance, a co-operative must be ‘open to all persons… without gender, social, racial, political or religious discrimination’ (ICA 2003: 2).
‘…the parties in the original position would wish to avoid at almost any cost the social conditions that undermine self-respect.’ (Rawls 1999: 386)
Abstract
Rawls identifies self-respect as a fundamental feature of his theory of justice, but diffuses it of political significance by arguing that it is essentially a by-product of other primary goods. This assertion can be questioned by taking suicide as an indicator of a catastrophic collapse of self-respect and considering the social factors which help produce this collapse. Pre-eminent amongst these factors is a lack of social integration, something which is largely independent of Rawls’ primary social goods. Therefore a new dimension must be added to the Rawlsian vision which has implications for the wider liberal agenda. Liberty and equality are not enough; they are worthless without fraternity.
Introduction
After his death at the age of 81 in 2002, John Rawls was described in his obituaries as the leading philosopher of the English-speaking world (Rogers 2002) and credited with producing ‘the 20th Century’s most complete philosophical defence’ of liberal democracy’ (Lovin 2002). His classic work, A Theory of Justice, reflects the concerns of most contemporary liberal activists, politicians and fellow philosophers in its focus upon the appropriate distribution of wealth and liberties. Yet, as the title quote shows, Rawls also attached great importance to the abstract personal quality of self-respect. This essay will consider the implications of taking Rawls’ emphasis on self-respect seriously.
Section 1 will examine the place of self-respect in Rawls’ political theory: its definition, importance and the contention that it is determined by the distribution of other primary goods. Section 2 will consider whether self-respect might not be influenced by factors other than the primary social goods. Sections 2.1 to 2.3 will give the reasons for using suicide as an indicator of low self-respect, and the problems with doing so; sections 2.4 to 2.7 will examine the causes of suicide and section 3 will consider ways in which a Rawlsian political programme might engage with these findings.
1 The place of self-respect in A Theory of Justice
1.1 A summary of Rawls’ theory
Rawls proposes that the principles guiding ‘the proper distribution of the benefits and burdens of social cooperation’ (Rawls 1999: 5) should be those chosen in an ‘original position’ where everyone is under a ‘veil of ignorance, such that nobody knows what position they will occupy in society, nor what conception of the good they will hold’ (ibid.: 118). In order to secure their wellbeing whoever they turn out to be, the parties of the original position will devise principles which ‘a person would choose for the design of a society in which his enemy is to assign him his place’ (ibid.: 133), arranging benefits and duties in order that they ‘work as part of a scheme which improves the expectations of the least advantaged members of society’ (ibid.: 65).
This scenario is not envisaged as a practical possibility, but as an intellectual ‘device for teasing out the implications of certain moral premises’ (Kymlicka 2001: 61). By thinking in terms of this ‘purely hypothetical situation’ (Rawls 1999: 11) we will arrive at principles of justice which embody the ‘the right of each individual to equal concern and respect’ (Daniels 1975: xxi) regardless of differences which should be irrelevant to justice.
Since they are ignorant of their ambitions, beliefs and personality, the parties in the original position will want to secure access to ‘things which it is supposed a rational man wants whatever else he wants’, what Rawls calls ‘primary goods’ (Rawls 1999: 79). For the sake of simplicity, Rawls restricts his discussion to the primary social goods – that is, goods which are directly controlled by the basic structure of society*, which he lists as ‘rights, liberties, and opportunities, and income and wealth’ (ibid.: 54). The only other primary good discussed in A Theory of Justice is self-respect.
1.2 Rawls’ definition of self-respect
In defining this good, Rawls reveals a very particular conception of self-respect:
We may define self-respect… as having
two aspects. First of all… it includes a person’s sense of his own
value, his conviction that his conception of his good, his plan of
life, is worth carrying out. And second, self-respect implies a
confidence in one’s ability, so far as it is within one’s power, to
fulfil one’s intentions. (Rawls 1999: 386)
In other words, a person has self-respect when she believes in the worthiness of her aims and is aware of her full potential and ability with regard to these aims. This conception of self-respect has been criticised as incomplete since it allows for a clearly illiberal society of masters and unquestioning servants, so long as the servants are convinced their servitude is inevitable and worthwhile (Massey 1983: 260).
To solve this problem, McKinnon (2002: 68) proposes that a self-respecting person be additionally defined as someone who would not ‘judge as illegitimate any expectation of hers that others offer her justifying reasons why she should perform actions which she is expected by them to perform’. Since Rawls considered his principles to ‘best express [people’s] nature as free and equal rational beings’, and since the parties of the original position would surely wish to avoid being duped into a lifetime of unquestioning servility to another’s arbitrary whims, we can be confident that had he addressed the issue, Rawls would have amended his definition in a similar way.
1.3 Self-respect as a fundamental primary social good
Rawls describes self-respect as ‘perhaps the most important primary good’ (Rawls 1999: 386, 440). In his later work, Political Liberalism, Rawls reaffirms self-respect’s ‘fundamental importance’ (Rawls 1993: 76). Considering that he defines self-respect essentially as a sense that one’s life has meaning, Rawls’ emphasis is not surprising:
When we feel that our plans are of little value, we cannot pursue them with pleasure or take delight in their execution. Nor plagued by failure and self-doubt can we continue in our endeavours… All desire and activity becomes empty and vain, and we sink into apathy and cynicism. (Rawls 1999: 386).
