scholarly journals Ethical perspectives on suicide and suicide prevention

2011 ◽  
Vol 17 (3) ◽  
pp. 214-219 ◽  
Author(s):  
Chris Kelly ◽  
Eric Dale

SummaryPhilosophy both influences and is influenced by clinical and legal practice relating to suicide. This article begins with a brief history of attitudes in the UK and Europe towards those who attempt suicide. It describes the main philosophical positions regarding suicide, including the principle of respect for life, the utilitarian position, the theological principle, and the principles of autonomy and duty to others. It concludes that short-term interventions are justified in most cases, for example when the suicide attempt is a ‘cry for help’ and/or the individual is ambivalent in their attempt or likely to have a mental illness.

2007 ◽  
Vol 12 (1) ◽  
pp. 75-89 ◽  
Author(s):  
Stephen Whittle ◽  
Lewis Turner

Gender transformations are normatively understood as somatic, based on surgical reassignment, where the sexed body is aligned with the gender identity of the individual through genital surgery – hence the common lexicon ‘sex change surgery’. We suggest that the UK Gender Recognition Act 2004 challenges what constitutes a ‘sex change’ through the Act's definitions and also the conditions within which legal ‘recognition’ is permitted. The sex/gender distinction, (where sex normatively refers to the sexed body, and gender, to social identity) is demobilised both literally and legally. This paper discusses the history of medico-socio-legal definitions of sex have been developed through decision making processes when courts have been faced with people with gender variance and, in particular, the implications of the Gender Recognition Act for our contemporary legal understanding of sex. We ask, and attempt to answer, has ‘sex’ changed?


1998 ◽  
Vol 173 (6) ◽  
pp. 531-535 ◽  
Author(s):  
Erkki T. Isometsä ◽  
Jouko K. Lönnqvist

BackgroundThis study investigated three questions with major implications for suicide prevention: the sensitivity of the history of previous suicide attempt(s) as an indicator of suicide risk, the time interval from a preceding suicide attempt to the fatal one, and switching of suicide methods by those eventually completing suicide.MethodThe lifetime history of suicide attempts and the methods the victims (n=1397) used were examined in a nationwide psychological autopsy study comprising all suicides in Finland within a 12-month research period in 1987–1988.ResultsOverall, 56% of suicide victims were found to have died at their first suicide attempt, more males (62%) than females (38%). In 19% of males and 39% of females the victim had made a non-fatal attempt during the final year. Of the victims with previous attempts, 82% had used at least two different methods in their suicide attempts (the fatal included).ConclusionsMost male and a substantial proportion of female suicides die in their first suicide attempt, a fact that necessitates early recognition of suicide risk, particularly among males. Recognition of periods of high suicide risk on the grounds of recent non-fatal suicide attempts is likely to be important for suicide prevention among females. Subjects completing suicide commonly switch from one suicide method to another, a finding that weakens but does not negate the credibility of restrictions on the availability of lethal methods as a preventive measure.


2019 ◽  
pp. 1-3 ◽  
Author(s):  
Simon Gilbody ◽  
Emily Peckham ◽  
Della Bailey ◽  
Catherine Arundel ◽  
Paul Heron ◽  
...  

Summary Smoking contributes to health inequalities for people with severe mental illness (SMI). Although smoking cessation interventions are effective in the short term, there are few long-term trial-based estimates of abstinence. The SCIMITAR trials programme includes the largest trial to date of a smoking cessation intervention for people with SMI, but this was underpowered to detect anticipated long-term quit rates. By pooling pilot and full-trial data we found that quit rates were maintained at 12 months (OR = 1.67, 95% CI 1.02–2.73, P = 0.04). Policymakers can now be confident that bespoke smoking cessation interventions produce successful short- and long-term quitting.


BJPsych Open ◽  
2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Sandra Flynn ◽  
Jane Graney ◽  
Thabiso Nyathi ◽  
Jessica Raphael ◽  
Seri Abraham ◽  
...  

