On a recent visit to Birmingham City Art museum I had a look at the painting above ‘The death of Chatterton’ by Henry Wallis (1856). This painting shows the dead body of Thomas Chatterton, an 18th century poet who killed himself by taking arsenic rather than live in poverty.
I suspect that if you weren’t familiar with this picture you wouldn’t guess that it shows an impoverished young man who has died of self administered arsenic poisoning. Although relatively unknown during his life, Chatterton’s death became a well known event because of the romanticised reaction it provoked. As well as this painting, there were poetic responses from the likes of Shelley, Wordsworth, Coleridge and Keats.
When Want and cold Neglect had chill’d thy soul,
Athirst for Death I see thee drench the bowl!
Thy corpse of many a livid hue
On the bare ground I view,
Whilst various passions all my mind engage;
Now is my breast distended with a sigh,
And now a flash of Rage
Darts through the tear, that glistens in my eye
(Monody on the death of Chatterton by Samuel Taylor Coleridge See link)
Arguably, this type of response served to glorify the act of suicide. Certainly, there is evidence of concern about how suicide was portrayed in the media. This essay on the Victorian web looks at attitudes to suicide and fears that media portrayals, especially in the ‘cheap press’ might increase suicide rates. How would we feel if a modern day suicide was to receive a response like this? The National Suicide Prevention Strategy is quite clear that it is necessary to promote “responsible representation of suicidal behaviour in the media”.
I was wondering though about how we as professionals really feel about suicide?
Personally, I do feel some uncertainty. I believe that somehow we need to sort out how we as a country are going to work with people who want to end their lives with dignity. There are large numbers of people who suffer from incurable illness and chronic physical and emotional pain who wish to have some control over when their lives will end. I don’t think that this should be left up to families to travel abroad (risking prosecution) with loved ones to assisted suicide clinics. I also think we would be better off if we didn’t have to rely on the likes of this ‘Euthanasia Doctor’ who recently visited the UK.
On the other hand, I spent many years working in in-patient mental health settings where I often cared for people who were considered at risk of suicide. Although we talk about the importance of ‘person centered care’ and working in collaboration with people - lets be blunt. This involved helping to detain people against their will. There was often (not always) a feeling that the person receiving the care was trying to outwit us. If they succeeded in doing so then a likely result would be the death of that person. Were we right to try and prevent this? – I believe that we were. Is this an ideal way to be treating people? – certainly not – does anyone have any better ideas?
Take a look at this debate (transcript here) with Thomas Szasz, filmed at Birmingham University. Having read the work of Szasz it seems clear to me that much of his critique of psychiatry and it’s contradictions makes sense. However, it seems quite clear that he wouldn’t approve of working with potentially suicidal people in the manner described above, i.e. “Compulsion is a bad thing”.
Trouble is though, where does this leave all of the people considered at risk of suicide who are currently detained in the UK? What about the people who are doing the detaining? How do we square this with an attempt to treat people with terminal illness’ with compassion and dignity. Lets be clear, I absolutely don’t pretend to have the answers to any of the issues raised above. I am pretty sure that there are no clear answers and certainly no answers that would please everyone. It will be interesting to see what the recent RCN consultation (see also) on the subject of assisted suicide will conclude. How this will affect people involved in mental health services remains to be seen, I hope it will lead to wider discussion about this subject.
What do you think? – I would be interested to see any comments.