본 논문은 자살을 현존을 넘어서는 ‘무제약적 행위’로 규정하는, 아직 국내에서는 다뤄지지 않은 야스퍼스의 자살론을 철학상담적관점에서 모색하고, 자살에 대한 실존철학적 이해를 도모한 뒤, 철학상담에서 자살위기에 내몰린 내담자를 도울 방안을 모색한다. 본 논문은 내담자로 하여금 자신이 당면한 문제를 비판적으로 성찰하게 한 뒤, 어떤 문제가 계속 살기를 포기하게 만드는지, 그 이유의 정당성을 합리적으로 검토하게 하고, 이를 넘어서서 죽어야할 이유가 아닌, 살아야 할 이유에 대해 질문의 초점을 달리함으로써 새로운 희망과 삶의 의미를 발견할 가능성을 상담자와 함께깊이 반성해봄으로써 자살위기의 내담자를 돕는데 목표를 둔다. 이를 위해 우선 (...) 고대에서부터 현재까지 이어져 온 자살에 대한 다양한 논의들을 몇몇 철학자들을 중심으로 살펴본 뒤, 이러한 이해를 바탕으로 무제약적 행위에 대한 결의론을 통해 실존론적 자살론을 발전시키는 야스퍼스의 철학적 논의를 이어갈 것이다. 그런다음 야스퍼스의 자살론을 철학상담에 적용하여 자살 담론의 지평을 확장해보고자 한다. (shrink)

Philosophical discussions of the morality of suicide have tended to focus on its justifiability from an agent’s point of view rather than on the justifiability of attempts by others to intervene so as to prevent it. This paper addresses questions of suicide intervention within a broadly Kantian perspective. In such a perspective, a chief task is to determine the motives underlying most suicidal behaviour. Kant wrongly characterizes this motive as one of self-love or the pursuit of happiness. Psychiatric (...) and scientific evidence suggests that suicide is instead motivated by a nihilistic disenchantment with the possibility of happiness which, at its apex, results in the loss of the individual’s conception of her practical identity. Because of this, methods of intervention that appeal to agents’ happiness, while morally benign, will prove ineffective in forestalling suicide. At the same time, more aggressive methods violate the Kantian concern for autonomy. This apparent dilemma can be resolved by seeing suicide intervention as an action undertaken in non-ideal circumstances, where otherwise unjustified manipulation, coercion, or paternalism are morally permitted. (shrink)

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon “near-suicide”. This study attempted to explore this phenomenon by examining how the seriousness of the patient’s illness or injury and the subjective evaluation of the patient’s and family’s financial situation after paying treatment fees affect the final decision on the (...) treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families’ financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost–benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients’ likelihood of making “near-suicide” decisions and improve social equality in the healthcare system. (shrink)

Despite its enduring insights, Durkheim’s theory of suicide fails to account for a significant set of cases because of its overreliance on structural forces to the detriment of other possible factors. In this paper, we develop a new theoretical framework for thinking about the role of culture in vulnerability to suicide. We argue that by focusing on the cultural dynamics of excessive regulation, particularly at the meso level, a more robust sociological model for suicide could be (...) offered that supplements structure-heavy Durkheimian theory. In essence, we argue that the relevance of cultural regulation to suicide rests on the (1) degree to which culture is coherent in sociocultural places, (2) existence of directives related to prescribing or proscribing suicide, (3) degree to which these directives translate into internalized meanings affecting social psychological processes, and (4) degree to which the social space is bounded. We then illustrate how our new theory provides useful insights into three cases of suicide largely neglected within sociology: specifically, suicide clusters in high schools, suicide in the military, and suicides of “despair” among middle-aged white men. We conclude with implications for future sociological research on suicide and suicide prevention. (shrink)

Patients with serious illnesses or injuries may decide to quit their medical treatment if they think paying the fees will put their families into destitution. Without treatment, it is likely that fatal outcomes will soon follow. We call this phenomenon “near-suicide”. This study attempted to explore this phenomenon by examining how the seriousness of the patient’s illness or injury and the subjective evaluation of the patient’s and family’s financial situation after paying treatment fees affect the final decision on the (...) treatment process. Bayesian Mindsponge Framework (BMF) analytics were employed to analyze a dataset of 1042 Vietnamese patients. We found that the more serious the illnesses or injuries of patients were, the more likely they were to choose to quit treatment if they perceived that paying the treatment fees heavily affected their families’ financial status. Particularly, only one in four patients with the most serious health issues who thought that continuing the treatment would push themselves and their families into destitution would decide to continue the treatment. Considering the information-filtering mechanism using subjective cost–benefit judgments, these patients likely chose the financial well-being and future of their family members over their individual suffering and inevitable death. Our study also demonstrates that mindsponge-based reasoning and BMF analytics can be effective in designing and processing health data for studying extreme psychosocial phenomena. Moreover, we suggest that policymakers implement and adjust their policies (e.g., health insurance) following scientific evidence to mitigate patients’ likelihood of making “near-suicide” decisions and improve social equality in the healthcare system. (shrink)

