Suicide is a common and difficult problem in all societies. Many studies have shown that pain and depression are potential risk factors for suicidal risk in medical patients. Acute changes in medical condition and loss of physical function have also been identified as risk factors, as have agitation and readily available lethal means in this population.
The interface of suicide and euthanasia in medical patients is an area where the attitudes of physicians, and especially psychiatrists are of great importance. One study compared the attitudes of psychiatrists in Japan and the United States in order to investigate their ideas on whether patients in general medical hospitals who have a desire to die should be allowed to, or assisted in this regard, and whether they require psychiatric evaluation and intervention, and the cultural influences on these attitudes.
Japanese and American general hospital psychiatrists' attitudes towards the reasonability of suicide, physician assisted suicide, and removal of life supports under various medical and psychosocial situations were compared. Seventy-two American and sixty-two Japanese psychiatrist's data was collected using the Suicidal Attitudes Inventory (SAI).
The majority of both American and Japanese psychiatrists agreed that there may be times when suicidal ideation, or completed suicide in medical-surgical patients could be reasonable. Significantly more Japanese psychiatrists responded with some agreement to the reasonability of suicide when one is unable to fulfill social role expectations, and had more concern about causing suicidal ideation by informing terminal patients of their diagnosis.
Proper use of antidepressants in appropriate suicidal patients is also necessary to consider. The status of antidepressants in Japan that are approved by the Japanese Authorities is an issue that needs to be followed as it has traditionally lagged far behind the West.
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“Would Hamlet have felt the delicious fascination of suicide if he hadn’t had an audience, and lines to speak?”
—Jean Genet (1910–1986)
“There may perhaps be a new generation of doctors horrified by lacerations, infections, women who have douched with kitchen cleanser. What an irony it would be if fanatics continued to kill and yet it was the apathy and silence of the medical profession that most wounded the ability to provide what is, after all, a medical procedure.”
—Anna Quindlen (b. 1952)
“I am a lantern—
My head a moon
Of Japanese paper, my gold beaten skin
Infinitely delicate and infinitely expensive.”
—Sylvia Plath (1932–1963)
“I am firmly opposed to the government entering into any business the major purpose of which is competition with our citizens ... for the Federal Government deliberately to go out to build up and expand ... a power and manufacturing business is to break down the initiative and enterprise of the American people; it is the destruction of equality of opportunity amongst our people, it is the negation of the ideals upon which our civilization has been based.”
—Herbert Hoover (1874–1964)
“It is almost impossible to be a doctor and an honest man, but it is obscenely impossible to be a psychiatrist without at the same time bearing the stamp of the most incontestable madness: that of being unable to resist that old atavistic reflex of the mass of humanity, which makes any man of science who is absorbed by this mass a kind of natural and inborn enemy of all genius.”
—Antonin Artaud (1896–1948)
“Success and failure in our own national economy will hang upon the degree to which we are able to work with races and nations whose social order and whose behavior and attitudes are strange to us.”
—Ruth Benedict (1887–1948)