Full Text for How to Deal with Cases of Attempted Suicide (Text)

Concordia Theological Monthly Vol. XVI SEPTEMBER. 1945 No.9 How to Deal with Cases of Attempted Suicide* The problem of suicide or attempted suicide has so many aspects and such far-reaching implications that no short treatise can possibly cover all of them. A suicide is a person who, with premeditation, has deliberately terminated his life. An attempted suicide is an individual who has made an attempt at suicide, but has failed in the act. The subject is bound up with the values that the individual, the community, and the Church attach to life, with existing attitudes towards death, with racial habits and cus­toms, with prevailing standards of life and the variations from such standards. Any attempt to deal completely with the question that has so many ramifications would baffle the skill of the most thoughtful student of human affairs. It is a study that concerns equally the physician and the lawyer, the teacher and the con­scientious pastor. "Suicide involves both the individual and society. External circumstances over which he has no control affect the character and mold the life of the individual. Hardships of various kinds, such as extreme poverty, hunger, ill health, mental abnormality, physical pain, prolonged suffering, and deformity, often lead men to the thought of self-destruction. The loss of honor, position, freedom, and love, contribute to the same result. But even ad­versity does not drive a person to attempt suicide unless he is already harassed by a serious emotional conflict. Another factor may be failure in the life of the individual with its accompanying disgrace and shame. These things all exert a most profound in­fluence on the likelihood of self-destruction. Information showing * A book which proved helpful in this study is To Be or Not to Be. By Louis I. Dublin, Ph. D., and Bessie Bunzel, M. A., co-authors. (By permission.) 37 578 How to Deal with Cases of Attempted Suicide the various methods in common usage which people use when they take their own lives, is not a part of this article. "Modern psychiatry may give us some insight into the motives underlying human conduct, although there still remains much un­certainty. Psychology will not unlock every closed door or ex­plain every complicated intellectual and emotional reaction. Un­fortunately, the mysterious working of the human mind eludes our understanding and defies neat arrangement into orderly pigeonholes. "Mental disease and the fear of becoming a mental case are perhaps even more important than physical illness as causes of attempted suicide. In numerous cases among those attempting self-destruction the reason given for the act has been a variation of the refrain, 'Thought I was going crazy.' 'Tried to kill myself so I wouldn't go crazy.' 'Did not want to lose my mind.' 'Some­thing snapped, and I thought I was going mad.' 'I am crazy, and there is no hope for me now' -and so on. In a mental hospital, suicide is an ever-present danger. Among the mentally ill the provocation is often of the most trivial kind, and self-destruction may follow a sudden impulse. Voices tell patients to kill or mutilate themselves: or patients do such acts in answer to God's imaginary commands or to save the family from disgrace. "Disappointment in love is a fertile cause of adolescent suicide. Disillusionment of age, realizing how little promise of success or happiness the future holds for him in old age, hopeless poverty, and unemployment provide very common motives for suicide. "On the borderline of personal homicide and fraud are the suicides that result from the desire to leave insurance funds to loved ones. Occasionally a person will kill himself in order that his family may be provided with the amount of his policy -and frequently one who commits suicide for this reason holds a large amount of insurance." These, then, and many other reasons prompt people of all sorts and conditions to attempt suicide -young and old, men and women, the weary and the disillusioned. Illness and fear of mental and physical disability lead many to take their own lives. To others suicide is an attempt to flee from stern realities. Hunger, poverty, unemployment, disgrace, dishonor, love, jealousy, tangled personal relationships, conflict of one kind or another, a sense of guilt, feelings of hatred, aggression, and hallucinations caused by acute mental disease force others to give up the game. It may be said that in most cases no single factor is responsible for self­destruction. Even when but one cause would seem to dominate the picture, closer investigation discloses that it never stands isolated, but is bound up with various other considerations lying How to Deal with Cases of Attempted Suicide 579 hidden and confused below the surface. Spiritual collapse, fol­lowed by self-accusations and deep remorse, may be the causative factor for the unholy act. But why go on and try to list all the motives which may lead to self-inflicted death? It cannot be done; neither can we dogmatize from so varied a group as these personal homicides constitute. It is interesting to note religious affiliation and suicide. Re­ligious affiliation is a potent influence in determining habits and governing acts. Suicide, which results from serious personal maladjustment, is very infrequent where the guidance and authority of religion are accepted without question, where the preaching of the Law of God and the Gospel forms the background and where duties toward God and man are rigidly prescribed. On the other hand, where the power of religion is not stressed, where the individual is allowed freedom to control his own life and be his own judge, people are likely to disregard the teachings of Holy Writ. You know that our own beloved Church adheres strictly to the teachings of Jesus Christ. We are enjoined, not only to hear the Word of God as it is preached in all its purity, but also to practice our faith in all our ways, especially in the days of trials and tribulations, when the Word of