Human suicide presents a fundamental problem for the scientific analysis of behavior. This problem has been neither appreciated nor confronted by research and theory. Almost all other behavior exhibited by humans and nonhumans can be viewed as supporting the behaving organism's biological fitness and advancing the welfare of its genes. Yet suicide acts against these ends, and does so more directly and unequivocally than any other form of maladaptive behavior. Four heuristic models are presented here to account (...) for suicide in an evolutionary and sociobiological framework. The first model attributes suicide to the extraordinary development of learning and cultural evolution in the human species. Learning may make human behavior so independent of biological constraints that it can occasionally assume a form entirely contrary to the principles of biological evolution. The second model attributes suicide to a breakdown of adaptive mechanisms in extremely stressful novel environments. The third model involves kin and group selection, arguing that in limited circumstances suicide may occur because of beneficial effects it has on other, surviving individuals who share the suicidal individual's genes. The last model suggests that suicide should be tolerated by evolution when it has no effect on the gene pool. This model holds particular promise in accounting for aspects of suicide not attributable to culture. The evidence indicates that suicide is most common in individuals who are unlikely to reproduce and unable to engage in productive activity; such individuals are least capable of promoting their genes. A complete explanation of suicide may derive only from an analysis of its biological significance. (shrink)

Arguments concerning central issues of contemporary Medical Ethics often not only bear similarities, but also derive their sheer essence from notions which belong to the celebrated history of Ethics. Thus, argumentation pro euthanasia and assisted suicide which focus on the detainment of dignity and the ensuring of posthumous reputation on behalf of the moral agent is shown to echo stoic views on arête and the subordination of life to the primary human goal, namely the achievement of virtue. The progress (...) made in palliative care when seen alongside the — steadily increasing — requests for suicide, is indicative of the fact that, though pain now days can be effectively controlled, moral agents often consider the preservation of their life detrimental to the detainment of virtue or posthumous reputation. The stoic view is considered to justify elective death as a personal choice, but is deemed inadequate as well as inconsistent in the broader context of a coherent value theory. (shrink)

ABSTRACTGrounded in Emotional Cascade Theory, we explored whether rumination and multisensory imagery-based cognitions moderated the relationships between affect and both odds of non-suicidal self-injury, and frequency of the behaviour. A sample of 393 university students completed self-report questionnaires assessing the constructs of interest. Contrary to expectations, rumination did not emerge as a significant moderator of the affect-NSSI relationship. However, the relationship between affect and frequency of NSSI was moderated by the use of imagery. Further, the relationship between negative affect (...) and NSSI was moderated by positive affect, underscoring the need to consider both negative and positive affect in models of NSSI. Most youth who self-injured reported thinking in images while the urge to self-injure was strong, with 53% thinking in images at least half the time. Future work is needed to explore how positive and negative affect work in concert to govern NSSI, and how imagery might eit... (shrink)

In contrast to the fruitful relationship between psychoanalysis/psychoanalysts and the humanities, institutionalized psychoanalysis has been largely resistant to the integration of psychoanalysis with other empirical branches of knowledge, as well as clinical ones [primarily cognitive-behavioral therapy ]. Drawing from two decades of theoretical and empirical work on psychopathology, psychotherapy, and psychoanalysis, the author aims to show how a reformulation of object relations theory using psychological science may enhance a clinical-psychoanalytic understanding and treatment of suicidal depression, which constitutes one of (...) the most formidable health challenges of our time. Specifically, he rewrote the notion of Melanie Klein positions—primarily the depressive position—using extant knowledge of structure of emotions, the centrality of mental representations of the future and the toxic nature of criticism-based emotions. This reformulation enables a dialog between clinical psychoanalysis and other therapeutic schools of thought and sheds light on the understanding and treatment of suicidal depression. (shrink)

ABSTRACT The technological revolution has created enormous opportunities for the provision of affordable, accessible, and flexible mental healthcare. Yet it also creates complexities and ethical challenges. While some of these challenges may be similar to face-to-face care, their nuance in the online milieu is different, as relationships, identities and boundaries in this setting are fluid, and there is an absence of physical presence. In this paper we consider the specific ethical complexities involved in the provision of a social networking intervention (...) for depression and problematic alcohol use involving providers and peers. We present a case in which clinicians encountered a participant who repeatedly expressed suicidal thoughts in this online forum, and reflect on how this situation was managed. In analyzing this case, we use relational ethics—which proposes that interpersonal relationships are the fulcrum for ethical decision-making and action—together with actor-network theory—which highlights the power of technology to transform and mediate social and ethical relationships. Our analysis demonstrates the need to move beyond human-centric approaches, to recognize the role of both human and non-human actors in shaping moral decisions and behavior in the provision of e-mental healthcare. (shrink)

