The NYTimes’ Ethicist: Health and Ethics: Crossing the Line
The NYTimes’ Ethicist: Health and Ethics: Crossing the Line
Sometimes, parsing a problem makes it easier to solve. In his column in the November 1, 2017 New York Times Magazine, Kwame Anthony Appiah, The Ethicist, tries just that. In his advice to a person looking for guidance in dealing with a relative who is in “a deep depression,” and has said “he will kill himself,” Appiah starts by separating out the medical/healthcare aspects of the problem with a disclaimer:
“I have no psychiatric training, and even if I did, I wouldn’t be able to offer a diagnosis on the basis of the information you’ve provided. Your relative’s reckless decisions, as well as his current condition, I’ll grant, suggest that he’s struggling with mental-health issues. Within these constraints, however, there is a common-sense way of describing his situation.”
So, he states his intent to steer clear of psychiatric/diagnostic advice. He then proceeds to list problems in the relative’s life (the loss of an important relationship, money, house and career), and that, “I’d have thought it would be a sign of a mental disorder not to be unhappy in these circumstances.”
Perhaps unknowingly, he thus ventures into the realm of mental-health diagnosis. It can seem logical to think that a depressed, suicidal person’s circumstances are causing their depression. But, in fact, determining the cause of depression is part of the diagnostic process, which Appiah has stated that he is not qualified, and does not intend, to venture into.
Appiah then goes on to advise the writer to “talk to your relative about all this and try to help him think through his choices,” and concludes with, “Helping friends or family members see their own situation more clearly is one of the gifts of love.”
In part due to Appiah’s lack of clarity about the mental-health diagnostic process, he neglects the most important response to the writer’s question: “Is the moral and loving thing to do to let him continue the search for love, which ruins him, or should we try to intervene?”
Yes. The writer should try to intervene, as quickly and as effectively as possible, to try to prevent her relative from his stated intent to commit suicide, and to get him treated – effectively – for depression. Unfortunately, The Ethicist never mentions that option, which is, in this case, the most-urgent, and most-needed, gift of love.
First things first.