Clients and Suicide: The Lawyer’s Dilemma

Imagine representing Socrates and then learning that he was planning to take hemlock, what should counsel have done?1 It is a question that would have perplexed the wisest of his time and ours.2 Add twenty-four centuries and the issues are all the more complicated.3

Mental health challenges abound in many precincts of modern society, including the practice of law,4 the prosecution and punishment of crime5 and the representation of clients.6 The stress of prosecution or litigation, whether it means risking a prison term, unemployment, bankruptcy, eviction, broken family relations, isolation, or other serious consequences can create or exacerbate a vulnerable and dangerous state of mind in a client.

Client suicidal thoughts, attempts or actions expose the intimacies of human autonomy and test the limits of the attorney-client relationship. They cross a range of legal, moral and medical contexts: professional responsibility, client confidentiality, effective assistance of counsel, legal malpractice, criminal liability, and end of life issues. So it is that attorneys confronted with signs of suicidal intentions in their clients need to be conscious of their legal and ethical responsibilities.7

This article collects notable materials on this complex and sensitive topic, including ethics opinions, law reviews, bibliographies and other resources.

ETHICS OPINIONS8

US: ABA Ethics Opinion 83-1500 (1983)
“This inquiry involves the situation in which a client who has retained a lawyer to draft her will confides to the lawyer that she intends to take her own life. The client also disclosed that she has been hospitalized for mental exhaustion on at least one occasion after a previous suicide attempt. Neither suicide nor attempted suicide is a crime in the jurisdiction. The lawyer asks whether the ABA Model Code of Professional Responsibility prohibits the lawyer from disclosing to a third person the intention of his client to take her own life.”

AL: Alabama State Bar Ethics Opinions RO-95-06
“Through Legal Services Corporation I have agreed to represent an indigent individual in a Petition to Modify his Divorce Decree to terminate or reduce his child support since he is now unemployed. He quit his job due to a nervous breakdown and has been hospitalized twice for suicide attempts. He has stopped seeking psychological counseling because he is scared of indigent health care systems and has feelings of paranoia about being watched and/or investigated.”

AK: Alaska Bar Association Ethics Opinion No. 2005-1
“An attorney represents a client charged with felony sexual assault, but realizes that the client has no credible defense. The client, however, is not interested in a plea bargain and is adamant about taking the case to trial. The client has further informed the attorney that if convicted of the felony sexual assault, the client will commit suicide rather than go to jail. Must the attorney disclose the client’s stated intention to commit suicide rather than go to jail if convicted?”

AZ: State Bar Arizona Ethics Opinion 91-18 (1991)
“The inquiring attorney represents a client who has sustained severe, disabling physical injuries. The client has informed the inquiring attorney that he intends to commit suicide after the personal injury action is concluded. In addition, the client has stated that his doctor, the defendant in the action, will “go down with him. The inquiring attorney states that he believes the client to be serious about the suicide but does not believe that the client is serious about bringing [the doctor] down with him.'”

CT: Connecticut Bar Association Ethics Opinion 00-5 (1999)
“We were asked to assume these facts: A client meets with his lawyer seeking estate planning advice and requests that the lawyer prepare the necessary documents on a rush basis. The client’s reason for requesting urgent preparation of documents is that he intends to take his own life in about two weeks. He is unemployed and cannot pay his mortgage or his child’s tuition. Despite trying hard to find a job, the client believes there is no current prospect of finding one. But he does have a life insurance policy and in it the client sees a way to provide for his family. The client seeks the lawyer’s assistance in carrying out the estate-planning component of this plan.

The lawyer in turn asked us to respond to two questions about his obligations under the Rules of Professional Conduct (the Rules). The first question is as follows: Does Rule 1.6 or any other Rule of Professional Conduct prohibit my disclosure of my client’s intent to commit suicide and related facts to law enforcement authorities, state health care authorities, his family, any judicial or administrative tribunal, or any other persons or entities I feel may provide help?”

