Farewell to the World by Marzio Barbagli

Author:Marzio Barbagli
Language: eng
Format: epub
ISBN: 9780745680422
Publisher: Wiley
Published: 2015-10-09T06:48:52+00:00

4.14 The treatment of pain and other illnesses

Those suffering from AIDS, multiple sclerosis, Huntington’s disease, kidney failure (undergoing dialysis), spinal cord injuries and cancer have a greater risk of taking their own lives than the general population.230 Over the two-year period 2005–6, oncologists were particularly surprised by the results of two major studies which showed how, age being equal, American, Swedish, Danish, Finnish and Norwegian women with breast tumours are 37 per cent more likely to kill themselves than unaffected women231 and, secondly, American men with prostate cancer have a much higher risk of suicide – all of 4.24 times higher – than the general population.232 However, many studies show that all forms of cancer increase the probability of suicide, although to different degrees.233 The probability is particularly high for cancers of the head or neck, which according to experts have a negative impact on the nervous system and cause mood disorders,234 but also pancreatic cancer and all those which have a poor prognosis.235 The risks are also high in the first six months after diagnosis and in metastases, namely when cancer causes psychological stress and physical pain that is extremely hard to bear.

However, in the last four decades of the twentieth century cancer became a much less important risk factor for suicide in many Western countries. Today cancer patients still commit suicide more frequently than the rest of the population, but the gap has narrowed over the past forty years.236 There are several reasons for this important change. Above all, tumours are discovered earlier than in the past. Treatments have also improved significantly, with innovations that have reduced the negative psychological impact (using conservative instead of radical breast surgery, for example) and increased the chances of survival. Furthermore, pain management and palliative care have also developed in all Western countries, even if to different degrees.

For centuries it was thought that physical suffering might prompt suicide when pain became insupportable. Even Pliny the Elder, in the first century CE, concluded that ‘the disease causing the sharpest agony is strangury from stone in the bladder; next comes disease of the stomach, and after that pains produced by diseases of the head; these being about the only diseases that are responsible for suicides’.237 But this hypothesis was only recently confirmed by research. In the 1990s, a follow-up study was carried out on a sample population of Finnish farmers suffering from back pain in order to establish the relationship between back pain and heart attack, but instead the study discovered that these farmers had a greater probability of killing themselves.238 Other studies have shown that chronic pain provoked by migraine headache, central nervous system lesions or metastases can increase the risk of suicide, crucially because these pathologies lead to major episodes of depression.239

Considerable advances have been made in controlling and reducing suffering. The traditional concept of pain as a sort of punishment, to be accepted with resignation, has been replaced by the view that it represents an alarm signal to be silenced as soon as its function has been accomplished.

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