God alone gives us strength and comforts and sustains us in the evil days. We know that cases of attempted or actual suicide are extremely rare in our Lutheran circles. When they do happen among our own people, we usually find after careful examination that the under­lying cause was a disordered mind tortured vvith phobias or per­secutory delusions. Our Lutheran Church is a large body, yet, by the grace of God, our own people are spared the horrors of a well-planned and premeditated suicidal death. There are ex­ceptions, but they are few and far between. That again proves the power of the Word of God unto such as believe it and live according to it. In one of the general prayers of the Church we are taught to say: "We commend to Thy fatherly goodness all those who are in any way afflicted or distressed in mind, body, or estate; that it may please Thee to comfort and relieve them according to their several necessities, giving them patience under their sufferings and a happy issue out of all their afflictions." Somewhere in the German Agenda we pray: "Vor einem boesen schnellen Tod, bewahre uns, 0 Herre Gott."-After these preliminary remarks we now come to the real topic of our paper: "How to deal with cases of attempted suicide." "Thou shalt not kill," thus saith the Lord in the Fifth Com­mandment of the Decalog. "What does this mean?" "We should 580 How to Deal with Cases of Attempted Suicide fear and love God that we may not hurt nor harm our neighbor in his body, but help and befriend him in every bodily need." To take the life of a human being is a grievous sin and a crime as well. A murderer shortens the time of grace and repentance of his victim. Christ says: "Ye have heard that it was said by them of old time, Thou shalt not kill; and whosoever shall kill shall be in danger of the judgment" (Matt. 5: 21). Holy Writ records the murder of Abel by his own brother Cain. (Gen. 4: 8). Eternal punishment will be the lot of a murderer. "Whosoever hateth his brother is a murderer; and ye know that no murderer hath eternal life abiding in him" (1 John 3:15). Equally guilty of transgressing the Fifth Commandment violently is the self-homicide. Human life is sacred. It involves the duty of absolute submission to God's will and the extreme importance attached to the moment of death. The person who deliberately takes away the life which was given him by the Creator, displays the utmost disregard for the will and authority of his Master. Worst of all, he does so in the very last minute of his life when his doom is sealed forever -the most dangerous thing of ali, because no time is left for sincere repentance. Life is a gift divinely bestowed on man and subject to His power who "killeth and maketh alive"; and therefore he who attempts to take his own life sins against God and usurps the privilege of deter­mining the span of life allotted to him while to God alone belongs the judgment of life and death. These arguments against suicide are deeply rooted in fundamental Christian doctrines. Judas Iscariot, one of the T-Vlelve, when he realized that he was condemned for the betrayal of his Lord and Master, repented himself; conscience stricken, he went and hanged himself (Matt. 27:3,4,5).-During the many years of ministration to the sick committed to large public institutions we have met frequently with cases of attempted suicides. It is a sad mission to perform, considering the case. These people arrive at the hospital in a weakened condition, physically as well as mentally. The missionary in most cases is a total stranger to them. It is for the missionary to make the initial and proper approach, which is essential also in general sick visitations. The person, a patient now on account of his rash act, if he is conscious at all, oftentimes shows signs of mental depression or is sullen and refuses to respond. He may even be­come resentful. Others again will listen to the pastor. If the patient is not . critically ill or in a dying condition, it is of greatest importance to first gain his confidence. This is done by approach­ing your patient in a friendly way, no matter what you think of his sinful act and to make him feel he still has some one who How to Deal with Cases of Attempted Suicide 581 cares for him. If you have gained his confidence and impressed him with your sincerity, he will soon tell you his sad story. This is the time when a pastor should prove himself a true shepherd with a passion for distressed souls who have gone astray and by a rash act have brought themselves so close to eternity. Tell the patient what it means to deliberately destroy a personal life. It is a flagrant transgression of the Fifth Commandment. It is closing the gates of heaven to himself, unless, by the grace of God, he repents. If it is evident that the charge is penitent, as far as we are able to judge, he should hear that the blood of Jesus Christ cleanseth us from all sin and that the Son of Man is come into the world to seek and save that which is lost. Jesus says: "Him that cometh unto Me" (in sincere repentance) "I will in no wise cast out" (John 6: 37). Invitingly Jesus says to the conscience­stricken, sin-burdened soul: "Come unto Me, all ye that labor and are heavy laden, and I will give you rest." He must realize, however, that he has committed a grievous sin by his suicidal at­tempt. He should thank God from the bottom of his heart that He did not permit him to die an unholy death. He must make a frank confession of his guilt, if he expects the Lord to have mercy upon him and graciously forgive him his sin.