Canterbury Christ Church University, UK.
University of Birmingham, UK.
Health (London). 2022 Jan;26(1):10-26. doi: 10.1177/13634593211046843. Epub 2021 Sep 20.
Drawing on interview and online ethnographic data from a study of suicide on the railways, this paper describes the ways in which many of the concepts, assumptions and practices of mainstream suicide prevention are challenged in the accounts of those who are planning, or have enacted, a suicide attempt. We reflect on the ethical dilemmas which can arise for researchers (and practitioners) when lived experience accounts diverge - theoretically, morally and in terms of practical implications - from present-day expert ones. In online, 'pro-choice' suicide discussions, people describe beliefs, attitudes, ways of thinking and acting which stand in contrast to existing professional and clinical descriptions of suicide and suicidal behaviour. Most obviously, there is often a rejection of 'pro-life' positions, which are framed as ideological, oppressive and naïve. For researchers engaging in online ethnography of 'pro-choice' spaces, dilemmas can arise in relation to the representation of perspectives which fundamentally challenge not only prevailing norms within suicide research and prevention practice but socio-cultural norms more widely. Similar issues can arise when considering how best to represent research participants when their accounts diverge from accepted 'expert' knowledge and beliefs. In-depth qualitative interviews with those who have thought about or attempted to take their own life indicate that existing theories and models of suicide which start from assumptions of deficit and pathology underestimate the extent to which suicide, as the end result of an often-complex series of actions, requires a person to engage in logistical processes of planning, decision-making, imagination and adaptation. The accounts described here, gathered using two different methodological approaches, highlight the ethical issues which can surface when there are competing claims to (expert) knowledge, as well as differences in beliefs, attitudes and moral stance towards life and death. We argue that researchers need to reflect on their own ethical-moral position in relation to suicide, and on the practical consequences of their privileging of some voices at the expense of other, less well represented, ones.
本文借鉴了一项关于铁路自杀研究的访谈和在线民族志数据，描述了在那些计划或实施自杀企图的人的描述中，主流自杀预防的许多概念、假设和实践是如何受到挑战的。我们反思了当生活经验描述在理论上、道德上以及实际影响上与当前专家描述存在分歧时，研究人员（和从业者）可能会遇到的伦理困境。在在线的“选择死亡”自杀讨论中，人们描述了信仰、态度、思维方式和行为方式，这些方式与现有的专业和临床自杀和自杀行为描述形成了鲜明的对比。最明显的是，人们经常拒绝“生命至上”的立场，认为这些立场是意识形态的、压迫性的和幼稚的。对于从事“选择死亡”空间在线民族志研究的研究人员来说，当代表的观点不仅从根本上挑战了自杀研究和预防实践中的主流规范，而且挑战了更广泛的社会文化规范时，就会出现困境。当考虑如何最好地代表那些与公认的“专家”知识和信仰存在分歧的研究参与者时，也会出现类似的问题。对那些思考过或试图自杀的人进行深入的定性访谈表明，现有的自杀理论和模型从缺陷和病理学的假设出发，低估了自杀作为一系列复杂行动的最终结果，需要一个人参与规划、决策、想象和适应的逻辑过程的程度。本文描述的这些描述，是通过两种不同的方法收集的，突出了在存在竞争的（专家）知识主张以及对生与死的信仰、态度和道德立场存在差异时可能出现的伦理问题。我们认为，研究人员需要反思自己在自杀问题上的伦理道德立场，以及在优先考虑某些声音而牺牲其他声音时的实际后果，这些声音的代表性较差。