A substantial portion of Adam Smith's discussion of Stoicism in TMS VII is dedicated to the Stoic “principle of suicide,” according to which suicide is sometimes morally required. While scholars agree that Stoicism exercised considerable influence over Smith, no recent work has explored his views on suicide, despite the central role it plays in his treatment of Stoicism. I argue that Smith opposes the principle of suicide on both epistemic and moral grounds, providing an important critique (...) of Stoicism. I also show how Smith departs from other early modern accounts of suicide by offering a notably humane analysis of this tragic act. I conclude by considering what Smith's discussion of Stoicism and suicide tells us about his moral theory, and I forward a reading of Smith as a skeptic. (shrink)

A principle of paternalism must be able to answer three questions. Who are the persons who are the proper object of paternalism? Which actions should we prevent persons from doing or induce them to perform? What should our goals be when acting paternalistically toward these persons? A satisfactory principle will also be reasonably precise in distinguishing appropriate from inappropriate instances of paternalism, and it will be comprehensive, speaking to most potential cases, including suicide. My purpose is not to reach (...) a conclusion about the acceptability of paternalistic restrictions on suicide. Rather, because such a conclusion will follow from the way in which a principle of paternalism is formulated, I want to examine several liberal attempts at formulation and the theoretical background underlying these attempts. (shrink)

Richard Brandt, following Hume, famously argued that suicide could be rational. In this he was going against a common ‘absolutist’ view that suicide is irrational almost by definition. Arguments to the effect that suicide is morally permissible or prohibited tend to follow from one’s position on this first issue of rationality. I want to argue that the concept of rationality is not appropriately ascribed – or withheld – to the victim or the act or the desire to (...) commit the act. To support this, I explore how the concept is ascribed and withheld in ordinary situations, and show that it is essentially future-oriented. Since the suicide victim has no future, it makes no sense to call his act rational or irrational. The more appropriate reaction to a declared desire for suicide, or to the news of a successful suicide, is horror and pity, and these are absent from Brandt’s account, as is a humble acknowledgement of the profound mystery at the heart of any suicide. (shrink)

Kant formulated a secular argument against suicide’s permissibility based on what he regarded as the intrinsic value of humanity. In this paper, I first show that Kant’s moral framework entails that some types of suicide are morally permissible. Just as some homicides are morally permissible, according to Kant, so are suicides that are performed according to equivalent maxims. Intention, foreseeability, voluntariness, diminished responsibility, and mental capacity determine the moral characterization of the killing. I argue that a suicide (...) taxonomy that differentiates types of suicide according to morally relevant criteria is compatible with Kantian ethics; it establishes that even where we hold a robust deontological sanctity of life position, we are not obligated to preserve the lives of people whose future life only offers profound suffering, and helping them to die may be justifiable if doing so honors their dignity and autonomy. Nevertheless, homicide and suicide are only weakly morally symmetrical in that even if a given suicide is morally impermissible, we do not normally have the right to prevent it forcibly, though this may be altered by juridical laws under some circumstances. (shrink)

Chapter one argues for the important contribution that a natural law based framework can make towards an analysis and assessment of key controversies surrounding the practices of suicide, assisted suicide, and voluntary euthanasia. The second chapter considers a number of historical contributions to the debate. The third chapter takes up the modern context of ideas that have increasingly come to the fore in shaping the 'push' for reform. Particular areas focused upon include the value of human life, the (...) value of personal autonomy, and the rejection of double effect reasoning. Chapter four engages in the task of pointing out structural weakness in utilitarianism and deontology. The thesis argues that major systemic weaknesses in both approaches can be overcome by a teleology of basic human goods. John Finnis' work becomes the underpinning of subsequent applied natural law analysis. Chapter five proceeds to argue for the defence of the intrinsic good of human life from direct attack. The thesis holds out for the proposition "that it is always a serious moral wrong to intentionally kill a human person, whether self or another, regardless of a further appeal to consequences or motive." In support of this, it defends the validity of double effect reasoning as an indispensable part of applied moral decision making. Chapter six critically assesses the arguments of anti-perfectionists that it is not the business of the state to enforce deep or substantive conceptions of the 'good life.' The chapter moves on to argue that the natural law conception of the person in society, centred on the common good, provides a solid framework for assessing both the justification for, as well as the limits on, the role of the state to use its power to legally impose certain moral standards. Chapter seven addresses the concrete relationship between natural law and legal policy by exploring the issue of assisted suicide in the constitutional context of the United States.















