Permitted Suicide: Model Rules for Mental Health Counseling. (Practice)

By Cohen, Elliot D. | Journal of Mental Health Counseling, October 2001 | Go to article overview

Permitted Suicide: Model Rules for Mental Health Counseling. (Practice)


Cohen, Elliot D., Journal of Mental Health Counseling


In mental health practice, no explicit provisions have been made for existing law and codes of ethics to protect freedom and confidences of clients who, due to serious, irremediable, physical illness, rationally desire to end their lives. This paper makes a case for permitting suicide in these special circumstances. Starting with an analysis of permitted suicide, the legal background for applying this concept is provided, and ten model rules for permitting suicide in mental health practice are developed.

**********

Physician assisted suicide has recently gained some legitimacy within the medical and mental health communities as a possible option for persons suffering from diseases such as Lou Gerhigs, multiple sclerosis, cancer, and HIV (American Counseling Association [ACA], Association for Gay, Lesbian and Bisexual Issues in Counseling, Coalition of Mental Health Professionals, Washington State Psychological Association, 1996; National Association of Social Workers [NASW], 1994; Oregon Death with Dignity Act, 1999; Slome, Mitchell, Charlebois, Benevedes, & Abrams, 1997; Werth, 1996). Nevertheless, contrary to recent correlation studies (ACA et al., 1996), standards of mental health practice invariably treat all suicides as products of mental illness, requiring paternalistic interventions such as incarceration or detention.

The counseling environment is presumed to offer prospective clients who have a need to work through problems of living, and of dying, a safe haven in which to do so. Unfortunately, for clients who suffer from severe irremediable medical conditions, which lead them to contemplate suicide, counseling portends risks of personal freedom and dignity. Counselors should be free to provide a conciliatory atmosphere in which to carefully work through end-of-life decisions, and clients should not be dissuaded from enlisting their services (ACA et al., 1996; NASW, 1994; Battin, 1991).

The idea of counselors permitting suicide of a client rather than intervening to prevent it may seem to fly in the face of conventional mental health wisdom. Nevertheless, an unqualified standard of intervention fails to accommodate the special circumstances of some clients whose contemplation of suicide is rational and is, therefore, not the result of cognitive dysfunction or mental defect.

This article introduces and defines the concept of permitted suicide. Second, it discusses the legal context for applying this concept to cases of rational clients who seek suicide as relief from the suffering and indignity of serious, irremediable physical conditions. Third, it considers the concept of rational suicide and applies it toward construction of standards for permitting suicide. Last, ten model rules for permitting suicide in mental health practice are proposed in light of the emerging analysis.

THE CONCEPT OF PERMITTED SUICIDE

Following is articulation of the (necessary and sufficient) conditions under which a mental health provider can be said to have permitted the suicide of a client:

A mental health provider (P) permitted a client (C) to commit suicide when (1) C successfully attempted suicide; (2) P reasonably anticipated that C would attempt suicide; (3) P was aware of at least one accessible intervention that could have thwarted C's anticipated suicide attempt; (4) P intentionally elected not to employ any such intervention; and (5) the proximate cause of C's death was C's lethal act.

The above conditions define permitted suicide in terms of the intentional omission of a preemptive suicide intervention. For purposes of these conditions, the variable P refers to any individual or institutional mental health provider having a legal duty of due care to its clients. This includes counselors as well as other mental health professionals such as social workers, psychologists, psychiatrists, and psychiatric nurses. P also includes any mental health facility such as a mental health agency or a psychiatric hospital. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Permitted Suicide: Model Rules for Mental Health Counseling. (Practice)
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.