A Psychiatrist Says This Woman Is Mistaken About Her Decision To End Her Life

[Keith Maitland]

Any thoughts on the following exchange between Jeremy Sealey, David Coyne and a psychiatrist? Do you think the psychiatrist is mostly right?


JEREMY SEALEY: A 40 year old lady wants to kill herself. This is not a view that she has come to lightly. She has been thinking about suicide fairly systematically for the last five years – ever since she turned forty in fact. She can think of reasons to live – her sister, for example, will miss her if she’s gone – but she can think of many more reasons not to live. She would say that she is not depressed exactly. It is more that she is profoundly bored: she is suffering from seemingly terminal ennui. She has thought hard about the morality of suicide. She knows that there are religious objections to the taking of one’s own life. She is aware, for instance, that the Catechism of the Roman Catholic Church states that suicide is ‘seriously contrary to justice, hope, and charity’. But she isn’t religious, and doesn’t believe in the afterlife, so she isn’t much impressed by such pronouncements. She has taken into account that some people, such as her sister, will mourn her death. But she does not believe that their suffering will be very great, and certainly not great enough to outweigh what she sees as her right to do as she wishes with her own life – including ending it. She is also aware that she might feel differently about things at some point in the future. However, she thinks that this is unlikely, and, in any case, she is not convinced of the relevance of this point: certainly, she does not think that she has any responsibility towards a purely hypothetical future version of herself. She has canvassed other people’s opinions about suicide, but so far she has heard nothing to persuade her that killing herself would be wrong. She is frequently told that she ‘shouldn’t give up’, that ‘things will get better’, and that she ‘should just hang on in there’, but nobody has been entirely clear about why she should do these things. For her part, she can’t really see that she stands to lose much of anything by ending her life now. She does not value it, and in any case, if she’s dead, she’s hardly going to regret missing out on whatever it is that might have happened to her had she lived. Would it be wrong for this woman to commit suicide? If so, why?

DAVID COYNE: I can find nothing wrong with Dorothy’s decision although I’d prefer that she have the opportunity to talk to somebody about it before carrying out the act. To me this is a relatively non-controversial point.

PSYCHIATRIST: Well, I'm a practicing psychiatrist who has spent the last 35 years trying to prevent people from committing suicide (among other clinical pursuits) so of course my opinion is tainted by what I do. This is not just some hypothetical scenario *for me.* It's what I actually do, daily. The main problem with this is the idea that.... "She is also aware that she might feel differently about things at some point in the future. However, she thinks that this is unlikely" when it is not unlikely at all, much the opposite. The vast majority of people who attempt suicide and get rescued (that is, are not allowed to die) or fail in their attempt (like in a botched attempt that doesn't kill them) come to change their minds in the future and to feel grateful for having been saved (or for having survived). This in itself invalidates her whole edifice of argumentation. Does she have a right to do it? Yeah, sure, in certain regards, depending on where she lives. Should she do it? Hell, no.

And also I can't really accept this: "It is more that she is profoundly bored: she is suffering from seemingly terminal ennui."

Oh, come on. Ennui?.... Give me a break. All that she is doing is a big rationalization, in huge denial that there is something wrong with her -- such as anhedonia. Yes, allowing boredom to prevail over the survival instinct does indicate in my opinion a very pathological state, because it is certainly not what the *natural* state is. I'd tend to call this, abnormal. At the very least, it escapes the statistical concept of the norm, because the norm is that most people want to survive.

[Bubbles]

I'm with the Psychiatrist.

No one can stop someone terminating their life if they are determined enough.

The problem is, a lot of people ( like this one)  want someone else to do it for them, or they want approval and to dump the responsibility onto others.

If they really wanted to, they would have done it by now.

No one can be punished once they are dead ( religious views aside).

If the woman is so profoundly bored, perhaps she ought to volunteer for something and think of someone else for a change.

I just don't have much sympathy for her , so many people who want to live have their lives tragically taken from them.

A friend was diagnosed with cancer not so long ago, she was dead in about 3 months .....

I wish I could have given her some more life and some more time, with her loved ones.

Especially at christmas time 

I haven't got the patience with some selfishly bored 40 year old drama queen..... Not ATM.

It's very hard when you see a bright and vibrant life cut short when that person has no choice, and no time.

[trippymonkey]

Do we not place far too much emphasis on THIS life rather than the zillion times, possible, longer we have after we 'die' ?
50 -60 - 70 years, it's not at all long compared to eternity, is it ?

Nick

[Keith Maitland]

Rose,

I'm with the Psychiatrist.

Psychiatrists, when deciding to stop a person from killing themselves, are doing something tantamount to assuming the prerogatives of god. It is not for them to decide when a person's time has come, yet so intoxicated are some of these people on the powers they possess they cannot even conceive of the immense presumptuousness and hubris involved in the whole endeavour of suicide prohibition.

