Ethics and the Law: The Suicide of a Terminally Ill Patient

Abstract

Suicide is one of the most distressing and difficult situations that healthcare professionals will encounter. It is a violent act, the impact of which reaches well beyond the actual person who commits suicide. Inevitably it leaves family members, friends, carers and professionals feeling helpless, inadequate and responsible. However, failure to prevent a patient committing suicide is rarely a reflection on the competence of the clinician. Despite the high incidence of depression and sadness in terminally ill people, suicide is extremely rare amongst dying people. The highest risk of suicide for those with cancer is at the time of diagnosis. This article examines the ethical and legal implications of an 87-year-old man, in the advanced stages of his disease, who expressed a wish to kill himself to a district nurse and subsequently committed suicide (see Case scenario box). It raises issues surrounding patient confidentiality and a health professional’s duty of care. It examines the nurse’s actions and asks whether she could have done anything differently to prevent the death. This case scenario is also the subject of the ‘Communication vignettes’ series on pages 22–25. Conflicts of interest: none