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Vol. 5. Issue 2.
Pages 107-120 (July - December 2019)
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Vol. 5. Issue 2.
Pages 107-120 (July - December 2019)
Original article
DOI: 10.1016/j.bioet.2019.02.005
A complete treatise on rational suicide
Un tratado completo sobre el suicidio racional
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183
Al Giwa
Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10128, United States
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Abstract

It was believed for a long time that people brought to the attention of healthcare and/or legal authorities with suicidality were automatically deemed to lack medical decision-making capacity or competence. This is despite many of these patients possessing the “mental ability to make a rational decision, which includes the ability to perceive, to appreciate all relevant facts and to reach a rational judgment upon such facts”. Several ethical and psychiatric specialists and defenders of patient rights have criticized this traditional paternalistic approach for failing to respect the right of a competent, rational person to self-determination and autonomy.

As society increasingly recognizes patients’ rights to refuse treatment, their autonomy to make decisions and the right to self-determination, the bioethical, medical and legal community must strive to identify those individuals who are not just impulsively acting and/or under the influence of factors that may hinder their capacity. As moral people who respect competent individuals who make rational decisions, regardless of whether we agree with them or not, we have a duty to respect their right to self-determination and suicide.

Keywords:
Suicide
Rational suicide
Autonomy
Capacity
Competence
Resumen

Durante mucho tiempo se ha sostenido que las personas que llamaron la atención de las autoridades sanitarias y/o legales con respecto al suicidio se consideraron automáticamente como carentes de capacidad para tomar decisiones médicas. Esto ocurre a pesar de que muchos de estos pacientes realmente poseen la “capacidad mental para tomar una decisión racional, que incluye la capacidad de percibir, apreciar todos los hechos relevantes y llegar a un juicio racional sobre tales hechos”. Varios especialistas en ética, psiquiatras y defensores de los derechos de los pacientes han cuestionado este enfoque paternalista tradicional al negarse a respetar el derecho de una persona racional competente a la libre determinación y la autonomía.

A medida que la sociedad reconoce cada vez más los derechos de los pacientes a rechazar el tratamiento, su autonomía para tomar decisiones y el derecho a la autodeterminación, la comunidad bioética, médica y legal debe esforzarse por identificar a aquellos individuos que no solo están actuando impulsivamente y/o bajo la influencia de factores que pueden dificultar su capacidad. Como personas morales que respetan a los individuos competentes que toman decisiones racionales, independientemente de que estemos de acuerdo con ellos o no, tenemos el deber de respetar su derecho a la autodeterminación y al suicidio.

Palabras clave:
Suicidio
Suicidio racional
Autonomía
Capacidad
Competencia

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