Fitzpatrick Scott J
Narrat Inq Bioeth. 2014 Summer;4(2):147-60. doi: 10.1353/nib.2014.0047.
Moral constructions of suicide are deliberately avoided in contemporary suicidology, yet morality persists, little or imperfectly acknowledged, in its practices and in the policies, discourses, and instruments that it underpins. This study used narrative methodologies to examine the normative force of suicidology and its implications for persons who had engaged in an act of nonfatal suicidal behavior. I interviewed a convenience sample of twelve persons from two inner-urban community mental health centers who were receiving crisis and case management services after a recent act of nonfatal suicidal behavior. Interviews focused on events leading up to and after participants' suicidal behavior; the responses their suicidal behavior generated in others, including family, friends, and the health professionals caring for them; and cultural views of suicide more broadly. Analysis of these interviews revealed that, although participants' narratives were broadly consistent with a number of recognizable, canonical story formats common to our cultural repertoire of stories of suicide, they also revealed important tensions, divisions, conflicts, and challenges to contemporary suicidological discourse and practice. Despite evidence to suggest that biomedical understandings of suicide provided some therapeutic benefit to participants, they did not address important social and moral dimensions of human life or explore their connection to suicidal behavior-aspects of the suicidal event that were critical to its causation and to its retelling and "resolution." The results of this study provide important insights into the moral features of suicidal behavior, the moral and ethical implications of suicide research, and the limitations of moral and ethical discourse in suicidology.
当代自杀学刻意回避自杀的道德建构，但道德在其实践以及作为其基础的政策、话语和手段中持续存在，只是很少得到承认或承认得并不充分。本研究采用叙事方法来审视自杀学的规范力量及其对有过非致命自杀行为的人的影响。我从两个城市中心社区心理健康中心抽取了一个便利样本，对12名近期有过非致命自杀行为后正在接受危机和病例管理服务的人进行了访谈。访谈聚焦于参与者自杀行为前后的事件；他们的自杀行为在他人（包括家人、朋友和照顾他们的健康专业人员）身上引发的反应；以及更广泛的自杀文化观点。对这些访谈的分析表明，虽然参与者的叙述在很大程度上与我们文化中一系列可识别的、典型的自杀故事形式一致，但它们也揭示了当代自杀学话语和实践中重要的紧张关系、分歧、冲突和挑战。尽管有证据表明对自杀的生物医学理解给参与者带来了一些治疗益处，但它们没有涉及人类生活的重要社会和道德层面，也没有探讨这些层面与自杀行为的联系——这些自杀事件的方面对其成因以及复述和“解决”至关重要。本研究结果为自杀行为的道德特征、自杀研究的道德和伦理影响以及自杀学中道德和伦理话语的局限性提供了重要见解。
