Scott Ames: a man giving up on himself

The tragic story of Scott Ames raises a fundamental question concerning involuntary commitment of patients when suicide seems likely. What right has a physician ever to interfere when apatient proposes to take his own life? Under ordinary cirucmstances one argues that because of depression, or some other mental illness, the patient's judgment is impaited, so that intervention to prevent suicide is reasonable and ethical, given the high probability that once the illness is treated, the patient will no longer want to kill himself, and will be glad he was prevented from it. Over some years of clinical experience I have observed that there is a greater reluctance among clinicians to stop a suicide attempt when the patient is already dying, and when the death the patient faces promises to be a harrowing one. There is a tendency in these circumstances no to interfere, for a variety of reasons, some reasonable and some hot.