Sargent D A, Jensen V W, Petty T A, Raskin H
JAMA. 1977 Jan 10;237(2):143-5. doi: 10.1001/jama.237.2.143.
Psychological barriers in the minds of the failing physician, his family, and colleagues may thwart prevention of physician-suicide. The failing physician may be shunned by colleagues for his disturbed behavior. He denies illness, resorts to self-medication, and avoids treatment. Recognition and rational handling of this presuicidal state may be hindered by the need of the doctor, family, and colleagues to preserve a fantasy of the doctor's omnipotence. Treatment also may be impeded by the failing physician's reluctance to form a therapeutic relationship with the treating psychiatrist. The psychiatrist must help his doctor-patient to determine if he should continue practicing. The key to successful intervention may depend solely on our awareness and handling of these problems.
意志消沉的医生本人、其家人及同事心中的心理障碍可能会阻碍对医生自杀行为的预防。意志消沉的医生可能因其行为失常而被同事们回避。他否认患病，自行用药，并拒绝治疗。医生、家人及同事维护医生无所不能这一幻想的需求，可能会阻碍对这种自杀前状态的识别和合理应对。意志消沉的医生不愿与主治精神科医生建立治疗关系，这也可能会妨碍治疗。精神科医生必须帮助他的患者（即这位医生）确定是否应该继续行医。成功干预的关键可能完全取决于我们对这些问题的认识和处理。
