The COVID-19 pandemic has affected the well-being and mental health of populations worldwide. This study sought to examine whether religious coping mediated the relationship between COVID-19-related fear and death distress. We administered an online survey to 390 adult participants (66.15% females; Mage = 30.85 ± 10.19 years) across Turkey. Participants completed a series of questionnaires measuring the fear they had experienced during the COVID-19 pandemic, their levels of religious coping and their levels of death anxiety and depression. (...) Our findings revealed that (a) fear of COVID-19 was associated with positive religious coping, negative religious coping, death anxiety and death distress; (b) negative religious coping was associated with death anxiety and depression and (c) negative religious coping mediated the relationship between fear of COVID-19 and death anxiety and depression. These results highlight the detrimental effect of negative religious coping in increasing the adverse effect of the COVID-19 fear on death depression. (shrink)

Schuklenk and van de Vathorst's paper is a very welcome addition to the literature on the assisted dying debate and will be of great interest to clinicians working in the field of mental health.1 Many psychiatrists will have had patients who have asked them to allow them to die, to desist in their efforts to prevent their suicide, and one of us has had personal experience, outside of professional life, of being asked to aid in someone's attempt to end their (...) life in the context of an episode of mood disorder. The person with depression asking professionals, friends and family members to aid them in ending their life is a very real phenomenon. In their discussion, Schuklenk and van de Vathorst's paper uses two principles that we endorse and add weight to their argument: namely, the reality of suffering in depression and the parity of mental and physical illness. Indeed, the case Schuklenk and van de Vathorst make is a strong one and our commentary will focus on the premise of the argument around choosing death and some empirical clarification about competence in depression and the nature of treatment-resistant depression (TRD) and its prognosis. The conceptual concern we wish to discuss in relation to assisted dying, endorsed by the state and legislature, is not linked to any moral or religious concern, or even on grounds related to ‘slippery slope’ or ‘abuse’ arguments. Rather the worry is how one could operationalise decisions around assisted dying as based on competence and capacity and view such decisions as rational. I think this concern is not limited to depressive illness, but to all decisions regarding choosing non-existence. Schuklenk and van de Vathorst offer the following useful criteria to regulate assisted suicide:1. (shrink)

Should people suffering from untreatable psychiatric conditions be eligible for physician-assisted death? This is possible in Belgium and the Netherlands, where PAD for psychiatric conditions is permitted, though rare, so long as the criteria of due care are met. Those opposed to all instances of PAD point to Belgium and the Netherlands as a dark warning that once PAD is legalized, restricting it will prove impossible because safeguards, such as the requirement that a patient be terminally ill, will inevitably (...) be eroded or discarded. However, some supporters respond that limiting PAD to those suffering from terminal illness, or physical illnesses generally, is arbitrary and illogical. In addition, precisely because such patients are not terminally ill, their suffering may last for years, even the rest of their lives. Finally, severe depression may not be treatable. If PAD is justifiable under some conditions—as I shall assume in this article—then why wouldn't it be justifiable for these patients? Why shouldn't psychiatrists who have nothing else to offer their suffering patients be able to help them to die, if that is what they want? (shrink)

Philip Larkin’s poem “Aubade” tackles the subject of mortality with technical facility and unsparing candour. It has a reputation for profoundly affecting its readers. Yet poets Seamus Heaney and Czeslaw Milosz think “Aubade” is bad for us and for poetry: it lures us into the underworld and traps us there, and betrays poetry’s purpose by transcribing rather than transforming the depressing facts of reality. Philosophers, however, quite like it. “Aubade” crops up repeatedly in contemporary philosophy of death. I examine (...) the various appeals that philosophers have made to Larkin’s poem with a view to drawing out subtleties in the poem and the philosophical texts, before turning my attention to broader questions of its merit. At first glance, philosophy’s affinity for “Aubade” may seem to confirm Heaney and Milosz’s contention that the poem is somehow against poetry and on the side of “reason, science, and science-inspired philosophy” (Milosz). I argue that the philosophical uses of the poem help to undercut if not entirely dissolve Heaney and Milosz’s polarising efforts; they are mistaken in their views about the different purposes of poetry and philosophy, but there is some philosophical support for their commitment to averting mortal despair. (shrink)

