THE STIGMA OF SUICIDE

JOHN COTTER,

JOHN COTTER,

Sir, - I read with interest the report of Professor Patricia Casey's views on suicide recently delivered at Knock. While I have no doubt she would do everything to try and reduce the appalling toll of suicide in our community, particularly by young people, I feel the proposals she moots, abeit personally expressed in a religious service of the faithful, are not the best way forward.

In the moral and social abyss that many young people can find themselves in, suicide indeed seems tempting, particularly in a society that values only consumption and material success, and where the institutions look morally and philosophically bankrupt. However in proposing a return to the stigmatisation, and consequently punishment, of suicide under the aegis of moral absolutism, one could row back the direction of centuries of ethical reflection on and change in the law about suicide. In any event stigma is mainly suffered by the survivors, adding to their burden.

One problem is that young people hold in contempt the religious absolutism that has delivered, as they see it, so much war and death.

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It has also arguably delivered many suicides historically, in particular the examples of Medina, Georgetown, the Christian martyrs and, of course, the military and paramilitary suicides of recent times spring to mind.

Youth cannot square the circle of qualified killing tolerated by many religious traditions with the commandment of non-killing. In a post-enlightenment, post-Darwinist, post-modernist reality, the old absolute certainties and rules simply ring hollow for many.

Who would be charged with policing these renewed cultural and religious sanctions? Just what sanctions are envisaged? Would secular humanists tolerate such sanction? Is there a way other than moral absolutism or arid secular humanism? Suicide should be discouraged at every opportunity.

As psychiatrists we know that beliefs about sin and damnation do not stop the mentally-ill from suicide and, in promoting their reinstatement, could further add stigma and shame to their acts. What then for the young? Practical sanctions against abusive drug and alcohol consumption might be the most effective measure.

In a wider context the challenge of society and the professionals engaged with this issue is perhaps to identify and be identified with a coherent ethic not of absolute, but of infinite value of human life, infinite hope, infinite courage and infinite compassion, without recourse to the moral absolutes as primary means of control.

I believe this is not only possible but indeed necessary. It may also point to an alternative way forward for the disconsolate and the despairing. - Yours, etc.,

Dr JUSTIN BROPHY, Consultant psychiatrist, Newcastle Hospital, Co Wicklow

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Sir, - Writing as one whose younger brother died by suicide about 10 years ago, I find Dr Patricia Casey's reported remarks (August 20th) to pilgrims at Knock most offensive.

Dr Casey's endorsing of the stigmatising of suicide is quite perverse if not disingenuous. She purports to care for "vulnerable people" while at the same time inciting the stigmatising of the most vulnerable. This is a thinly veiled version of Jim McDaid's "selfish bastards" comment earlier this year.

In perhaps the most profound book on the subject, Suicide and the Soul, James Hillman eloquently debunks the theological prejudice implicit in Dr Casey's remarks: "it does not follow that suicide because it is anti-theological must be ungodly or irreligious. Cannot suicide prompted from within also be a way for God to announce the time to die?"

As David Hume wrote in his brief essay On Suicide: "When I fall upon my own sword, therefore, I receive my death equally from the hands of the Deity as if it has proceeded from a lion, precipice, or a fever."

It was inappropriate, to say the least, for Jim McDaid, as a medical doctor, to make such a callous remark in a public forum. Dr Casey's remarks are even more inappropriate, given her very public profile as an expert on suicide. Moralistic finger-pointing that panders to a communal sense of self-righteousness can only worsen the isolation of the most vulnerable and thus make more likely the "evil" that Dr Casey would condemn. - Yours, etc.,

JOHN COTTER, Ballykeeffe, Limerick

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Sir, - I am fascinated by Patricia Casey's recent attribution of the blame for increasing suicide rates in Ireland to the increasing secular humanism. This is presumably based on the lack of caring for others evident among amoral humanists, who seem to be the cause of so many of the country's modern evils.

Her solution, to reintroduce the long (and, we are to presume, mistakenly) fought-against stigma surrounding suicide is thoughtful. It suggests a way of reducing our suicide rate without having to bother with providing support services for the depressed and suicidal. One simply returns to the old way where the family of the deceased, concerned to preserve the memory of their lost relative, pressurises medical staff, coroners and the general public to ascribe their loved one's death to a "tragic accident" or "death by misadventure" or some such other cause. That has always kept the rate down in the past and could do so again in the future.

Presumably such a stigma could be promoted by the religious amongst us, allowing them (quite justifiably) to take the credit for lowering the suicide rate, thus demonstrating that the more power that the religious establishment has in a country, the more caring its citizens. - Yours, etc.,

JAIME HYLAND, Berlin

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Sir, - Dr Patricia Casey, Professor of Psychiatry at UCD, told pilgrims at the annual Knock Shrine Novena in Co Mayo that taboos and sanctions serve useful functions in controlling social behaviour (August 20th). She said: "I also wonder if by removing the cultural and religious sanctions against it (suicide) we are unwittingly presenting it to vulnerable people as an option in some circumstances."

This address took place only yards from a huge monument to Pope John Paul II, whose promotion of taboos and religious sanctions against homosexuality have led many young people to commit suicide. The good doctor would preserve the very source of some of the suicides she seeks to prevent! - Yours, etc.,

DECLAN KELLY, Rathfarnham, Dublin