Citation

Pauker SL, Cooper AM. Am. J. Psychiatry 1990; 147(4): 488-491.

Copyright

(Copyright © 1990, American Psychiatric Association)

DOI

10.1176/ajp.147.4.488

PMID

2316737

Abstract

The authors describe cases illustrating two types of high-risk and especially difficult suicidal psychiatric inpatients. In the first case, a suicidal patient reacted to psychiatric life support measures (maximum observation) with increasingly life-threatening acting out, necessitating a difficult, seemingly paradoxical staff decision to withdraw life support. In the second, a patient felt to be improving killed herself when life support was withdrawn. The authors argue that there are clinical limits to psychiatric life support and an appropriate goal of psychiatric treatment is to maximize the chances for patient survival, rather than to attempt to guarantee such survival.

Language: en

Keywords

Adult; Behavior Control; Death and Euthanasia; Ethics, Medical; Female; Hospitalization; Humans; Mental Disorders; Mental Health Therapies; Mentally Ill Persons; Personal Autonomy; Professional Patient Relationship; Psychiatry; Risk Assessment; Schizophrenic Psychology; Self Care; Suicide Prevention; Withholding Treatment