Citation

Gontier E, Prigent Y. Ann. Med. Psychol. (Paris) 2011; 169(5): 319-321.

Copyright

(Copyright © 2011, Societe Medico-Psychologique, Publisher Elsevier Publishing)

DOI

10.1016/j.amp.2011.04.005

PMID

unavailable

Abstract

The ethical questions involved in the treatment of patients who have attempted suicide will be addressed here on the basis of two contradictory positions, which appear in codes of deontology. On one hand, we find individual freedom and protection of the person; on the other, professional secret and shared secret. The reflection, developed along the lines of psychoanalytical theory, is enriched by contributions from crisis management. It is illustrated by means of clinical situations taken from clinical practice in the domain of suicide prevention. What is revealed is the fact that suicide does not correspond, in the case of our patients, to the exercise of freedom and as a consequence, it requires us to intervene. Suicide attempts are often associated with pathologies in which we can find a life history marked by separations, abandonments and trauma, corresponding to a failure of the environment which the treatment must be careful not to reproduce. This implies that, between the contradictory terms evoked above, we make the choice of protection of the person and of shared secret. As concerns the analytically based psychotherapeutic framework, the guidelines of traditional neutrality for the analyst, whose value remains complete, must be redefined toward a more interventionist counter-transferential position. © 2011.

Language: fr

Keywords

protection; human; Therapeutic alliance; psychotherapy; suicide attempt; Suicide prevention; medical ethics; article; psychoanalysis; clinical practice; patient care; counter transference; Crisis management; Benevolent neutrality; Deontology