Ethical And Cultural Dimensions In Suicidal Behavior Workbook Activity - Case Study Example

458138 Ethical And Cultural Dimensions In Suicidal Behaviour Workbook Activity Activity Suicide in Australia (601) According to the group, Living is for Everyone (2007), " Around 2,000 Australians die by suicide every year, affecting families, friends, work places and communities" (p. 1). This means that the individual created a specific act against themselves that caused them to die. Males were more often the ones who committed suicide than women and usually the age group was 20 to 34 years old. In females, the highest rate of suicide was in the elderly (for 2006) between the ages of 70 and 74, age groups for elderly men seemed to be higher at 85 years and over. Jones (2010) suggests that many of these suicides could be a result of workplace stress. The study that is quoted in this particular blog post supports this idea because many people who go into a workplace are unstable and have mental health challenges. Another issue is that some people who become first responders to a suicide can suffer a problem called "compassion fatigue" which can cause them to have different ideas about what suicide is and does to people. According to Mindframe National Media Initiative (2010) migrant suicides tend to mirror the suicide rates in the country of origin of the individual. In countries where the suicide rate is high, the immigrants coming to the host country are more at risk of suicide. In Australia, 25% of the suicides are in migrants with 60% being from non-English speaking countries. Those at higher risk of suicide are those who do not want to migrate to anther country. Also, when they come to Australia and cannot assimilate easily into the new culture, they are at risk for suicide (Mindframe National Media Initiative, 2010). Often socio-cultural factors that can contribute to suicide ideation include stressful situations, not being able to take care of the family well, drug or alcohol use and low acculturation into the new community. According to the Commonwealth of Australia (2010) the cost of suicides every year can be set in the billions of dollars but it cannot be easily seen because suicide is underreported. Part of the challenge seems to be that frontline staff often has no awareness of suicide and how it can be prevented. This study suggests that there should be more information given to people who are within social service organizations, hospitals and schools about suicide, suicide ideation and people how have previously attempted suicide. This information may help prevent future suicide attempts. The Commonwealth suggests that there are many socio-cultural factors that can put a person at risk of suicide. As an example, if an individual feels isolated, this could mean that they would take their life. Many people who had family members who committed suicide also withdrew from their support networks, quit their jobs and often moved out of their homes where their loved one had committed suicide. The toll for them was often as difficult as it was for the person who committed suicide (Commonwealth of Australia, 2010). Unfortunately, it is difficult to understand how many people actually die from suicide because it must be reported as such. In many cases, suicide cannot be determined because it can look like accidental death. The first responders to the scene (e.g. the police) or the coroner must make this determination. The statistics for suicide in Australia seem to be similar to the suicide rate nationally and internationally. The Department of Health and Aging (2003) suggests that suicide was 2.2% of deaths across the globe and in their study the suicide rates primarily suggested youth and young adults to be the ones most likely to commit suicide nationally. Activity 2 Philosophical interpretations of suicide (399) There are a variety of ways that people interpret suicide. As an example, Berman, Silverman, and Bongar (2000) state that in most religions, the body and the soul are two different entities. This means that it is only the body that dies in death. This creates in some religions a death cult attitude in that the physical death by suicide is a release from the world that has created problems for the individual into a better place. In this study, when researching suicides in Chicago, most people stated that it was a release from a troubled life or it was a transition to an afterlife that would be better. There are several philosophical interpretations in addition to the religious ideas. Kantian perspective would suggest that an individual was doing harm against themselves in suicide and therefore was in violation of ones duty to self (Berman, Silverman and Bongar, 2000, p. 475). Further, the Kantian perspective would suggest that the individual was throwing themselves away, which would be wrong. In contrast, the