GA: State Disciplinary Board Advisory Opinion 42 (1984)(State Bar of Georgia)
“Attorney (A) represents client (C), who is facing a multiple felony indictment and substantial possibility of conviction thereon. C has sought advice from A concerning matters one would normally expect to be consulted about by a terminally ill person trying to put his affairs in order prior to death. Although C has never directly so stated to A, by his actions and conduct, C has led A to believe that C intends to commit suicide prior to his criminal trial. A has inquired whether Informal Opinion No. 83-1500 of the ABA Standing Committee on Ethics and Professional Responsibility (June 24, 1983), which authorized a lawyer to disclose to other persons the definite threat of his client to take his own life would apply to a situation where the client has not definitely expressed such an intention, but, by his actions, has given his attorney reason to believe that he intends to take his own life.”

MA: Massachusetts Bar Association Ethics Opinion No. 01-2
“In the course of a discussion about his affairs, a client informs a lawyer that he has decided to commit suicide. So far as the lawyer knows, the decision is not precipitated by terminal illness or any particular disease. The client seems overwhelmed by his life’s problems. The lawyer is reasonably certain that the client is serious about his suicide threat. The lawyer inquires whether she may reveal that information to others in a position to prevent the client from carrying out the threat.”

NE: Nebraska Ethics Advisory Opinion 91-4
“If an attorney reasonably believes a client to be mentally incompetent, the attorney may disclose confidential attorney-client communications to the extent necessary to protect the best interests of the client.”

NY: New York State Bar Association Ethics Opinion 486 (1978)
“May a lawyer disclose his client’s expressed intention to commit suicide? Neither the Code, the former Canons of Professional Ethics, nor any ethics committee opinion of which we are aware, directly address the issue of a lawyer’s obligations when told by a client that the client is contemplating suicide. The issue is a difficult one. The lawyer’s obligations will depend in part upon the circumstances of each case, and upon the experience, wisdom and skill at human relations of the lawyer to whom the disclosure is made. There is also a need to balance the law’s longstanding policies concerning the protection of human life against customary professional standards involving the preservation of client confidences and secrets.”

PA: Philadelphia Bar Association Ethics Opinion 2003-11
“The inquirer represented a client who was being evicted from a private recovery facility where he was being treated for serious substance abuse and mental health problems. During the inquirer’s negotiations with the facility owner to delay the client’s eviction, the client committed suicide. Another resident of the facility told the inquirer that the client argued with the facility owner shortly before the suicide occurred. The client’s father has asked the inquirer for information about events leading up to the client’s death. The father is aware of the client’s argument with the facility owner because the client told him about it. Following the suicide, the inquirer discovered several regulatory irregularities concerning the facility from several tenants who lived there and from a review of public records. The inquirer asks whether the duty of confidentiality and the attorney-client privilege prevent him from responding to the father’s request for information and/or from contacting the media or governmental agencies about the regulatory irregularities at the facility. The inquirer also asks whether the ability to make disclosures to the father would change if the father were appointed executor of the client’s estate.”

UT: Utah State Bar Ethics Advisory Opinion 95 (1989)
“May a lawyer disclose a client’s threats to commit suicide to another who might help prevent it, even though the client’s communication is privileged and confidential and otherwise falls within the scope of the attorney-client relationship?”

LAW REVIEWS

Community Divided: Defense Attorneys and the Ethics of Death Row Volunteering, 25 Law & Soc. Inquiry 849 (2000)
“When death row inmates elect to waive appeals and proceed directly to execution a series of problematic legal and ethical questions are raised. This article examines the ethics of volunteering from the perspective of death row inmates’ defense attorneys. Studying attorneys is important for two reasons: since they are charged with protecting their clients’ interests they must resolve the difficult question of whether death is ever in someone’s best interest; and perhaps more important, most death row defense attorneys are themselves against the death penalty and must thus negotiate between their clients’ desire for execution and their own personal value systems. Interviews were conducted with 20 attorneys who have participated in representing would-be volunteers. Qualitative analysis suggests that most are faced with profound ethical dilemmas, both professional and personal, when a client elects to waive appeals. This article explores how attorneys interpret, experience, and resolve those dilemmas.”

