* Cases of mistaken difficulty. Mental illness can make people feel despair in situations where the perceived problem is not real, or is real but much less serious than believed. For example, depressed people may feel lonely and hopeless even if family members care deeply about them. This can sometimes be fixed with various treatments, and by all means people should try to save the victim. However, some forms of mental illness do not respond to available treatments, in which case the despair is accurate and this is really one of the other cases described below.
* Cases where the problem is significant, could be solved, but the person believes it will not be. For example, crippling debt. Society could forgive the debt and allow the person to get on with their life, but it chooses not to do so. The person could suffer years of debt-induced poverty, guilt, and misery but they choose not to do so. The social contract is so unappealing that it is rejected in favor of death. The despair is not absolute in theory, but it is accurate in practice. For society to try interrupting the death process without first removing what drives the person toward death is a bait-and-switch that amounts to stopping a victim from escaping torture; that is evil.
* Cases where the problem is dire and improvement is not possible with extant resources. For example, prisoners of war in current captivity may suffer less if they die quickly than if they are imprisoned and tormented for years.
* Cases where the problem was dire but the situation has improved. For example, prisoners of war may continue to suffer the effects of torment even after they get rescued. The despair was accurate but now is less so. In this case, it is valid for rescuers to attempt to revive the victims with interventions tailored to their stage of collapse. Some will likely respond and improve, while others may still decline and die.
* Cases where the root problem cannot be solved, but its collateral damage could be improved enough to make life livable. For example, people who have just suffered a major injury or illness leaving them with an acquired disability. The level of accuracy depends greatly on how much effort other people choose to invest in making material improvements in the victim's quality of life. The more improvements, the less accurate the despair and the more likely the recovery. But if bystanders ignore the person, or exhort them to keep living in a miserable state, then the despair remains accurate and death may be preferable to years of unrelieved suffering. It is essential for people to provide good support for those in need, to prevent a disaster from becoming a death sentence.
* Cases where the situation is such that the person simply does not wish to live with it. For example, someone diagnosed with early stage dementia may have years of potential life remaining, some of them relatively functional; but they do not want to experience the slow decay of mentality, suffer the miseries it brings, or endure the knowledge of that ugly future. A relatively quick death following a dire diagnosis or a sudden drop in life quality may cause the soul to abandon the body, much as a person would flee a sinking ship. It is simply a faster -- and sometimes more mindful -- version of the detachment that happens to everyone at death. Interrupting this process is a violation of integrity and boundaries; it is each soul's choice when to enter and leave a life, what things are or are not worth living for.
These are nuances of ethnics and care which few people seem to consider. The medical industry is geared to preserve biological life -- not quality of life -- as long as possible, which often leads to torturing people, which is wicked. Society considers many people to be garbage and treats them accordingly. Sometimes it blithely stands by and lets them die of preventable causes, which is wrong but at least not torture. Other times is refuses to let its victims escape, which is evil. In many cases, the desire for death could be quite feasibly relieved by making practical changes. These chances should be watched for and capitalized upon whenever possible. But society often chooses not to do this, and then criticizes its victims for attempting to escape the torment. Society has no grounds to complain if people find its treatment unendurable. It is heinous for society to have the means of relief and not furnish them to those in need.
People often say that suicidal thoughts, or despair, are insane. However, insanity is fundamentally about a mismatch between fact and perception. If the facts of the case are intolerable, then soul withdrawal is not insane, but rather a sensible response to a horrible situation. The reaction is only insane if it is inaccurate, which is only true some of the time. Always check the facts to see which description applies and what action is prudent.