Within the psychiatric paradigm, suicide is usually viewed as an irrational act arising from mental disorder. Philosophical perspectives have at times challenged this assumption, arguing that there may be circumstances in which suicide can be viewed as rational. However, such circumstances are generally only considered to include physical disease, terminal states and chronic pain. Psychogenic pain rarely qualifies as acceptable grounds for rational suicide. People with schizophrenia who voice suicidal ideation are usually deemed irrational in their desires by both psychiatric and philosophical paradigms, wherein their desire to die is seen to arise as a direct consequence of mental disorder. Suicide prevention in such cases is therefore considered to be morally justified in preventing what are considered substantially nonvoluntary acts. This construction of suicide and schizophrenia however fails to take account of two key variables: Firstly, the risk of suicide for people with schizophrenia is highest when positive symptoms are in remission and/or where insight is greatest. Secondly, quality of life studies show that subjective satisfaction is substantially related to social functioning and not the severity of positive symptoms. Such data questions the assumption that suicidal ideation for people with schizophrenia is always a direct result of psychotic phenomena. In this work, I challenge the view that people with schizophrenia are always globally irrational and nonautonomous, and argue that such persons may reasonably evaluate the course and consequences of living with serious mental illness. For the person with schizophrenia, who is subjected to repeated relapses and rehospitalisation, consequent psychic, social and interpersonal losses may lead to a state of hopelessness. I propose that such existential hopelessness is not necessarily pathogenic, but may be a rational response to unendurable suffering. Therefore, I conclude, that such prolonged psychological suffering may legitimately influence a person's desire to die and that there may be circumstances where the suicides of people with schizophrenia can be correctly viewed as rational
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:522029 |
| Date | January 2009 |
| Creators | Hewitt, Jeanette Linda |
| Publisher | Swansea University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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