International Library Of Ethics, Law, and the New Medicine, 2008
This chapter examines the nature of ethical concerns regarding suicide research in the context of... more This chapter examines the nature of ethical concerns regarding suicide research in the context of common ethical perspectives on the acceptability of suicidal behaviours and the obligations and limitations to intervening to prevent suicides. Suicide is a major health problem worldwide. According to World Health Organization data, almost one million people die by suicide each year (WHO 2002). There are
There is paucity of data on the burden of suicidality in HIV/AIDS and associated clinical factors... more There is paucity of data on the burden of suicidality in HIV/AIDS and associated clinical factors in sub-Saharan Africa. Yet, the region accounts for 70% of the HIV burden. This study aimed to assess the rate and clinical risk factors for suicidality in HIV-positive individuals in semi-urban Uganda. It was a cross-sectional survey of 543 HIV-positive individuals aged 15 years and above recruited from two HIV specialized clinics in Mbarara. Using logistic regression analysis, factors significantly associated with suicidality at 95% confidence interval and p-value of ≤ 0.05 were identified. The rate of suicidality was 10% (n= 54; 95% CI: 5.00-15.00); suicidal ideation 8.8% (n=48; 95% CI: 6.70-11.50) and suicidal attempt 3.1% (17, 95% CI 2.00-5.00). Risk factors for suicidality were: perception of poor physical health (OR 2.22, 95%CI 1.23-3.99, p= 0.007), physical pain (OR 1.83, 95%CI 1.01-3.30, p= .049), reducing on the work due to illness (OR = 2.22, 95%CI 1.23-3.99, p= 0.004) and re...
Suicide is a leading cause of injury and death worldwide -Almost one million people die by suicid... more Suicide is a leading cause of injury and death worldwide -Almost one million people die by suicide each year -Lifetime prevalence of suicide attempts range between 0.4 % and 5.1 % • Help-seeking as a means of prevention • Cross sectional telephone survey of the French general population • Two samples
Background: Research shows that there is a high prevalence of suicide among nurses. Despite this,... more Background: Research shows that there is a high prevalence of suicide among nurses. Despite this, it has been 15 years since the last literature review on the subject was published. Aim: The aim of this article is to review the knowledge currently available on the risk of suicide among nurses and on contributory risk factors. Method: A search was conducted in electronic databases using keywords related to prevalence and risk factors of suicide among nurses. The abstracts were analyzed by reviewers according to selection criteria. Selected articles were submitted to a full-text review and their key elements were summarized. Results: Only nine articles were eligible for inclusion in this review. The results of this literature review highlight both the troubling high prevalence of suicide among nurses as well as the persistent lack of studies that examine this issue. Conclusion: Considering that the effects of several factors related to nurses' work and work settings are associated...
To determine the relative effectiveness of telephone intervention styles with suicidal callers, r... more To determine the relative effectiveness of telephone intervention styles with suicidal callers, researchers listened unobtrusively to 617 calls by suicidal persons at two suicide prevention centers and categorized all 66,953 responses by the 110 volunteer helpers according to a reliable 20-category checklist. Outcome measures showed observer evaluations of decreased depressive mood from the beginning to the end in 14% of calls, decreased suicidal urgency ratings from the beginning to the end in 27% of calls, and reaching a contract in 68% of calls, of which 54% of contracts were upheld according to follow-up data. Within the context of relatively directive interventions, a greater proportion of "Rogerian" nondirective responses was related to significantly more decreases in depression. Reduction in urgency and reaching a contract were related to greater use of Rogerian response categories only with nonchronic callers.
This review focuses on suicide in patients with Autism Spectrum Disorders (ASD) as well as risk f... more This review focuses on suicide in patients with Autism Spectrum Disorders (ASD) as well as risk factors and comorbidities of persons with ASD who have attempted suicide. Research was conducted by searching PubMed and Psychinfo for articles. Suicide in ASD is largely understudied. Although suicide is common in clinical samples, we have little knowledge of suicide in persons with ASD in the general population. Comorbidity, particularly with depression and other affective disorders or schizoid disorders and psychotic symptoms, is often reported, so it is difficult to determine if suicidality is associated with ASD or the comorbid disorder. Clinical samples suggest that suicide occurs more frequently in high functioning autism. Physical and sexual abuse, bullying, and changes in routine are precipitating events associated with suicide risk. Persons with ASD present risk factors inherent to their diagnosis (deficit in expression of feelings and thoughts), along with risk factors pertaining to the general population (abuse, depression, anxiety, etc.). The inability of persons with Pervasive Developmental Disorder (PDD) to express emotions and thoughts makes the diagnosis of suicidal ideation difficult and demands important adjustments to traditional psychotherapeutic interventions. More research is needed to determine the incidence of suicidal behaviors in persons with ASD, to identify risk and protective factors, as well as to assess the effectiveness of prevention strategies and interventions.
