Sir, With regard to the continuing debate about assisted suicide, there are certain points concerning the suicidal state of mind that are not given sufficient consideration.
To begin with, there is the problem of concluding that a person has irrevocably lost all hope to live. My experience in caring for suicidal individuals has taught me that it is hazardous to assume that hope has gone forever. What is more, hope in suicidal persons can vary in intensity from time to time, even from one moment to the next. It is sometimes possible to revive hope, which may apparently have disappeared. In general the techniques involved may be deceptively simple.
One important component is to listen for as long as it takes, with a realistic yet positive and reassuring attitude towards continuing with what life still has to offer. A gentle, fully explained refusal to agree with despair can itself be very helpful as a way of instilling confidence and encouraging the wish to go on living.
I acknowledge the particular problem posed by severe irreversible physical illness: yet even in this case the above points are relevant. Adequate care must address both physical and psychological issues, promoting confidence that intolerable suffering, the prospect of which is of course so frightening, may well not be inevitable.
These considerations are essential in any worthwhile debate concerning assisted suicide. They explain why any conclusion that hope has become irreversibly lost is a particularly unreliable judgment to make.
Professor Gethin Morgan
Emeritus Professor of Mental Health, University of Bristol
I have added the emphasis to the sentence about the refusal to agree with despair, which seems to me to reflect the pastoral need that might arise at the bed side of a patient.
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