Legal Aspects of Treating Suicidal Patients

1983 ◽  
Author(s):  
A Berman ◽  
◽  
R. Cohen-Sandler
Keyword(s):  
Legal Aspects ◽  
Suicidal Patients

Suicide Litigation: From Legal to Clinical Wisdom

1994 ◽  
Vol 28 (3) ◽  
pp. 431-437 ◽  
Author(s):  
Christopher H. Cantor ◽  
Peter M. McDermott
Keyword(s):  
Risk Assessment ◽  
Suicide Prevention ◽  
Legal Aspects ◽  
Issues Management ◽  
Life Itself ◽  
Direct Causation ◽  
The Individual ◽  
Suicidal Patients ◽  
Chronic Risk ◽  
Management Issues

Literature on legal aspects of suicide prevention is reviewed to focus on fundamental issues of care. The legal basis of liability is discussed in the context of risk assessment and risk management of suicidal patients. The “four Ds” — duty, dereliction of duty, damages and direct causation — are illustrated. Standards are described at three levels: of the profession, the court and the individual practitioner. Risk assessment is often confused with prediction; the latter is conceptually unsound, and while the former is more sound it is disappointingly imprecise. Despite reliability problems, risk assessment and appropriate management are important, as life itself is involved. Clinicians should be aware that informed consent requires responsibility for suicide prevention to be shared with patients. Such involvement of patients in self-destructive frames of mind raises complex issues. Management issues of both inpatients and outpatients at acute or chronic risk are discussed. Potential pitfalls for clinicians are outlined. Communications with, and the supervision of, other staff must be carefully considered. Families of vulnerable persons or those following bereavement also merit consideration. Patients are entitled to treatment with dignity and liberty — the latter should not be compromised any more than is essential — even when suicide is a possibility. Balancing these difficult issues may be easier if clinicians have a clear awareness of them.

Presence and Persistence of Sleep-Related Symptoms and Suicidal Ideation in Psychiatric Inpatients

Crisis ◽  
2014 ◽  
Vol 35 (6) ◽  
pp. 398-405 ◽  
Author(s):  
Michael R. Nadorff ◽  
Thomas E. Ellis ◽  
Jon G. Allen ◽  
E. Samuel Winer ◽  
Steve Herrera
Keyword(s):  
Risk Factor ◽  
Suicidal Ideation ◽  
Inpatient Treatment ◽  
Improve Method ◽  
Sleep Problems ◽  
Psychiatric Inpatients ◽  
Poor Sleep ◽  
Treatment Termination ◽  
Suicidal Patients ◽  
The Relationship

Background: Although sleep is an important risk factor for suicidal behavior, research has yet to examine the association between sleep problems and suicidality across the course of inpatient treatment. This study examined the relationship among sleep-related symptoms and suicidal ideation across inpatient treatment. Aims: To examine whether poor sleep at admission longitudinally predicts less improvement in suicidal ideation over the course of treatment. Further, to examine whether suicidal ideation is reduced in patients whose sleep does not improve. Method: The study utilized the Beck Depression Inventory (BDI)-II, which contains items measuring depressive symptoms, sleep-related symptoms, and suicidal ideation. The study sample consisted of 1,529 adult psychiatric inpatients. Patients were assessed at admission, biweekly, and at treatment termination. Results: Admission fatigue, loss of energy, and change in sleep pattern were associated with higher levels of suicidal ideation at admission and discharge. Fatigue at admission predicted suicidal ideation at termination independent of admission depression and suicidal ideation. Individuals whose sleep did not improve over the course of treatment had significantly higher suicidal ideation scores at termination relative to those whose sleep symptoms improved, after controlling for sleep, depression, and suicidal ideation scores at admission. Conclusion: These findings suggest that persistence of sleep-related symptoms warrants clinical attention in the treatment of suicidal patients.

