On assisted suicide and psychiatric suicidilaty

Suicidality:  The likelihood of an individual completing suicide

suicidality (countable and uncountable, plural suicidalities)

1. (uncountable) The tendency of a person to commit suicide
2. (countable) A fatality that is an instance of suicide

On assisted suicide and psychiatric suicidality:

Suicidal ideation, behavior, and risk are continuous guidelines that orient professionals in making informed decisions as to a patient's behavior and the risk to self.

Psychiatric “euthanasia" is an oxymoron. If the person, with all the risk to self or other language can by the extension of time or the intensity of the dark night of the soul provide enough evidence to a group of doctors and lawyers that s/he is unfit to continue on living and does not wish to prolong her or his possibly long but depressing life, in Belgium, it is so. In fact, Belgium has extended that right to minors, although no case has come to the courts so far.

As a Clinical Social Worker, I am thrown to the proverbial wolves with this policy. That a person at the end of life, can choose to not be further tormented with invasive treatments, I understand the meaning and the humanity behind letting a loved one go, letting them choose how to live the last few days or even months of their lives. I applaud it personally, ethically and professionally.

Psychiatry however, is another matter! An entirely different animal. A ridiculously subjective affair. Depending on the psychiatrist, depending on the therapist, depending on the quality of life, a person often, with years of suicidal tendencies, can change. After many years of different providers, medications and therapeutic styles and even schools of thought, a person can and indeed does change. If not, they are quite adept at taking matters into their hands. Efficiently, quietly and  in general effectively. The blotched attempts, the threats, the calls in the middle of the night are pleas for help, help that we might not be able to provide, but that they, of their own volition, do not wish upon themselves.

Assisted psychiatric suicide takes me to the dark sides of our professions, social workers and physicians  with the dark past of forced sterility on those we deemed inferior for reasons of race, intelligence and other subjective aspects. Social workers, psychologists, and  other professions involved in the well being of the Other, made sure that the Other did not propagate any further. We look upon this as a dark time in our history.

Assisted suicide when a cancer or other advanced illness that has no treatment anywhere, no matter the cost, no matter the expertise, will provide a short time of life in misery and is clearly a short road to the great gig in the sky, that is done with palliative care and non intrusive treatments every day in every state and most countries.

I work with suicidal patients every day, and have known some who have taken their lives in either quick and no opportunity to back track or in stronger and stronger attempts until one day. I have known of patients who hold us by the psychologically hostage by their constant threats that appear to never come to fruition. A life is a life. We are mental health professionals and the purpose of our work it to make sure that no such occasion ever comes to pass.

If indeed people with severe depression, bipolar disorder and even autism can choose when to end their lives what are mental health professionals doing? Showing them the door? What are the criteria. How many treatments is a person subjected to and what kind?

But, again, assisted psychiatric suicide is an oxymoron! Discounting the journalistic levity with which it has been managed, it is nonetheless a denial of the foundation that comprises mental health care.

TheNew Yorker in a disturbing June article explores the Belgic dilemma with critical optics. I cannot blame the journalist. The quotes are disturbing, the analogies and allegories even more so. Mixing Catholic scripture and Auschwitz references, angry bereaving children and self contained and self assured doctors, the article obviously guides one towards the natural conclusion that it is madness to help someone with bipolar illness, anorexia , even autism to commit suicide. By this logic, most of the patients I see could go to the local Euthanasia Specialist, (Euthanicist?) and get them to pull the plug, to the great nothing from whence we came. Is psychiatry ready to do away with its own specialty?    

It is a theme that I plan or reading much more into and will repost on.

 

 

 

 

life is a crap shoot and social workers exist to increase the odd that life will be beeter

On Social Work: In as much as we have structures with specific professional roles working there, such as courts, we have or must create the institutions that will have social workers as an intrinsic part of their functioning. Those left out of a society that is more and more fragmented, without family support and with a job market that has become progressively less secure, as it appears that those at the top want everyone to be a individual indentured to whatever little jobs they can get, those, I say, need social workers, because we know how to maneuver the bureaucracies that gets them housing and food and medication and mental health. Not every depressed person needs  medication but could sure use some words of kindness WITH the assistance that will make their sadness diminish, be it group therapy, better resources or how to think through a problem. Do psychiatrists know how to help someone with housing difficulties? Does a lawyer know how to deal with a woman who lives in a room with three children and cannot afford to get better housing? Does a psychologist know how to get that woman to the right places, and as a result, get the woman better housing, help her get training, and thus give her a possible future, not doomed to destitution? We are multilayered and multitaskers, we know who and how to talk to the right people, and get training in networking resources that together, constitute and substitute for what a functional well off family, an extended one, used to do and still does! Are we ignoring that we are the ones who deal with the problems of the child who is abused, the frail elderly who has no place to go, the person who wants to get out of a life where alcohol and other substances have become the only thing in their lives, robbed of home, family and dignity. Anybody who thinks that social work is a profession in extinction is either not looking around them, or living in a fantasy land where there are no poor, no homeless, no migrant refugees, no undocumented immigrants, no abused children, no beaten women who have to leave in the silence of the night lest they be killed by the beast next to them. Can I move to that idyllic place? I'll happily find a new profession because they will be Abundant, housing affordable, sick leave paid for, eduction free and should I become ill, I will not need a social worker to find me a way to get affordable medication, food delivered to my house or even a home assistant or transportation that will take me to the places I'll need to go to. Oh, and yes, I can sure use some words of kindness, therapy if you will, not the "god only gives you what you can take or cancer can be a blessing in disguise" type of worn out and offensive clichés, but researched and well thought out manners of saying words which will leave me thinking that maybe I am not such a useless piece of garbage. That's what I do every day, because the world I live in is an unfriendly one to those who have bad luck and bad timing. Shoot, who wouldn't have liked to have been born to a wealthy resourceful family? But we don't get to choose. Life is a crap shoot and social workers exist to increase the odds at a better life. There, that's my defense of social work for today!