The Taoiseach, the psychiatrist and the Pandora’s Box syndrome

Teasing out the moral distinctions involved in protection from suicide in differing circumstances

“It’s not so much the money as the principle, the Pandora’s Box syndrome.” Photographer: Dara Mac Donaill

“It’s not so much the money as the principle, the Pandora’s Box syndrome.” Photographer: Dara Mac Donaill

Fri, Jun 28, 2013, 12:00

A phone rings on the Taoiseach’s desk. He picks it up.
“Hello”.
“Hello, Taoiseach. It’s Dr Clarity, from the Mater hospital – psychiatric unit. You’ll remember I was on to you there a couple of weeks back?

“Oh yes, Doctor. A query about a patient of yours…”

“That’s right, Taoiseach. The poor man who felt suicidal on account of his bank putting pressure on him over a debt.”

“How is he progressing, Doctor?”

“Ah, well, unfortunately, he is no longer with us. Took his own life a month ago – a short time after our conversation, in fact. I’ll spare you the details.”

“Well, I’m very sorry to hear ...”

“Oh, I know that, Taoiseach…”

“But you understand, I think, that what was proposed was completely untenable and unprecedented?”

“Well, perhaps, Taoiseach. As I told you at the time, I was merely passing on his request. I didn’t have any strong position on the matter, and indeed to do so would have placed me outside my professional remit. I merely conveyed to you the nature of the man’s request, which I accept was rather unusual.”

“Indeed, Doctor. If I may say so, a rather eccentric request. The idea that the taoiseach of the day could simply write a cheque to pay off a bank debt simply because one of the bank’s customers claimed to be suicidal… well, eh… Much as I might sympathise with the man’s predicament….”

“Of course, Taoiseach. I understand. I appreciated your point that the Government cannot afford to establish precedents. And it was rather a lot of money.”

“Two million, If I remember rightly.”

“Yes, Taoiseach.”

“But, of course, eh, it’s not so much the money, Doctor, as the principle. The Pandora’s Box syndrome.”

“Yes, Taoiseach – opening the floodgates, as you put it.”

“Yes, Doctor. We don’t want half the country threatening to kill themselves, eh?”

“Indeed not, Taoiseach.”

“Anyway, Doctor, what can I do for you?”

“Ah, well, the thing is: I have another client who’s come in recently presenting something of the same dilemma.”

“Well, I’m afraid, Doctor, that my answer must be the same as before.”

“Yes, Taoiseach, I anticipated that this might be your response.”

“I hope that you will be able to assist this poor man to ensure that he doesn’t succumb to the same fate as the other poor chap.”

“Well, Taoiseach, there’s the thing: this time it’s not a man. It’s a woman.”

“A woman, you say?”

“Yes, Taoiseach, a woman.”

“I see.”

“The circumstances are broadly the same as before, except for that element. Even the quantum is in the same ballpark.”

“I see.”

“I’ve explained to her, naturally, what I understand the position to be. I did so only, I assure you, because she raised the issue herself – in much the same terms as the unfortunate man in the previous situation. But, of course, the fact of her being a woman seems to make it a bit different. I suppose the way I’m looking at it is that, in the near future, once the proposed legislation goes through the system, I’ll be dealing occasionally with women who’ll present me with the same dilemma in the rather different context of pregnancy, and that’ll be reasonably straightforward as a result of the legislation. So I wanted to be clear that I fully understand the principle you refer to. I suppose what I’m asking, essentially is: what am I to tell this woman and others like her? In the case of the man, I accept, it was somewhat radical to propose that the Government might have any role in preventing him from killing himself, particularly in the light of the rather large sum involved…”

“Well, as I said, Doctor, it wasn’t the money….

“And anyway, Taoiseach, I accept that there is no reasonable comparison.”

“Indeed, none.”

“After all, who ever heard of a man going to a doctor and demanding that his pregnant wife be subjected to a termination because he, merely the father, is feeling suicidal about having the responsibility of an additional, unexpected and possibly unwanted child?”

“Eh…”

“Even if his bank is threatening to put him and his rapidly expanding family out on the street.”

“Uh…”

“I hope you don’t mind, Taoiseach – I took the liberty of providing the lady in question with outline details of our previous conversation. It was she who broached the matter, pointing out that your Government has shown such a concern for women who claim to be suicidal in the pregnancy context. She wondered why there should be any moral distinction between the State having an obligation to prevent her from killing herself in the context of an unwanted pregnancy and saving her life in the circumstances in which she now finds herself. I admit that I was unable to give her a clear answer.”

“I see.”

“So I was hoping you might be able to assist me.”

To be continued.

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