This then is why self-respect stands above other primary goods – if we do not find our pursuits worthwhile, the resources and the freedoms which allow us to pursue them are meaningless.
1.4 Wider relevance of Rawlsian self-respect
Rawls’ theory has had such an immense impact on political philosophy because it is so clearly based on the fundamental tenets of liberalism – ‘the equality of all men under the law’ (von Mises 2002: 28) and ‘toleration of all opinions’ (ibid.: 56). Many regard A Theory of Justice as ‘the paradigmatic statement of contemporary liberalism’ (Mulhall 1996: xv). At the very least Rawls is the central philosopher of contemporary ‘social’ liberalism**. The commitment to providing all citizens, so far as possible, with primary goods – the means necessary to pursue the goals they have chosen – is central to social liberalism as a whole, not just Rawls’ particular theory. Thus if Rawls succeeds in showing that self-respect is an essential primary good (and as seen in the previous section, it is difficult to see how one could argue otherwise) then it has vital relevance to all social liberal political programs, not just a Rawlsian one.
It is therefore unsurprising to find that Rawls is not alone in giving self-respect a central place in a liberal philosophy. Bedau (1968: 571) asserts that a list of ‘natural or human rights’ can only be derived from ‘a prior inventory of… what men need… in order to be free and self-respecting persons’. Feinberg (1970: 252) reverses this statement in arguing that the value of human rights is dependent on the possession of a self-respecting character – ‘that minimal self-respect that is necessary to be worthy of the love and esteem of others’. What Rawls, Bedau and Feinberg share is the conviction that freedom and equality enshrined in political rights are not in themselves enough to secure the full liberty desired by all social liberals. Rather they require the desire and confidence to uphold and make use of these rights – qualities which these philosophers term self-respect.
1.5 Rawls’ account of the social bases of self-respect
Clearly, the acceptance of self-respect as an essential primary good has ‘important implications for our assessment of social, political, and economic institutions’ (Massey 1983: 259). Although, as an abstract personal quality, self-respect cannot be secured for people directly, the state can ‘provide persons with opportunity to develop… self-respect’ (McKinnon 2002: 125).
The social bases of self-respect can be re-arranged, but self-respect can’t be. (Rawls 1971: 62)
What are these social bases? Firstly, there is the underlying ethos of the society. In a just society, founded on precepts of equality and pluralism, ‘persons express their respect for one another in the very constitution of their society’ (ibid.: 156) ensuring widespread self-respect (ibid.) and a ‘democracy in judging each other’s aims’ (ibid.: 388).
Self-respect is also facilitated by the ‘full and diverse internal life of the many free communities of interests that equal liberty allows’ (ibid.: 477). Thus, in the pluralist society which Rawls’ principles give rise to, all kinds of interests and goals are catered for. Associations provide recognition, in the form of fellow enthusiasts who appreciate one’s aims and interests, and resources in the form of equipment and facilities ‘necessary for associates’ pursuit of their individual criteria of excellence’ (McKinnon 2002: 127). Through membership of one more of such associations ‘we acquire a sense that what we do in everyday life is worthwhile’ (Rawls 1999: 387).
Importantly, Rawls claims that self-respect ultimately results from the distribution of other primary goods:
…in a well-ordered society the need for
status is met by the public recognition of just institutions, together
with the full and diverse internal life of the many free communities of
interests that equal liberties allow. The basis of self-respect in a
just society is… the publicly affirmed distribution of fundamental
rights and liberties. (ibid.: 477)
This explains why he produces ‘no principle of justice which directly addresses the distribution of the social bases of self-respect’ (McKinnon 2002: 78). Since he conceives of self-respect as a by-product of the arrangement of freedoms and economic opportunities ‘any difference between people in terms of their access to the social bases of self-respect is to be explained by differences between them in terms of their basic rights and liberties, their freedom of movement and free choice of occupation, and their income and wealth’ (ibid.: 78). The idea is that if you get these primary social goods rights, self-respect will flourish without any need for direct political policies on this issue.
Can this contention be supported? It is this question which section 2 will seek to answer.
2 Suicide rates: assessing the social bases of the absence of self-respect
2.1 Suicide as an indicator of chronically low self-respect
Suicide is an appropriate indicator of low self-respect for two reasons. Firstly, the parties of the original position prioritise above all else the welfare of the least-advantaged (see section 1.1). Since suicide is nearly always an indication of a complete absence of self-respect (see section 2.2) it follows that the suicidal are the least-advantaged in terms of self-respect. Secondly, suicide is convenient for research. Self-respect in itself is an abstract mental quality and as such any attempt to measure it and find correlations with social conditions is fraught with difficulties. In contrast, suicide is a distinct event the incidence of which has long been recorded by governments (although see section 2.3).
Suicide can be defined as an act which successfully results in the intended outcome: the perpetrator’s own death (Maris, Berman & Silverman 2000: 30-31). This essay will not be concerned with attempted suicide, both because there is much less data available and because many suicidologists consider most attempted suicides to be cries for help rather than genuine attempts at self-annihilation (Eglin 1988: 7). Indeed the social and psychological profiles of suicide attempters and suicide completers differ significantly (Pritchard 1995: 30) – e.g. in nearly all countries, men are much more likely to complete suicide while women are much more likely to attempt suicide (Kerkhof 2000: 55-56).
