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‘No-suicide Contracts’ and Informed Consent: an analysis of ethical issues

Christchurch Polytechnic Institute of Technology, New Zealand, farrowt{at}cpit.ac.nz

Anthony J O’Brien

University of Auckland, New Zealand

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.

Key Words: ethics • informed consent • mental health • no-suicide contracts

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