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February 8, 1980

Danse Macabre

JAMA. 1980;243(6):552. doi:10.1001/jama.1980.03300320044026

Medical involvement with suicide is recent. When Pliny the Elder opined, "Amid the miseries of our life on earth, suicide is God's best gift to man," he did not envision the intervention of a physician. Nor did Nietzsche, centuries later, when he mused, "The thought of suicide is a great consolation; by means of it one gets successfully through many a bad night." And certainly the physician was far removed from his mind when Albert Camus stated, "There is but one serious philosophical problem, and that is suicide."

The physician entered the suicide scene when psychiatrists began to gain insights into the psyche of candidates for self-destruction. Freud held that suicide is a form of aggression against a loved person that has turned on the self, a triumph of the "death wish." Meninger viewed suicide as an amalgam of the wish to die—to kill and to be killed. Without probing