2.2 Theoretical problems with using suicide
Is suicide really an outcome of low self-respect? As established in section 1.2, to have Rawlsian self-respect, a person must have a sense that ‘his conception of his good, his plan of life, is worth carrying out’ and confidence in his ‘ability, so far as it is within one’s power, to fulfil [his] intentions’ (Rawls 1999: 386). Intuitively it seems obvious that someone who has determined to end his own life has ceased to have any sense that his chosen endeavours are worthwhile and/or has lost faith in his ability to successfully pursue them.
However, suicide encompasses a wide variety of actions, many of which do not fit our initial assumptions about motivations for suicide (Eglin 1988: 6-7). The Buddhist monks who set themselves on fire in protest at the Vietnam War, the Palestinian suicide bombers who have died believing they will receive a heavenly reward for their sacrifice and the 914 Jonestown cult members who died in a collective act of ‘revolutionary suicide’ in Guyana all committed suicide according to the definition given in section 2.1. Yet these deaths did not entail the despairing abandonment of the perpetrators’ plan of life, but rather its fulfilment.
However, these types of suicide are anomalous. The psychiatric research on suicidal behaviour shows that the vast majority of suicides are motivated by a desire to escape ‘intolerable psychological or mental pain, perturbation and pressure’ (Shneidman 1993: 293), what Shneidman terms ‘psychache’. This ‘introspective experience of negative emotions’ is a necessary condition for non-anomalous suicide (ibid.: 287). Holden et al. studied the association between Schneidman’s Psychache Scale and suicide ideation, previous suicide attempts and the likelihood of future suicide attempts and found that ‘current data support the validity of the Psychache Scale and provide support for Shneidman's theory of suicide’ (Holden et al. 2001: 231).
A key feature of the suicidal person’s mental pain is hopelessness. That is, she can see no solution to her troubles and ‘anticipates dire outcomes to… her problems’ (Beck et al. 1990: 190). Clinical hopelessness epitomises the absence of Rawlsian self-respect – the hopeless person can see no point in attempting to carry out her plan of life.
Hopelessness [is] a thought process
that expects nothing; and a behavioural process in which the person
attempts little or takes inappropriate action. (Farran et al. 1995: 25)
Moreover, it is a defining aspect of suicide. In a 10 year study of 207 suicide attempters Beck et al. (1985) found that while depression did not differentiate the suicide ideators who ultimately committed suicide from those who didn’t, hopelessness was a characteristic of 91% of the eventual suicides. Similarly, Young et al. (1996) found that hopeless subjects attempted suicide even between episodes of depression and that when feelings of hopelessness subsided, so did suicidal behaviour. Likewise, Rifai et al. (1994) found an association between post-depression feelings of hopelessness and a history of suicidal behaviour. People only resort to suicide when it seems impossible to achieve even their most basic concept of the good – they appear trapped in their unhappiness:
The common cognitive state in suicide is constriction (Schneider 1985: 138)
However, the suicide rate should not be conceived of as exactly equivalent to the incidence of very low self-respect. One factor affecting the suicide rate is the availability of the means necessary to commit suicide. For example, Kreitman (1980) argues that the main cause of Britain’s anomalously declining suicide rate between 1961 and 1977 was the gradual reduction of the carbon monoxide content in British domestic gas during the 1960s, making it much less dangerous. This is evidenced by the sharp decline in the rate of suicide by domestic gas poisoning and slight rise in suicide by other means during this period of detoxification. Likewise, a person may have very low self-respect but still choose not to resort to suicide, perhaps because the emotional experience of this low self-respect is not sufficiently painful, or because, maybe for religious reasons, suicide is completely unacceptable. So while (excepting anomalous ideologically-motivated suicides) all suicides are caused by a state of chronically low self-respect, the incidence of very low self-respect being translated into suicide is affected by other factors. Nevertheless, the suicide rate is still a useful, if imperfect indicator of low levels of self-respect.
2.3 Empirical problems with using suicide
For most of its history, sociological study of suicide has followed the quantitative tenets established by its founding father, Emile Durkheim (Eglin 1988: 3, see section 2.5 for Durkheim’s theory of sucide). However, in the mid-1960s newly emerging approaches to sociology began a radical assault on the foundations of Durkheim’s positivist perspective. Ethnomethodologist Jack D. Douglas brought attention to the fallibility of the methods by which suicide statistics are produced. He attacks the fatal ‘assumption that “suicidal actions” have a necessary and sufficient, unidimensional meaning throughout the Western world’ (Douglas 1967: 229). Rather coroners and medical examiners utilise unstated and diverse criteria and are subject to myriad pressures and prejudices as they seek to establish a cause of death. Douglas turns Durkheim’s finding that social integration is inversely related to the suicide rate (see section 2.5) on its head and asserts that ‘the more integrated the deceased individual is… the more [officials] responsible for deciding what the cause of death is will be… favourably influenced… by the preferences of the deceased and his significant others’ (ibid.: 213). He concludes that ‘official statistics cannot be expected to have any significant value in constructing or testing sociological theories of suicide’ (ibid.: 247) and advises suicidologists to concentrate instead on the ‘intensive observation, description, and analysis of individual cases’ (ibid.: 231).
