i feel once the pt is brought to the hospital then he should recieve the treatment which is good enough to keep him alive and an immediate psychological counselling and support may probably change his mindset and he/she may become more positive toward life.

"i feel once the pt is brought to the hospital then he should recieve the treatment which is good enough to keep him alive"

   So, regardless of the patient's wishes, treatment should be imposed in a paternalistic manner?   I think if such patients recover they could successfully sue the doctor for overriding their autonomy.

if the attempt is close to lethal, the patient is most probably unconscious and goes to reanimation. if the attempt is not lethal, we need to treat him anyway, to exclude complications, which are also non-lethal, but may be crippling. i guess that person doesn't want to become an invalid. besides, there is a need to talk to a person to inquire about his mental status etc. as i work with suicidal patients, i can tell that most of them don't want to die, they want to change their current situation. they feel psychache, which is troubling them, and they are ambivalent about their life. those who want to die deliberately need to think of something lethal then, but there is no need to sue the clinic. Clinic does its job, and if the person wants to die, she dies. 

"i can tell that most of them don't want to die,"

    But what do the patients say when they first come in?  Are they asked to consent to treatment, or are they treated anyway?

i am not a doctor, so i don't know, i am a psychologist. they say that either they didn't want to die in the first place (so they dissimulate suicidal tendencies), or that they wanted to but don't want now. very little people say that they still want to die, and they usually agree that they are depressive and want help from these thoughts

There is a fine line between making a conscious, clear-thinking decision to suicide and having an illness interfere w/one's ability to think & make good choices.  How do we determine which group the suicidal patient falls into?  And in making the determination, are we playing God?

There is one school of thought that believes since we put down (euthanize) sick or injured animals to relieve their untreatable pain, we should allow the same choice to people.  At the same time, there is the opposing school of thought that believes there is a difference between euthanizing a companion animal and a human being.  Who is right?  And if someone is right, then it stands to reason the other is wrong.

I've evaluated people who have come into the emergency room after a suicide attempt.  There seems to be an equal number who tell me the attempt has changed their minds, they don't really want to die, those who continue their suicidal ideation, & those who say they don't want to die but see no other way of making the pain stop.  Additionally, there are those whose behavior can be said to be a slow form of suicide--alcoholics, addicts, self-mutilation, and many others.  Then there are those who are determined to suicide and no matter the intervention, will eventually succeed as they eliminate all of the ways that did not work.

The question of treating people with suicidal ideation must be answered on several different levels.  There is the physical treatment of reversing whatever they have done in the attempt.  The mental treatment, which may involve medication to treat a mood disorder.  And the spiritual dimension, which is where the provider must be clear within themselves about what they believe with the recognition that the client may not hold the same beliefs.  And there is the idea that people have the right to be wrong.  

Do we treat people with suicidal thoughts?  I think that we must even while we recognize their right to be wrong and  we perceive the person with unconditional positive regard. 

The vital point to recognise is that many, if not virtually all, of the patients we see in emergency departments have a situational or mental health crisis which pushes them towards attempts at self harm, and as one of the writers above succinctly points out, very, very few people persist in wanting to kill themselves when the acute problem is resolved. This is nothing to do with paternalism, this is recognising that most suicide attempts are the expression of a crisis and seldom really reflect either the person's underlying state of mind or their true wishes. In my experience, the people who really want to end their life, whether due to loneliness, sadness or terminal illness take a great deal more care to ensure that they are not prevented, found or resuscitated, and there is a powerful argument to allow them to do just as they plan. Please don't confuse different situations.

"Then there are those who are determined to suicide and no matter the intervention, will eventually succeed as they eliminate all of the ways that did not work"...

And there is the idea that people have the right to be wrong.  

Do we treat people with suicidal thoughts?  I think that we must even while we recognize their right to be wrong and  we perceive the person with unconditional positive regard."

****************************************

   This all looks contradictory to me.   We respect a person's view about ending life, then ignore and override it.  

Your responses seem like you have made up your mind on whether or not you think emergency personnel (both medical and psychological) should treat those who attempt suicide. In that case, nothing anyone says will change your mind.