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abstract In his ‘Suicide Intervention and Non‐Ideal Kantian Theory’ (2002), Michael J. Cholbi argues that nihilism and hopelessness are often motivating factors behind suicide, contrary to Immanuel Kant's prescribed motive of self‐love. In light of this, Cholbi argues that certain paternalistic modes of intervention may not only be effective in preventing suicide, but are ultimately consistent with Kantian morality. This paper addresses certain perceived shortcomings in Cholbi's account of Kantian suicide intervention. Once the psychological complexities (...) of the suicidal person are brought to bear, the suicidal person is found in many cases to be irrational at the time of her death. Because of this, rationalistic intervention strategies may prove ineffective, despite their being consistent with Kantian morality, and despite instances of suicide being non‐ideal circumstances. Cholbi assumes throughout his article that suicidal human beings remain Kantian moral agents. However, because rationality represents a crucial criterion for Kantian moral agency, and because certain human beings who commit suicide are not rational, such human beings are not Kantian moral agents. Because Cholbi's intervention strategies are not applicable to (or effective towards) irrational suicidal people, his account is found incomplete. (shrink)

Peña-Guzmán (2017) argues that empirical evidence and evolutionary theory compel us to treat the phenomenon of suicide as continuous in the animal kingdom. He defends a “continuist” account in which suicide is a multiply-realizable phenomenon characterized by self-injurious and self-annihilative behaviors. This view is problematic for several reasons. First, it appears to mischaracterize the Darwinian view that mind is continuous in nature. Second, by focusing only on surface-level features of behavior, it groups causally and etiologically disparate phenomena (...) under a single conceptual umbrella, thereby reducing the account’s explanatory power. Third, it obscures existing analyses of suicide in biomedical ethics and animal welfare literatures. A more promising naturalistic approach might seek a theoretical understanding of the social/ecological circumstances that drive humans and perhaps other animals to self-destruction. (shrink)

Although in Italy there is currently no effective law on physician-assisted suicide or euthanasia, Decision No. 242 issued by the Italian Constitutional Court on September 25, 2019 established that an individual who, under specific circumstances, has facilitated the implementation of an independent and freely-formed resolve to commit suicide by another individual is exempt from criminal liability. Following this ruling, some citizens have submitted requests for assisted suicide to the public health system, generating a situation of great uncertainty (...) in the application processes. As a matter of fact, shared and defined procedures are lacking as Decision 242/2019 merely added some principles on which the legislature will have to base its future intervention. This paper analyses the advisory role that the Decision attributes to territorial ethics committees with the aim of stimulating discussions on their role in oversight mechanisms. The proposed conclusion is that the envisaged role does not appear consistent with the functions of these bodies and is ultimately substantially undefined and unjustified. (shrink)

Suicide is considered a global public health issue and compulsory admission is a commonly used measure to prevent suicide. However, the practice has been criticised since several studies indicate that the measure lacks empirical support and may even increase suicide risk. This paper investigates whether the practice has enough empirical support to be considered proportionate. To that end, arguments supporting compulsory admission as a suicide-preventive measure for most suicidal patients are scrutinized. The ethical point of departure (...) is that the expected benefits of compulsory admission should outweigh the potential harms of the measure to be proportionate and defensible. It is concluded that, for most suicidal patients, suicide-preventive compulsory admission cannot be presumed to be a proportionate measure. To be so, the expected medical benefits of the measure should be greater than the potential increase in suicide risk and other harms that compulsory admission could entail. Instead of using compulsory admission as a suicide-preventive measure, extra safety measures may be needed during and after compulsory admission to prevent the risk of hospitalisation-induced suicide. (shrink)

Through a series of texts and phone calls, Michelle Carter encouraged her boyfriend Conrad Roy to act on his suicidal thoughts, and after Roy killed himself, Carter was convicted of involuntary manslaughter. The case has received widespread attention, generating reactions ranging from rage at Ms. Carter to disbelief that she was convicted. An issue emphasized up to now is what it might mean for the First Amendment right of free speech if we hold that words can kill. In presenting the (...) case against punishing Ms. Carter, I show how the free speech issue intertwines with several others: Should the intimate exchanges between Carter and Roy have remained private? While privacy is valuable, it should not be a shield for harmful conduct, but did Ms. Carter, through her words, cause harm? If she believed that suicide would relieve Conrad of unbearable suffering, did she even act badly? And should the fact that society judges an individual’s actions to be immoral mean that the individual should be legally punished? The case serves as a touchstone for addressing fundamental issues of political, moral and legal theory with implications broader than whether Ms. Carter goes to prison. (shrink)