BackgroundThe death of a loved one can trigger a range of responses, including painful thoughts and emotions, as well as positive changes, such as post-traumatic growth. To understand more about the relationship between these outcomes this study explored the co-occurrence of depression, anxiety and PTG among a group of bereaved Chinese adults.MethodsData were collected from 194 participants, who had lost a first-degree relative. Latent class analysis was used to analyze the data to identify subgroups of participants with shared (...) symptom profiles.ResultsThree classes were identified: a Growth class, a Depression/Anxiety/Growth class and a Depression/Anxiety class. Marital status, social support, close relationship with the deceased and witnessing the suffering of the deceased were identified as differential predictors of class membership.ConclusionThe findings contribute to our understanding of the potentially wide ranging impacts of bereavement and highlight the important role of stressor characteristics and support and in influencing impairment and positive outcomes. (shrink)

Untreated depression at the end of life may affect treatment and raise ethical concerns. Patients with a major depressive disorder may desire a hastened death, may refuse reasonable and beneficial medical care, or may present with cognitive distortions that hinder their ability to make decisions about care. Treating depression can avert or minimize these problems in many cases. For a patient who does not respond to antidepressant medications and other interventions, however, the unrelieved depression could tip (...) the balance and make additional medical treatments burdensome. In such cases, a proposed medical treatment might be considered extraordinary. National Catholic Bioethics Quarterly 14.4 : 697–710. (shrink)

Because of the coronavirus pandemic, reminders of death are particularly salient. Although much terror management theory research demonstrates that people engage in defensive tactics to manage mortality awareness, other work shows that existential concerns can motivate growth-oriented actions to improve health. The present study explored the associative link between coronavirus anxieties, fear of death, and participants' well-being. Results, using structural equation modeling, found that increased mortality concerns stemming from COVID-19 were associated with heightened benefit finding from the pandemic. (...) Increased benefit finding, in turn, was related to higher life satisfaction, meaning in life, self-esteem, resilience, and vitality while also correlating negatively with depression and stress scores. There was no evidence for reverse mediation in that fear of mortality did not predict well-being through coronavirus worries. Overall, although many persons have experienced mental health concerns as a function of the COVID-19 pandemic, our findings demonstrate positive benefits that paradoxically follow in terms of an increased appreciation of life, improved relationships, and better health. (shrink)

Next SectionBackground There is an established link between depression and interest in hastened death in patients who are seriously ill. Concern exists over the extent of depression in patients who actively request euthanasia/physician-assisted suicide (PAS) and those who have their requests granted. Objectives To estimate the prevalence of depression in refused and granted requests for euthanasia/PAS and discuss these findings. Methods A systematic review was performed in MEDLINE and PsycINFO in July 2010, identifying studies reporting rates (...) of depression in requests for and cases of euthanasia/PAS. One author critically appraised the strength of the data using published criteria. Results 21 studies were included covering four countries. There was considerable heterogeneity in methods of assessing depression and selecting patients. In the highest quality studies, in the Netherlands and Oregon, 8–47% of patients requesting euthanasia/PAS had depressive symptoms and 2–17% of completed euthanasia/PAS cases had depressive symptoms. In the Netherlands, depression was significantly higher in refused than granted requests, and there was no significant difference in the rate of depression between euthanasia cases and similar patients who had not made a request for euthanasia. Conclusion It is unclear whether depression increases the probability of making a request for euthanasia/PAS, but in the Netherlands most requests in depressed patients are rejected, leaving a depression rate in cases that is similar to the surrounding population. Less evidence is available elsewhere, but some level of depression has been identified in patients undergoing euthanasia/PAS in all the countries studied. Whether the presence of depression is ever compatible with an ethical decision on euthanasia/PAS is discussed. (shrink)