Background It is estimated that 1 in 10 people have a personality disorder. People with emotionally unstable personality disorder are at high risk of suicide. Despite being frequent users of mental health services, there is often no clear pathway for patients to access effective treatments. Aims To describe the characteristics of patients with personality disorder who died by suicide, examine clinical care pathways and explore whether the care adhered to National Institute for Health and Care Excellence guidance. Method National consecutive case series (1 January 2013 to 31 December 2013). The study examined the health records and serious incident reports of patients with personality disorder who died by suicide in the UK. Results The majority had a diagnosis of borderline/emotionally unstable or antisocial personality disorder. A high proportion of patients had a history of self-harm (n = 146, 95%) and alcohol (n = 101, 66%) or drug misuse (n = 79, 52%). We found an extensive pattern of service contact in the year before death, with no clear pathway for patients. Care was inconsistent and there were gaps in service provision. In 99 (70%) of the 141 patients with data, the last episode of care followed a crisis. Access to specialised psychological therapies was limited; short-term in-patient admissions was adhered to; however, guidance on short-term prescribing for comorbid conditions was not followed for two-thirds of patients. Conclusions Continuity and stability of care is required to prevent, rather than respond to individuals in crisis. A comprehensive audit of services for people with personality disorder across the UK is recommended to assess the quality of care provided.


2020 ◽  
pp. medhum-2019-011842
Author(s):  
Sarah Chaney

The word ‘compassion’ is ubiquitous in modern healthcare. Yet few writers agree on what the term means, and what makes it an essential trait in nursing. In this article, I take a historical approach to the problem of understanding compassion. Although many modern writers have assumed that compassion is a universal and unchanging trait, my research reveals that the term is extremely new to healthcare, only becoming widely used in 2009. Of course, even if compassion is a new term in nursing, the concept could have previously existed under another name. I thus consider the emotional qualities associated with the ideal nurse during the interwar period in the UK. While compassion was not mentioned in nursing guidance in this era another term, ‘sympathy’, made frequent appearance. The interwar concept of sympathy, however, differs significantly from the modern one of compassion. Sympathy was not an isolated concept. In the interwar era, it was most often linked to the nurse’s tact or diplomacy. A closer investigation of this link highlights the emphasis laid on patient management in nursing in this period, and the way class differentials in emotion between nurse and patient were considered essential to the efficient running of hospitals. This model of sympathy is very different from the way the modern ‘compassion’ is associated with patient satisfaction or choice. Although contemporary healthcare policy assumes ‘compassion’ to be a timeless, personal characteristic rooted in the individual behaviours and choices of the nurse, this article concludes that compassionate nursing is a recent construct. Moreover, the performance of compassion relies on conditions and resources that often lie outside of the nurse’s personal control. Compassion in nursing—in theory and in practice—is inseparable from its specific contemporary contexts, just as sympathy was in the interwar period.


2002 ◽  
Vol 17 (2) ◽  
pp. 92-95 ◽  
Author(s):  
F. Montagnon ◽  
S. Saïd ◽  
J.P. Lepine

SummaryThis study concerns 81 cases of lithium poisoning and shows that deliberate intoxications are prevalent during the first 3 years of lithium treatment as well as in cases with a previous history of suicide attempt. Therapeutic intoxications could generally be avoided by education concerning hygiene and diet and careful monitoring in cases of intercurrent diseases.


2018 ◽  
Vol 54 ◽  
pp. 19-26 ◽  
Author(s):  
Federico M. Daray ◽  
Ángeles R. Arena ◽  
Arnaldo R. Armesto ◽  
Demián E. Rodante ◽  
Soledad Puppo ◽  
...  

AbstractObjective:The serotonin-transporter-linked polymorphic region (5-HTTLPR) polymorphisms are associated with suicidal behavior; however, prospective studies are scarce. Herein we aim to determine if 5-HTTLPR polymorphisms predict risk of short-term suicide reattempt in a high-risk suicidal sample. We also explore possible mediators or moderators of this relationship.Methods:A multicenter prospective cohort study was designed to compare data obtained form 136 patients admitted to the emergency department for current suicidal ideation or a recent suicide attempt. Subjects were clinically evaluated, genotyped, and monitored for a new suicide attempt for 6 months.Results:At 6 months of follow up, 21% of the subjects had a new suicide attempt. The frequency of L-allele and L-carrier was higher in reattempters when compared with non-reattempters (55.8% vs. 35.4%, p = 0.01 and 76.9% vs. 54.2%, p = 0.04, respectively). Reattempters also differ from non-reattempters patients with respect to age, history of previous suicide attempts, and age of onset of suicidal behavior. The logistic regression model showed that L-carriers had an odds ratio of 2.8 (95% CI: 1.0–7.6) for reattempts when compared to SS genotype. The adjusted model indicates that this association is not mediated or moderated by impulsivity.Conclusion:The 5-HTTLPR polymorphisms predicted short-term risk of suicidal reattempt independently of age and sex. L-carriers have almost three times more risk of relapse when compared with SS carriers.