The aim of this paper is to investigate how different liberal theories can be applied in order to explain and assess honour suicide cases in the Batman area of Turkey. In the first section of the study, the general framework of these theories and their viewpoints regarding gender inequality in a multicultural world will be analyzed. The second section will explain socio-economic facts about Turkey, its Southeastern region and the Batman area. The last section will outline how these theories (...) are inadequate in explaining and solving the Honour-Suicide problem in Batman and why an alternative approach must be taken in order to assess this case. (shrink)

There is a growing trend among some physicians, psychiatrists, bioethicists, and other mental health professionals not to treat physician-assisted suicide (PAS) as suicide. The grounds for doing so are that PAS fundamentally differs from other suicides. Perhaps most notably, in 2017 the American Association of Suicidology argued that PAS is distinct from the behavior that their organization seeks to prevent. This paper compares and contrasts suicide and PAS in order to see how much overlap there is. Contrary (...) to the emerging view that emphasizes their differences, I argue that there is significant overlap such that we ought not to separate PAS into its own category, making it diverge from how we think about and address suicide more generally. I start by examining several prominent theories of suicide and argue that PAS fits squarely within them. I then examine several apparent differences between PAS and other kinds of suicide and argue that these differences are merely apparent or they do not justify treating PAS as a fundamentally different kind of thing from suicide. (shrink)

Ethnic minority status and female gender convey a risk for suicidal behavior, yet research of suicidality of ethnic minority female immigrants is scarce. The authors of this article conducted qualitative interviews with 15 young women in the Netherlands, who either had attempted suicide or contemplated suicide, and analyzed these in a narrative psychology tradition. Suicidality was associated with despair and frustration over the violation of the women’s personal autonomy and self-integrity regarding strategic life choices. Autonomy restrictions and violations (...) followed two patterns, which are interconnected with four criteria regarding the capacity for autonomy. Findings are discussed with referral to Durkheim and feminist theories of autonomy. (shrink)

A wide body of psychological research corroborates the claim that whether one’s life is (or will be) meaningful appears relevant to whether it is rational to continue living. This article advances conceptions of life’s meaningfulness and of suicidal choice with an eye to ascertaining how the former might provide justificatory reasons relevant to the latter. Drawing upon the recent theory of meaningfulness defended by Cheshire Calhoun, the decision to engage in suicide can be understood as a choice related (...) to life’s meaningfulness insofar as an individual can see no point in investing her agency in her anticipated future. These meaning-based reasons relevant to suicidal choice either cannot be reduced to the reasons of well-being that philosophers have typically used to analyse suicide decisions or at least forms a distinct class of reasons within those that contribute to well-being. (shrink)

The great majority of species that lived on this earth have gone extinct. These extinctions are often explained by invoking changes in the environment, to which the species has been unable to adapt. Evolutionary suicide is an alternative explanation to such extinctions. It is an evolutionary process in which a viable population adapts in such a way that it can no longer persist. In this paper different models, where evolutionary suicide occurs are discussed, and the theory behind (...) the phenomenon is reviewed. (shrink)

Several writers have recently developed proposals calling for a public policy that would allow a number of individuals to commit suicide if they so choose. Suicide, it is argued, is a fundamental matter of personal liberty and as such only very minimal restrictions should be placed on it. In this essay I offer a critique of these views and the public policies they entail. The result is a defense of the general outlines of current professional and legal policies (...) which permit intervention, even coercive intervention, with suicidal persons in almost every case. (shrink)

Several writers have recently developed proposals calling for a public policy that would allow a number of individuals to commit suicide if they so choose. Suicide, it is argued, is a fundamental matter of personal liberty and as such only very minimal restrictions should be placed on it. In this essay I offer a critique of these views and the public policies they entail. The result is a defense of the general outlines of current professional and legal policies (...) which permit intervention, even coercive intervention, with suicidal persons in almost every case. (shrink)

Defends Kantian paternalism: Interference with an individual’s liberty for her own sake is justified absent her actual consent only to the extent that such interference stands a reasonable chance of preventing her from exercising her liberty irrationally in light of the rationally chosen ends that constitute her conception of the good. More specifically, interference with an individual’s liberty is permissible only if, by interfering, we stand a reasonable chance of preventing that agent from performing actions she chose due to distorted (...) reasoning and which would result in that agent’s rationally chosen ends not being as fully realized as they would have been had she so acted. -/- Applied to suicide intervention Kantian paternalism implies that such intervention is justified to the extent that it prevents a person from ending her life when, due to distorted reasoning, she engages in suicidal behavior that is at odds with her rationally chosen ends. (shrink)