Conflict Between Confidentiality and Disclosure When a Client Announces Suicidal Intentions: a Proposed Amendment to the Model Ethics Codes, 40 Wayne L. Rev. 1629 (1994)
“This Note begins with an overview of the development of suicide-related law and a discussion of suicide prevention efforts. It then examines the history, purpose, and confidentiality provisions of the Model Code of Professional Conduct (Model Code) and the Model Rules of Professional Responsibility (Model Rules), jointly referred to as the model ethics codes. Next, the Note analyzes both the conflict between confidentiality and disclosure with respect to clients who have announced their suicidal intentions and the special problems presented by disciplinary proceedings and claims of civil liability. This Note then considers the ethical guidance available to attorneys faced with suicidal clients, and determines that this guidance is extremely insufficient. Finally, the Note proposes an amendment to the model ethics codes that mandates the disclosure of a client’s suicidal intentions, and concludes with a discussion on the advantages and disadvantages of such an amendment.”

Criminals Get All the Rights: The Sociolegal Construction of Different Rights to Die, SSRN (2014)
“In the United States, different people have different rights to die. After sketching the legal standards for hastening death, this article uses empirical research on “volunteers,” death-sentenced prisoners who hastened execution by dropping their appeals, to argue for integrating into adjudications of requests to hasten execution a Fourteenth Amendment analysis comparable to that used in medical cases. The article discusses socio-legal influences contributing to death-sentenced prisoners’ simultaneously more expansive and less protective right to assistance in dying. Further, it contends that death-sentenced prisoners are more successful in hastening death not simply because of their sentence, but because the law is responding to differently defined social problems. Paradoxically, in this case, the more expansive right reflects and furthers social marginalization. In addition to raising important questions about the legitimacy of the American death penalty, the Article illuminates the different ways in which rights to accelerate death can be implemented. In so doing, the Article contributes to the increasingly pressing political debate over ordinary Americans’ ability to end their own lives.”

‘I’ll Make Them Shoot Me’: Accounts of Death Row Prisoners Advocating for Execution, 46 Law & Soc’y Rev. 589 (2012)
“About 11% of death-sentenced prisoners executed in the United States hastened executions by abandoning their appeals. How do these prisoners persuade courts to allow them to abandon their appeals? Further, how do legal structures and processes organize these explanations, and what do they conceal? An analysis of Texas cases suggests that prisoners marshal explanations for their desires to hasten execution that echo prevailing cultural beliefs about punishment and the death penalty. The coherence of these accounts is amplified by a non-adversarial, unreliable legal process. This article contributes to our understanding of legal narratives, and expands their analysis to include not only hegemonic stories and legal rules, but also the legal process that generates them.”

Killing the Willing:”Volunteers,” Suicide and Competency, 103 Mich. L. Rev. 939 (2005)
“Of the 822 executions, in the modern era of capital punishment, 106 involved volunteers, or inmates who chose to waive their appeals and permit the death sentence to be carried out. The debate about volunteers, although intense, has primarily been polemic. Those who wish to curtail a death row inmate’s ability to waive his appeals refer to volunteer cases as nothing more than “state assisted suicide;” advocates of permitting inmates to choose execution reject the suicide label, instead focusing on respect for a death row inmate’s right to choose whether to accept his punishment. This article takes a different approach. It asks how, and how often, volunteers are in fact similar to suicidal persons and offers some empirical comparisons between the characteristics of death row inmates who have waived their appeals and been executed with those of people who commit suicide in the “free world.” The demographic and epidemiological similarities between death row volunteers and free world suicides strongly suggest that the present legal standard for assessing the legitimacy of a death sentenced inmate’s desire to waive his appeals–the competency standard–has turned a blind eye to the possibility that many waivers are motivated by the inmate’s desire to commit suicide. Thus, this article proposes a standard for assessing waiver which both attempts to insure that a death row inmate is not permitted to use the death penalty as a means of committing state assisted suicide, and which protects the right of a mentally healthy inmate to forego further appeals when motivated by acceptance of the justness of the punishment.”

