心と身体の架橋としての自殺論 : 精神科領域における自殺への治療的介入の倫理的問題

抄録

In the fields of medical service, the death of patients is regarded as a failure of medical care. Patients have rights to live and exercise their rights during the therapeutic process, so the therapist should respect their rights and perform medical care with all his energy in order to save the patients' life. As a result, medical care shows a marked tendency toward excessive intervention in order to prevent patients' death. In psychiatry, there are many patients who attempt suicide. Psychiatrists should encourage them to give up the idea of attempting suicide. To help patients avoid suicide, restrictions shoild be placed on therapeutic interventions such as psychological, pharmacological and physical restrictions. Most patients will give up suicide with appropriate treatment. But only a few psychotic patients think themselves to be not alive already. They are dead mentally and socially, but not dead only physically yet. There is deep discrepancy between their mind and body. They cannot die a natural death about their body, so attempt suicide as a linkage between their dead-mind and living-body to recall their lost identity again. Excessive intervention in order to prevent them from suicide will bring them more severe despair. They think they are deprived of their death, and believe they cannot only live but also die. We must know the facts and give patients the chance to recognize their true wishes to live, and we should try to look for some pieces of hope through alternative excessive restrictions.