Animal death is a complex, uncomfortable, depressing, motivating and sensitive topic. For those scholars participating in human-animal studies, it is - accompanied by the concept of 'life' - the ground upon which their studies commence, whether those studies are historical, archaeological, social, philosophical, or cultural. It is a tough subject to face, but as this volume demonstrates, one at the heart of human-animal relations and human-animal studies scholarship. '... books have power. Words convey moral dilemmas. Human beings are capable (...) of being moral creatures. So it may prove with the present book. Dear reader, be warned. Reading about animal death may prove a life-changing experience. If you do not wish to be exposed to that possibility, read no further... In the end, by concentrating our attention on death in animals, in so many guises and circumstances, we, the human readers, are brought face to face with the reality of our world. It is a world of pain, fear and enormous stress and cruelty. It is a world that will not change anytime soon into a human community of vegetarians or vegans. But at least books like this are being written for public reflection.' from the foreword by The Hon. Michael Kirby AC CMG. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 10.1 (2003) 87-89 [Access article in PDF] Death, Disability, and Dialogue Gerald Casenave IN THEIR INSIGHTFUL and constructive review, "Death, Disability, and Dogma," Jennifer Clegg and Richard Lansdall-Welfare manage to create the very dialogue that they argue is lacking. Their contention is that the lack of dialogue between different realms of discourse has led to rigid service response by caregivers that attempt to (...) address losses experienced by individuals with intellectual disabilities. They argue that this situation arises because of the complexity of the cultural meaning of death and the uncertainty of the meaning for individuals with intellectual disabilities.Their essay, in itself, is powerfully cross-disciplinary. They review the concept of bereavement from different perspectives: social science research, psychiatric practice, and underlying cultural meanings. This review indicates that social science research has moved from attempting to develop definitive statements about the meaning of death. From their review, it is possible to discern that there may have been an underlying positivist orientation that assumed that a univocal meaning to the loss experience can be discovered. But the only universal fact about death is that there is a loss. It is a significant life event. Going all the way back to the early work of Holmes and Rahe (1967), it is clear that the impact and meaning of the same life event varies from individual to individual. There are multiple layers of meaning that include at least one's larger culture, subgroup values, family meaning, and finally individual interpretation. Clegg and Landsdall-Welfare see the current findings of social science as pointing to the need to be sensitive to the meaning of the death event for the specific individual. It appears to be inappropriate to impose normative stages onto an individual's grief experience.The finding from the review of psychiatric investigation of loss experiences is that bereavement can contribute to health problems. The loss experience is not necessarily pathologic. This compares to the acknowledgement that depression and anxiety are not necessarily illnesses to be treated, but basic human coping mechanisms that can become problematic. Similarly, the loss experience can be a traumatic experience with negative health implications.Clegg and Landsdall-Welfare acknowledge the limited nature of their review of the role of culture in the meaning of the loss experience. But even so, it is clear that the larger cultural context contributes critically to the individual's experience of loss. Oversimplification and reductionistic approaches to the death experience result in insensitive, stereotypic, formulaic, and consequently unsuccessful intervention strategies.The problem, as Clegg and Landsdall-Welfare see it, is that these discoveries and insights have not been effectively integrated into the discourse about and interventions for loss experiences for individuals with intellectual disability. This failure has occurred because of the strong continued [End Page 87] effect of the normalization orientation in the field of intellectual disability and vulnerability of the meaning of life for individuals with intellectual disability.They caution against hasty attempts to integrate the insights on loss from various sources into the discourse on bereavement in the field of intellectual disability. They cite the fragility of meaning of life for individuals with intellectual disability. This fragility leaves them vulnerable to being overwhelmed by the larger discourse with a resulting loss of identity. Their brief mention at the conclusion of their essay of other contested concepts in other clinical services gives rise to thinking further.Clearly, the fundamental challenge for any discussion of the meaning of a loss experience is the complex nature of our understanding of death. First, there are problems with basic definitions of death from the perspective of science. But from an intervention and treatment perspective, the greatest problem has to do with our larger cultural discomfort in even discussing death and loss. The issue of intervention concerning loss for a specific population, such as those with intellectual disability, is in part only a reflection on our confusion concerning intervention in loss for any person, regardless of their disability status. Here again is confirmation of fundamental likeness across individual differences. This is not to be confused with normalization; rather, it... (shrink)

Our 2021 article, "Dying Well in Nursing Homes During COVID-19 and Beyond: The Need for a Relational and Familial Ethic," addresses the response to the COVID-19 pandemic within nursing homes and the impact it had on the lives of residents, care providers, and families. We acknowledge that, at the height of the pandemic, when infection and death rates were soaring in these facilities, extreme "lockdown" measures may have been justified; but these measures resulted in significant relational costs. The collateral (...) damage caused by these lockdown measures included extreme isolation, loss of community, and experiences of confusion, depression, and mental decline for the elderly residents that... (shrink)

Concern with elective-death decisions usually focuses on individuals' competence and understanding of their situations and prospects. If problematic influences on individuals are considered, they almost invariably have to do with matters such as depression and the effects of medication. Too little attention is paid to how individuals, as subjects, are products of both external cultural and social influences on them, and of internal efforts and needs that determine their subjectivity.