Role of Law in Suicide Prevention: Beyond Civil Commitment-Bystander Duty to Report Suicide Threats, 39 Stan. L. Rev. 929 (1987)
“Suicide is a societal ailment of tremendous proportion, and one for which there is no easy cure. The only practical approach to the problem is prevention: first, the immediate prevention of the attempt and second, treatment of the underlying problems that motivated that attempt. Such prevention will, of course, require the cooperative efforts of many disciplines. The analysis that follows explores a role that law can play in these prevention efforts.
Part I of this note reviews the historical involvement of the law with suicide and the primary legal prevention strategy in the United States — the civil commitment of mentally-ill suicidal individuals. Part II develops legal justifications for suicide prevention efforts. Part III explores limitations of current prevention efforts. Finally, Part IV proposes that a legal duty to report suicide threats be imposed on bystanders, enabling mental health professionals to evaluate the situation and respond, when appropriate, before suicide is attempted.”

Swilling Hemlock: The Legal Ethics of Defending a Client Who Wishes to Volunteer for Execution, 63 Wash. & Lee L. Rev. 147 (2006)
“This Article advances in six Parts. The first, this introduction, summarizes the scope of the article and its key concepts. The second Part, entitled “Lawyers’ Nightmares Do Come True: When the Client Volunteers for Execution,” reviews three seminal Supreme Court cases that established the modem death penalty, describes the swelling ranks of death row in the United States and the commensurate need for death row representation, addresses the disorienting ethical universe of the capital volunteer, and analyzes a number of ethical approaches to lawyering.
The third Part, entitled “Grasping at Straws: Competence as a Means of Avoiding the Volunteering Conundrum,” describes the competence hearing as an illusory solution to the problem of the volunteer. It outlines the legal standards of competence, contrasts legal standards against medical standards, and concludes that competence assessments are ineffectual as checks on the volunteering client. While competence hearings may prevent the overtly psychotic defendant from committing state-assisted suicide by volunteering for execution, they cannot prevent the competent-but-severely-depressed defendant from doing so. This Part of the Article also analyzes Smith v. State.
The fourth Part, entitled “The Ethics of Killing Your Client,” suggests that the ambiguities of the Model Rules allow lawyers to construe their obligations in whatever manner they wish. Because of these ambiguities, the Model Rules fail to provide meaningful guidance to the capital attorney. There are also difficulties in applying abstract Model Rules to concrete facts involving real clients.
The fifth Part of the Article, entitled “Primum Non Nocere: Reasoning by Analogy,” suggests that some meaningful ethical guidance might be available from outside the profession. It notes that medical professionals are often confronted with analogous decisions and concludes that medical ethics may shed valuable light on legal ethics. This Part of the Article contrasts the roles of physicians and attorneys, compares terminal illnesses and pending executions, and concludes that dealing with the volunteering death row client more resembles physician-assisted suicide than mere withdrawal of treatment. This Part of the Article also discusses Soering v. United Kingdom, describes the phenomenon of “death row syndrome,” and considers the implications of death row syndrome on a defendant’s waiver of appeals.
The sixth Part of the Article, the conclusion, recapitulates the principal themes of the argument and concludes that the ethical lawyer should refuse to acquiesce to the volunteering client’s wishes, not because the lawyer has paternalistically substituted his or her judgment for that of the client, but because it is impossible to distinguish the will of the client from the situational effects of death row syndrome.”