Resumen: El presente trabajo trata de la relación entre la misión suicida y el concepto de suicidio. Las misiones suicidas se han convertido en un importante instrumento de lucha política en la era contemporánea. Desde el punto de vista del atacante, el suicidio es una condición para el éxito de la acción y, desde el punto de vista del análisis, un concepto regulador que permite comprender las relaciones entre el individuo y la sociedad. Ahora bien, el concepto de suicidio puede (...) ser insuficiente o tener cargas ideológicas que hacen difícil cernir las características esenciales de dicho tipo de acto. Revisaremos, con criterios contemporáneos, algunos de los principales aspectos de la noción de suicidio definida por Durkheim, y cómo la llamada teoría del progreso es un instrumento teórico utilizado políticamente para desacreditar las misiones suicidas.: We treat in this article the relation between the suicide mission and the concept of suicide. Suicide missions have become an important instrument of political struggle in present era. From the point of view of the attacker, suicide is a condition for the success of the action, and, from the point of view of the analysis, it is regulator concept, which allows understanding the relations between the individual and the society. Nevertheless, the concept of suicide might be insufficient or might be ideologically loaded. Because of this, it might render difficult to grasp the essential characteristics of that act. It will be necessary to examine, with contemporary criteria, some of the principal aspects of the notion of suicide defined by Durkheim, as well as the way in which the so-called theory of progress is a theoretic instrument politically used to discredit suicide missions. (shrink)

In recent years, much has been learned about the strategic and organizational contexts of suicide attacks. However, motivations of the agents who commit them remain difficult to explain. In part this is because standard models of social learning as well as Durkheimian notions of sacrificial behavior are inadequate in the face of the actions of human bombers. In addition, the importance of organizational structures and practices in reinforcing commitment on the part of suicide recruits is an under-explored factor (...) in many analyses. This essay examines the potential applicability of evolutionary models of altruism to the understanding of commitment to suicide on the part of terrorist organizational recruits. Three evolutionary models of sacrificial behavior in nonhuman species and many categories of human behavior are explored cross-organizationally: reciprocity, inclusive fitness theory, and induced altruism. Reciprocal altruism is unlikely to be a major motivator in suicide attacks because the costs exhibited by attackers are too high to be adequately compensated. However, the role of evolved self-deception in perceptions of personal death, and thus of rewards in the afterlife, is potentially illuminating. Inclusive fitness theory can help explain the motivations of attackers because rewards to kin often are offered by organizations to suicide recruits. However, suicide bombers also often act out of revenge for the loss of or injury to relatives, and inclusive fitness theory generally, as well as more specific theoretical models of retaliatory aggression, may not adequately account for the bombers' actions. Predictions from induced altruism theory appear to be well supported because suicide terror organizations tend to be tightly structured around practices intended to maintain and reinforce commitment though the manipulation of kinship-recognition cues. (shrink)

The past 20 years have seen dramatic rises in suicide rates in the U.S. and other countries around the world. These trends have been identified as a public health crisis in urgent need of new solutions and have spurred significant research efforts to improve our understanding of suicide and strategies to prevent it. Unfortunately, despite making significant contributions to the founding of suicidology – through Emile Durkheim’s classic Suicide (1897 [1951]) – sociology’s role has been less prominent (...) in contemporary efforts to address these tragic trends, though as we will show, sociological theories offer great promise for advancing our understanding of suicide and improving the efficacy of suicide prevention. Here, we review sociological theory and empirical research on suicide. We begin where all sociologists must: with Durkheim. However, we offer a more comprehensive understanding of Durkheim’s insights into suicide than the prior reviews provided by those in other disciplines. In so doing, we reveal the nuance and richness of Durkheim’s insights that have been largely lost in modern suicidology, despite being foundational to all sociological theories of suicide – even those that have moved beyond his model. We proceed to discuss broadly acknowledged limitations to Durkheim’s theory of suicide and review how more recent theoretical efforts have not only addressed those concerns, but have done so by bringing a larger swatch of sociology’s theoretical and empirical toolkit to bare on suicide. Specifically, we review how recent sociological theories of suicide have incorporated insights from social network theories, cultural sociology, sociology of emotions, and sociological social psychology to better theorize how the external social world matters to individual psychological pain and suffering. We conclude by making explicit bridges between sociological and psychological theories of suicide; by noting important limitations in knowledge about suicide – particularly regarding the roles of organizations, inequality, and intersectionality in suicide – that sociology is well situated to help address. (shrink)