However, although a consensus exists that there is widespread underreporting of suicide (Taylor 1982: 43-50), studies have found that this misreporting ‘has little effect on the relationship between suicide rates and indicators of concepts in sociological theories of suicide’ (Pescosolido & Mendelsohn 1986: 94) and in fact ‘rather than explaining all variation in official rates from one area to another, actually masks the true variation’ leading to the underestimation of the importance of social factors (ibid.: 95).
So accepting that empirical studies of suicide are worthwhile, what do they tell us?
2.4 Suicide and the economy
If Rawls’ claim that self-respect is a derivative of his primary social goods is correct, we would expect to find the suicide rate to be inversely correlated with indicators of economic wellbeing. This is certainly the case with the most obvious indicator of economic distress: unemployment. Unemployment has been identified as a key predictor of suicide in a range of countries: in an Austrian study, Schony and Grausgruber (1987) found an unemployed suicide rate of 98.3 compared to the local population’s rate of 24; in a British study the equivalent figures were 73.4 and 14.1 (Platt 1984); in an Italian study 3.2 and 2.1 (Platt 1992) and in Indianpolis 13.7 and 19.2 (Sholders 1981).
What about other indicators? Although several studies have found that suicide rates increase with SES*** (Sainsbury 1971: 251), most recent research has found a reverse pattern (Boxer, Burnett & Swanson 1995). Again, this finding has been reproduced in a number of countries: in Austria, Schony & Grausgraber (1987) found a suicide rate of 17.9 for white-collar workers compared to 35.5 for blue-collar workers; in Australia, Burnley (1995) recorded a suicide rate of 32.5 for male manual workers, 20.5 for male technical workers and 19.4 for male clerical and sales workers while in England and Wales, Kreitman, Carstairs and Duffy (1991) found that the suicide rate for working age males was highest for those with the lowest SES.
However, in interpreting these correlations it must be considered that they ‘do not factor out the influence of the covariates of lower SES’ (Stack 2000: 196). Kposowa, Breault and Singh (1995) found that when seven other variables were taken into account, the relationship between the suicide rate and SES was insignificant. Similarly, is the unemployed status of suicidal persons a result of economic factors or of ‘psychological problems [which] prevent them from being productive workers’ (Platt 1984: 95)? Studies which attempt to answer this question have produced mixed results – pending further research we cannot be sure of unemployment’s role (Stack 2000: 197, 199).
A less ambiguous finding is that the suicide rate rises in times of economic recession and falls in times of prosperity (Henry 1964: 42). Although Durkheim claimed the opposite to be true, ‘the great bulk of the evidence’ is against him on this matter (Stack 2000: 207). Since the kind of doubts surrounding the role of SES and employment obviously do not apply here, this is one case where an economic factor clearly has independent influence on suicide risk. However, it should be noted that it is the most socially dominant group – white males of high SES – whose propensity to commit to suicide increases the most during an economic downturn (Henry 1964: 41). So even this finding provides no evidence of a simple inverse association between prosperity and suicide.
It is also worth noting that some prestigious high-income occupations are amongst the most suicide-prone. For example, Stack (1996) found that, even after controls for associated covariates, dentists are 6.64 times more likely than the general populace to commit suicide.
2.5 Suicide and social relations
2.5.1 Social integration
So if suicide research does not point to economics as the main influence on suicide rates, what key factors can be identified? Overshadowing all later suicidology is the work of Durkheim. Durkheim sought to explain human behaviour through the influences of external social forces on naturally un-socialised individuals (Maris 1969: 26-28). In the case of suicide, while Durkheim accepted that individual motives such as relationship breakdowns and sickness play a part, he contended that such mishaps occur at the same frequency everywhere, whereas social influences vary, so that only social forces were relevant to explaining variations in the suicide rate (Durkheim 1962: 213-214).
The key variable for Durkheim is social integration – the degree of interaction, collective identity and sense of allegiance an individual experiences with regards to a group. Forms of social integration include religious belief, political activism and membership of an intimate interdependent community such as a family. His central claim was that ‘suicide varies inversely with the degree of integration of the social groups of which the individual forms a part’ (Durkheim 1962: 209)†.
While many criticisms have been levied against Durkheim and his claims, the central contention that suicide varies inversely with social integration has largely been borne out:
His genius is seen in the fact that
despite the passing of a hundred years since the first publication of
Le Suicide, his main premise, though perhaps not in detail, remains
intact. (Pritchard 1995: 92)
Social isolation has been found to be strongly associated with suicide:
Classically, suicides are thought of as
profoundly alone, low in self-esteem, abjectly depressed, and
desperately disconnected from sustaining meaningful social relations.
(Maris, Berman & Silverman 2000: 258-259)
In a study of suicides in Chicago, Maris (1981: 113-115) found that 49% of suicide victims had zero close friends, frequently having no informant to help fill out a suicide death certificate, or even no-one to identify the body, compared to 29% for natural deaths. Similarly 50% of suicide victims did not belong to any social organisation compared to 30% for natural deaths. Likewise unmarried, widowed and divorced status are all associated with a higher suicide risk (Retterstøl 1993: 79-80).
