Dr Kerry Gutridge has research interests in biomedical ethics in general. However, the particular focus of her research is in the philosophical, ethical and policy issues raised by psychiatry.
Her PhD investigated the controversial issue of allowing self harm in institutions. The aim of her thesis was to establish whether “assisted self-harm” should be allowed (or provided) in mental health care facilities, specifically in adult acute inpatient environments. The term “assisted self-harm” refers to management strategies for self-harm which strive to reduce or limit, rather than stop, the behaviour. Potential strategies include offering advice on safer places to injure, providing sharp implements, or materials to dress wounds. Specifically, she was interested in whether the approach is ethical and moral; in other words, consistent with how people should live their own lives and treat other people.
To answer this question, she drew on empirical research. She combined philosophical analysis with empirical studies to produce normative, rather than descriptive, conclusions. She conducted qualitative interviews with patients and professionals with relevant experience of self-injury. The interviews provided descriptive data about people’s motivations, reasons and intentions when they self-injure, as well as predictive data about the possible consequences of allowing injury and participant-driven arguments for or against the approach. This data was used to complement theoretical analysis of the key concepts “autonomy”, “responsibility” and “harm” and was integrated into her own arguments, in order to provide recommendations for action.
Based on the combined analysis, she argued that “assisted self-harm” is justifiable in the short-term as a means to reduce long-term harm, provided that five conditions are met. Thus, where the patient: is using self-injury primarily to manage distress; is injuring in a way which is associated with a low probability of physical damage (given the presence of appropriate support, such as advice on technique); possesses sufficient mental acuity after injury to engage with therapy; has an honest and open relationship with staff who are familiar with their history; and is capable of injuring in private, then “assisted self-harm” may be an appropriate and effective approach.