Utilitarian perspective would suggest that would be more interested in the consequences of the suicide not only for the individual but for the people around them. They would submit suicide as a wrong act if it would cause harm to anyone be it financial harm, emotional, social or legal harm (Berman, Silverman and Bongar, 2000). In these cases, the suicide should not take place. In addition, Goldsmith (2001) states that in those countries or regions where Catholicism is greater, suicide rates are lower because Catholics believe that suicide is a sin. Another study quoted in Goldsmiths study showed that Protestants were more apt to commit suicide than other religions. When cross cultural investigations of suicide take place, it would seem that the philosophical implications would be more important in the prevention of suicide than in actual suicide completions. The investigators would have more opportunity to help someone who had either attempted suicide and not completed it or in preventing suicide with certain groups. Colucci (2008) states that religion must be taken into consideration when dealing with suicidology. In most cases, psychiatrists are reluctant to add this component as a way of understanding what the individual was thinking prior to their attempt. Usually, an individuals ideas of love, hope, meaning and purpose in life are attached to some spiritual or religious belief and this is important to their recovery. Activity 3: Arguments For And Against Assisted Suicide And Euthanasia (401) Generally speaking, most countries say that assisted suicide is nothing more than murder. Central to a discussion on Euthanasia is the voice of Jack Kevorkian also known as Dr. Death who assisted many people in their own suicides before he spent time in jail for murder. His controversial work brought assisted suicide into the mainstream media. On the side of those who say that assisted suicide and euthanasia are a good thing, the right to die is at the top of the list. According to The First Post (n.d.), the pros of assisted suicide say that an individual should have a right to choose their way of dying and their time if their quality of life is terrible; they should have the right to stop their suffering. Those people who assist them to have a quiet and peaceful death should not be prosecuted because the euthanasia laws do not work. On the against side, people suggest that because life is something sacred, it should not be terminated whenever someone wants it to happen. Also, people who are terminally ill or who are suffering from a long lasting disease, are more vulnerable and may be able to be talked into assisted suicide so they can ease their familys burden in taking care of them (The First Post, n.d.). In many cases, doctors in hospitals assist with euthanasia when a patient has requested assistance. Often, society sees this as a way that the doctor allowed the individual to end their suffering. Goldney (2001) studied euthanasia and states that there must always be safeguards for the patients when a doctor is going to assist. Many states and countries have enacted legislation about assisted suicide. According to Nightingale Allegiance (n.d.) many states in the U.S. have laws against assisted suicide and these usually fall under general homicide laws Humphry (2005) states that in many countries, the laws are not well defined but this does not mean that someone would go free if they assisted in suicide. As example, Sweden does not have an actual law against assisted suicide, but they prosecute this under manslaughter charges. Finland is more relaxed about it if an individual tells law enforcement that they assisted and the circumstances of the assist. Most countries seem to have the understanding that a crime has been committed in assisted suicide and this is the only principle upon which the legislation has been developed. Activity 4: Malpractice Liability (395) Liability and malpractice are issues that happen when discussing suicide and euthanasia. A clinician must be careful in what they do and say during the process of working with someone who is showing suicidal ideation. Cantor and McDermott (1994) suggest that there must be three issues that are clear in order to avoid malpractice: 1) practitioners must have a degree of skill that works with suicide 2) they must have exercised reasonable care in assisting the suicidal patient and 3) they must be able to prove that they used their best judgement. The individual would need to prove that they took enough precautions in light of the individuals behaviour and mental health to help them before they made the suicide attempt or completed it. In a clinical setting, this means that two questions must be satisfied: 1) "Was the clinicians evaluation sufficiently thorough to assess suicidiality" and if so, 2) "were adequate prevention measures taken, given the risk?" (Cantor and McDermott, 