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Abstract
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BACKGROUND: In recent decades the literature on suicide and suicidal behaviour has been predominantly characterized by psychiatric research results on epidemiology, clinical issues, and preventive measures. However, results from humanistic research could provide a fertilization of reflection on the anthropological significance of suicide.
OBJECTIVE and method: After exploring the dichotomy between a philosophical and a medical paradigm of suicidal behaviour, the paper suggests a pragmatic compromise. Practical approaches are thereby mainly concerned with ethical feasibility. Various lines of thought are discussed as a starting point for the formulation of the psychiatric respectively philosophical paradigm. An anthropological position is explored as a compromise. Brief digression on the examination of the legitimacy of a physician-assisted suicide.
RESULTS: A stringent as well as a moderate position within both paradigms can be formulated. Compatibility is achieved through the medical holistic view of the human being, consisting of five dimensions. The formulation of five feelings (anxiety, anger, helplessness, ambivalence, and power) that are symmetrical to the physician, the patient, and the society could illuminate the question of the importance of the therapeutic relationship in dealing with humans at suicide risk. This view is embedded in the holistic medical perspective of the human being.
DISCUSSION: The psychiatric-medical paradigm has its justification on the level of medical intervention, while the philosophical paradigm is helpful in the reflection on tragic suicide circumstances. It is, hence, detached from intervention imperatives. A medical-anthropological position is able to connect both paradigms through a holistic, medical view of the human being, especially regarding the dimension of therapeutic relationship. The question of the legitimation of assisted suicide points to the necessity of medical answers beyond the curative self-understanding of the medical profession.
Language: en |