Volunteers for Execution: Directions for Further Research into Grief, Culpability, and Legal Structures, 82 UMKC L. Rev. 295 (2014)
“About 11% of those executed in the United States are death-sentenced prisoners who sought their own execution. These prisoners are commonly called “volunteers,” and they succeed in hastening execution by waiving their right to appeal their conviction and sentence. Certain interpretations dominate. Those who oppose a condemned prisoner’s request for execution often cite the prisoner’s history of mental instability and frame the prisoner’s decision as a product of suicidal depression. Related to this narrative is one that links death row conditions to the prisoner’s decision to hasten death. Conditions, in this account, contribute to the decision to abandon appeals by wearing the prisoner down to the point that he loses the will to live, or by contributing to “death row syndrome,” an evolving (and controversial) psychiatric diagnosis describing a mental condition that some prisoners develop as a result of living under a death sentence in highly socially isolating and stark conditions of confinement. Other narratives focus on ideas of rational choice and personal autonomy. This account emphasizes prisoners’ desire to control their own destiny and the civic virtue of respecting autonomy and choice, even for the least among us. The empirical support for these explanations is sparse, and this article emerges from a larger effort to test the hypothesis that prisoners who seek execution resemble those who take their own lives in prison. The prison suicide literature has identified certain characteristics — such as race, sex, age, mental illness, and prison conditions — as increasing the risk of suicide behind bars. My research on Texas volunteers generally suggests many, but not all, of those traits characterize that volunteer population as well. This article focuses on findings that point to areas for future research not only on volunteers but also on larger questions of processes of hopelessness and culpability among criminal offenders, and how the criminal justice system may influence life-ending decisions.”

When Something is Not Quite Right: Considerations for Advising a Client to Seek Mental Health Treatment, 6 Hastings Race & Poverty L.J. 209 (2009)
“This Article advocates that a lawyer should consider counseling a client to seek mental health treatment where the lawyer has concerns about the client’s behavior, emotional state, or cognition. It stresses that mental health counseling should be presented within ethical bounds and only after adequate consideration is given to the legal matter, to the client’s goals, and to factors relating to identification of an appropriate mental health referral. Focus on the legal problem is a lawyer’s professional responsibility, and concern for a client’s mental health is part of a humanitarian function of lawyering. Advising a client to seek treatment should be considered supportive of the ethical-social values of the legal profession, part of what develops as part of a lawyer’s professional identity.

Lawyers have no specific guidance on what to say to the client with a mental health problem about seeking its resolution. This Article explores rules of professional responsibility, theory, and reasoning processes related to advising clients to seek mental health treatment. Furthermore, it looks at cultural and financial aspects of treatment, and concludes with recommendations on how a lawyer should counsel her client once she determines that mental health treatment is appropriate. It presents a framework for considering how evaluation and treatment for mental illness might affect the legal matter for which the attorney has been retained, and sets forth recommendations for how a lawyer should advise her client to seek mental health treatment, considering her professional role, the impact of treatment on the legal matter, and the effects of race, culture, and ethnicity and affordability of mental health treatment.”

REPORTS AND SUMMARIES

Recognizing and Responding to Suicidal Persons: What Lawyers Need to Know (Boston Bar Assoc. 2013)
“It is important for attorneys to understand the risk of suicide and related warning signs that may be demonstrated by clients, witnesses, and defendants facing criminal prosecution or incarceration. Learn how to assess suicide risks and how to connect clients with available resources.”

Selected Materials on Ethical Issues in the Representation of People with Disabilities (Center for Public Representation 2003)

This bibliography contains a national Summary of Ethical Opinions Regarding Attorney’s Responsibility to Report a Client’s Suicide Threat.

Suicide and Homicide in State Prisons and Local Jails (BJS 2005)
“Describes historical trends in State prison and local jail inmate mortality rates based on inmate death records submitted by local jails (for 2000-2002) and State prisons (for 2001-2002). The report also compares current prison and jail mortality rates by demographic characteristics, offense types, and facility size and jurisdiction and compares the general population mortality rates with mortality rates in correctional facilities. Comparisons are made to both the raw mortality rates for the general population and those standardized to match the demographic makeup of the inmate populations. This report presents the first findings from the Deaths in Custody Reporting Program, which implements the Death in Custody Reporting Act of 2000 (P.L. 106-297). This new program involves the collection of individual records for every inmate death in the Nations local jails and State prisons. The program also includes the collection of death records from State juvenile correctional authorities (begun in 2002) and State and local law enforcement agencies (begun in 2003).” See generally Mortality in Local Jails and State Prisons (BJS).

