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Theorizing the Intersections of Ableism, Sanism, Ageism and Suicidism in Suicide and Physician-Assisted Death Debates
Published in Joel Michael Reynolds, Christine Wieseler, The Disability Bioethics Reader, 2022
There are also disputes pertaining to the type of disability/sickness/illness that makes someone eligible for PAD, such as debates surrounding requests made solely on the basis of mental illness. On the one side is the idea that suicidality is caused by mental illness that impairs decision-making capacity and annihilates autonomy, and thus the desire to die in the absence of physical disability/sickness/illness is cast as abnormal or irrational (Creighton et al. 2017). On the other side, other bioethicists mobilize the parity argument to show that mental suffering can be as real and irremediable as physical suffering, therefore justifying the support for people with mental illness to access PAD without concomitant physical conditions (Appel 2007; Rich 2013; Kious and Battin 2019). These authors show that while terminality is a central criterion for allowing PAD in some national contexts, such as in the US, it is not the case in other national contexts such as the Netherlands or Belgium, which insist on unbearable suffering. However, when bioethicists support the extension of the right-to-die to mentally ill people, I contend that they do so on the basis of what they consider to be a severe and irremediable psychiatric diagnosis, thereby establishing a medical condition as the paramount criterion to justify PAD, leaving unexamined the ontology of PAD based on disability/sickness/illness, be it physical or psychological. In other words, the ontology of PAD rests upon a presumption that a medical diagnosis is necessary to justify assisted death.
Definitions of suicide and related terms
Published in Lorraine Bell, Helping People Overcome Suicidal Thoughts, Urges and Behaviour, 2021
SUICIDALITYis used broadly to include suicidal ideation (serious thoughts about taking one’s own life), suicide plans and “completed” or attempted suicide or the tendency of a person to die by suicide. Meyer et al (2010) argue the term “suicidality” is not as clinically useful as more specific terminology (ideation, behaviour, attempts and suicide).
Final reflection on suicidality after brain injury
Published in Alyson Norman, Life and Suicide Following Brain Injury, 2020
This paints a somewhat bleak picture for individuals who experience suicidality post-injury, but the literature does also highlight key protective factors that can reduce suicidal ideation. Good levels of social support, hope and religion or spirituality can help to mediate these feelings of suicidality (Brenner et al., 2009; Knight et al., 2019), as can building one’s own sense of self-worth (Knight et al., 2019). This identifies the importance of community rehabilitation and integration that focus on rebuilding the person’s life post-injury and increasing their access to wider social networks. Access to community rehabilitation increases the likelihood that individuals will be able to return to some form of employment or education post-injury (Brannigan et al., 2017). This is an important component in building self-worth (Khan, Baguley & Cameron, 2003).
Considerations when selecting an antidepressant: a narrative review for primary care providers treating adults with depression
Published in Postgraduate Medicine, 2023
C. Brendan Montano, W. Clay Jackson, Denise Vanacore, Richard Weisler
When initiating patients on antidepressant therapy, suicide risk must be monitored, as some antidepressants have been associated with an increased risk of suicidal thoughts and behaviors, particularly in children, adolescents, and young adults [48,61,62]. In 2004, the FDA directed manufacturers of all antidepressants to revise their labeling as the result of an increase in suicidality among children and adolescents being treated with antidepressants. This warning was based on a combined analysis of 24 short-term (up to 4 months), placebo-controlled trials of 9 antidepressant drugs among more than 4400 children and adolescents with MDD or other psychiatric disorders. A greater risk of suicide during the first few months of treatment was observed in patients receiving antidepressants (4% vs. 2% in patients receiving placebo) [62]. In 2007, the FDA revised the warning, changing the target period from childhood and adolescence to young adulthood (aged 18–24 years) during initial treatment [62]. However, clinicians should continue to monitor for suicidality in all patients being treated for depression with or without antidepressant medication.
Trends in Suicide Among Lesbian, Gay, and Bisexual Hispanic Individuals: National Violent Death Reporting System Data from 2012–2016
Published in Journal of Homosexuality, 2023
Luis R. Alvarez-Hernandez, Orion Mowbray
Suicide is influenced by a person’s experiences with mental health issues, alcohol and drug use, and mental health and substance use treatment engagement. Suicidality is an issue for those who experience psychosis (DeVylder, Lukens, & Link, 2015), posttraumatic stress disorder (Conner et al., 2014), and major depression (American Psychiatric Association, 2013). Excessive alcohol use has also been linked to completing suicide (Conner et al., 2014), and drug use among younger adults is associated with feelings of loneliness and suicidal ideation (Lamis, Ballard, & Patel, 2014). Individuals with co-occurring disorders (i.e., the presence of both mental health and substance use disorders) are also at risk for suicidal behavior (Yuodelis-Flores & Ries, 2015). However, in a systematic review spanning 10 years, Zalsman et al. (2016) found various levels of effectiveness among different treatment approaches for suicidality but ultimately concluded that various psychosocial and pharmacological prevention and treatment approaches were effective means to reduce suicide. Although mental health and substance use are factors associated with suicide, death by suicide in the United States is also a major public health concern for minoritized populations given their experiences with discrimination (Wang, Lin, & Wong, 2018).
Suicidality in patients with post-traumatic stress disorder and its association with receipt of specific secondary mental healthcare treatments
Published in International Journal of Psychiatry in Clinical Practice, 2023
Elena Opie, Nomi Werbeloff, Joseph Hayes, David Osborn, Alexandra Pitman
Suicidality was defined as suicidal ideation, behaviours and attempts (Meyer et al., 2010). We identified all patients with PTSD and recorded suicidality within the 6 months prior to, or 6 months after, a diagnosis of PTSD. Suicidality was measured using the Non-accidental self-injury scale (scale 2) on the Health of the Nation Outcome Scales (HoNOS) (Gowers et al., 1998). The HoNOS is a validated instrument (Pirkis et al., 2005) administered by clinicians to assess health and social functioning in individuals with mental health difficulties. The instrument includes 12 Likert-style scales rated from 0 (no problem) to 4 (severe problem) (Wing et al., 1998). The non-accidental self-injury scale in the HoNOS instrument reflects clinician judgement on a patient’s degree of suicidal ideation and behaviour (see Box 1).