However, if you're actually open to different perspectives, there are many, a handful of which have been discussed here already. I think there is another layer that must be explicated, though, as well. The experience of a depressed or otherwise mentally ill person is not always realistic. As Jenny Lawson, an outspoken mental health advocate and writer says, "depression lies." It's not just depression, though. Bipolar, anxiety, schizophrenia, PTSD, and many other illnesses impair and twist the experiences of those who suffer from them. So on some level, those who come in after a suicide attempt related to psychological distress are as ill as someone who presents with any other kind of medical distress which impairs their ability to function in their everyday life. Their distress is so extreme that that--in their impaired mind--the only sensible way to stop their distress is suicide. But in a large number of cases, that is cutting off the nose to spite the face. There are other options besides suicide, but the impaired perception caused by their mental illness doesn't let them see, understand, or seek these other options. It's our job to help them access these, in order to restore maximum functioning and alleviate their distress.

The cases of suicide attempts in those who have a known terminal illness, it gets a little more complicated. However, in the acute phase, as healthcare providers, we can't always decisively determine if they were of sound mind before the attempt. Often, these patients will attempt suicide in the privacy of their home, without anyone around, so a family member will come in and find them unconscious or otherwise in distress/impaired, and not know the causes. It's not like most cases come in with a suicide note attached to their chest; it's simply not that clear cut. In these cases, most healthcare professionals prefer to take a rather conservative stance and treat the person, which allows for further care decisions to be made by the patient and family. In my experience as an ER nurse, in patients who we know are terminal who may come in multiple times for things we may or may not view as suicide attempts, we encourage them to seek palliative and hospice care in order to alleviate as much suffering as possible and allow them a death with dignity. This is something that the patients and their family have to do, though, but we can often at least get appropriate personnel consulted so they have accurate and thorough information. Do we sometimes make the wrong choice? Probably. We aren't infallible. But we have to do what we think is best for the person given the information we have, which is often piecemeal in these cases.

"Your responses seem like you have made up your mind on whether or not you think emergency personnel (both medical and psychological) should treat those who attempt suicide."

No I haven't, which is why I put up this question. I wanted to highlight the conflict between the dominant modern principle of patient autonomy, and of medical staff acting in the best interests of the patient, since Society and the Professions are in denial over this clash.

"It's our job to help them access these, in order to restore maximum functioning and alleviate their distress."

In other words, make them change their minds. Where is the boundary line between this and bullying, brainwashing or paternalism?

I have fortunately never been in the position to have to make a judgement. If I were an A & E doctor, I would section far more patients than is the case at present, in the long-term interests of themselves, their families and society. I would act autocratically and override their autonomy.

This is an interesting ethical question, but the fact rains that this person has no regard for their life and clearly has a plan to end it. At this point they are not competent to make decisions about their welfare, therefore they require intervention/treatment. This can turn into a very judgemental discussion, but in the end the patient requires treatment for their suicidal tendencies. Access to care is the question, not autonomy.

Yes, they should. The treatment always is doctors' aim and their work.

It is a main objective the treatments and in this case the preventive measures

Continuing my first answer, on the other hand, the patient is possible to has changed opinion and to want the treatment voluntary and gladly.

Besides to this attempt of the treatmemt by the doctor, comes as allied the God in the Jesus Christ's person by His verb - commandment ( Mat. 5,21-22) and by Mosaic law (Ex 20,13, Dt 5,17), as the Hippocrates by his oath.

Of course, we should treat, because it is our aim. (I'm a doctor)

I fully agree with Dr. Unluoglu comment, of course!!!

"Of course, we should treat, because it is our aim. (I'm a doctor)"

I do not think it is that simple. Whilst not necessarily disagreeing that A & E patients attempting suicide should be treated, this obviously conflicts with the modern doctrine of patient autonomy. If we say people should not be allowed to kill themselves, what about abortion, infanticide, euthanasia, where some say that killing is justified. Either people are allowed to decide things for themselves, or they are not.

I think it's very different to discuss the theory of a profession and to practice it. Undoubtedly, international and national laws and regulations limit us. In my country (active) euthanasia is not legal. In my first answer I mentioned my profession to emphasize that I practice this profession. As a doctor, I believe that my goal (within legal limits) is to protect and sustain human life.

How should live a life?

For what should live a life?

Do you think why people suicide?

Are they incompentet or weak?

Or are they too much susceptive to world's bizarre daily function which consumption based?

