title: Advance directives, preemptive suicide and emergency medicine decision making.
abstract: As the United States population ages, there is a growing group of aging, elderly, individuals who may consider "preemptive suicide"(Prado, 1998). Healthy aging patients who preemptively attempt to end their life by suicide and who have clearly expressed a desire not to have life -sustaining treatment present a clinical and public policy challenge. We describe the clinical, ethical, and medical-legal decision making issues that were raised in such a case that presented to an academic emergency department. We also review and evaluate a decision making process that emergency physicians confront when faced with such a challenging and unusual situation .
authors.forename: Richard L
authors.initials: RL
authors.lastname: Heinrich
authors.forename: Marshall T
authors.initials: MT
authors.lastname: Morgan
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Rottman
mesh_terms: D000046:Academic Medical Centers; D016223:Advance Directives / Q000331:legislation & jurisprudence*; D000369:Aged, 80 and over; D003657:Decision Making / Q000941:ethics*; D004635:Emergency Medicine / Q000941:ethics*; D004636:Emergency Service, Hospital / Q000941:ethics; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D012151:Resuscitation / Q000941:ethics* / Q000379:methods; D012297:Right to Die / Q000941:ethics; D013405:Suicide; D013406:Suicide, Attempted / Q000941:ethics / Q000523:psychology*; D013997:Time Factors