Suicide

Beyond the clinical difficulties in treating suicidal patients, suicide is a unique ethical challenge to psychiatrists. For unlike therapy in which patients and doctors share the desirability of the treatment’s goal, suicidal patients and doctors diverge in the way they consider the value of life as such. This makes the traditional standards of informed consent, beneficence, and the ‘do not harm’ principle hard to apply. After shortly outlining the history of the philosophical attitude towards suicide, including its ‘medicalization’ in modern times, the article tackles the problem of intervention in preventing suicidal behaviour, by examining four clinical cases that are distinguished by the intention of the patient, the effectiveness of treatment, and the rationality of the motive. The following section then addresses the heated debate on physician-assisted death, which is more controversial than suicide prevention. Two real-life cases, Bouvia and Chabot, are discussed in detail. Finally, the article focuses on the unique ethical features of research of suicide behaviour and treatment.