Voices.

In psychiatry you learn that a surprising number of people hear voices. Many people can successfully go through day to day life hearing voices (aka auditory hallucinations) and frequently without other people finding out. When we talk to patients who have auditory hallucinations sometimes they like the voices. It may be the voice of their mother telling them comforting things. Sometimes it is their own voice which is telling them positive self talk saying things like, 'don't be sacred' or 'you can do it,' etc. However, perhaps even more frequently, the voices are degrading and cruel. They may say things to the patient over and over again such as, "You are worthless. You are worthless. You are ugly." One patient said the voices said to her, "Eat, eat, eat, and die." Others have voices that say, "Kill yourself." Over and over again. Perhaps the most horrific, are the voices are those that state that if the patient does not kill him or herself that something terrible will happen to the rest of the world (the world be destroyed, all the children in the world will die, etc). Usually the patient has some sort of understanding (however small) that voices do not indicate reality and that if the person does not kill him or herself that the world will not come to an end. However, this led me to the question: What if the patient actually believed that if he or she didn't kill him or herself that many other people will die?

In Biblical philosophy it is said that there is no greater love than to lay down one's life for one's friend. Likewise, it is also considered by many to sacrifice yourself in service to your country. In some religions it is considered a sin to commit suicide which may even result in the person committing suicide going to hell. But what if the patient truly believed that if they didn't kill him or herself then many other people would die? In that situation, although it is of course a terrible tragedy that the individual has tried to end his or her life, is it not also an incredibly selfless act? Although their reasoning is flawed as they have been given incorrect data, they are acting along one of the most noble of moral codes of our culture. Just food for thought.