These people presume to have existential alchemical powers or something. Yet just like the Inquisition's war on evil begot the very thing it purported to remedy, psychiatry begets the very suffering it purports to remedy, and for this and other reasons its claims to authority on this issue should occasion disbelief.

Part of the problem is is that as society is currently constituted, we are incapable of envisaging simply leaving people to decide for themselves whether or not life is worth living, a decision based on experience and circumstance. We are culturally conditioned to associate such a respect for a person's right to self-sovereignty and self-determination with something of equivalent moral value to murdering someone. In such a cultural climate, suicide prohibition seems like it is prescribed by necessity, which generates the need for theories that provide a rationale for this process.

Yet the truth as I see it is that not only is the right to top oneself a right anterior to the most basic of rights, one which should be vigorously upheld because it acts as a bulwark against those who seek to enslave us and tighten the existential shackles of those whose existence occasions insufferable torment, but because life is cruel, and those who profess to save us from life's cruelty and to ameliorate the sufferer's existential conditions constitute a large part of just why life is cruel.

The truth as I see it is that the only nourishment life provides for a lot of people is despair, privation, boredom, disease, humiliation, degradation, disillusionment, loneliness, alienation, and bitter experience generally. We need to work towards a society which accepts this and does not presume to know what is best for those whose life is unbearable, especially when our judgments are made from a privileged vantage point.

[ekim]

Rose,

Psychiatrists, when deciding to stop a person from killing themselves, are doing something tantamount to assuming the prerogatives of god. It is not for them to decide when a person's time has come, yet so intoxicated are some of these people on the powers they possess they cannot even conceive of the immense presumptuousness and hubris involved in the whole endeavour of suicide prohibition.

These people presume to have existential alchemical powers or something. Yet just like the Inquisition's war on evil begot the very thing it purported to remedy, psychiatry begets the very suffering it purports to remedy, and for this and other reasons its claims to authority on this issue should occasion disbelief.

Part of the problem is is that as society is currently constituted, we are incapable of envisaging simply leaving people to decide for themselves whether or not life is worth living, a decision based on experience and circumstance. We are culturally conditioned to associate such a respect for a person's right to self-sovereignty and self-determination with something of equivalent moral value to murdering someone. In such a cultural climate, suicide prohibition seems like it is prescribed by necessity, which generates the need for theories that provide a rationale for this process.

Yet the truth as I see it is that not only is the right to top oneself a right anterior to the most basic of rights, one which should be vigorously upheld because it acts as a bulwark against those who seek to enslave us and tighten the existential shackles of those whose existence occasions insufferable torment, but because life is cruel, and those who profess to save us from life's cruelty and to ameliorate the sufferer's existential conditions constitute a large part of just why life is cruel.

The truth as I see it is that the only nourishment life provides for a lot of people is despair, privation, boredom, disease, humiliation, degradation, disillusionment, loneliness, alienation, and bitter experience generally. We need to work towards a society which accepts this and does not presume to know what is best for those whose life is unbearable, especially when our judgments are made from a privileged vantage point.

Perhaps the psychiatric method should be changed and the psychiatrist should say...  5 years thinking about suicide is enough to bore anybody, it's now decision time.  We are now going to take you up in an aeroplane and show you how to use a parachute.  You are free to jump or not jump.  If you jump you will then have another x minutes to decide to pull the chord or not.

[Nearly Sane]

All very dramatic,  Keith,  though the fact that there is no actual suicide prohibition pushes it into melodrama.

[Shaker]

All very dramatic,  Keith,  though the fact that there is no actual suicide prohibition pushes it into melodrama.

Although laws against (attempted) suicide are patently absurd there has been no such law in this country since 1961 so there's no direct prohibition per se; but the provisions of the 1983 Mental Health Act allow a person to be detained and treated against their will - sectioned - if their own life/safety are in danger. The police even have powers to enter a private residence, someone's own home, by force with a section 135 warrant in certain circumstances. (Their own life and safety, remember, not just someone else's). That looks very much like a prohibition on suicide to me.

[Bubbles]

Rose,

Psychiatrists, when deciding to stop a person from killing themselves, are doing something tantamount to assuming the prerogatives of god. It is not for them to decide when a person's time has come, yet so intoxicated are some of these people on the powers they possess they cannot even conceive of the immense presumptuousness and hubris involved in the whole endeavour of suicide prohibition.

These people presume to have existential alchemical powers or something. Yet just like the Inquisition's war on evil begot the very thing it purported to remedy, psychiatry begets the very suffering it purports to remedy, and for this and other reasons its claims to authority on this issue should occasion disbelief.

Part of the problem is is that as society is currently constituted, we are incapable of envisaging simply leaving people to decide for themselves whether or not life is worth living, a decision based on experience and circumstance. We are culturally conditioned to associate such a respect for a person's right to self-sovereignty and self-determination with something of equivalent moral value to murdering someone. In such a cultural climate, suicide prohibition seems like it is prescribed by necessity, which generates the need for theories that provide a rationale for this process.