Data analysis from diverse medical fields suggests that we have reached a tipping point in the digitalization dynamic through the ongoing COVID-19 crisis, leading to an escalation of physical inactivity and related diseases. The lack of prioritization of physical activity designed to intervene against obesity, diabetes, loneliness, depression, anxiety disorders and suicide risk could destabilize our current global health system beyond rehabilitation. To counteract this, the author outlines the basis for a sustainable solution to best integrate physical activity into (...) work, daily life and education. In addition, he highlights the potential benefits of combining exercise training with microdosing of psilocybin or of active ingredient essences of psilocybin-containing mushrooms. The article also shows that the integration of mindfulness-based practice and neuroplastic movement practice is a necessity and a competitive advantage for the future. (shrink)

Hegel’s idealism is generally perceived as a system of rational sublation (Aufhebung) of all empirical contingencies: nothing resists notional mediation which, in a movement of negation of negation, establishes a rational totality. Already Schelling opposed to this complete sublation an “indivisible remainder” of empirical contingency. However, a close reading of Hegel makes it clear that the concluding moment of a dialectical movement of sublation is an empirical remainder which totalizes it, like the body of Christ in Christianity. And the same (...) goes for the process of “negation of negation”: it concludes with a failure of negation, and its ultimate form is a failed suicide where the subject survives as a living dead. Such a reading of Hegel makes him a thinker of our time which is the time of a failed negation: most of us live as survivors of our death, with life dragging on in depressive apathy. (shrink)

This article focuses on the legality of euthanasia and assisted suicide in the Netherlands. Euthanasia and assisted suicide are allowed in certain cases, but there is no consensus with respect to the extent of the situations in which physicians should not be prosecuted. I argue that the individual, and, more specifically, his/her suffering, should be the focal point, and that the present legislation falls short in this respect; no solution can as yet be offered to individuals whose suffering cannot be (...) resolved through medical means and which cannot be subsumed under the terms the law specifies. (shrink)

In 1980, the late French Marxist philosopher Louis Althusser, a long-time sufferer of manic-depressive illness, murdered his wife and was committed to a psychiatric hospital. Never allowed to stand trial, he was eventually released and spent the years until his 1990 death in fitful obscurity. The posthumous publication of his autobiography, especially when taken in tandem with the first volume of the biography by his friend Yann Moulier Boutang, allows his readers hitherto unavailable insights into the man, and even (...) into the possible interpenetration of the man and his philosophy.Contrary to the claims of his editors, however, Althusser's autobiography is far from a portrait of madness from the inside. The author's attempt at an "objective" self-portrait, even with its objective mistakes and ellipses, is at a very far remove from the depiction of madness as experienced by the madman. The entire thrust of Althusser's self-interpretation, moreover, with its psychoanalytic excavation of neurotic determinants, appears to aim at the reduction of psychosis to more readily comprehensible mental turbulence. A similar reduction is at work in the author's seeming inability, or unwillingness, to trace the links between the institutional and political contexts of his life and the more intimate, personal sphere--and that remains the case even when he seems to be tracing those very connections.The question remains--and it is the overriding question of this article--whether any relationship can be traced between Althusser's interpretation of Marxist philosophy and his selfinterpretation. The answer lies in Althusser's ultimately fissured and fragmented account of the social "whole" as a "structure of structures," in which psychic factors are irrelevant to historical understanding and vice-versa.The limitations of Althusser's self-understanding are thus seen to parallel the limitations of his conception of Marxism. (shrink)

Sixty years after the famous ‘Conférence des écrivains et artistes noirs at the Sorbonne’, and sixty years after Black-Label, the third collection of poetry by French Guianese Leon-Gontran Damas, the word “nègre” and “nigger” remain offensive words all too much used in postcolonial Europe today. Even after the short lived Obamamania, Damas’s poetry remains actual as it expresses the censorship all too many times endured by the lyrical voice who cannot speak out loud against those violent verbal, physical, and thus (...) psychological assaults. Consequently, his “mors dans la bouche”, or “bit in the mouth” is incoporated in his less wellknown work which testifies to the “mort dans l’âme”, it is the constant feeling of depression and blues lurking on the Black or coloured citizen of France and the West Indies. Standing in the shadow of the cofounders, and quite neglected by the leading Martinicans of the post-Négritude era, Damas nevertheless understood the urgency of transcontinental and transcultural solidarities in this battle and wrote against the dichotomies of race, class, and gender. Damas and James knew each other for over forty years. Damas read James’s novel, Minty Alley before they met in Paris when James was doing the research for The Black Jacobins, his landmark history of Tousssaint L’Ouverture and the revolution in the French colony of Saint-Domingue. Damas helped James with translations and discovering documents at the Bibliothèque Nationale. On one occasion, Damas brought James to the home of Robert Desnos. Both lived in Washington, DC, in the 1970s when Damas was at Howard University and James taught at Federal City College/University of the District of Columbia. (shrink)

