Abstract
AbstractThe standard of care in the United States favors stabilizing any adult who arrives in an emergency department after a failed suicide attempt, even if he appears decisionally capacitated and refuses life‐sustaining treatment. I challenge this ubiquitous practice. Emergency clinicians generally have a moral obligation to err on the side of stabilizing even suicide attempters who refuse such interventions. This obligation reflects the fact that it is typically infeasible to determine these patients’ level of decisional capacitation—among other relevant information—in this unique setting. Nevertheless, I argue, stabilizing suicide attempters over their objection sometimes violates a basic yet insufficiently appreciated right of theirs—the right against bodily invasion. In such cases, it is at least prima facie wrong to stabilize a patient who wants to die even if they lack a contrary advance directive or medical order and suffer from no terminal physical illness.
Reference35 articles.
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3. Assessing psychiatric safety in suicidal emergency department patients
4. In fact my topic is even narrower in two ways. First I consider whether suicide attempters have a right against clinicians (particularly emergency clinicians) the right not to be stabilized by them. I therefore take no stand on the question of how extensive the obligations of other medical personnel (such as paramedics or emergency medical technicians) or nonpractitioners (such as the patient's loved ones or mere bystanders) might be. Second I want to remain silent on the question of whether clinicians and other medical personnel are permitted to frustrate a suicide attempter's suicidal intention in other ways for example by forcibly preventing him from realizing that intention once he has been admitted as a patient. Thanks to Philip Reed for prodding me to clarify these limitations of my discussion.