There are widely held premises that suicide is almost exclusively the result of mental illness and there is “strong evidence for successfully detecting and managing suicidality in healthcare”. In this context, ‘zero-suicide’ policies have emerged, and suicide risk assessment tools have become a normative component of psychiatric practice. This essay discusses how suicide evolved from a moral to a medical problem and how, in an effort to reduce suicide, a paternalistic healthcare response emerged to predict (...) those at high risk. The evidence for the premises is critiqued and shown to be problematic; and it is found that strong paternalistic interventions are being used more often than acknowledged. Using a Principles approach, the ethics of overriding autonomy in suicide prevention is considered. Ethical concerns are identified with the current approach which are potentially amplified by the use of these risk assessments. Furthermore, it is identified that the widespread use of risk assessments in health settings is equivalent to screening without regard to the ethical principles of screening. The essay concludes that this is unethical; that we should abandon the use of standardized suicide risk assessments and ‘zero-suicide’ policy; and that this may improve outcomes. (shrink)

Suicide as a form of political protest is a little studied social phenomenon that cannot be dismissed simply as being irrational or patholognomic. We consider protest suicide to be a meaningful social action as purposive political act intended to change oppressive policies or practices. This paper synthesizes theoretical propositions associated with suicide in general, and protest suicide in particular, so as to construct a general explanatory model of protest suicide as a social phenomenon. Then, it (...) analyzes protest suicide as a meaningful social action. People considering protest suicide have to discern the logic of the situation in which such action is to take place. This involves answering two fundamental questions: Is suicide an acceptable course of social action? Is the envisaged protest suicide likely to achieve their hopes, aspirations and goals? How these questions are answered gives rise to a set of protest suicide archetypes. Our analysis generates a more sophisticated understanding of the potential reasons for, and motivations behind, protest suicide as a social phenomenon. (shrink)

In a recent article in this journal, Rolf Ahlzén treats a moral problem related to physician-assisted suicide and the notion of authenticity. The problem is whether considerations of a patient’s “true self” should be included in judgments of PAS. In this short commentary, it is argued that Ahlzén neglects to attend to central contributions to the philosophy of authenticity, provides an internally inconsistent theory thereof, and conflates crucial distinctions in the debate.

Suicide is complex; yet suicide research is dominated by ‘psy’ disciplines which can falter when seeking to explain social patterning of suicide rates, and how this relates to individual actions. This article discusses a multidisciplinary report which aimed to advance understandings of socioeconomic inequalities in suicide rates in the UK. Contrasts are drawn between health psychology and sociology. Important intersections are highlighted, including a lack of attention to socioeconomic inequalities, and an emphasis on adverse life experiences (...) and emotions to understand inequalities and suicide. There are also curious disconnects, both within and between relevant psychological and sociological perspectives. The article argues that there are significant gaps in existing theorization regarding suicide, which can only be addressed through meaningful inter-disciplinary collaborations between sociologists, psychologists and others. Current theorization in mainstream suicide research is limited by its failure to engage with enduring, yet vitally important sociological debates regarding structure and agency, nature and culture. (shrink)

It is plausible that what possible courses of action patients may legitimately expect their physicians to take is ultimately determined by what medicine as a profession is supposed to do and, consequently, that we can determine the moral acceptability of voluntary euthanasia and physician-assisted suicide on the basis of identifying the proper goals of medicine. This article examines the main ways of defining the proper goals of medicine found in the recent bioethics literature and argues that they cannot provide (...) a clear answer to the question of whether or not voluntary euthanasia and physician-assisted suicide are morally acceptable. It is suggested that to find a plausible answer to this question and to complete the task of defining the proper goals of medicine, we must determine what is the best philosophical theory about the nature of prudential value. (shrink)

Le suicide collectif apparaît comme une aberration sociale, une extrême anomalie de la culture. Et si c'était au contraire l'aboutissement de toute collectivisation achevée? Si c'était la destinée cachée - sectaire et mystique - de toute histoire commune, de toute pensée unique? Admettons-le, ne serait-ce qu'un moment. Nous sommes alors contraints de bouleverser notre perception de la vie sociale et politique. Celle-ci ne devrait pas sa survie à la recherche d'unité bien-gérée, mais aux " trous " dans le collectif (...) ; à la résistance des corps vivants, et non à l'Esprit qui tente de les fondre en une mortelle idéalité commune. La théorie freudienne du " lien de masse " rend compte de cette dérive fatale des collectifs idéalisés. Sous- estimée par les sciences sociales, elle permet de lire ce qu'il advient aujourd'hui de nos sociétés saisies dans l'imago d'une " secte-monde ", et du péril majeur qui les y guette. Elle permet aussi, rétroactivement, d'analyser l'histoire occidentale comme une suite d'oscillations entre la capture fatale par l'Idéal et le retour à la pluralité vivante des Corps. Est-ce dans ce balancement, cette danse entre Corps et Esprit, que la culture humaine résiste au cours des temps à la fascination narcissique? (shrink)