Religion also offers a protection against suicide. However, whereas Durkheim claimed that Protestants were at greater suicide risk than Catholics, more recent research has found that membership of the relatively integrated evangelical Protestant and Roman Catholic congregations does protect against suicide, whereas membership of the more impersonal institutional Protestant churches (e.g. Episcopal, Congregational) does not, suggesting, in line with Durkheim’s central argument, that it is the degree of social support offered by a church which determines suicide risk (Pescosolido 1994: 274).
Support for the Durkheimian hypothesis also comes from studies of differing suicide rates within urban areas. Various US studies found that suicide rates were highest in areas of ‘social disorganisation’ - ‘neighbourhoods, normally situated near the city centre, where there is great deal of lateral mobility, a high immigrant ratio… a large proportion of the population lives alone in lodgings or flats [and where] social life is generally unstable in character, and lacking in a coherent set of norms’ (Giddens 1971: 243). However such neighbourhoods were also the areas of greatest poverty, so that it proved difficult to distinguish the role of economic factors from that of social disorganisation (Sainsbury 1971: 247). This problem did not affect Sainsbury’s 1955 study of London since here ‘the prosperous north-western boroughs [had] the highest rates of mobility, isolation and social disorganisation [while] the poor eastern boroughs [had] the lowest’ (ibid.: 247). Sainsbury’s finding that it was the wealthy but socially disorganized boroughs which had the highest suicide rates and the poor but socially organised boroughs which had the lowest ‘unequivocally supports the view that social disorganization, not poverty, is the paramount factor’ (ibid.: 247).
A sense of the potency of social integration even in situations of impoverishment can be found in Jonathan Sacks’ description of his childhood community:
The Jews of the East End were poor in
everything else, but they were rich in social capital. They had
families whose members made sacrifices for one another. They had
communities that were networks of support. And they had faith that gave
them confidence, self-respect and trust. (Sacks 2000: xvii)
2.5.2 Suicide in Scandinavia
Further evidence of the importance of social relations comes from an assessment of suicide rates in Norway, Sweden and Denmark. In terms of political and economic social structure (the key determinant of self-respect according to Rawls), they have moved in parallel and in a decidedly Rawlsian direction††, and yet their suicide rates have differed markedly. Although the rates have converged in recent years, Norway has traditionally enjoyed a low suicide rate, while Sweden and Denmark have suffered high rates (see figure 1). Surely if Rawls’ account of the social bases of self-respect is adequate, we would expect to see similar rates for all three countries. What accounts for the differences?
Returning to the issues raised in section 2.3, one explanation is that Norway simply has less stringent procedures for recording suicide than its neighbours (Giertsen 2000). However, in 1977, the Scandinavian countries and Finland set up the Nordic Planning Group for Suicide Research (Juel-Nielsen, Retterstøl & Bille-Brahe 1987) which later set up a sub-project specifically to study the role of differing registration procedures in influencing suicide rates. Although the data for all four nations were judged to have underestimated the true rate, they were found to have the same degree of reliability. Reviewing this and other studies on the issue, Giertsen (2000) concludes that ‘it appears reasonable to conclude that changes in suicide rates in Norway in recent decades reflect genuine changes’.
What social factors might account for the variation? Hendin (1964) and Farber (1977), on the basis of interviews and anecdotal observations, both attributed the differences to child-rearing styles. Hendin claimed that while ‘the Norwegian child is not required to excel in order to win his mother’s affection’ (Hendin 1964: 112) and openness and independence are encouraged, Swedish mothers are neglectful (Hendin 1964: 50) and Danish mothers encourage over-dependence (Hendin 1964: 30). Farber argued that Norwegian families are more affectionate and warm and that the Norwegian father is ‘a figure of strength’ (Farber 1977: 54).
While such generalisations are always problematic, empirical support for a link between suicide and family is provided by Allardt’s (1975) study of social variables in Nordic countries. He found group cohesion to be strongest in Norway - a sense of belonging, a feeling of identity with the nation, a general degree of satisfaction and, in particular, family solidarity, were all highest in Norway. Similarly, Fuchs, Gaspari and Millendorfer (1977) studied several Western European nations and found that the two which were rated most highly with regard to data on the quality of family life, the Netherlands and Norway, were also countries with a noticeably low suicide rate. Likewise Narrol (1983) found that close family groups and smaller communities offered the best form of protection against socially deviant behaviour, including suicide, and in a comparison of twelve developed nations, declared Norway a ‘model country’.
More recently, the Nordic Planning Group for Suicide Research (Juel-Nielsen, Retterstøl & Bille-Brahe 1987) found that levels of social integration were considerably lower in Denmark than in Norway, particularly for women. Norway’s high level of integration stemmed ‘partly from family contact and relations to friends, partly from the Norwegians’ engagement in community life, particularly in respect of their local community’ (Juel-Nielsen, Retterstøl & Bille-Brahe 1987: 59). In line with Durkheim’s hypothesis, social integration was found to be lowest amongst high-suicide groups such as 50-65 year old Danish women and 20-29 year old Norwegian men.
