The title of this review could recall the strange journey of the 1964 film with the same title, directed by Fernando Fernán Gómez, which narrates the “Crime of Mazarrón”, which should have been the title, but did not resist the censorship of Francoist Spain. of the time (¹). Likewise, it could also recall the strange journey of Fangoria’s self-titled album released in 2006, a dozen pop songs with rock, glam and electronica influences with diverse themes (²). It is not the case. Strange journeys are frequent when addressing various topics of human life, since strange derives from the Latin extraneare, which is based on extraneous (from outside, alien). At first, this word referred to the perception of something strange, usually with surprise, admiration or strangeness. Later, he referred to feeling something out of the ordinary, as when one is outside of the situation considered normal. For this reason, the Diccionario de la Real Academia Española, consigns the adjective strange as “rare, singular” in the second meaning. Many nouns ending with the suffix -aje- came to the Spanish language from French (tattoo, message, homage, fuselage, garage, etc.). However, trip comes from the Catalan viatge, which in turn comes from the Latin viaticum (which left the word viático in Spanish), in turn coming from via, which means path. Hence, the DRAE defines travel in its second meaning as “transfer that is made from one part to another by air, sea or land”. Without a doubt, the subject dealt with by Ángel Alonso Salas moves from one place to another in a unique way; it has been difficult trying to understand that a person disposes of their own life, and it has been even more disruptive to think that an action of this type can be evaluated as a rational act.

Bioethics literature is vast, but if some topics have caused rivers of ink to flow on tons of paper, it has been those that have to do with the beginning of human life and with the end of human life. Moreover, not about any kind of problematic, but those that relate the issues to self-awareness, autonomy, freedom and will. The strange journey through which Alonso Salas can be accompanied moves from the contemporary vision, widely extended, of considering suicide as a health problem, first, towards the past, to reconstruct the transition of suicide from sin to illness. Then we move to the future, in order to carry out a bioethical reflection. Here lies much of the strangeness of the journey; the amazement lies in rethinking suicide from cases where it can be considered as a rational act (the proposal certainly does not lead to think that all cases of suicide are).

As it usually happens when presenting a good book, it can be traced that it is a subject that the author has been thinking about for more than a decade. Ángel Alonso Salas (Mexico, 1978) obtained a degree in philosophy from the Universidad Autónoma Metropolitana at the turn of the century and into the new millennium. His thesis was on democracy (³). He completed the rest of his education at the Universidad Nacional Autónoma de México. His master’s thesis in philosophy was devoted to themes of philosophy of culture and Mexican philosophy. However, he quoted the work of Mexican historian Alfredo López Austin, which already points to one of the themes that would occupy him later: “In life itself are found the divine gifts that make suffering bearable: laughter, sleep, sustenance, strength, sexual pleasure, conjugal union, human reproduction, all as a pleasant intoxication that keeps men away from the idea of suicide”. (⁴) Probably this idea will be latent in the intellectual formation of the author of the work reviewed here, since in his doctoral thesis in philosophy (on philosophy of culture and aesthetics) he outlines another way of appreciating death, not within the human voluntariness that may exist to think it, plan it, desire it and/or eventually execute it, but in what has seemed something inexorable since biology: death as a biological fact. The author resumes that “Apoptosis is not, therefore, a disorderly cellular disaster, but, on the contrary, it is a careful disassembly of structures, breaking up enzymes, releasing substances, with which the cell eliminates itself” (⁵). It should be remembered that apoptosis has also been called “programmed cell death” and has been treated as a kind of “cell suicide”.

Already a PhD in Philosophy, he completed a second PhD in Sciences, specializing in bioethics, where he dealt directly with the subject of the reviewed book (⁶), which could represent a first version of the now published text. The strange journey that Alonso Salas takes is not one that invites fundamental questions of philosophy in Paul Gauguin’s painting, such as: D’où venons nous? Que sommes nous? Où allons nous? Nor in the musical version Who are we? Where do we come from? Where do we go? Made by the Galician punk-rock group Siniestro Total. The trip, impeccably documented and enjoyable at the same time, has a fundamental, implicit problem at its base: life. Not life as abstraction; not a conceptual question; not the state of aggregation of matter that Erwin Schrödinger analyzes, not life as can be understood in the quote from his doctoral thesis. The life to which he is referring throughout the text is human life, life that appeals to the possibility of quoting his master’s thesis. This, which seems obvious, obviously does not have much.