1994, p. 413). The clinician must also be able to show that communication was clear between parties and that there was enough information from both sides to help the individual. The Connecticut State Department of Education (2004) suggests that any policy and procedural manual should include information about risk factors, risk categories, protective factors, resources, curriculum materials and outside resources. Their information is geared towards teens and it is important to give information to teens about suicide and their risks of it. Ministry of Health New Zealand (2003) suggests that anyone talking about suicide should be taken seriously and certain precautions should be taken to insure their safety. A suicide assessment should be done, case notes should be taken from the beginning, and staff must have proper training in order to assist. In Australia, the Duty to Care states that when an individual suggests they want to commit suicide, their level of distress and degree of risk must be assessed. Once this is understood, the practitioner must attempt to defuse the emotional distress and find ways to intervene to insure the individuals safety. Next, the individual must be referred to an agency that can give long term support and they must be linked to emergency services if necessary (MensLine Australia, 2010). Although a clinician can take many precautions, it is not know whether everything they do will hold up in a court of law. References Berman, M.R.W., Silverman, M.M., and Bongar, B.M., (2000). Comprehensive textbook of suicidology. Pt. 4, Chapter 19. Ethical, religious and philosophical issues in suicide. 473-479. NY: Guilford Press. Cantor, C.H. and McDermott, P.M. (1994). Suicide litigation: From legal to clinical wisdom. Australian and New Zealand Journal of Psychiatry. 28, 431-437. Colucci, E. (2008). Recognizing spirituality in the assessment and prevention of suicidal behaviour. World Cultural Psychiatry Research Review (WCPRR), 77-95. September 14, 2010 from http://www.wcprr.org/pdf/03- 02/2008.02.7795.pdf Commonwealth of Australia. (2010). The hidden toll: Suicide in Australia. Retrieved September 14, 2010 from http://www.aph.gov.au/senate/committee/clac_ctte /suicide/report/report.pdf Connecticut State Department of Education. (2004). Guidelines for suicide prevention: Policy and procedures. Retrieved September 14, 2010 from http://www.sde.ct.gov/sde/lib/sde/PDF/DEPS/Student/PsychSocial/SP_Guidelines .pdf Department of Health and Aging. (2003). International suicide rates: recent trends and implications for Australia. Retrieved September 14, 2010 from http://www.health.gov.au/internet/main/publishing.nsf/content/mental-pubs-i- intsui Goldney, R. (2001). Euthanasia: The Australian experience in Diego, L. (2001). Suicide and euthanasia in older adults: A transitional journey. 172-179. WA: Hogrefe and Huber. Humphry, D. (2005). Tread carefully when you help to die: Assisted suicide laws around the world. Euthanasia Research & Guidance Organization. Retrieved September 14, 2010 from http://www.assistedsuicide.org/suicide_laws.html Guthiel, T. G. (1999). Liability issues and liability prevention in suicide. In Jacobs, D.G. The Harvard medical school guide to suicide assessment and intervention. CA: Jossey Bass. Jones, K. (2010). New suicide report has something to say about workplace mental health. Safety At Work Blog. Retrieved September 14, 2010 from http://safetyatworkblog.wordpress.com/2010/06/28/new-suicide-report-has- something-to-say-about-workplace-mental-health/ Goldsmith, S.K. (2001). Reducing suicide: A national imperative. Chapter 6, Society and culture. 193-227. Washington DC: National Academy Press. Ministry of Health New Zealand. (2003). The assessment and management of people at risk of suicide For emergency departments and mental health service acute assessment settings. Retrieved September 14, 2010 from http://www.nzgg.org.nz/guidelines/0005/acf50e.pdf MensLine Australia. (2010). Duty to care suicide and self harm. Retreived September 13, 2010 from http://www.menslineaus.org.au/Duty-of-care.html Nightingale Allegiance. (n.d.). Legal status of assisted suicide/euthanasia in the United States. Retrieved September 14, 2010 from http://www.nightingalealliance.org/pdf/state_grid.pdf The First Post. (n.d.). Pros and cons of assisted suicide. Retrieved September 14, 2010 from http://www.thefirstpost.co.uk/45778,news-comment,news-politics,pros-and- cons-assisted-suicide Living is for Everyone. (2007). Fact sheet 3: Statistics on suicide in Australia. Retrieved September 14, 2010 from http://www.livingisforeveryone.com.au/ IgnitionSuite/uploads/docs/LIFE-Fact%20sheet%203.pdf Mindframe National Media Initiative. (2010). Reporting suicide and mental illness: A resource for media professionals. Retrieved September 14, 2010 from http://www.mindframe-media.info/site/index.cfm?display=84370 Read More