Linked to this latter finding is the fact that Norway’s rising suicide rate mainly reflects the phenomenal recent rise in youth suicide (Retterstøl 1993: 27). This is thought to reflect the greater influence of characteristically modern, socially disintegrative, forces on the young:
…the same development that reached the other countries earlier is now occurring in Norway. (ibid.: 74)
2.5.3 The modern malaise†††
What is it about modern society that engenders social disintegration? For the purpose of explaining suicide, we can divide the anomie of modernity into two aspects. In exploring the first aspect, we can look at the way in which a closely integrated social framework works to supports a person’s identity as a necessary part of a meaningful social entity. Philosopher Alisdair MacIntyre cogently argues that a coherent identity can only be founded upon a sense of the social ‘stories’ of which we find ourselves a part (MacIntyre 1985.: 216). Through relationships with others and through performing necessary functions within institutions, we know who we are and who we should be – our lives are given direction and meaning. The more these social roles engage and challenge us and the more they are based on interdependent, personal and long-lasting social relations the more supportive of identity they will tend to be.
As Durkheim and many others have observed, the nature of modern society is such that it tends to undermine the development of meaningful social relations. Sandel identifies a pervasive ‘sense that, from family to neighbourhood to nation, the moral fabric of community is unravelling around us’ (Sandel 1996: 3) as a defining anxiety of our era. Capitalism has reduced the social relations of the archetypal workplace to contracts of supply and demand. From the employer’s viewpoint, the employee is a tool – he is there because a machine cannot yet do the same work more cost-effectively. From the employee’s viewpoint, work is a means to the ends of money and status.
An impersonal world, dominated by
states and markets, international corporations and global forces, is
one where each of us is replaceable, none of us valued for what we
uniquely are. (Sacks 2000: xix)
Outside of work, people are increasingly disconnected from their neighbours. Slum clearances, greater mobility and the power of the market have combined to uproot established communities. Meanwhile, the political community consists of the state – an enormous impersonal bureaucracy over which the individual has influence only as an insignificant component of a massive collective. Conflating all of this is modernity’s tendency to partition ‘life into a variety of segments, each with its own norms and modes of behaviour’ (MacIntyre 1985: 204), such that it is difficult to see how one’s life forms a coherent whole. In contrast, the pre-modern social relations of work, family, political and social life were interwoven, each reinforcing the significance of the other.
The other aspect to the importance of social relations is the quality of those social relations. Social relations can be highly effective in giving identity and meaning while still being of no or even negative value in terms of emotional support. Good social relations act as source of comfort and support in times of distress. But these aspects of social relations are also undermined by modern life. Where there is greater migration, less contact with neighbours and greater general anonymity there is less opportunity to develop supportive intimate relationships which might protect against suicide.
2.6 Other factors
Needless to say, poor social relations and economic difficulties are not the only contributors to a person’s decision to commit suicide. However space considerations allow only a brief summary of other factors. Alcohol and drug abuse is one particularly common precursor to suicide – 25-55% of suicide victims practice substance abuse (Murphy 2000: 135). However:
The single factor most often associated with suicide is mental illness, mainly depression. (Pritchard 1995: 33)
Psychological autopsy studies suggest depression is present in 29-88% of suicides (Lönnqvist 2000: 107). But this finding in itself is unhelpful – the question simply shifts from ‘what causes suicide?’ to ‘what causes mental illness?’ Many studies suggest that biology plays a large role - suicide appears to be related to decreased activity in the brain’s serotenergic system, resulting in ‘impaired inhibition and a greater propensity to act on powerful feelings such as suicidal or aggressive feelings’ (Mann 1998: 26). However, once again this does not in itself tell us much since our internal chemistry is profoundly affected by our environment – merely glancing at an attractive face is enough to spark measurable changes in the brain (Muir 2001). Nevertheless, our propensity to chemical imbalance in the brain is at least partly independent of our environment – as shown by a study which found that adopted children display a greater likelihood of developing bipolar depression if their biological parents suffered mood disorders (Faraone, Tsuang & Tsuang 1999: 40).
An entirely different kind of cause is the build-up of undesirable life events and stresses over long periods of time. These include ‘blows to self-esteem, guilt, legal problems, economic strain, interpersonal discord, loss of important social relationships, threat of jail or imprisonment, loss of social status, just being repeatedly overworked, and so forth’ (Maris, Berman & Silverman 2000: 83). Suicide is frequently associated with life transitions – e.g. from middle-age to retirement, from marriage to divorce (ibid.: 261-262).
As suggested in section 2.5.2, a person’s upbringing also has a significant influence. Most studies have focussed on the family’s impact on suicidal children and adolescents. Of those studying the link with adult suicide, Maris (1981: 122) found that, compared to those dying of natural causes, suicide completers were much less close to their fathers, and four times more likely to have received mainly physical discipline from their fathers as children. Other studies suggest early separation from one’s mother for long periods, physical, sexual and emotional abuse by one’s parents, young adult promiscuity and frequent changes of residence in childhood are all related to suicide in adulthood (Maris, Berman & Silverman 2000: 83). Many psychologists view the quality of one’s childhood as the main root of problems in adulthood:
…personal deficiencies and limitations
in adult functioning… in our experience… have most often been found to
be closely related to, even overdetermined by, abuses suffered in the
process of growing up. (Firestone 1997: 189)
2.7 Bringing the findings together
So far the causes of suicide have been considered as a list of contributing factors, an approach which in itself does not amount to a full explanation:
The difficulty of the factor approach
beloved by epidemiologists and medical practitioners is that the
developmental process is left out and the meaning of events is not even
considered. (Aldridge 1998: 271)
Instead, factors must be ‘organized into a comprehensive picture of suicidal dynamics that takes into account the dynamic interaction among various factors’ (Weinberg 2000: 606). What might this picture look like?