A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller char... more A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller characteristics and changes during the calls. The relationship between intervention characteristics and call outcomes are reported for 1,431 crisis calls. Empathy and respect, as well as factor-analytically derived scales of supportive approach and good contact and collaborative problem solving were significantly related to positive outcomes, but not active listening. We recommend recruitment of helpers with these characteristics, development of standardized training in those methods that are empirically shown to be effective, and the need for research relating short-term outcomes to long-term effects.
Models of telephone crisis intervention in suicide prevention and best practices were developed f... more Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problemsolving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.
Callers to a suicide prevention center concerned about high risk men were randomly invited to par... more Callers to a suicide prevention center concerned about high risk men were randomly invited to participate in one of four programs: Information Session, Information Session with Telephone Follow-up, Rapid Referral to mental health and abuse programs, or Telephone Support. Comparison of pre-test, 2 month post-test and 6 months follow-up with 131 participants found that after third party participation, the third party participant reported that the suicidal men had significantly less suicidal ideation, fewer suicide attempts, and less depressive symptoms. Family and friends had less psychological distress, used more positive coping mechanisms, and reported their communication with the suicidal man was more helpful. The Telephone Support was considered the most useful program.
The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue p... more The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue policies of the Samaritans and the AAS and the U.S. National Suicide Prevention Lifeline network. We contrast moralist, relativist, and libertarian ethical premises and question whether suicide can be rational. Samaritans respect a caller's right to decide to die by suicide; U.S. helplines oblige emergency intervention during an attempt even against the caller's will. We analyze the effect of emergency rescue when there is high suicide risk but an attempt has not been initiated. We examine links between values and actions, needs for empirical evidence to guide practice, and propose vigorous dialogue about values in the gray zone of moral practice.
The promotion of suicide and description of suicide methods on the Internet have led to widesprea... more The promotion of suicide and description of suicide methods on the Internet have led to widespread concern that legal control is mandated. Apart from value concerns pertaining to attitudes about suicide, the guarantee of freedom of expression presents a serious challenge to the introduction of restrictive laws. Recent developments in Australia and Europe are presented, noting jurisdictional complexity as an obstacle to effective application. Finally, scientific data of an epidemiological nature are revealed to be insufficient to warrant making causal assertions about the Internet and its relation to suicidal acts, including those of vulnerable populations. Recommendations are made with respect to public education, suicide prevention, and future research.
Evidence of a media impact on suicide is mixed and needs further research. The main objective of ... more Evidence of a media impact on suicide is mixed and needs further research. The main objective of this article is to document the effects of the media coverage following the suicide of a well-known and popular television reporter in Quebec, Canada. A content analysis of the printed media and an analysis of suicide rates during the following year, of coroners' records and of calls to Suicide Prevention Centres during the following 3 months was conducted. Most guidelines for responsible reporting of a suicide were not applied. The results showed a rise in the suicides rates immediately after the reporter's suicide, especially by hanging as in the original case. A cluster of six suicides by hanging also took place in the small municipality where the reporter's suicide occurred. There was also an indication of direct influence in the coroners' records and a rise in calls to Suicide Prevention Centres. This research indicates that the reporting of the suicide of a popular figure preceded an important rise in the number of suicides. A possible theoretical explanation is that a positive role model appeared to suddenly fail to cope with life, thus creating high distress and cognitive dissonance in the audience. The news media should apply more caution and follow recommended guidelines in reporting this type of news.
ABSTRACT This study evaluated the development of the concept of suicide in sixty children ages si... more ABSTRACT This study evaluated the development of the concept of suicide in sixty children ages six to eleven. It was hypothesized that children's understanding of the concept of suicide would be related to their age, cognitive development, maturity of the concept of death, ...