Suicide Prevention and Recommended Practices (US Marshals Service)
“Here you will find specific sources that are directly relevant to the DOJ Condition of Confinement Suicide Prevention initiatives.” Includes A Bibliography on Suicide Risk Assessment and Prevention (“This list provides additional resource materials for facilities interested in enhancing their suicide prevention efforts.”).

AMERICAN LAW REPORTS

Admissibility of Evidence Relating to Accused’s Attempt to Commit Suicide, 73 A.L.R.5th 615
“Applying the same principle that deems evidence of flight by one accused of a crime as probative of a consciousness of guilt, courts have frequently held admissible evidence that the accused, after the crime was committed, attempted to commit suicide. For example, in Aldridge v. State, 229 Ga. App. 544, 494 S.E.2d 368, 73 A.L.R.5th 817 (1997), the court held admissible testimony that, within hours of being accused of fondling an eight–year–old girl, the defendant had attempted suicide first by swallowing pills and then by attempting to hang himself. This annotation collects and analyzes cases that consider when testimony regarding the accused’s attempt to commit suicide is admissible and other issues germane to the jury’s proper consideration of such evidence.”

Civil Liability for Death by Suicide, 11 A.L.R.2d 751
“This annotation deals with the question as to whether and under what circumstances a civil liability exists for causing a person to commit suicide. It integrates the later developments in the law with the earlier decisions on this subject, as found in 23 A.L.R. 1271, with the important limitation that the present annotation does not purport to deal with cases arising under the workmen’s compensation acts on the ground that such cases are based on different concepts of social expediency. In conformity with its use in the popular sense the term “suicide” is employed in this annotation to characterize the act of self-destruction regardless of whether and to what degree the person committing suicide was mentally capable of forming an intention to take his own life.”

Civil Liability of Prison or Jail Authorities for Self–Inflicted Injury or Death of Prisoner, 79 A.L.R.3d 1210
“This annotation collects the cases which deal with the civil liability of prison authorities for self–inflicted injuries or suicide of prisoners in their charge. Issues pertaining to the existence of governmental immunity from tort liability are not within the scope of this annotation.”

Civil Liability of Psychiatrist Arising Out of Patient’s Violent Conduct Resulting in Injury to or Death of Patient or Third Party Allegedly Caused in Whole or Part by Mental Disorder, 80 A.L.R.6th 469
“As a general rule, an individual has no duty to protect another from the acts of a third party. Psychiatrists or other mental health care professionals, however, may be under a duty to protect third parties from their patients and may be found to be liable for their patients’ criminal or tortious acts. In Shea v. Caritas Carney Hosp., Inc., 79 Mass. App. Ct. 530, 947 N.E.2d 99, 80 A.L.R.6th 767 (2011), the court found that in order to show that a psychiatrist had a duty to warn a potential victim about a patient who had not made an explicit threat to kill or inflict serious bodily injury, a plaintiff must establish that the patient had a history of physical violence that was known to the psychiatrist, that the psychiatrist had a reasonable basis to believe there was a clear and present danger that the patient would attempt to kill or inflict serious bodily injury, and that the potential victim was reasonably identified. This annotation collects and analyzes court cases applying state law that have determined the liability of one treating a mentally afflicted patient for the patient’s acts to both third parties injured by the patient and to the patient himself or herself.”

Criminal Liability for Death of Another as Result of Accused’s Attempt to Kill Self or Assist Another’s Suicide, 40 A.L.R.4th 702
“This annotation collects and analyzes the state and federal cases in which the courts have discussed or decided whether, or under what circumstances, a defendant is criminally liable—and for what crime—where, in attempting to commit suicide, he unintentionally kills another person or where he assists or encourages another person in that person’s suicide.”

Druggist’s Civil Liability for Suicide Consummated with Drugs Furnished by Him, 58 A.L.R.3d 828
“This annotation collects the cases which have passed upon the question whether a druggist may be held liable for damages resulting from a suicide carried out with drugs or poisons supplied by the druggist.”