ObjectiveThe aim of this study was to investigate possible associations between obstructive sleep apnea and fatigue. This naturally led to considering the association between OSA and excessive sleepiness, depression, and anxiety.BackgroundOSA is a highly prevalent sleep disorder, associated with a risk of hypertension, cardiovascular events, daytime sleepiness, poor cognitive function, and sudden death during sleep. Both excessive sleepiness, fatigue, and symptoms of depression are frequently reported.Method5,464 patients referred to a university hospital for obstructive sleep apnea underwent standard (...) respiratory polygraphy. The severity of OSA was defined as either mild, moderate, or severe, using the apnea–hypopnea index. Validated questionnaires were used to assess excessive sleepiness, pathological fatigue, depression, and anxiety.ResultsNearly 70% of the patients were men, and median age was 50 years. One in three had moderate-to-severe OSA. Excessive sleepiness and pathological fatigue were present in 43 and 39%, respectively. The prevalence of possible depression and anxiety was 19 and 28%, respectively. The proportion of patients with male sex, obesity, and excessive sleepiness increased with the severity of OSA. In contrast, the proportion of patients with pathological fatigue did not increase with OSA severity, and there was a decrease in depression and anxiety with increasing OSA severity.ConclusionOur study reports that pathological fatigue, as well as anxiety and depression, did not increase with OSA severity, whereas excessive sleepiness did. Knowledge concerning conditions related to OSA severity may be indicative of pretest probability of OSA and thus change the priority for polygraphy. Furthermore, the high prevalence rates of fatigue, anxiety, and depression among these patients warrant further investigations. (shrink)

The advancement of Artificial Intelligence (AI) poses challenges in the field of bioethics, especially concerning issues related to life and death. AI has permeated areas such as health and research, generating ethical dilemmas and questions about privacy, decision-making, and access to technology. Life and death have been recurring human concerns, particularly in connection with depression. AI has created systems like Thanabots or Deadbots, which digitally recreate deceased individuals and allow interactions with them. These systems rely on information (...) generated by AI users during their lifetime, raising ethical and emotional questions about the authenticity and purpose of these recreations. AI acts as a mediator between life, death, and the human being, enabling a new form of communication with the deceased. However, this raises ethical issues such as informed consent from users and the limits of digital recreation. Companies offer services like the Digital Resurrection of deceased individuals and the generation of hyper-realistic avatars. Still, concerns arise about the authenticity of these representations and their long-term emotional impact. Interaction with Thanabots may alter perceptions of death and finitude, leading to a potential “postmortal society” where death is no longer viewed as a definitive end. Nevertheless, this raises questions about the value of life and the authenticity of human experiences. AI becomes a bridge between the living and the dead, partially replacing rituals and mystical beliefs. As technology advances, there will be a need for greater transparency in interacting with AI systems and ethical reflections on the role of these technologies in shaping perceptions of life and death. Ultimately, the question arises of whether we should allow the dead to rest in peace and how to balance the pursuit of emotional relief with authenticity and respect for the memory of the deceased. A deeper ethical consideration is needed on how AI alters traditional notions of life, death, and communication in contemporary society. In this research, an interdisciplinary approach was utilized to conduct a comprehensive systematic review of the recent academic literature, followed by a detailed analysis of two key texts. Central ideas were extracted, and recurring themes were identified. Finally, a reflective analysis of the findings was conducted, yielding significant conclusions and recommendations for future research. (shrink)

Drawing the line on physician assistance in physician-assisted death continues to be a contentious issue in many legal jurisdictions across the USA, Canada and Europe. PAD is a medical practice that occurs when physicians either prescribe or administer lethal medication to their patients. As more legal jurisdictions establish PAD for at least some class of patients, the question of the proper scope of this practice has become pressing. This paper presents an argument for restricting PAD to the terminally ill (...) that can be accepted by defenders as well as critics of PAD for the terminally ill. The argument appeals to fairness-based paternalism and the social meaning of medical practice. These two considerations interact in various ways, as the paper explains. The right way to think about the social meaning of medical practice bears on fair paternalism as it relates to PAD and vice versa. The paper contends that these considerations have substantial force when directed against proposals to extend PAD to non-terminally ill patients, but considerably less force when directed against PAD for the terminally ill. The paper pays special attention to the case of non-terminally ill patients who suffer from treatment-resistant depression, as these patients present a potentially strong case for extending PAD beyond the terminally ill. (shrink)

Abstract:The specialty of psychiatry has a long-standing, virtually monolithic view that a desire to die, even a desire for a hastened death among the terminally ill, is a manifestation of mental illness. Recently, psychiatry has made significant inroads into hospice and palliative care, and in doing so brings with it the conviction that dying patients who seek to end their suffering by asserting control over the time and manner of their inevitable death should be provided with psychotherapeutic measures (...) rather than having their expressed wishes respected as though their desire for an earlier death were the rational choice of someone with decisional capacity. This article reviews and critiques this approach from the perspective of recent clinical data indicating that patients who secure and utilize a lethal prescription are generally exercising an autonomous choice unencumbered by clinical depression or other forms of incapacitating mental illness. (shrink)