-Others make all kinds of excuses and try to justify their sel£­homicide. Such must be told L'l plain language that all their ex­cuses will not stand before a just Judge in eternity. His command is: "Thou shalt not kill." Only one thing can save them, contrite faith in the Savior. There is but one plea for them: "God, be merciful to me, a sinner." Perhaps the person has had sad ex­periences in life, disappointments, and failures, yet that does not alter the case. No man has the right to destroy his own body, which God has created. If he is successful in his attempt, eternal condemnation will be the verdict. There come to our mind unfortunate men and women possessed with persecutory delusions. We of sound mind call them imagina­tions, but these delusions seem real to the patient. He passes through great fear and sees his life endangered by cruel and in­human tortures inflicted upon him by merciless enemies. In order to escape a cruel death, great pain and suffering, he comes to the conclusion, it is far better for him to end his life in a humane way, thus escaping the cruelties and tortures of his imaginary per­secutors. We sympathize with these poor deluded people. The Lord will not hold them accountable for their clouded minds, which causes them to do things which they would never do in Lhe days of health, especially not as Christians. They know not what they do. They are mentally ill. It is a very difficult task to deal with such cases and try to convince the victims that these 582 How to Deal with Cases of Attempted Suicide delusions are imaginary. The ideas of persecutions have become fixed.-We find this same difficulty with patients who accuse them­selves of having grieved the Holy Spirit. All your assurances that they are not guilty of the "unforgivable sin" will avail you nothing. We include in our list of persons who attempt to take their own life, but cannot be held responsible for their rash act because they have committed it while in a fever delirium. The attempts may happen in a hospital or sanitarium, if such patients are not properly protected by a restraint jacket or heavily barred windows. Finally, among the self-homicides we also find some in great pain, caused by wounds, for which they must blame only them­selves. What are 'we to say to them? We know what to say to a poor brother or sister whose ailment causes them much pain and sleepless nights. We comfort them with the Word of God and tell them that our blessed Savior also bore much pain and suffering, more than we can ever bear. He sacrificed His own body on Calvary's Cross. All this that we might be saved from sin and eternal death. He suffered and died for us. We pray at their bedside that the Lord in His mercy alleviate their pain and, if it be His will, to grant them better days again, even health. We remind them that in the hour of trial and tribulation the Lord is especially close to us. In all his troubles a Christian comforts himself with the words of the Apostle Paul: "We know that all things work together for good unto them that love God." It is not so with the person whose pain and suffering is the result of his attempt at self-destruction. He is not bearing a cross. His misery, mental and physical, is a just punishment for his flagrant transgressions of the Fifth Commandment: "Thou shalt not kill," and only when he in true repentance accepts Christ as his Savior, will this punishment be changed to a wholesome chastisement. In conclusion a brief word as to the burial of suicides. A Chris­tian pastor may officiate at the funeral of persons who, on their own accord, have terminated their own life but cannot be held respon­sible for it, as in definite cases and types of "insanity" or during a period of elevated fever temperature. If it is clearly evident that the deceased was utterly nn­penitent, Christian committal of such a body must be refused. Never should a Christian pastor assist in giving a Christian burial to a suicide who deliberately took his own life.-It is interesting to note the Jewish law concerning suicide and a wicked person's death. Though dating from the very be­ginning of modern times, these rules remain the present-day prac­tice of orthodox Jews. So I will quote them in full: The Lord's Prayer, the Pastor's Prayer 583 "1. There is none more wicked than one who has committed suicide, as it is said: 'And surely your blood of your lives will I require,' Genesis, chapter 9, verse 5. Also for the sake of the individual was the world created, thus he who destroys one soul is as though he had destroyed the whole world, therefore one should neither rend the garment nor mourn for him who had de­stroyed himself, nor should a funeral oration be pronou,,"1ced on his behalf. He should, however, be cleansed, dressed in shrouds, and buried, and with regard to the saying of Kadish the ec­clesiastical authorities should be consulted. "2. When one who had been killed was discovered, as far as possible the act of killing should be regarded as the deed of an­othei' person and not as his own deed. "3. If a child committed suicide, it is considered that he had done the deed unwittingly. Likewise if an adult killed himself and it is evident that the act was prompted by madness or through fear of terrible torture, he should be treated as an ordinary de­ceased person."-We have spoken. We sincerely hope th~t our modest treatise will be of a little help to someone called upo~ to minister to these unfortun.ate people. May the epitaph on our tombstone some day read: "Hie iacet Christianus, Requiescat in pace!" ••• E. A. DUEMLING The Lord's Prayer, the Pastor's Prayer The Fifth Petition The expositor may feel free to depart from the old and practical division of the petitions, which proposes that the first three petitions embrace spiritual blessings, the fourth, temporal gifts, and the last three, entreaties for deliverance from evil. The pastor may disregard entirely the classification of a petition if he has per­suaded himself that his course of thought is more practical than the old grouping. The Fifth Petition is the only one in plurals, and it is the longest. It must be prayed always true to the forms; for the sinful, loveless flesh insists on modifying the form to destroy the sense. In the Sermon on the Mount, having concluded the Lord's Prayer, Jesus immediately returns to the Fifth Petition and appends remarks pertinent to it to emphasize the importance of this prayer and to warn against thoughtless repetition of it. In Matt. 6: 12 this Petition reads as follows: And forgive us