Liability of Attorney for Suicide of Client Based on Attorney’s Professional Act or Omission, 41 A.L.R.4th 351
“This annotation collects and analyzes the state and federal cases discussing or deciding the liability of a lawyer for the attempted or successful suicide of a present or former client based on the lawyer’s act or omission in a professional capacity.”

Liability of Doctor, Psychiatrist, or Psychologist for Failure to Take Steps to Prevent Patient’s Suicide, 81 A.L.R.5th 167
“While a person is not ordinarily liable for the actions of another and has no duty to protect another from harm, an affirmative duty may arise where a special relationship exists. A special relationship typically exists where the plaintiff is particularly vulnerable on the defendant, who has some control over the plaintiff’s welfare, such as a relationship between a therapist and a patient. Moreover, a psychiatrist has the duty to provide appropriate treatment, consistent with standards in the professional community, to potentially suicidal patients, whether or not the patient is in a hospital. The court in Kockelman v. Segal, 61 Cal. App. 4th 491, 71 Cal. Rptr. 2d 552, 81 A.L.R. 5th 725 (6th Dist. 1998), while in no way imposing an absolute duty on a psychiatrist to prevent a patient’s suicide, held that a psychiatrist’s duty toward a patient includes taking appropriate suicide prevention measures if warranted by the circumstances, regardless of whether the patient is an outpatient. This annotation collects and analyzes those cases in which the courts have discussed the liability of a doctor, psychiatrist, or psychologist for the failure to take steps to prevent a patient’s suicide.”

Liability of Hospital, Other Than Mental Institution, for Suicide of Patient, 60 A.L.R.3d 880
“This annotation collects those cases concerned with the question of liability of a hospital, other than a mental hospital, for injuries or death suffered by a patient as the result of his suicidal act during a period in which he was a general patient at the hospital. Excluded, therefore, are all cases involving patients in institutions expressly for the confinement or treatment of mental patients, and cases involving patients in the psychiatric wards of general hospitals. Nonetheless, cases in which a general hospital not having separate facilities for psychiatric care has admitted a patient for care and treatment relating to his mental disturbance, or in which the hospital has knowingly admitted as a patient a mentally disturbed person, but with the objective of treating the physical maladies of that person, have been treated as coming within the scope of the present annotation.”

Liability of Mental Care Facility for Suicide of Patient or Former Patient, 19 A.L.R.4th 7
“This annotation collects and analyzes the state and federal cases in which the courts have discussed or decided whether, or under what circumstances, a mental care facility is civilly liable for a patient’s suicide.”

Liability of One Causing Physical Injuries as a Result of Which Injured Party Attempts or Commits Suicide, 77 A.L.R.3d 311
“This annotation collects and discusses judicial decisions considering the civil liability of a tortfeasor who has inflicted a physical injury on a plaintiff or on a plaintiff’s decedent, for the attempted or consummated suicide by the injured party. The fact that the defendant is or may be liable for the antecedent physical injury is presupposed; for instance, a case in which ultimate liability for suicidal actions is defeated by a showing that the defendant is not civilly liable for the personal injuries which are said to have triggered the suicidal behavior is excluded.”

Validity of Criminalization of Urging or Assisting Suicide Under State Statutes and Common Law, 96 A.L.R.6th 475
“The vast majority of states condemn or outright criminalize the act of urging, encouraging, or assisting another to commit suicide despite the fact that suicide itself is not deemed a crime in any state. Constitutional challenges against statutes and common law criminalizing assisted suicide have been brought, arguing that such laws violate freedom of speech, due process, equal protection, privacy rights, and other constitutional guarantees. In most cases, the courts have rejected these constitutional challenges, upholding the validity of the laws. In a few cases, however, courts have found such laws to be in violation of freedom of speech or void for vagueness. In State v. Melchert-Dinkel, 844 N.W.2d 13, 42 Media L. Rep. (BNA) 1555, 96 A.L.R.6th 755 (Minn. 2014), the Minnesota Supreme Court reversed the lower court and held invalid the portion of that state’s statute proscribing encouragement of suicide, holding that it was an unconstitutionally overbroad content-based restriction on speech. This annotation collects and discusses all the federal and state cases which have ruled on the constitutional validity of such statutes and common law applications.”