Human life is a peculiar life, since ancient times it has been considered to have two dimensions: one biological, the other biographical. Biological life is life that is studied by the “natural sciences”, for example, anatomy, physiology and biochemistry, among others. Biographical life is the one studied by the “social sciences”: politics, sociology, anthropology, etc. From the texts of Plato and Aristotle, zoé and bíos are distinguished (retaken in Giorgio Agamben’s Homo sacer). For example, Aristotle speaks in the Nicomachean Ethics of bíos teoretikos (contemplative life), bíos politicos (political life) and bíos apolaustikos (life of pleasure); nowhere does a zoé teoretikos appear. It is not a question of understanding by human life a biographical life independent of biological life (as it could be understood from the tradition of Christian spiritualism; even, as Cartesian dualism would understand it). Nor is it a question of understanding a biographical life superimposed on a biological, organic life (and with this, biographical life would be “superorganic”, as Alfred Kroeber proposes). A philosophical current that usually begins with Søren Kierkegaard and whose name Jean-Paul Sartre uses to define his own philosophical position proposes what human life would be: “existence”. In Spain, it corresponds to what José Ortega y Gasset tried to call simply “life”. Moreover, he only tried, because to talk about life, Ortega has to resort to the terms “living life” and “intellectual life”; He devotes excellent pages to this in Ideas and beliefs.

Throughout history, it seems that the impossibility of reducing or subsuming biographical life in biological life is a constant. And it seems that each dimension has its own rhythm. The biblical text of Ecclesiastes says that there is a time for everything, “a time to be born, and a time to die.” When you have the case of a young mother who loves her very young children, doing everything for and for them, and dies in the lottery of life due to metastatic cancer with a bad prognosis, it is more or less clear that biological life ends before the biography. In another case, the old woman from the village who tells her great-grandchildren that she has already done everything that was her mission and only hopes “that God will pick her up”, it is clear that the biographical life ended before the biological one. Both cases are far from the analysis of Alonso Salas, since for the very fact of dying (and even, the way of doing it), in this pair of hypothetical cases cited, self-awareness, autonomy, freedom or will do not mediate. In a rational suicide, yes. Alonso Salas clearly shows that death, in addition to a biological or organic dimension, has another biographical or cultural one.

The book begins with a brief introduction (p. 7). The first chapter is entitled Suicide: a health problem (p. 13), with two parts; the first, data about suicide, and the second with a genealogy of suicide; In the original doctoral thesis there was a second part, Suicide: a bioethical problem, which he analyzes and reformulates at another time in a separate text to be mentioned. The second chapter is from suicide as a sin to suicide as a disease (p. 28); It is a readjustment of the second chapter of the doctoral thesis, Genealogy of suicide: From suicide as a sin to suicide as a crime. In this second part, he develops one of the key ideas for understanding the book and the approach that not all suicide is derived from a mental disorder or health problems that have no treatment (and where palliative care offers little). Thinking that there are cases where suicide can be derived from a rational, considered activity, not associated with mental or physical health problems, the right of physical self-determination that assists people should be respected. He studied this subject in depth during his doctoral training in bioethics (⁷) and before publishing the book he returned to the subject in a more informative volume (⁸).

The third chapter of the book is entitled Rational suicide: a bioethical problem (p. 58); the corresponding chapter of his thesis bore a similar name, Lucid Suicide. The thesis had a second part in chapter one, as already mentioned, as well as a chapter three, which does not appear in the published book either, entitled The medicalization of suicide. After analyzing these ideas and discussing them in a specialized congress, he produced a publication where he expanded the reflections of the thesis and delved into the thought of Thomas E. Ellis, Jean Amery and Thomas Szasz (⁹). The subject of suicide continues to worry the author, so that he recently devoted another specialized text to the analysis of Spinoza’s thinking on this subject (¹⁰). As can be seen through the mentions made of his work about suicide (his work in bioethics deals with various topics), the book is a mature review of a complex problem. Undoubtedly, the mere fact of considering the possibility of cases where suicide is rational or lucid makes the text somewhat disruptive.

In the mid-1980s, Mayo noted that when people spoke of “rational suicide”, they did not invoke some special sense of “rational”, but rather it was generally used in an everyday sense as a synonym for sensible, appropriate, in accordance with one’s fundamental interests, defensible for good reasons, or even admirable (¹¹). At that time Mayo considered that to consider decisions as rational, the concurrence of beliefs and values was required. The assessment of the relationship between freedom and autonomy with respect to one’s own life has undoubtedly varied over time. Although the human act of giving oneself death has occurred throughout history, although it has not been named -as in the title of this review- (¹²), the term suicide was not used in classical and Medieval Latin (¹³). The appearance of the term in the early modern world denotes a shift in the valuation of freedom and autonomy (to some extent, linked to secularization). In the mid-1990s, the rationality of such an act was still being questioned (¹⁴). Alonso Salas’s analysis of suicide as a sin, crime, disease, until he recognizes that, in some cases (and since always) there have been cases of rational or lucid suicide, makes it clear that the change of values is giving a turn regarding the bioethical problem at the end of human life. As always, there is nothing better than reading the author to agree or disagree, but always with a willingness to understand in order to establish an adequate critique.