When do we have the right to intervene
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hackenslash wrote:
I recently wrote a blog post about suicide. It wasn't about my own ideations, which have been pretty frequent of late, for reasons that I'll probably go into at some point in the near future. It received mixed reviews in some circles, varying from very positive from some, especially those whose ideations are fairly constant, to carpet-bitingly shrill howlings from others.
Some said that, as somebody who is a vocal advocate for mental health and suicide prevention, I was being irresponsible.
I'd be interested in discussing this a little. The psych and neuro forum doesn't really feel like the right place for this,because I don't accept the notion that suicidal ideation is but it's the best place we have here.
hackenslash wrote:Still I'd be hugely interested in what people here think. I'm most interested in whether or not anybody can logically defend the premise that living is better than not living.
Thomas Eshuis wrote:I'm unsure what you're saying there. Could you elaborate?
I don't think so, not in an objective sense anyway.
As far as I can see and it is an admittedly vague and generalized view, as long as a persons's choice to end their life is not based on issues that can be remedied (for example: lack of friends/loved ones, bad luck in their financial life and or social security etc, they should be allowed to end or not end their life as they see fit.
(Even in the aforementioned temporary cases, I'd still think it's ultimately their choice, but would hope they'd try changing the situation first)
Macdoc wrote:My take is that treatment should be mandatory as suicide attempts being a clear symptom of mental illness.
hackenslash wrote:Macdoc wrote:My take is that treatment should be mandatory as suicide attempts being a clear symptom of mental illness.
I'd love to see some flesh put on this assertion, because this is the question before us. Is suicide ideation/attempt/completion necessarily a symptom of mental illness?
I reject this claim as unsupported.
Is living better than not? Can this be demonstrated?
hackenslash wrote:I don't think so, not in an objective sense anyway.
As far as I can see and it is an admittedly vague and generalized view, as long as a persons's choice to end their life is not based on issues that can be remedied (for example: lack of friends/loved ones, bad luck in their financial life and or social security etc, they should be allowed to end or not end their life as they see fit.
(Even in the aforementioned temporary cases, I'd still think it's ultimately their choice, but would hope they'd try changing the situation first)
Thank you, Thomas.
What I actually advocate most strongly is the notion that we should support first, and then explore whether there's anything that can be fixed to change the situation.
I've spoken to people whose lives have been filled with such atrocity that simply dismissing them as having mental health issues isn't just incorrect, but horribly destructive.
If I were to tell you, for example, of a woman I know who was passed around among her father's friends as a party favour until the age of 8, at which point her mother took her shopping to lingerie so she'd look sexier, or another woman very close to me who complained to her grandmother at the age of 5 about being repeatedly raped by all and sundry, only to be told that she should shut up, because this was her duty to her family, would you try telling them that living is better than not?
These are real-world examples of people I know and have counseled, and they're far from the 'worst' (setting aside that comparisons are asinine).
I should also add here a piece about giving advice, written some time ago. It highlights the many problems we have with the way we think about suicide, mental health, and how to support people.
Selfish! Weak!
Macdoc wrote:It IS in the view of current society and the medical community.
I'd say you have to demonstrate it's not and is not harmful to society/others.
By undertaking the act you absent yourself from censure and leave others to clean up the splatter.
I'd love to see some flesh put on this assertion, because this is the question before us. Is suicide ideation/attempt/completion necessarily a symptom of mental illness?
By undertaking the act you absent yourself from censure and leave others to clean up the splatter. Toilet training generally occurs earlier.
zulumoose wrote:I'd love to see some flesh put on this assertion, because this is the question before us. Is suicide ideation/attempt/completion necessarily a symptom of mental illness?
I would say it usually is, if you define severe depression as mental illness, which I don't.
It is helpful to put that label on it in a medical sense, but I think severe depression can be perfectly natural and not something to be treated as such, so the label is a bit of a poor fit in my view.
zulumoose wrote:
By undertaking the act you absent yourself from censure and leave others to clean up the splatter. Toilet training generally occurs earlier.
I hope this was intended differently to how it appears to me, which is a callous dismissal of suicidal people and a horrible misunderstanding of what their reality can be at the time.
When seriously considering suicide the rest of the world can be completely irrelevant, "others" can be just part of the reality that has rejected you, your ties to those you cared about can seem absolutely false and meaningless. Concern for those left behind would be a recognition of a future that does not exist in your reality. Don't make the mistake of believing that someone on the brink of suicide is thinking in a way that you would recognise and could relate to or judge. It is fantastically unhelpful and wrong to judge suicide as an act of selfishness or cowardice, since at the time those concepts can be completely meaningless.
Fallible wrote:I mean, cancer is perfectly natural, but it's definitely an illness.
What a weirdly specific and graphic description. Are you unaware that multiple countries already allow assisted suicide?
We have assisted suicide for those with terminal illness and a panel of medical personnel to oversee that.
Clinical assessment
The guiding ethical principle underlying a clinical assessment where risk of self-harm is a central issue is beneficence. Even if the patient does not want to be in the ER or to be assessed by a physician concerning these matters, physicians have a duty to act in the patient's interest and preventing harm to self is considered on its face to be in the patient's interest.
Mental health legislation that permits involuntary assessment and hospitalization is informed by the common-law doctrine of parens patriae—the notion that the sovereign (or, in our case, the state) has the authority to protect persons from themselves.
there are authors who have argued that persons should never be forced into hospital against their will—that the right to self determination is always more important than any interest that society may have in protecting people from self-harm. In other words, the question of whether people should be involuntarily hospitalized is a classic conflict between the ethical principles of autonomy and beneficence (acting in someone else's best interest).
In Canada, from a public policy point of view, beneficence has been deemed to be more important than autonomy in cases where people are at risk of self-harm. This is because it is believed that self-harm generally occurs in the context of mental disorder, and mental disorder diminishes people's abilities to act autonomously.
Is Sarah's capacity to make treatment decisions relevant to decisions about intervening in situations of self-harm?
Sarah's capacity to make treatment decisions is not relevant to decisions about hospitalization, except in Saskatchewan. In Saskatchewan, a person has to be incapable of consenting or refusing treatment for the disorder that is leading to the involuntary admission.
In all other provinces, the decision about hospitalization is made on the basis of self-harming behaviour or threats of self-harming behaviour. This is regardless of the person's capacity to consent to or refuse treatment, even treatment for the very disorder that is leading to the admission.
when the circumstances have passed, a lessening, and an expression of new emotions in accordance with the new circumstances. Severe depression is when one feels severe sadness, lack of motivation, suicidal ideation, etc. when these feelings are not in response to circumstances
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