Deciding on life-saving treatment after a violent suicide attempt: an ethical case report

Additionally, brain damage is common, and the death wish may persist or even strengthen due to the added burden of physical pain and the fear or prospect of long-lasting disability.4 For a number of reasons, clinicians may have doubts about the value of continuing treatment, especially when a patien...

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Bibliographic Details
Published in:General psychiatry 2024-04, Vol.37 (2), p.e101409-e101409
Main Authors: Wichers, Robert, Heller, Hanna M, van Veen, Sisco
Format: Article
Language:English
Subjects:
Brain damage
Case reports
Decision making
Fractures
Hallucinations
Injuries
Letter
Mental disorders
Psychiatry
Rehabilitation
Suicide, Attempted
Suicides & suicide attempts
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Summary:Additionally, brain damage is common, and the death wish may persist or even strengthen due to the added burden of physical pain and the fear or prospect of long-lasting disability.4 For a number of reasons, clinicians may have doubts about the value of continuing treatment, especially when a patient is unable to make informed treatment choices and clarify their wishes. [...]violent suicide can lead to brain damage, which may further limit the patient’s ability to make an informed decision.6 Last, people who attempt suicide in a violent manner often suffer from a psychiatric disorder, such as psychosis or severe depression, that can unduly influence their decision-making capacity concerning life-saving treatment.2 Hence, it will often occur that the patient is unable to make informed choices about treatment after a violent suicide attempt. [...]someone who recently attempted suicide may see this differently, especially taking into consideration that any sustained injuries may further hamper the quality of life. Research shows that people are typically in a state of entrapment when attempting suicide and are not in a position to rationally consider their options.7 However, a violent suicide attempt can be reasonably interpreted as a sign of severe distress and suffering. [...]when weighing the harms and benefits of continuing life-saving treatment, it is important to consider whether there are acceptable options to alleviate the suffering that drove them to suicide in the first place.
ISSN:2517-729X
2096-5923
2517-729X
DOI:10.1136/gpsych-2023-101409