Journal of Personality and Social Psychology, 1976
Kinesthetic Aftereffect (KAE), once a promising personality index, has been abandoned by many inv... more Kinesthetic Aftereffect (KAE), once a promising personality index, has been abandoned by many investigators because of poor retest reliability and intermittent validity. In challenging this current consensus, we argue that (a) first-session KAE is valid; (b) poor retest reliability simply reflects later-session bias; (c) hence, multisession studies should not be used to assess validity without taking this bias into account. Those recent studies which failed to support KAE validity were each multisession in design. If our bias contention is correct, these studies should be ignored, and the claim of intermittent validity is thus rebutted. Reanalysis of the most recent major multisession, nonsupportive validity study indicates (a) Session 1 validity, (b) later-session bias, and (c) later-session valdiity when multisession scores are combined to avoid bias. Thus, KAE validly measures personality.
Journal of Personality and Social Psychology, 1979
Research suggests that kinesthetic aftereffect (KAE) scores reflect status on a postulated stimul... more Research suggests that kinesthetic aftereffect (KAE) scores reflect status on a postulated stimulus intensity modulation (SIM) mechanism that damps down subjective stimulus intensity for some (reducing) and increases it for others (augmenting). Such a mechanism would help account for empirically observed individual differences in such behaviors as pain tolerance, sensory deprivation reactivity, and stimulation seeking. It was hypothesized and confirmed in three adult female samples that KAE varies curvilinearly over the menstrual cycle: Greater KAE reduction occurs at the cycle's beginning and end. Neither tiredness, oral contraception, medication, attention, nor social expectations can explain this finding. Of the behaviors studied in the KAE literature, only five are also encompassed by the menstrual cycle literature. Four of these (antisocial behavior, acute schizophrenic episodes, accidents, and activity level) show similar curvilinearity over the cycle. We hypothesize that cyclical variation in the SIM mechanism mediates the curvilinear pattern observed for both these four behaviors and KAE.
Men die by suicide three to four times more often than women in Western countries. The adverse im... more Men die by suicide three to four times more often than women in Western countries. The adverse impact of the traditional male gender role as well as men's reluctance to seek help are possible explanations of this gender gap, but these hypotheses have not been well documented empirically. This study compares two groups of men who experienced comparable severely stressful life events during the preceding 12 months: 40 men admitted to hospital emergency following suicide attempts, and 40 men with no history of suicide attempts. Structured interviews were conducted to measure adherence to the traditional male gender role, help seeking behaviour, social support, suicide acceptability and mental health. ANOVAS indicated that attempters are more likely to adhere to the traditional masculine gender role and regression analysis revealed that this relationship persists even when the presence of mental disorders is statistically controlled. Sequential regression analysis support the mediation model and show that the effects of the traditional male gender role on suicidal behavior are mediated through protective and risk factors for suicide, namely mental state, help seeking and social support. The traditional male gender role appears to increase the risk of suicidal behavior in men by undermining their mental state and by inhibiting the protective factors of help seeking and social support. This study underscores the importance of encouraging men to seek help.
Moralist, libertarian and relativist ethical positions concerning suicide and its prevention are ... more Moralist, libertarian and relativist ethical positions concerning suicide and its prevention are presented in order to clarify premises upon which ethical issues in suicide research may be resolved. Ethical concerns are differentiated from legal considerations and the implications of the vulnerability of suicidology research participants are discussed. Specific issues that arise in design, choice of participants, interpretation, diffusion of results and evaluative research are treated. These include: experimental methodologies, obtaining informed consent, deception and disclosure, studying innovative and unproven interventions, unknown consequences of participation, rescue criteria, disclosure of information to third parties, research with special populations, risks in publicizing results and measuring the value of human life. When specific legal obligations are lacking, ethical premises concerning the acceptability of suicide and obligations to intervene may influence research protocols.