Firstly, an individual may, probably as a result of both genetic inheritance and a troubled childhood, possess one or more psychological traits, such as a predisposition to depression or a weak sense of identity, which make her more vulnerable to the loneliness and psychic disorientation resulting from the anomic social environment described in section 2.5.3. Psychological problems may also inhibit the vulnerable individual’s ability to form satisfying, lasting social relations. Without this social support, the tragedies, disappointments and general stresses of life, will be particularly painful and difficult to deal with. The problem of the loss of important identity-affirming statuses and relationships will also be exaggerated in the context of an anomic modern social environment in which the role of community-member is of little significance. Thus the end of working life or physical fitness and the death or departure of children and spouses will often leave a void – a lack of purpose and connection to the world. Without such reasons-for-living, we can understand how a troubled person might choose to end the struggle through suicide:
The individual can no longer go on being with an identity that he has achieved or can no longer maintain. The narrative stops. Hopelessness is when there is no story to go on with. (Aldridge 1998: 39-40)
3 A new agenda
The account of suicide established in the previous sections, reveals it to be a result of forces largely independent of wealth and liberty. In particular, the key social factor, social integration, can exist amidst both wealth and poverty, and varies significantly within identical or similar political-legal frameworks. Therefore, since suicide is equivalent to very low self-respect, Rawls’ assertion that the social bases of self-respect are adequately supplied through the primary social goods of freedoms and economic wellbeing is wrong.
…aimlessness and hopelessness are the cause [of suicide], not poverty (Sainsbury 1971: 253)
This is not to say that they are irrelevant to self-respect. As section 2.4 showed, economic difficulties do seem to play some role. Moreover, in raising self-respect beyond the bare minimum, Rawls’ primary social goods are certainly crucial – they facilitate the pursuit of the diverse interests which contribute to a person’s sense of her life as worthwhile (McKinnon 2002: 132-139).
However, the social bases of the minimal level of self-respect are not secured by money and rights. If Rawls’ theory and the sociology of suicide are to be taken seriously, political programmes must be developed specifically to support social integration. This section will consider what these programmes might look like. It should be noted that, within the context of Rawls’ theory, not all social integration is good integration – it cannot come at the price of liberty, nor can it engender relations of unthinking subservience (see section 1.2).
First of all, a new attitude to politics is required. Political commentators have tended to judge a government’s success in terms of what can be easily measured – e.g. the distribution of wealth, the performance of the health service, the efficiency of the transport system. Without denying the importance of these matters, it is necessary to recognise that none of them matter if people lack a basic sense that life is worthwhile. We must ‘realise that the story of man-the-political-and-economic-animal is only half of the truth of our human situation’ (Sacks 2000: 268). The fact that growing numbers of people in the developed world are losing that sense, to the extent of resorting to suicide‡, should, if we take the Rawlsian concern for the least-advantaged seriously, be our most pressing concern.
While governments are not oblivious to the importance of mental health, the issue is very far from occupying the primary place on the agenda where it belongs. Why, when traffic mortality rates have been decreasing and suicide rates sharply increasing over the last two decades, do the resources for tackling suicidal behaviour constitute only a tiny fraction of what is available for the prevention of motor traffic deaths (Diekstra 1996: 2)?
Secondly, greater imagination is required. The UK government has set itself the target of reducing the suicide rate by 20% by 2010 (Great Britain, Dept. of Health 2002: 5). However, its intended strategy, while not inconsequential, focuses only on short-term risk reduction and awareness-raising. For example, frontline clinical staff are to receive improved ‘risk management skills’ (ibid.: 19-20) while the NHS will see the addition of new ‘clinical teams providing assertive outreach, early intervention and crisis resolution’ for people with a history of mental illness (ibid.: 17). There no recognition that suicide and mental illness are the results of particular personal histories and particular social contexts which are in turn shaped by forces over which the government has some measure of control.
Despite our current emphasis on medical diagnoses, sophisticated technology, economic cutbacks and ‘quick fixes’, what patients need most in the midst of this health care maze is sensitive and caring individuals who are willing to enter into interpersonal relationships that foster hope and prevent hopelessness. (Peplau 1995: x)
While this can be partly rectified through the funding and resourcing of the many volunteers, social workers and therapists who are willing to enter into such relationships, it would obviously be far better if suicidal people did not suffer negative or absent social relations in the first place.
