Citation

Krieger S, Finkel J, Gligorov N. Mt. Sinai J. Med. 2008; 75(1): 53-56.

Affiliation

Department of Neurology, Mount Sinai Medical Center, New York, NY 10029, USA. stephen.krieger@exchange.mssm.edu

Copyright

(Copyright © 2008, Mount Sinai Journal of Medicine, New York, Publisher John Wiley and Sons)

DOI

10.1002/msj.20016

PMID

18306250

Abstract

Uncompleted suicide attempts are a significant cause of morbidity, which in catastrophic cases can be both medically and ethically challenging to manage. We discuss the case of a 63-year-old man who survived a suicide attempt by venlafaxine (Effexor) overdose, causing an intracranial hemorrhage and leaving him in an apparently awake but noncommunicative state. Ethical concerns arose when considering if he should be indefinitely maintained on life support. These include the difficulties of characterizing his level of consciousness and prognosis; establishing his decisional capacity regarding end-of-life decisions in a setting of depression and suicidality; and assessing the suitability of a surrogate decision-maker. In conclusion, we discuss whether the fact that his grave neurological condition was caused by a suicide attempt was relevant to the decision to continue or withdraw life support.

Language: en