The purpose of this study was to investigate mental effects of coronavirus disease 2019 and its relationship with death attitudes and coping styles among Hungarian, Norwegian, and Turkish psychology students. A total of 388 participants from Hungary, Norway, and Turkey were recruited during the pandemic. The Depression, Anxiety and Stress Scale, the Impact of Event Scale-Revised, the Carver Brief COPE Inventory, and the Death Attitude Profile-Revised were used. The results indicated that escape acceptance might be the most (...) maladaptive death attitude during COVID-19, as it was related to poorer mental health among the Hungarian, Norwegian, and Turkish psychology students. Self-blame, behavioral disengagement, self-distraction, and substance use coping styles were also related to poorer mental health, whereas positive-reframing and humor were related to better mental health among our sample in the context of COVID-19. The findings implied that death attitudes and coping styles may differ in their efficacy among the Hungarian, Norwegian, and Turkish participants. These differences were discussed in detail in the discussion part. During the pandemic, practitioners might pay closer attention to patients with higher escape acceptance death attitude and patients who use dysfunctional coping styles. Additionally, patients can be encouraged to use techniques involving positive reframing and humor coping styles. (shrink)

Ischemic stroke involves numerous and complex pathophysiological mechanisms including blood flow reduction, ionic exchanges, spreading depressions and cell death through necrosis or apoptosis. We used a mathematical model based on these phenomena to study the influences of intensity and duration of ischemia on the final size of the infarcted area. This model relies on a set of ordinary and partial differential equations. After a sensibility study, the model was used to carry out in silico experiments in various ischemic conditions. (...) The simulation results show that the proportion of apoptotic cells increases when the intensity of ischemia decreases, which contributes to the model validation. The simulation results also show that the influence of ischemia duration on the infarct size is more complicated. They suggest that reperfusion is beneficial when performed in the early stroke but may be either inefficacious or even deleterious when performed later after the stroke onset. This aggravation could be explained by the depolarisation waves which might continue to spread ischemic damage and by the speeding up of the apoptotic process leading to cell death. The effect of reperfusion on cell death through these two phenomena needs to be further studied in order to develop new therapeutic strategies for stroke patients. (shrink)

Ketamine, a dissociative anesthetic commonly used by US physicians, has recently been shown to be a powerful anti-depressant and is also capable of eliciting transpersonal experiences that can be transformative. Although currently approved in the US only for use as an anesthetic, physicians there can legally prescribe it off-label to treat various psychological/ psychiatric problems and it has been used for these non-anesthetic purposes in Argentina, Iran, Mexico, Russia, and the UK, as well as in the US. The literature on (...) using ketamine psychotherapeutically is reviewed and two case studies using ketamine-enhanced psychotherapy for treating death anxiety in terminally-ill people are reported. The potential importance of beginning formal research on using KEP during end-of-life for those suffering death anxiety is emphasized. (shrink)

When elderly people are ideating on manners to end their lives, because they feel life is over and no longer worth living, it is important to understand their lived experiences, thoughts and behaviour in order to appropriately align care, support and policy to the needs of these people. In the literature, the wish to die in elderly people is often understood from a medical, psychopathological paradigm, referred to as cognitive impairment, depressive disorder, pathological bereavement, and suicidality. In this paper, we (...) evaluate this dominant paradigm by considering three serious limitations, namely: (1) the risk of epistemic transformation; (2) the risk of reduction; and (3) the risk of obscuring the social and cultural embeddedness. Drawing on insights from our empirical–phenomenological research on the issue of elderly and the self-chosen death, this paper argues for a phenomenological perspective to counteract the medicalisation of death wishes in elderly people. (shrink)

This book offers a radical alternative to the positive orientation of popular psychology. This positive orientation has been criticized numerous times. However, there has yet to be a coherent alternative proposed. We all know today that life hurts and that there is no ultimate remedy to this pain. The positive approach feels to us as dishonest and irrelevant. We require a new, more negative, perspective and practice, one that is honest and does not pretend to offer an escape from the (...) agonies of the world. This book offers in three main chapters a ‘depressive realist’ perspective that explores the structural role of negativity and tragedy in relation to the individual psyche, society, and nature. It explores the possibility of ‘negative psychoanalysis’ which takes into account the tragedy of human existence instead of adopting escapist positions. (shrink)

The aim of this book, by providing a set of conceptual tools drawn from critical theory, is to open up questions and new problems and new research agendas for the study of environmental politics.

