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Tijdschrift voor Psychiatrie 51 (2009) 5, 315 - 324

Review article

Ethical advice on the prevention of suicide in mental health care

A. Liégeois, M. Eneman

Professional carers are regularly confronted with clients who want to commit suicide.
aim To develop ethical advice on the question how professional carers can provide ethically justified care that will prevent suicide.
method The research method combines ethical discussion with a review of the literature.
results According to the ethical advice, suicide is a manifestation of an existential crisis and is determined partly by the client's pathology. Three values are at stake in the prevention of suicide: the inviolability of life, the autonomy of the client and the care relationship between carers and their client. In order to integrate these values it is advisable to give attention to the following points. The best prevention consists of good care and a good care relationship involving intensive counselling of the client with regard to existential questions. In this way carers can increase the client's freedom and responsibility. Sometimes, however, carers need to come to protective agreements with the client or impose coercive measures in order to restrict the client's freedom. Such preventive measures must be accompanied by care for the carers themselves and the client's next of kin.
conclusion By means of the integrating value of the care relationship carers should try to achieve a reasonable balance between the inviolability of life and the autonomy of the client.


keywords ethics, prevention, suicide, values