'No-suicide contracts' and informed consent: an analysis of ethical issues.
The 'no-suicide contract' is a frequently utilized tool in both the assessment and dispersal of suicidal patients. However, little attention has been given to questioning whether suicidal persons are able to give informed consent to enter such a contract. This article utilizes both the existing literature on no-suicide contracts and the results of recent research into the effects of this tool, to examine whether its use is consistent with the legal and ethical doctrine of informed consent. Particular attention is given to issues of competence, fullness of information, voluntariness and paternalistic intervention when no-suicide contracts are used. This analysis finds the tool to be problematic and suggests that individual patients' ability to give informed consent about a no-suicide contract needs to be carefully considered by clinicians.
Farrow
Tony L
TL
School of Nursing, Christchurch Polytechnic Institute of Technology, PO Box 540, Christchurch 8032, New Zealand. farrowt@cpit.ac.nz
O'Brien
Anthony J
AJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D004993:Ethics, Nursing; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D016743:Mental Competency; D008875:Middle Aged; D017008:Negotiating / Q000523:psychology*; D009723:Nurse-Patient Relations; D009730:Nursing Assessment; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000592:standards; D011568:Psychiatric Nursing / Q000941:ethics* / Q000379:methods*; D018570:Risk Assessment; D013406:Suicide, Attempted / Q000941:ethics* / Q000523:psychology*; D011795:Surveys and Questionnaires