An Alternative to Suicide?

A healthy man who wants to kill himself and a sick one who wants to live but is doomed for lack of a vital organ appear to have little in common. But Psychiatrist Paul H. Blachly of the University of Oregon Medical School believes that they have something to offer each other. He advocates a "symbiotic juxtaposition" of the two--bringing them together so that the potential suicide can gain a new outlook on life by donating either blood or an organ to the person who needs it to live.

Writing in the current issue of Life-Threatening Behavior, the new official journal of the American Association of Suicidology,* Psychiatrist Blachly suggests that the suicidal person who wants to destroy his whole body may find an alternative in sacrificing just part of it. When Eisenhower was suffering repeated heart attacks, Blachly recalls, at least 20 people offered him their hearts; such offers frequently come from people who are looking for a way to die. But that death wish might be purged, he reasons, if the donor gives an organ that is not essential to his own life. People who donate a kidney, Blachly notes, often experience "a sustained feeling of satisfaction and of being noble," and their personal relationships frequently become more satisfying.

Non-Fatal Sacrifices. Even more important in Blachly's thinking is the fact that suicides decrease in wartime and other periods demanding personal sacrifice; then, he says, "the intensity of egoism and anomie is diminished as the individual participates in a common social goal." To put his theory into practice, Blachly proposes an alliance between organ-transplant centers and some of the many suicide-prevention services that are now in existence. The services, which usually offer psychiatric help to callers, would refer appropriate cases to transplant centers as possible donors. The customary two-or three-month waiting period before surgery would give psychiatrists time to study the would-be donor's motives and his chances of benefiting from giving an organ. The result, Blachly says, might well be an enhanced "sense of dignity and self-determination" on the part of the donor that would let him "rejoin the human race on his own terms." In ancient days, kings, favorite sons, daughters, wives or slaves were often slain in sacrificial rites as a means of atonement and because, as Psychoanalyst Roger Money-Kyrle once wrote, "the gift of life places one with the gods." Blachly believes that nonfatal sacrifices might have the same expiative effect.

*A jargonistic term for the study of suicidal behavior.

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