In my opinion before to give a clear answer scientist should ask many question for understand the basis of circumstance. Do not forget despite the all answers you have collect, none of them are true. I believe that life is a important time duration, because of this we should try to preserve it all time that we have.

Best Regards.

An answer to Ekrem Akbuga.

In my opinion, to live the life is to accept this God's gift which has only pleasure, satisfaction, profit, enjoyment, peace and hapiness. The man should live the life according His commandments ( The Christian commandments).

Dear Theodore John Drizis

Of course it is your life and it is your choise. For me it is not important how that how you choosed (if you choosed) a life to live it. it is important that if you do not restrict anyone's indipendence and it is important that your satisfaction of your living duration your life.

In my answer for 'Should doctors treat patients who have attempted suicide?' I mean that we must think too much to judge to any idea regarding human life. I shoul repeat it no answer is true; because all truths are depend conditions; if you change the conditions you will see the truths are changing naturally. Boiling point of water is 100 c at 1 atmosphere of pressure.

Enjoy your life.

Best Regards.

I think is completely necessary

In my opinion always, the life as Trinitarian God's gift is beyond any condition, any challenge, any change, any disease and death.

Study and search the New Testament and you will take the answers to your questions.

"Noa Pothoven wasn’t euthanised—but it was what she wanted

BMJ 2019; 365 doi: https://doi.org/10.1136/bmj.l4142 (Published 12 June 2019)Cite this as: BMJ 2019;365:l4142...

Melanie Newman reports

As news broke of the death of a 17 year old mentally ill rape victim in the Netherlands, a media storm was inevitable. The Daily Mail, the Daily Beast, Euronews, and the Independent were among news outlets that rushed out stories on a teenager who had been “legally euthanised.” The story spread rapidly around the globe: the teenager’s name, Noa Pothoven, was trending in Italy on 5 June before a Politico reporter, Naomi O’Leary, debunked the story on Twitter.1

Pothoven, who last year published an autobiography describing multiple sexual assaults,2 had depression, anorexia, and other mental health problems for which she had been repeatedly admitted to hospital. She had sought euthanasia from a clinic in the Hague when she was 16, but this was refused because her parents had not been informed, said a Dutch newspaper...

O’Leary checked with the reporter of that story, who told her that Pothoven had not been euthanised. She also discovered that the euthanasia claim had appeared only in English language outlets: Dutch news reports did not mention it. The first articles in English had made assumptions based on a report that Pothoven had once requested euthanasia, as well as on an Instagram post in which she had said that she intended to die.

Pothoven’s family and the Royal Dutch Medical Association later stated that she had in fact died at home after refusing food and fluids4—prompting a rash of media corrections. The Dutch health minister has announced an investigation into the full facts,5 but it’s already clear that the teenager’s death did not meet the association’s definition of euthanasia6: “the active termination of life at a patient’s voluntary and well informed request.”..

Both euthanasia and assisted suicide—where patients are helped to take their own life—have been legal in the Netherlands since 2002 for patients experiencing “unbearable suffering with no prospect of improvement.” Children as young as 12 may be euthanised with parental permission, while patients aged 16 to 18 may have death induced against parental wishes as long as the parents have been made aware.

Mental ill health

The New York Times interviewed the director of the end-of-life clinic in the Hague that had turned Pothoven down.7 Of 2600 requests for euthanasia made to the clinic in 2018, about a quarter were from people solely with mental ill health, the newspaper reported. And of the 727 patients euthanised at the clinic last year about 50 (7%) had solely mental health problems...

Pothoven would not have been eligible for assisted dying under the law change that Dignity in Dying is seeking in the UK, added Davies. He explained, “The law we propose would allow dying adults of sound mind whose suffering is beyond the reach of palliative care to choose the manner and timing of their death.”

Pothoven’s death has some aspects in common with that of Merryn Crofts, a 21 year old Briton, in 2017. Crofts, who had myalgic encephalomyelitis, was in constant pain and, like Pothoven, had undergone repeated unsuccessful hospital treatments. Crofts died from starvation in the UK in 2017,8 having rejected further treatment for an infection that had meant that she had to stop using her feeding tube.9

UK guidance dating back to 1997 allows doctors to force feed anorexic patients if they are deemed to lack mental capacity. Doctors may also over-rule patients’ refusal of medical treatment on capacity grounds."