Global Justice: The Basics is a straightforward and engaging introduction to the theoretical study and practice of global justice. It examines the key political themes and philosophical debates at the heart of the subject, providing a clear outline of the field and exploring: the history of its development the current state of play its ongoing interdisciplinary development. Using case studies from around the world which illustrate the importance of the debates at the heart of global justice, as well as activist (...) campaigns for global justice, the book examines a wide range of theoretical debates from thinkers worldwide making it ideal for those seeking a balanced introduction to global justice. (shrink)

COVID-19 has caused far-reaching humanitarian challenges. Amongst the emerging impacts of the pandemic is on the dynamics of human trafficking. This paper presents findings from a multi-methods study interrogating the impacts of COVID-19 on human trafficking in Sudan—a critical source, destination, and transit country. The analysis combines a systematic evidence review, semi-structured interviews, and a focus group with survivors, conducted between January and May of 2021. We find key risks have been exacerbated, and simultaneously, critical infrastructure for identifying victims, providing (...) support, and ensuring accountability of perpetrators has been impeded. Centrally, the co-occurrence of the pandemic and the democratic transition undercut the institutional and governance capacity, limiting the anti-trafficking response and exposing already vulnerable groups to increased risks of human trafficking. Findings point to increased vulnerabilities for individuals with one or more of the following identities: migrants, refugees, females, and informal labourers. (shrink)

This massive book is an intensive inquest into the fate of the human subject as it passes through the primitive, despotic, passional and capitalist regimes found in Deleuze and Guattari. Emphatic, acerbic, loquacious, impassioned, and marshaling a considerable array of theoretical and literary frameworks--from Schelling, Kantorowicz, Agamben, Hegel, Nietzsche, Badiou, Rosenzweig, Lévinas, Derrida, Blanchot, Kierkegaard, Marx, Lazzarato, Berardi, Zizek and Plotinus to Solzhenitsyn, Pessoa, Fuentes, Dostoyevsky, Kafka, Beckett, Mann, Schreber, Dante, Milton, Shakespeare, Sade, the Midrash and Kabbalah--and cavorting through vast (...) expanses of world history, Bartosz Łubczonok scrutinizes the maladies of pain, resentment, bad conscience, ideology, immiseration, torture, death, depression and suicide that have and continue to afflict humanity, and the possibilities of its vertiginous liberation. All is here: the auto-genesis of God, the Crucifixion, the Holocaust, September 11. The Apotheosis of Nullity is a searing indictment of all forms of oppression and despotism, inclusive of neoliberal capitalism, and far surpasses any usage of Deleuze and Guattari to date. It is relentless. (shrink)

Anxiety -- Depression -- Death -- Authenticity -- Faith -- Ethics -- Love.

Suicide is amongst the top ten causes of death for all age groups in most countries of the world. It is the second most important cause of death in the younger age group (15-19 yrs.) , second only to vehicular accidents. Attempted suicides are ten times the successful suicide figures, and 1-2% attempted suicides become successful suicides every year. Male sex, widowhood, single or divorced marital status, addiction to alcohol ordrugs, concomitant chronic physical or mental illness, past suicidal (...) attempt, adverse life events, staying in lodging homes or staying alone, or in areas with a changing population, all these conditions predispose people to suicides. The key factor probably is social isolation. An important WHO Study established that out of a total of 6003 suicides, 98% had a psychiatric disorder. Hence mental health professionals have an important role to play in the prevention and management of suicide. Moreover, social disintegration also increases suicides, as was witnessed in the Baltic States following collapse of the Soviet Union. Hence, reducing social isolation, preventing social disintegration and treating mental disorders is the three pronged attack that must be the crux of any public health programme to reduce/prevent suicide. This requires an integrated effort on the part of mental health professionals (including crisis intervention and medication/psychotherapy), governmental measures to tackle poverty and unemployment, and social attempts to reorient value systems and prevent sudden disintegration of norms and mores. Suicide prevention and control is thus a movement which involves the state, professionals, NGOs, volunteers and an enlightened public. Further, the Global Burden of Diseases Study has projected a rise of more than 50% in mental disorders by the year 2020 (from 9.7% in 1990to 15% in 2020). And one third of this rise will be due to Major Depression. One of the prominent causes of preventable mortality is suicidal attempts made by patients of Major Depression. Therefore facilities to tackle this condition need to be set up globally on a warfooting by governments, NGOs and health care delivery systems, if morbidity and mortality of the world population has to be seriously controlled . The need, first of all, is to identify suicide prevention as public health policy, just as we think in terms of Malaria or Polio eradication, or have achieved smallpox eradication. (shrink)