International Library Of Ethics, Law, and the New Medicine, 2008
This chapter examines the nature of ethical concerns regarding suicide research in the context of... more This chapter examines the nature of ethical concerns regarding suicide research in the context of common ethical perspectives on the acceptability of suicidal behaviours and the obligations and limitations to intervening to prevent suicides. Suicide is a major health problem worldwide. According to World Health Organization data, almost one million people die by suicide each year (WHO 2002). There are
There is paucity of data on the burden of suicidality in HIV/AIDS and associated clinical factors... more There is paucity of data on the burden of suicidality in HIV/AIDS and associated clinical factors in sub-Saharan Africa. Yet, the region accounts for 70% of the HIV burden. This study aimed to assess the rate and clinical risk factors for suicidality in HIV-positive individuals in semi-urban Uganda. It was a cross-sectional survey of 543 HIV-positive individuals aged 15 years and above recruited from two HIV specialized clinics in Mbarara. Using logistic regression analysis, factors significantly associated with suicidality at 95% confidence interval and p-value of ≤ 0.05 were identified. The rate of suicidality was 10% (n= 54; 95% CI: 5.00-15.00); suicidal ideation 8.8% (n=48; 95% CI: 6.70-11.50) and suicidal attempt 3.1% (17, 95% CI 2.00-5.00). Risk factors for suicidality were: perception of poor physical health (OR 2.22, 95%CI 1.23-3.99, p= 0.007), physical pain (OR 1.83, 95%CI 1.01-3.30, p= .049), reducing on the work due to illness (OR = 2.22, 95%CI 1.23-3.99, p= 0.004) and re...
Suicide is a leading cause of injury and death worldwide -Almost one million people die by suicid... more Suicide is a leading cause of injury and death worldwide -Almost one million people die by suicide each year -Lifetime prevalence of suicide attempts range between 0.4 % and 5.1 % • Help-seeking as a means of prevention • Cross sectional telephone survey of the French general population • Two samples
Background: Research shows that there is a high prevalence of suicide among nurses. Despite this,... more Background: Research shows that there is a high prevalence of suicide among nurses. Despite this, it has been 15 years since the last literature review on the subject was published. Aim: The aim of this article is to review the knowledge currently available on the risk of suicide among nurses and on contributory risk factors. Method: A search was conducted in electronic databases using keywords related to prevalence and risk factors of suicide among nurses. The abstracts were analyzed by reviewers according to selection criteria. Selected articles were submitted to a full-text review and their key elements were summarized. Results: Only nine articles were eligible for inclusion in this review. The results of this literature review highlight both the troubling high prevalence of suicide among nurses as well as the persistent lack of studies that examine this issue. Conclusion: Considering that the effects of several factors related to nurses' work and work settings are associated...
To determine the relative effectiveness of telephone intervention styles with suicidal callers, r... more To determine the relative effectiveness of telephone intervention styles with suicidal callers, researchers listened unobtrusively to 617 calls by suicidal persons at two suicide prevention centers and categorized all 66,953 responses by the 110 volunteer helpers according to a reliable 20-category checklist. Outcome measures showed observer evaluations of decreased depressive mood from the beginning to the end in 14% of calls, decreased suicidal urgency ratings from the beginning to the end in 27% of calls, and reaching a contract in 68% of calls, of which 54% of contracts were upheld according to follow-up data. Within the context of relatively directive interventions, a greater proportion of "Rogerian" nondirective responses was related to significantly more decreases in depression. Reduction in urgency and reaching a contract were related to greater use of Rogerian response categories only with nonchronic callers.
This review focuses on suicide in patients with Autism Spectrum Disorders (ASD) as well as risk f... more This review focuses on suicide in patients with Autism Spectrum Disorders (ASD) as well as risk factors and comorbidities of persons with ASD who have attempted suicide. Research was conducted by searching PubMed and Psychinfo for articles. Suicide in ASD is largely understudied. Although suicide is common in clinical samples, we have little knowledge of suicide in persons with ASD in the general population. Comorbidity, particularly with depression and other affective disorders or schizoid disorders and psychotic symptoms, is often reported, so it is difficult to determine if suicidality is associated with ASD or the comorbid disorder. Clinical samples suggest that suicide occurs more frequently in high functioning autism. Physical and sexual abuse, bullying, and changes in routine are precipitating events associated with suicide risk. Persons with ASD present risk factors inherent to their diagnosis (deficit in expression of feelings and thoughts), along with risk factors pertaining to the general population (abuse, depression, anxiety, etc.). The inability of persons with Pervasive Developmental Disorder (PDD) to express emotions and thoughts makes the diagnosis of suicidal ideation difficult and demands important adjustments to traditional psychotherapeutic interventions. More research is needed to determine the incidence of suicidal behaviors in persons with ASD, to identify risk and protective factors, as well as to assess the effectiveness of prevention strategies and interventions.
