The Medicalization of Suicide in England: Laymen, Physicians, and Cultural Change, 1500-1870

Abstract

Defining a behavior as a medical problem can change both its moral and legal consequences. Responses to suicide were secularized in the late seventeenth and eighteenth centuries as coroners' juries increasingly adopted the medical explanation for self-destruction and excused suicides as innocent lunatics who were not criminally responsible for their act. It was medical laymen, however, not physicians, who were the principal champions of the medical explanation as they sought to alleviate the effects of the suicide laws on survivors. The change in societal attitudes and responses to suicide illustrates both the negotiated quality of disease definition and the way in which formal medical thinking constituted only one factor in a diverse political, religious, and cultural context.

Scientism as a Social Response to the Problem of Suicide

“…Historians of early modern Europe have therefore questioned the view that the medicalization of suicide was comprehensive and widespread, a result of the powerful influence afforded the medical profession, and that it marked a clear shift from the moral to the scientific-from the prescriptive to the descriptive (Houston 2009;MacDonald 1989). Rather, they see a wider cultural and political context for medicalization in which the medical profession played only a minor role.…”

“…Rather, they see a wider cultural and political context for medicalization in which the medical profession played only a minor role. A more prominent role is accorded the social and cultural environment in which scientism, Enlightenment humanism, and romanticism brought profound changes in understandings of self and society (Macdonald 1989). The emergence in Western Europe of an unprecedented common space in which the public, linked through the print media and small group or local exchanges, began to discuss matters of common interest also had considerable normative force in changing public opinion and practices (Taylor 2007).…”

“…The emergence in Western Europe of an unprecedented common space in which the public, linked through the print media and small group or local exchanges, began to discuss matters of common interest also had considerable normative force in changing public opinion and practices (Taylor 2007). Emerging from this public debate was a view of suicide as a relatively commonplace, albeit tragic, human event-the result of various circumstances: illness, poverty, physical suffering, love, grief, shame, poverty, honour, and humiliation (MacDonald 1989;Minois 2001)-while the response of organizations such as the Royal Humane Society demonstrated a pastoral concern for suicidal persons in recognizing that these people can and should be helped (Colt 2006).…”

Consideraciones acerca de la conducta suicida de pacientes hospitalizados y responsabilidad del médico tratante

“…El suicidio es un problema humano que se ha medicalizado 3,4 , lo que de por sí ya genera un problema bioético 3 , pero que se puede entender por la alta correlación entre las conductas autolíticas y enfermedad mental 5 . La especialidad médica que lidia preferentemente con este tipo de enfermedades es la psiquiatría, lo que hace que estos especialistas enfrenten la problemática del suicidio de manera más frecuente que otros médicos.…”

“…Está demostrado, sin embargo, que existe una alta correlación entre el suicidio y los trastornos mentales 14,15 , cuyo tratamiento realizan médicos, y de aquí la progresiva medicalización del problema 3,4 . Pese a esta asociación es importante no perder de vista que el suicidio es un fenómeno mucho más complejo, que trasciende los límites de la enfermedad mental y la medicina, siendo conocidos los ejemplos de conductas suicidas en otros contextos como ocurre en una serie de situaciones sociales, como manifestación de descontento social, como opción de honorabilidad, como una muerte altruista o ante enfermedades somáticas terminales o que involucran dolor o limitaciones crónicas 16,17 .…”