Retterstol (1993: 212) notes that while ‘training is required for most professions… no training is required to enter one of the most demanding areas of society we have – marriage’ and advises that if we expect marriages to be mutually supportive and long-lived, we should be willing to invest in widely available marriage guidance, including giving the subject a place in the school curriculum. To help troubled adolescents, Bird & Faulkner (2000: 14) propose ‘school programmes for equipping young people with effective problem-solving skills’ and help for school staff in dealing with ‘at risk’ students. Perhaps most crucially, it would be helpful to improve the relations between parents and their children. DeMause (1998) declares that rather than contenting ourselves with ‘endless repair work on damaged adults, with more jails and police and therapists and political movements’ we should directly address what in his view is the underlying cause of the damage and create a new profession of ‘child helpers’, giving parenting classes and performing home visits, as the logical sequel to universal education. He cites a pioneering parenting centre in Boulder, Colorado which, on the evidence of careful follow-up studies and reduced police reports and hospital entrance rates, has measurably reduced child abuse.
However, the social relations relevant to mental health are not just familial ones – none of the above addresses the anomie described in section 2.5.3. In considering what his native Norway can do to reverse the trend of recent years and reduce the suicide rate, Retterstøl (1993: 74) advises the protection of those small, rural communities where social cohesion is still strong through a programme of decentralisation. However such efforts can only have a very limited impact – small, closely-knit rural communities developed as a result of a particular economic and technological framework. The forces of modernity push inexorably in the opposite direction – towards a society of highly mobile urban individuals. It is the economic framework which must be altered if the shape of society is to change.
One possible solution lies in the co-operative movement. The co-operative ethos of democratic member-ownership, allows for co-operative businesses to become socially integrated communities rather than simply machines for making money for an impersonal body of shareholders. Thus in a co-operative organisation, employees are not simply means for somebody else’s end, and there is a greater likelihood that work becomes more than a means to the worker’s end of earning a wage. Because of their ‘people before profit’ ethics, co-operatives are also far more likely than standard businesses to risk employing the mentally ill and other disadvantaged people – i.e. those most at risk of losing their self-respect. The co-operative movement is a solution which seeks to reform the forces of modernity, rather than attempting to turn the clocks back and return to a bygone era. We should also note that the socially integrated communities of yesteryear were no bastions of liberal principles – social integration tended to go hand in hand with arbitrary hierarchy and rigid social roles. In contrast, while they are, to a greater extent even than ‘traditional’ communities, based on shared interests and a single shared project, co-operatives are firmly founded upon principles of equality and tolerance‡.
Needless to say, this section is far from comprehensive. It is intended only as an exploration of the kind of discussions and ideas which might be generated were the fundamental relevancy of self-respect and its relationship to social integration embraced by liberal politics.
Conclusion
Rawls is right to emphasise the critical importance of self-respect. Without it, wealth and freedom amount to nothing. But if we are to take the Rawlsian commitment to the least-advantaged seriously, we must acknowledge that the findings of sociology and psychology expose Rawls’ plan for guaranteeing self-respect as inadequate. Underlying the despair of those who have entirely lost their self-respect is not economic injustice or authoritarian law books, but the impossibility of coping with the strains, tragedies and confusion of life in a context of loneliness and alienation. Unless it develops a response to this context, a Rawlsian political agenda cannot live up to the compassion and humanitarianism at the heart of Rawls’ justice.
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Footnotes
* ‘…the way in which the major social institutions distribute fundamental rights and duties and determine the division of advantages from social cooperation’ (Rawls 1999: 6).
** Liberalism can be divided into two main schools – classical liberalism and social, or new, liberalism (Vincent 1992: 27). Both are founded upon the citizen’s right to equal liberty but differ in their conception of that liberty. Classical liberalism advocates a negative conception of liberty (e.g. ‘the state in which a man is not subject to coercion by the arbitrary will of another’ (Hayek 1960: 11)) and hence a minimal state. Social liberalism propounds a positive conception of liberty (e.g. ‘…to enjoy liberty means… to have the capacities… to be able to pursue different courses of action’ (Held 1996: 263)) and hence an interventionist state.
*** Socioeconomic status
† Durkheim’s actually conceived of four categories of suicide: egoistic and altruistic, resulting from lack and excess of integration respectively, and anomic and fatalistic, resulting from lack and excess of regulation respectively. But Durkheim frequently conflated the two forces, integration and regulation, referring to egoistic and anomic suicides as ‘two different aspects of one social state’ (Durkheim 1962: 179) – namely a lack of social integration (Travis 1990: 225-226). Likewise, altruistic and fatalistic suicide were not considered by Durkheim to be generally relevant to modern society (Breault 1986: 628) – they are the anomalous suicides described in section 2.2.
†† The Scandinavian states are all liberal parliamentarian democracies headed by constitutional monarchs, have relatively regulated capitalist market economies, are characterised by close relations between organised interests and government and share the distinctive ‘Scandinavian welfare model’ (Ervik & Kuhnle 1996: 88-89).
††† Space considerations preclude a full account of the issues summarised in this section.
‡ In 1998, there were 5,905 suicides in the UK – sixteen suicides for every day of the year (Office for National Statistics 1998), in British men under 35, suicide is the leading cause of death (Great Britain, Dept. of Health 2002: 7) and for every completed suicide there are an estimated 10-15 attempted suicides (Retterstøl 1993: ix).
‡‡ To qualify for membership of the International Co-operative Alliance, a co-operative must be ‘open to all persons… without gender, social, racial, political or religious discrimination’ (ICA 2003: 2).