The article aims at elaborating a non-speculative concept of social pathology. In the first section, various conceptualizations (e.g. Habermas, Honneth) are critically revaluated. It is argued that (a) applying the originally medical concept of ‘pathology’ on social entities has untenable connotations (due to the lacking social equivalent of death); (b) grounding social pathology on the level of ‘social suffering’ is not in accordance with the actors’ horizon shaped by biomedical- and psy-discourses. To avoid these dead-ends, social pathologies are reinterpreted (...) as structural distortions causing diseases or mental disorders. To refine this initial definition, in the second section, Merleau-Ponty’s concept of chiasm is used as an ontological framework translating between medical and social diagnoses. The proposed concept of social pathology refers to those patterns of disrupted pre-intentional, intentional and mediated intertwining, which manifest as ill or psychopathological chiasm. In the third section, two case studies are elaborated: the intersubjective structures of depressed and asthmatic chiasm. Finally, the implications for critical theory and praxis are overviewed. (shrink)

Although the use of ECT has declined dramatically from its inception, this decrease has recently shown signs of leveling out because of ECT's powerful therapeutic effect in severely ill depressed individuals who either do not respond to pharmacologic alternatives or are too ill to tolerate a relatively lengthy drug trial. Notwithstanding its therapeutic benefits, ECT has also remained a controversial treatment modality, particularly in the eye of the public. Given the unsavory qualities associated with the word “electroconvulsive,” claims of possible, (...) probable, or even certain brain damage with ECT have easily found listeners. A careful, nonselective assessment of data covering the areas of pathology, radiology, electrophysiology, biochemistry, and neuropsychology leads both to certain conclusions and to certain unanswered questions. ECT is not the devastating purveyor of wholesale brain damage that some of its detractors claim. For the typical individual receiving ECT, no detectable correlates of irreversible brain damage appear to occur. Still, there remains the possibility that either subtle, objectively undetectable persistent deficits, particularly in the area of autobiographic memory function, occur, or that a rarely occurring syndrome of more pervasive persistent deficits related to ECT use may be present. Clearly, more research directed toward answering these questions needs to be carried out so that the role of ECT can be more rigorously defined. While such research is pending, however, we cannot expect that the conditions that predispose to clinical referrals for ECT will disappear. Given the misery, anguish, and risk of death by suicide, starvation, or debilitation associated with severe depressive illness, for example, it still appears that ECT, at least for the present, must continue to be available. (shrink)

The main aim of this paper is to reconstruct different aspects of the history of ideas of suicide, from antiquity to late modernity, and contemplate their dialectical tension. Reflexive suicide prevention, drawing on the ancient wisdom that the art of living is inseparable from the art of dying, takes advantage, it is argued, of the contradictory nature of suicide, and hence embraces, rather than trying to overcome, death, pain, grief, fear, hopelessness and milder depressions. This approach might facilitate the (...) transformation of inner shame to inter-personal guilt, which is the precondition for coping with losses through grieving that is shared with others. The traditional projection of suicide on the ‘Other’, reinforced by modernity’s bio-political suppression of death, has inhibited development of good suicide prevention. Awareness of the ambiguity and ambivalence found in suicide may work as a resource when measures are taken to address as many causal mechanisms as possible, and bringing special emphasis to external factors. (shrink)

This paper elucidates the structure of Toni Morrison’s novel, Beloved, using the framework of human emotions in response to grieving and death as developed by Elisabeth Kubler-Ross. Through her studies of terminally ill patients, Kubler-Ross identified five stages when approaching death: denial and isolation, anger, bargaining, depression and acceptance. These stages accurately fill the process that the character Sethe experiences in the novel as she learns to accept her daughter’s death.

In nursing ethics the role of narratives and dialogue has become more prominent in recent years. The purpose of this article is to illuminate a relational-narrative approach to ethics in the context of palliative nursing. The case study presented concerns a difficult relationship between oncology nurses and a husband whose wife was hospitalized with cancer. The husband’s narrative is an expression of depression, social isolation and the loss of hope. He found no meaning in the process of dying and (...) death. The oncology nurses were not able to recognize his emotional and existential problems. A narrative perspective inspired by relational ethics indicates that participants may develop a relational narrative that seeks good for all involved in a situation. In palliative nursing this entails open communication about the fragility of life and approaching death. In relational narratives, answers to these ethical dilemmas are co-authored, contingent and contextual. (shrink)