Self-Harm and Medicine's Moral Code: A Historical Perspective, 1950–2000

In: Cresswell , M & Karimova , Z 2010 , ' Self-Harm and Medicine's Moral Code: A Historical Perspective, 1950–2000 ' , Ethical Human Psychology and Psychiatry , vol. 12 , no. 2 , pp. 158-175 . https://doi.org/10.1891/1559-4343.12.2.158

Abstract

"Deliberate self-harm"— acts of self-poisoning (overdosing) or self-injury (e.g., cutting) that do not result in death — has historically provoked a moral judgment in those professionals who treat it. Such judgments negatively value the act of self-harm and lead to the discriminatory treatment of self-harmers in accident and emergency departments and upon psychiatric wards. This article argues that the treatment of self-harmers in such environments has its origins in a "moral code" that negatively values the act of self-harm in comparison to (a) suicide, (b) the accident victim, and (c) individuals considered to be "genuinely" physically ill. The article fulfi lls two functions. First, it tracks the history of "medicine's moral code" as it surrounds self-harm in the British context during the period 1950–2000. Then it turns to examine the ways in which patients groups — so-called psychiatric survivors — resisted such discriminatory treatment in the period 1988 –2000. Such resistance, the article concludes, creates the opportunity for a democratic dialogue to develop between patient groups and service providers that could potentially ameliorate the deleterious effects of medicine's moral code. The article's tone is polemical and is expressly written from a perspective sympathetic to the political claims of "survivors," which the authors conclude forms a central component in the development of democratic practices within medicine and psychiatry.