Yet the truth as I see it is that not only is the right to top oneself a right anterior to the most basic of rights, one which should be vigorously upheld because it acts as a bulwark against those who seek to enslave us and tighten the existential shackles of those whose existence occasions insufferable torment, but because life is cruel, and those who profess to save us from life's cruelty and to ameliorate the sufferer's existential conditions constitute a large part of just why life is cruel.

The truth as I see it is that the only nourishment life provides for a lot of people is despair, privation, boredom, disease, humiliation, degradation, disillusionment, loneliness, alienation, and bitter experience generally. We need to work towards a society which accepts this and does not presume to know what is best for those whose life is unbearable, especially when our judgments are made from a privileged vantage point.

Keith

Psychiatrists have a duty of care, which means they have powers to protect  vunerable people from hurting themselves or others.

Often it is for a short period until that person can be stabilised and are able to look at things in a more balanced way.

To be statemented you need to be more than someone who just wants to kill themselves.

Sometimes people become unbalanced for shortish periods of time ( it can be because their brain produces an imbalance of chemicals) and the vunerable person loses their sense of reality.

Lots of people take up very dangerous hobbies like skiing off mountains but no one sections them.

The people who are sectioned are the ones who for whatever reason have lost touch with reality, the Psychatrist has a duty of care to protect them and other people while they are in that state.

I have a friend who as part of her job, sections people, but they are normally " away with the fairies" and their own families can't cope with them.

Sometimes people get sectioned at the request of the family, who are unable to deal with the situation.

Most rational people who decide to end it all, don't get sectioned because they don't draw attention to themselves and show in some way they are obviously unable to cope with real life.

If someone removes all their clothes runs down the local high street, says the end of the world has come, and they are now living in times that the lion lies down with the lamb and it has returned to Adam and Eve and they don't need clothes anymore and the angel Gabriel has told then to jump off the village hall, so they can be saved.... Obviously they are going to get sectioned especially if family are alarmed and can't cope.

Someone who just decides life isn't worth living doesn't get sectioned because their behaviour doesn't call for it and being rational they are able to go through their issues voluntary.

Irrational behaviour gets sectioned.

If a Psychatrist then sees someone who can talk rationally they won't necessarily get sectioned.

If you accept help voluntarily you don't tend to get sectioned so keep your rights.



http://www.mind.org.uk/information-support/legal-rights/sectioning/overview/#.Vn6W1UqQGK0

[Bubbles]

Although laws against (attempted) suicide are patently absurd there has been no such law in this country since 1961 so there's no direct prohibition per se; but the provisions of the 1983 Mental Health Act allow a person to be detained and treated against their will - sectioned - if their own life/safety are in danger. The police even have powers to enter a private residence, someone's own home, by force with a section 135 warrant in certain circumstances. (Their own life and safety, remember, not just someone else's). That looks very much like a prohibition on suicide to me.

Which they rarely use in many failed suicide attempts.

[Shaker]

Which they rarely use in many failed suicide attempts.

Rarely, perhaps; but the fact that such extreme, civil liberties-denying measures exist at all rebuts the assertion that there's no suicide prohibition.

[Shaker]

Keith

Psychiatrists have a duty of care, which means they have powers to protect  vunerable people from hurting themselves or others.

But that's done simply by defining them as vulnerable because they're said to be at risk of harming or killing themselves.

Keith's earlier post did well to mention the paternalism inherent in much of the psychiatric profession, the attitude that they know best not merely about the nuts and bolts of mental illness - that's a given - but whether somebody else's life is worth living and the power to override that person's wishes if they don't coincide with their own.

[Bubbles]

But that's done simply by defining them as vulnerable because they're said to be at risk of harming or killing themselves.

Keith's earlier post did well to mention the paternalism inherent in much of the psychiatric profession, the attitude that they know best not merely about the nuts and bolts of mental illness - that's a given - but whether somebody else's life is worth living and the power to override that person's wishes if they don't coincide with their own.

All laws are open to abuse, but a lot of people who are sectioned are not rational and are suffering from far more symptoms than just not wanting to live anymore.

That's why they are assessed.

There are certain common symptoms, like not taking care of themselves, self harming that are indicators of a mental disorder and a vunerablilty rather than just a rational desire to end it all.

A rational person tends to know how to respond to throw the doctors off track, the vunerable ones can't, because they are ill.

Any professional would find it hard to stop a rational determined suicide.

I think they know this.

All you would need to do is take up sky diving and not bother to pull the cord.

Or fall off a mountain while climbing.

There are many ways someone could end it, without appearing to commit suicide.

Which makes me wonder why it is necessary for anyone to make a big statement by making it obvious.

If someone is just ending it, why bother with the obvious suicide?



For the vast majority, a suicide attempt is a cry for help.

They are, by making the motions of going for the big exit, saying I need help! Or attention!

Otherwise why bother?