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'Revolutionary Suicide': UCLA Psychiatrists Cheer Self-Immolation in Leaked Audio

Med school talk glorified self-harm, violated CDC guidance, experts say

Drs. Afaf Moustafa (L) and Ragda Izar (R) (Institute for International Health and Education, STARC clinic)
April 12, 2024

UCLA medical school’s psychiatry department hosted a talk earlier this month that glorified self-immolation as a form of "revolutionary suicide," raising concerns from prominent doctors and deepening a public relations crisis that has embroiled the elite medical school.

The talk, "Depathologizing Resistance," was delivered on April 2 by two psychiatry residents at UCLA, Drs. Ragda Izar and Afaf Moustafa, under the auspices of the department’s diversity office and UCLA’s Health Ethics Center, according to slides and emails obtained by the Washington Free Beacon.

The remarks centered on the suicide of Aaron Bushnell, the U.S. serviceman who set himself on fire in February to protest U.S. support for Israel—or, as Izar put it, "indigenous Palestine."

Bushnell had shown signs of mental distress before he died, according to a police report, and was widely seen as a casualty of mental illness. The presentation argued he could also be considered a "martyr," a man in full control of his mental faculties who had responded rationally to a "genocide" unfolding thousands of miles away.

 

"Yes, he carried a lot of distress," Izar said, according to audio of the talk reviewed by the Free Beacon. "But does that mean the actions he engaged in are any less valid?"

Isn’t it normal, she continued, "to be distressed when you’re seeing this level of carnage" in Gaza?

The talk reflects the erosion of what was until recently a bedrock medical norm: From the American Psychiatric Association to the American Academy of Child and Adolescent Psychiatry, all professional mental health bodies warn against glorifying self-harm, lest it inspire others to harm themselves.

That norm has weakened with the rise of activist doctors and their capture of medical organizations. Pediatricians got a vivid taste of the brave new world in 2022 when Morissa Ladinsky, in an address at the American Academy of Pediatrics’s annual conference, praised a transgender teenager, Leelah Alcorn, for "boldly … ending her life" and leaving a suicide note that "went viral, literally around the world."

Ladinsky, a pediatrician at the University of Alabama Children’s Hospital, leads the clinic’s "Gender Health Team." She later apologized for her remarks, saying she hadn’t meant to glorify self-harm.

At UCLA, Izar and Moustafa, who are practicing psychiatrists, argued that self-immolation is a reasonable response to geopolitical events and that the taboo against it serves "the interests of power." By "perpetuating the stigma of self-immolation," they said, psychiatrists "discredit" resistance to "power structures" like "colonization," "homophobia," and "white supremacy," framing legitimate acts of protest as signs of psychiatric dysfunction.

"Psychiatry pathologizes non-pathological … reactions to a pathological environment or pathological society," Moustafa said. "It’s considered illness to choose to die in protest of the violence of war but perfectly sane to choose to die in service of the violence of war."

Their contentions undercut official guidance from the Centers for Disease Control and Prevention, which warns that "bestowing honor and admiration" on suicide victims can inspire others to take their own lives.

That guidance "was certainly violated by the presenters," said Elliot Kaminetzky, a psychologist who specializes in anxiety disorders and reviewed audio of the talk at the Free Beacon’s request.

The stigma against self-immolation, Kaminetzky added, is one reason Western countries see so little of it. "This is a good thing," Kaminetzky said. "For mental health professionals to encourage removing the stigma is reckless" and could "lead to an increase in the number of individuals who protest in this tragic and horrifyingly painful fashion."

Sally Satel, a psychiatrist at Yale Medical School, said the talk itself was unlikely to inspire copycats, drawing a distinction between suicide and "cataclysmic protest." But she agreed with Kaminetzky that destigmatizing self-immolation could increase its prevalence.

"The more a culture venerates that kind of behavior as honorable," Satel said, "the more we are likely to see additional examples."

In a slide titled "Call to Action," which summarized the takeaways from the lecture, Izar and Moustafa told attendees to "cultivate safe spaces" for their patients. Neither doctor responded to a request for comment.

 

Izar and Moustafa’s talk is the latest lecture to rock UCLA medical school, which hosted Lisa "Tiny" Gray-Garcia, a self-described "poverty scholar," as a guest speaker in its mandatory "structural racism" course in March. Garcia led the class in chants of "Free, Free Palestine," derided the "crapitalist lie" of private property, and, in an audio clip that has since gone viral, had students kneel and pray to "mama earth." The spectacle followed news that UCLA had divided its medical students into race-based discussion groups and assigned them readings on "indigenous resistance," "decolonization," and "settler colonialism."

Such jargon was peppered throughout Izar and Moustafa’s talk. One slide asserted that psychiatry has "weaponized tools of colonization, racism, anti-blackness, homophobia, and various tools of oppressions." Another told psychiatrists to "embed your practice with an anti-colonial lens" and "recognize that mental health is intimately tied to liberation."

 

At one point, Izar castigated statements made by various medical bodies, including the American Psychiatric Association, about Hamas’s October 7 rampage through Southern Israel, saying they had "centered the suffering of one group of people"—Jews—without discussing the "trauma" Palestinians had faced "at the hands of colonizing forces for 75 years." That remark drew blowback from Vivian Burt, an emeritus psychiatry professor at UCLA, who testified about the lecture at a meeting of the University of California Board of Regents on Wednesday.

"This is but the latest and most grotesque example of how anti-Semitism has been allowed to metastasize at UCLA," Burt said. "I implore the Regents to act for the safety of our students, faculty, and staff, as well as those in our care as healthcare professionals."

UCLA did not respond to a request for comment.

The talk, which was streamed over Zoom and open to all psychiatry residents and faculty, argued that concerns about copycat suicide are selective and politically loaded, using former president Barack Obama’s praise of Mohamed Bouazizi—the Tunisian street vendor who helped jumpstart the Arab Spring when he self-immolated in 2010—as an example.

"We praise people who do it over there," Izar said. "But when it happens here, not so much."

The talk also drew a distinction between Eastern and Western cultures, arguing that the Global South tends to view "protest suicide" as honorable and "heroic."

It’s true that self-immolation is more acceptable outside the West, Kaminetzky said. And it’s true that Americans have greeted certain acts of self-immolation, including Bouazizi’s, with more fanfare than Bushnell’s.

But the divergent reactions don’t necessarily reflect a double standard, Kaminetzky said. Mental illness, after all, is often characterized by a disregard for social norms. Since those norms vary across cultures, Kaminetzky argued, a behavior that indicates mental illness in one country may not indicate it in another.

"Given that self-immolation is not part of Western culture, individuals in the West who choose to protest by ending their life likely have multiple mental health and other challenges," Kaminetzky told the Free Beacon. "I would not make the same assumption for individuals in Tibet"—where many monks have self-immolated in protest of China—"though I would discourage it for them as well."

Toward the end of their talk, Izar and Moustafa brought up the Goldwater Rule, which states that psychiatrists should not comment on the mental health of people they haven’t evaluated. The rule, codified in the American Psychiatric Association’s Principles of Medical Ethics, was repeatedly flouted during the Trump years as psychiatrists pontificated from afar about the former president’s mental state.

 

"In the same way that we shouldn’t be commenting on political candidates running for president," Izar said, the Goldwater Rule "raises the question of what authority do we have as psychiatrists to publicly comment upon instances of revolutionary suicide and other acts of resistance."

Update 2:40 p.m.: This post has been updated to reflect that Elliot Kaminetzky is a psychologist, not a psychiatrist.