I read a startling article this morning, which pushed my planned article to the back burner. In April, the UK’s Royal College of Nurses will debate how best to treat self-mutilation or cutting. According to the article:

“Patients who want to harm themselves could be given clean blades and advice on where to cut, under plans drawn up by nurses’ leaders.
The move is aimed at minimising the risk of infection from cuts made with dirty implements, just as drug addicts are issued with sterile needles.”

Stupid British can’t even spell “minimizing” correctly. Anyhow, they’re weighing two factors here: harm-reduction versus increasing the incentive to cut. True, the combination of a clean razor with the knowledge of the safest body part to cut would probably reduce the risk of infection, disease, or worse. However, when you make a harmful behavior safer and even subsidize it, then discouraging it becomes more difficult. You might even encourage that behavior. So we’ll see which factor wins out.

I think it’s probably a bad idea. Let the British experiment with it, and we’ll just sit back and watch what happens. But effectiveness of the plan aside, isn’t there a simpler way to do this? Why not just publish a PSA? Or a manual? Why not just tell parents: “Show your children how to sterilize their razors with alcohol and a lighter; show them the safe places to cut; and when they show up with fresh cuts, tell them they really shouldn’t do it anymore.” Then wait a few years for it to stop. Isn’t that the short and sweet version of what the RCN wants to do?

This reminds me of a college friend who would self-mutilate…himself. He owned a khukuri, the famous sword of the Nepalese Ghurkas. The legend is that the blade can not be returned to its sheath before drawing blood, so this friend would cut his forearm whenever he drew the khukuri—which was often enough that his inside forearms were crosshatched white with scar tissue. I suspect the self-mutilation ended shortly after he knicked his radial artery and spent the night in the hospital. But I guess the good news is that the cuts never got infected.

This entry was posted on Sunday, February 5th, 2006 at 5:18 PM.

4 Responses to “Remember kids, cutting yourselves is bad.”

1. The Questioner Says:
   February 12th, 2006 at 9:22 AM

What do you think of the use of this type of behavior in patients with dissociate disorders?

1. Vincent Viscariello Says:
   February 12th, 2006 at 6:25 PM

What are you asking, should we cut them up?

1. The Questioner Says:
   February 14th, 2006 at 2:52 PM

No, but as weird as it sounds this is one way that a solution can be built for a person. So long as there is not a suicide risk. I am not suggesting that people start doing this but in some cases where this is going on already, this can be a tool.

1. Vincent Viscariello Says:
   March 8th, 2006 at 3:26 PM

I hear you, but I think the trick is determining which people this tool would help, and which people would be adversely affected. It’s kind of like the programs for severe alcoholism which provide booze to the patients– it can work for them, but some of them just drink themselves to death.