+++++

1 The death of Socrates has been defined as self-killing by judicial order that incorporated the option of suicide. See Michael Cholbi, Suicide in Stanford Encyclopedia of Philosophy (2004; updated 2012); R.G. Frey, Did Socrates Commit Suicide?, 53 Philosophy 106 (1978)(“It is rarely, if at all, thought that Socrates committed suicide; but such was the case, or so I [R.G. Frey] want to suggest. My suggestion turns not upon any new interpretation of ancient sources but rather upon seeking a determination of the concept of suicide itself.”). See generally Richard Kraut, Socrates in Encyclopedia Britannica (2014).

2 See Lisa J. Colpe and Beverly A. Pringle, Data for Building a National Suicide Prevention Strategy, Am J Prev Med 2014; 47(3S2):S130–S136. See generally American Association of Suicidology (AAS); Preventing Suicide: A Global Imperative (WHO); Suicide (Medline Plus); Suicide Prevention (CDC); Suicide Prevention (Nat’l Institute of Mental Health).

3 For example, questions surrounding the resolution of actual innocence claims and the death penalty have sparked debate and soul searching among practitioners, scholars, judges and most importantly the condemned. Compare Debra Cassens Weiss, Judge Kopf: I Would Uphold the Death Penalty for an Innocent Man Rather Than Play Games with the Law, ABA J., Sept. 15, 2014 with Defendant Dares Judge to Give Death Penalty, Channel 6 South Florida, Sept. 15, 2015 (“”Honestly and truly, I’m not asking you to spare me,” James Herard said in Broward County courtroom on Friday. “Go ahead and do what you gonna do. I pretty much dare you to give me the death sentence because I’m innocent.”” “”I’m actually hoping you give me the death penalty because I know the Supreme Court won’t allow me to die for something I didn’t commit,” Herard said Friday.”).

4 See, e.g., Lawyer’s Mental Decline Needn’t Be Reported Without Evidence of Actual Violation of Rules (ABA/BNA Lawyers’ Manual on Professional Conduct July 31, 2014). See generally Suicide (ABA Commission on Lawyer Assistance Programs)(“Lawyers are not immune to suicide. As research suggests that lawyers experience depression and substance abuse at higher rates than the general population, lawyers may be at a greater risk for suicide.”).

5 See Kevin Johnson, Mental Illness Cases Swamp Criminal Justice System, USA Today, July 21, 2014.

6 See generally State Legislation Report 2013: Trends, Themes & Best Practices in State Mental Health Legislation (NAMI 2013)(“Suicide Prevention: After a period of stability the U.S. suicide rate increased sharply during the recession as Americans grappled with the stresses of unemployment. With the enactment of (SB 72), Kentucky established mandatory training requirements in suicide assessment, treatment and management for: social workers, marriage and family therapists, professional counselors, fee-based pastoral counselors, alcohol and drug counselors, psychologists and occupational therapists. Other states enacting suicide prevention legislation included Alaska (SB 37), Oklahoma (SB 181), Utah (HB 154) and Washington (HB 1376). See Appendix 12”).

7 This scenario is complicated when the client is on death row and decides not to pursue further legal avenues to avoid execution or is imprisoned and expresses an intention to take their own life. The lawyer’s responsibilities additionally require parsing the individual’s state of mind from the effects of their incarceration. See J. C. Oleson, Swilling Hemlock: The Legal Ethics of Defending a Client Who Wishes to Volunteer for Execution, 63 Wash. & Lee L. Rev. 147 (2006).

8 The annotations are limited to the questions presented, which provide details and insights into the multi-tiered analysis of the opinions. For additional opinion abstracts, see Summary of Ethical Opinions Regarding Attorney’s Responsibility to Report a Client’s Suicide Threat (Center for Public Representation 2003).

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