Predicting and diagnosing suicide not scientific

Predicting and Diagnosing Suicide Lacks Experts

The “expert” group on the Heads of Protection of Life During Pregnancy/Abortion Bill 2013 are today (May 20th) debating whether or not to allow abortion for women with suicidal ideation. Some experts say psychiatry can’t predict suicide. Yet prediction is an indication of scientific authenticity, therefore in simple syllogistic terms, psychiatry is not scientific so therefore is not a sound guide for prescribing abortion in suicidality.

In a timely confirmation to the foregoing conclusion a doctor (Ph.D. in science, not a medical doctor) has responded to a devastating act of killing/suicide by explaining in today’s (31/12/14) Irish Times:

There is a need to acknowledge that psychiatric risk assessment for suicide and violence is of extremely limited value in general psychiatric practice.

This was the conclusion arrived at by one of the world’s foremost experts on risk assessment research, Prof George Szmukler, two years ago.

Prof Szmukler concluded that rare events, such as suicide or serious violence – no matter how tragic they are or how much our society wishes us to prevent them – are impossible to predict with a degree of accuracy that is clinically meaningful.

Society expects psychiatrists to fulfil the role of predicting these risks, but the evidence is very clear – it cannot be done.

There is a need for an open and honest debate about this whole subject to try to find new ways forward to reduce the likelihood of such catastrophes happening again in the future.

Dr Ciaran Crummey,
Co Cavan.

First, it shows psychiatry is not a science. As Lord McColl of Durham, former professor of surgery at Guy’s, said in the Daily Telegraph:

There is a widespread, but unwarranted, notion among the public that medicine is an exact science. It isn’t: mistakes happen in diagnosis and prognosis… Lord Joffe was told by the Royal College of Pathologists that post-mortems¹ regularly reveal “significant errors”, including misdiagnosis of terminal illness, in around one in 20 cases.

Psychologist Linda Blair, in her weekly column for the Daily Telegraph, titled Beware the Dangers of Psychiatric Diagnosis, adds to the consensus that psychiatric diagnosis is not a science:

While doctors rely on tests for accurate diagnosis of an illness, psychiatrists can often only guess at problems. This means the potential for mistakes can be huge.

predict diagnose suicide psychiatry science authority abortion

John Locke: “Appeal to authority is a fallacy”

Relying on experts to predict and diagnose suicide is an appeal to authority, a fallacy first pointed out by the empirical philosopher John Locke.

Second, society and medical practitioners would be better off if all agreed that medicine, while a science in a test tube (in vitro), is not a science in vivo, i.e. when applied to a complex individual. Practitioners would then be free to practise medicine as an art as well as a science, as they should, then they and the public would be under less pressure to expect guaranteed results more typical of a mechanical science. Until then we all remain under a false hope as to our expectations of medicine… and some in society will continue to sneer at homeopathy – the art and science of medicine.

1. Post-mortems are useful for diagnosing. Dr James Tyler Kent explains:

Doctor: I can only treat when I know the cause.
Dr James Tyler Kent: When will you know the cause?
Doctor: After the post-mortem!

Further Reading
For more on medicine as art see my post here and posts on psychiatry

September 2016: The dramatic increase in filicide-suicide appears to largely coincide with an increase in the use of anti-depresssants.

Picture credit: WikiCommons

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