THE COUNSELING PSYCHOLOGIST / July 2000Silverman / RATIONAL SUICIDE
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REACTIONS
Rational Suicide, Hastened Death,and Self-Destructive Behaviors
Morton M. Silverman
University of Chicago
One of the 15 major recommendations from
The Surgeon General’s CalltoActiontoPreventSuicide
(U.S.PublicHeathService,1999)wasto“insti-tutetrainingforallhealth,mentalhealth,substanceabuse,andhumanserviceprofessionals (including clergy, teachers, correctional workers, and socialworkers) concerning suicide risk assessment and recognition, treatment,management,andaftercareinterventions.”Therefore,Icommendtheeditorsofthisjournalforpresentingthisspecialsetofarticlesdevotedtothetopicsof suicideassessment,intervention,andprevention,aswellastheroleofmentalhealth professionals in deliberations concerning rational suicide and has-tened death. These major contributions may well serve as the template forotherprofessionaljournalstoeducatetheirreadershipsaboutcurrentcontro-versies,challenges,andopportunitiesformentalhealthprofessionalsastheyengage in clinical encounters related to death and dying, dying with dignity,andtheassessment,treatment,andpreventionofsuicideandself-destructivebehaviors.In this response article I will elaborate on some of the more controversialissues raised by Werth and Holdwick (2000 [this issue]), as well as byWestefeld et al. (2000 [this issue]). Both articles are rich in ideas, concepts,andscientificdata.Iwillcommentontheimplicationsoftheseoverviewsforthe training and clinical practice opportunities of counseling psychologists.Mygoalsaretocriticallyanalyzecertainaspectsofthestateoftheartinthesefields to stimulate and challenge thinking about working with patients whochoose to end their lives. My own training, experience, and expertise aremorefocusedinthefieldsofsuicidologyandthepreventionofmentaldisor-ders than in the areas of death and dying. Therefore I will direct more of myresponses and reactions to these areas.Probablythemostcontroversialareawithinthefieldofsuicidologytodayrelates to the appropriate role for mental health professionals in decisionsaboutdeathanddying.Specifically,Irefertotheconceptsof
rationalsuicide
and
hastened death
, and the meanings and connotations that these termsengender. Many professional organizations have prepared statements and
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THE COUNSELING PSYCHOLOGIST, Vol. 28 No. 4, July 2000 540-550© 2000 by the Division of Counseling Psychology.
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