A Question of Suicide?

Henry Wallis (1856-58) Reproduced with the kind permission of Birmingham Museums & Art Gallery
The Death of Chatterton: Henry Wallis (1856-58) Reproduced with permission and ©Birmingham Museums & Art Gallery  (click image for more details)

 

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.

Update 10th June – See comments re an interesting debate on Mental Nurse Blog re Szasz link here & here

5 thoughts on “A Question of Suicide?

  1. The discussion regarding suicide/euthanasia can only evoke strong polarised views – I would go as far as saying that if anyone thinks that there is a simple and easy answer then they don’t understand the complexities involved.

    I am a supporter of euthanasia. Indeed, I have the appropriate ‘clauses’ in my will to demonstrate my wishes should I ever have to book that single ticket to Switzerland. But I have it worded so if my physical health deteriorates etc etc – so what about my mental health? This links to my previous posting regarding how mental health plays second fiddle to physical health. Surely the bottom line with euthanasia is that I am not happy with my life – isn’t this suicide? Obviously, this is one of the old arguements on this issue but this doesn’t mean that it is wrong.

  2. Of course the trouble with suicide – at the risk of sounding flippant – is that you don’t get to change your mind. How many people have gone on to live worthwhile lives and contributed hugely to society who might have killed themselves if it had been seen as socially acceptable? Not to mention the loved ones left behind with a lifetime of guilt and ‘what ifs.’ The more we can move away from seeing suicide as a matter of personal choice with no consequences for anyone else the better.

  3. I have to agree with the comments left. I too feel that people ought to be able to choose when their life should end and with the same dignity that is expected throughout their lives. However having a mental health difficulty that may (or may not!) distort this thinking is something else. I can remember as a newly qualified staff nurse caring for a woman who had made many attempts at taking her own life. She was admitted to hospital under section, she was not eating, drinking or communicating and her physical health rapidly deterioated. There was talk in the MDT meetings of compulsory ECT for her and I feared this could be one of the worst things to impose on another human being. I worked very hard at encouraging her to talk, to try to eat and I must admit it worked.It was a long and frustrating time and she often used to say to me, “but you don’t know how I feel inside, I’m so empty”. This all happened over a long time, several weeks, by which time I had been asked to move wards to “act up” in the absence of another ward manager. When arriving for duty on my new ward a couple of weeks later, I was told that I had had a visit from a lady who wanted to say “cheerio” as she was going home. I realised that this must have been the woman who had tried to take her own life. Many years later, I visited a store in Birmingham, searching for furniture for my new house and as I walked in I saw a face that I sort of recognised. She recognised me and smiled. She then took another woman by the arm and walked towards me. As she stood in front of me, she turned to the other woman and said “Mary, this is Carole, this is the person who saved my life”
    She was then running a successful business buying and selling antique jewellry and lived life to the full.
    I think at that point it made me realise that if I hadn’t have had the skills, patience and determination to help this woman through an extremely difficult time in her life, she too could have ended up as another suicide statistic.

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