2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Liam Young

This essay examines the Vegetarian Advocate, a British monthly periodical that ran from 1848 to 1850, and it argues that the periodical’s serial form shaped its representation of vegetarianism. As the first official organ of the UK Vegetarian Society, the Vegetarian Advocate carried different messages to different audiences. For members of the Society, it circulated information on the organization’s publications, annual meetings, membership statistics, and finances, subjects that would be of interest only to insiders. For outsiders and the uninitiated, it published articles explaining vegetarian principles, using arguments drawn from physiology, chemistry, natural history, economics, and ethics to persuade curious readers to experiment with a vegetarian diet. However, drawing on press scholarship and Michel Foucault’s techniques of the self, this essay argues that the serial form of the periodical itself carried an important message on the vegetarians’ ‘serialization of life’, their belief that life be lived serially or, in other words, that forward progress and self-improvement come through repetition, attention to routine, and the everyday training of oneself. Specifically, this essay claims that the seriality of the Vegetarian Advocate allowed the Vegetarian Society to represent its dietary regimen as serial — that is, as a repetitive yet progressive, sequential system of self-transformation in which all forms of activity (from eating to exercising to socializing) accrued meaning sequentially, serially, and relationally, orientating vegetarianism and vegetarians towards a teleological objective, or what Foucault calls the ‘telos of the ethical subject’. Serialization, it claims, was integral to both the practice and concept of vegetarianism: vegetarian print materials were published serially while the practice itself was conceptualized as a progressive step in the development of the individual and the species.


Crisis ◽  
2019 ◽  
Vol 40 (1) ◽  
pp. 27-35 ◽  
Author(s):  
Sang-Uk Lee ◽  
Mina Jeon ◽  
Jong-Ik Park

Abstract. Background: A suicidal person can go through different stages that include suicidal thoughts and suicide attempts. For a few individuals, these can end up with suicide. However, there have been no studies investigating any differences in attitudes toward suicides among individuals with no suicidal thoughts, those with suicidal thoughts, and those with suicide attempts. Aims: This study was carried out to compare attitudes toward suicide among three different groups: individuals with a history of no suicidal thoughts, those with a history of suicidal thoughts, and those with a history of suicide attempts. Method: To examine Koreans' attitudes toward suicide, we analyzed the data from the 2013 National Suicide Survey involving 1,500 participants aged between 19 and 75 years. Results: Different attitudes toward suicide were found among the three groups. Persons reporting that they had made a suicide attempt in their life showed the most permissive attitudes toward suicide. Limitations: Since this research is based on cross-sectional data, it is difficult to eliminate the possibility of changes in attitude toward suicide completely after having a suicidal thought and suicide attempt. Conclusion: These results can be a useful source for constructing effective messages for suicide prevention campaigns and can ultimately contribute to an improvement in the public's perceptions of suicide in the future.


1989 ◽  
Vol 34 (3) ◽  
pp. 249-254 ◽  
Author(s):  
Z.J. Lipowski

After a period marked by one-sided emphasis on psycho-dynamics and social issues, or what could be called “brainless” psychiatry on account of its relative neglect of cerebral processes, we are witnessing an opposite trend towards extreme biologism or “mindless” psychiatry. The pendulum has swung periodically from one to the other of these reductionists positions throughout the history of psychiatry. The author argues that neither brainless nor mindless psychiatry can do justice to the complexity of mental illness and to the treatment of patients. Psychiatry's distinguishing feature as a clinical discipline is its equal concern with subjective experience, or the mind, and with the body, including brain function, which together constitute a person, a psychiatrist's proper focus of inquiry and intervention. Moreover, a person, viewed as a mindbody complex, is in constant interaction with the environment. It follows that both study of mental illness and clinical practice need to take into account the psychological, the biological and the social aspects. These three aspects are not mutually reducible and are indispensable for the understanding and treatment of the individual patient. Such a comprehensive, biopsychosocial approach provides an antithesis to the reductionistic viewpoints and, in the writer's opinion, is both practically and theoretically most satisfying.


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