A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller char... more A total of 2,611 calls to 14 helplines were monitored to observe helper behaviors and caller characteristics and changes during the calls. The relationship between intervention characteristics and call outcomes are reported for 1,431 crisis calls. Empathy and respect, as well as factor-analytically derived scales of supportive approach and good contact and collaborative problem solving were significantly related to positive outcomes, but not active listening. We recommend recruitment of helpers with these characteristics, development of standardized training in those methods that are empirically shown to be effective, and the need for research relating short-term outcomes to long-term effects.
Models of telephone crisis intervention in suicide prevention and best practices were developed f... more Models of telephone crisis intervention in suicide prevention and best practices were developed from a literature review and surveys of crisis centers. We monitored 2,611 calls to 14 centers using reliable behavioral ratings to compare actual interventions with the models. Active listening and collaborative problemsolving models describe help provided. Centers vary greatly in the nature of interventions and their quality according to predetermined criteria. Helpers do not systematically assess suicide risk. Some lives may have been saved but occasionally unacceptable responses occur. Recommendations include the need for quality assurance, development of standardized practices and research relating intervention processes to outcomes.
Callers to a suicide prevention center concerned about high risk men were randomly invited to par... more Callers to a suicide prevention center concerned about high risk men were randomly invited to participate in one of four programs: Information Session, Information Session with Telephone Follow-up, Rapid Referral to mental health and abuse programs, or Telephone Support. Comparison of pre-test, 2 month post-test and 6 months follow-up with 131 participants found that after third party participation, the third party participant reported that the suicidal men had significantly less suicidal ideation, fewer suicide attempts, and less depressive symptoms. Family and friends had less psychological distress, used more positive coping mechanisms, and reported their communication with the suicidal man was more helpful. The Telephone Support was considered the most useful program.
The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue p... more The ethical basis of suicide prevention is illustrated by contrasting helpline emergency rescue policies of the Samaritans and the AAS and the U.S. National Suicide Prevention Lifeline network. We contrast moralist, relativist, and libertarian ethical premises and question whether suicide can be rational. Samaritans respect a caller's right to decide to die by suicide; U.S. helplines oblige emergency intervention during an attempt even against the caller's will. We analyze the effect of emergency rescue when there is high suicide risk but an attempt has not been initiated. We examine links between values and actions, needs for empirical evidence to guide practice, and propose vigorous dialogue about values in the gray zone of moral practice.
The promotion of suicide and description of suicide methods on the Internet have led to widesprea... more The promotion of suicide and description of suicide methods on the Internet have led to widespread concern that legal control is mandated. Apart from value concerns pertaining to attitudes about suicide, the guarantee of freedom of expression presents a serious challenge to the introduction of restrictive laws. Recent developments in Australia and Europe are presented, noting jurisdictional complexity as an obstacle to effective application. Finally, scientific data of an epidemiological nature are revealed to be insufficient to warrant making causal assertions about the Internet and its relation to suicidal acts, including those of vulnerable populations. Recommendations are made with respect to public education, suicide prevention, and future research.
Evidence of a media impact on suicide is mixed and needs further research. The main objective of ... more Evidence of a media impact on suicide is mixed and needs further research. The main objective of this article is to document the effects of the media coverage following the suicide of a well-known and popular television reporter in Quebec, Canada. A content analysis of the printed media and an analysis of suicide rates during the following year, of coroners' records and of calls to Suicide Prevention Centres during the following 3 months was conducted. Most guidelines for responsible reporting of a suicide were not applied. The results showed a rise in the suicides rates immediately after the reporter's suicide, especially by hanging as in the original case. A cluster of six suicides by hanging also took place in the small municipality where the reporter's suicide occurred. There was also an indication of direct influence in the coroners' records and a rise in calls to Suicide Prevention Centres. This research indicates that the reporting of the suicide of a popular figure preceded an important rise in the number of suicides. A possible theoretical explanation is that a positive role model appeared to suddenly fail to cope with life, thus creating high distress and cognitive dissonance in the audience. The news media should apply more caution and follow recommended guidelines in reporting this type of news.