In 2017, Italy passed a law that provides for a systematic discipline on informed consent, advance directives, and advance care planning. It ranges from decisions contextual to clinical necessity through the tool of consent/refusal to decisions anticipating future events through the tools of shared care planning and advance directives. Nothing is said in the law regarding the issue of physician assisted suicide. Following the DJ Fabo case, the Italian Constitutional Court declared the constitutional illegitimacy of article 580 of the (...) criminal code in the part in which it does not exclude the punishment of those who facilitate the suicide when the decision has been freely and autonomously made by a person kept alive by life-support treatments and suffering from an irreversible pathology, the source of physical or psychological suffering that he/she considers intolerable, but fully capable of making free and conscious decisions. Such conditions and methods of execution must be verified by a public structure of the national health service, after consulting the territorially competent ethics committee. This statement admits, within strict and regulated bounds, physician assisted suicide, so widening the range of end-of-life decisions for Italian patients. Future application and critical topics will be called into question by the Italian legislator. (shrink)

Sociological theory on the phenomenon of suicide continues to rely heavily upon the Durkheimian perspective. While such accounts are valuable additions to the field, engagement with alternative theoretical traditions may likewise be stimulating and provide distinct concepts to delve into the issue. This article contributes to expanding sociological understanding of suicide by drawing upon Pierre Bourdieu’s theory, a relatively untapped resource in the study of suicide. I suggest that the concept of hysteresis – a mismatch (...) between embodied and objectified structures – enables an understanding of under what circumstances agents may become vulnerable to suicide. I then theorise how socioeconomic, political, and cultural dynamics may deepen the hysteresis effect and increase the chances that individuals in specific social positions experience it. Finally, I argue that individuals’ responses to such distress depend on their space of possibles: the culturally laden idea of suicide and alternatives to it. (shrink)

Proponents of assisted suicide who base their arguments on autonomy err in ways that are little attended to. In the absence of a substantive theory of the good, in neither a descriptive nor an ascriptive sense can the concept of autonomy distinguish those acts that should be morally prohibited from those that may be permitted. And to impose a particular theory of the good, whether individual liberty or the sanctity of life, violates the autonomy of those who (...) do not share a commitment to that theory. (shrink)

Objectives: To discover what factors affect lay people’s judgments of the acceptability of physician assisted suicide and euthanasia and how these factors interact.Design: Participants rated the acceptability of either physician assisted suicide or euthanasia for 72 patient vignettes with a five factor design—that is, all combinations of patient’s age ; curability of illness ; degree of suffering ; patient’s mental status , and extent of patient’s requests for the procedure .Participants: Convenience sample of 66 young adults, 62 middle (...) aged adults, and 66 older adults living in western France.Main measurements: In accordance with the functional theory of cognition of N H Anderson, main effects, and interactions among patient factors and participants’ characteristics were investigated by means of both graphs and ANOVA.Results: Patient requests were the most potent determinant of acceptability. Euthanasia was generally less acceptable than physician assisted suicide, but this difference disappeared when requests were repetitive. As their own age increased, participants placed more weight on patient age as a criterion of acceptability.Conclusions: People’s judgments concur with legislation to require a repetition of patients’ requests for a life ending act. Younger people, who frequently are decision makers for elderly relatives, place less emphasis on patient’s age itself than do older people. (shrink)

Over the last 25 years, suicide attacks have become an alarming threat. They are a political tool which has been adopted by several organizations in Sri Lanka, Palestine and the Occupied Territories, Turkey, Chechnya, Afghanistan, Pakistan and, in particular, by the Al-Qaeda-led insurgency in Iraq in its struggle against the US and its allies. Recent analyses have traced back the use of suicide terrorism to its `strategic logic': organizations and their militants resort to suicide attacks mainly because (...) they view this form of violence as an efficient weapon for their revolutionary and nationalist campaigns. An explanation based on the paradigm of rational choice theory or instrumental rationality alone is, however, insufficient. This article suggests the importance of combining the paradigm of instrumental rationality with that of axiological rationality. Only this kind of explanation is able to clarify the crucial role played by those cultural and symbolic elements which justify and encourage the martyrdom of suicide attackers. Moreover, by adopting a multi-causal analysis of the armed organizations, their constituencies and the attackers, as well as of their interaction, the article outlines a theoretical model of the most important social mechanisms underlying the use of suicide tactics. (shrink)