Facing a Patient Who Seeks Help After a Suicide Attempt

Crisis ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 110-122 ◽  
Author(s):  
Inês Areal Rothes ◽  
Margarida Rangel Henriques ◽  
Joana Barreiros Leal ◽  
Marina Serra Lemos
Keyword(s):  
Health Professionals ◽  
Suicide Attempts ◽  
Self Report ◽  
Suicidal Patient ◽  
Emotional Difficulties ◽  
Specific Training ◽  
Patient Suicide ◽  
Professional Groups ◽  
Professional Characteristics ◽  
Suicidal Patients

Background: Although intervention with suicidal patients is one of the hardest tasks in clinical practice, little is known about health professionals’ perceptions about the difficulties of working with suicidal patients. Aims: The aims of this study were to: (1) describe the difficulties of professionals facing a suicidal patient; (2) analyze the differences in difficulties according to the sociodemographic and professional characteristics of the health professionals; and (3) identify the health professionals’ perceived skills and thoughts on the need for training in suicide. Method: A self-report questionnaire developed for this purpose was filled out by 196 health professionals. Exploratory principal components analyses were used. Results: Four factors were found: technical difficulties; emotional difficulties; relational and communicational difficulties; and family-approaching and logistic difficulties. Differences were found between professionals who had or did not have training in suicide, between professional groups, and between the number of patient suicide attempts. Sixty percent of the participants reported a personal need for training and 85% thought it was fundamental to implement training plans targeted at health professionals. Conclusion: Specific training is fundamental. Experiential and active methodologies should be used and technical, relational, and emotional questions must be included in the training syllabus.

Outreach Psychiatric Emergency Service

Crisis ◽  
2020 ◽  
Vol 41 (5) ◽  
pp. 375-382
Author(s):  
Remco F. P. de Winter ◽  
Mirjam C. Hazewinkel ◽  
Roland van de Sande ◽  
Derek P. de Beurs ◽  
Marieke H. de Groot
Keyword(s):  
General Practitioner ◽  
General Hospital ◽  
Suicidal Behavior ◽  
Emergency Service ◽  
Attempted Suicide ◽  
Emergency Services ◽  
Psychiatric Emergency ◽  
Psychiatric Emergency Services ◽  
Psychiatric Emergency Service ◽  
Suicidal Patients

Abstract. Background: Outreach psychiatric emergency services play an important role in all stages of a suicidal crisis; however, empirical assessment data are scarce. This study describes characteristics of patients assessed by these services and involved in suicidal crises. Method: During a 5-year period, detailed information from psychiatric emergency service assessments was recorded; 14,705 assessments were included. Characteristics of patients with/without suicidal behavior and with/without suicide attempts were compared. Outcomes were adjusted for clustering of features within individual patients. Results: Suicidal behavior was assessed in 32.2% of patients, of whom 9.2% attempted suicide. Suicidal behavior was most commonly associated with depression or adjustment disorder and these patients were referred to the service by a general practitioner or a general hospital, whereas those who attempted suicide were less likely to be referred by a general practitioner. Those who attempted suicide were more likely to be female and have had a referral by a general hospital. Self-poisoning by medication was the most common method of attempting suicide. Limitations: Bias could be due to missed or incomplete assessments. Primary diagnoses were based on clinical observation at the time of the assessment or on the primary diagnosis previously recorded. In addition, suicidal behavior or attempted suicide might have been underestimated. Conclusions: Suicidal behavior is commonplace in assessments by psychiatric emergency services. Suicidal patients with/without a suicide attempt differed with respect to demographic features, primary diagnoses, and referring entities, but not with respect to treatment policy. About 40% of the suicidal patients with/without an attempt were admitted following assessment.

Studying Demand for Institutes of Corporate Governance: Legal Aspects

2003 ◽  
pp. 50-61 ◽  
Author(s):  
T. Medvedeva ◽  
A. Timofeev
Keyword(s):  
Corporate Governance ◽  
Legal Aspects ◽  
Joint Stock Company ◽  
Federal Law ◽  
Stock Company ◽  
Open Joint Stock Company ◽  
Open Joint ◽  
Market Relations ◽  
Corporate Legislation

The article analyzes legal aspects of institutes of corporate governance. Different draft laws "On Joint-Stock Companies" are considered which reflected interests of separate groups of participants of market relations. Stages of property redistribution are outlined. The advantages of the model of the open joint-stock company are formulated. Special attention is paid to the demand for legal institutes of corporate governance as well as to the process of accepting the Federal Law "On Entering Amendments to the Federal Law "On Joint-Stock Companies"" which was enacted in 2002. The article contains proposals directed at improvement of corporate legislation.

The historical legal aspects of becoming of penitentiary medicine in Russia

2018 ◽  
Vol 26 (6) ◽  
Author(s):  
Vorobey S. V. ◽  
◽  
Tulenkov A. M. ◽  
Ponomarev S. B. ◽  
◽  
...  
Keyword(s):  
Legal Aspects
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