ABSTRACT This study evaluated the development of the concept of suicide in sixty children ages si... more ABSTRACT This study evaluated the development of the concept of suicide in sixty children ages six to eleven. It was hypothesized that children's understanding of the concept of suicide would be related to their age, cognitive development, maturity of the concept of death, ...
Journal of Personality and Social Psychology, 1976
Kinesthetic Aftereffect (KAE), once a promising personality index, has been abandoned by many inv... more Kinesthetic Aftereffect (KAE), once a promising personality index, has been abandoned by many investigators because of poor retest reliability and intermittent validity. In challenging this current consensus, we argue that (a) first-session KAE is valid; (b) poor retest reliability simply reflects later-session bias; (c) hence, multisession studies should not be used to assess validity without taking this bias into account. Those recent studies which failed to support KAE validity were each multisession in design. If our bias contention is correct, these studies should be ignored, and the claim of intermittent validity is thus rebutted. Reanalysis of the most recent major multisession, nonsupportive validity study indicates (a) Session 1 validity, (b) later-session bias, and (c) later-session valdiity when multisession scores are combined to avoid bias. Thus, KAE validly measures personality.
Journal of Personality and Social Psychology, 1979
Research suggests that kinesthetic aftereffect (KAE) scores reflect status on a postulated stimul... more Research suggests that kinesthetic aftereffect (KAE) scores reflect status on a postulated stimulus intensity modulation (SIM) mechanism that damps down subjective stimulus intensity for some (reducing) and increases it for others (augmenting). Such a mechanism would help account for empirically observed individual differences in such behaviors as pain tolerance, sensory deprivation reactivity, and stimulation seeking. It was hypothesized and confirmed in three adult female samples that KAE varies curvilinearly over the menstrual cycle: Greater KAE reduction occurs at the cycle's beginning and end. Neither tiredness, oral contraception, medication, attention, nor social expectations can explain this finding. Of the behaviors studied in the KAE literature, only five are also encompassed by the menstrual cycle literature. Four of these (antisocial behavior, acute schizophrenic episodes, accidents, and activity level) show similar curvilinearity over the cycle. We hypothesize that cyclical variation in the SIM mechanism mediates the curvilinear pattern observed for both these four behaviors and KAE.
Men die by suicide three to four times more often than women in Western countries. The adverse im... more Men die by suicide three to four times more often than women in Western countries. The adverse impact of the traditional male gender role as well as men's reluctance to seek help are possible explanations of this gender gap, but these hypotheses have not been well documented empirically. This study compares two groups of men who experienced comparable severely stressful life events during the preceding 12 months: 40 men admitted to hospital emergency following suicide attempts, and 40 men with no history of suicide attempts. Structured interviews were conducted to measure adherence to the traditional male gender role, help seeking behaviour, social support, suicide acceptability and mental health. ANOVAS indicated that attempters are more likely to adhere to the traditional masculine gender role and regression analysis revealed that this relationship persists even when the presence of mental disorders is statistically controlled. Sequential regression analysis support the mediation model and show that the effects of the traditional male gender role on suicidal behavior are mediated through protective and risk factors for suicide, namely mental state, help seeking and social support. The traditional male gender role appears to increase the risk of suicidal behavior in men by undermining their mental state and by inhibiting the protective factors of help seeking and social support. This study underscores the importance of encouraging men to seek help.
Moralist, libertarian and relativist ethical positions concerning suicide and its prevention are ... more Moralist, libertarian and relativist ethical positions concerning suicide and its prevention are presented in order to clarify premises upon which ethical issues in suicide research may be resolved. Ethical concerns are differentiated from legal considerations and the implications of the vulnerability of suicidology research participants are discussed. Specific issues that arise in design, choice of participants, interpretation, diffusion of results and evaluative research are treated. These include: experimental methodologies, obtaining informed consent, deception and disclosure, studying innovative and unproven interventions, unknown consequences of participation, rescue criteria, disclosure of information to third parties, research with special populations, risks in publicizing results and measuring the value of human life. When specific legal obligations are lacking, ethical premises concerning the acceptability of suicide and obligations to intervene may influence research protocols.
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Papers by Brian Mishara