A case from the department of neurology

Stephen Krieger, Jennifer Finkel, Nada Gligorov

Research output: Contribution to journalArticlepeer-review

Abstract

Uncompleted suicide attempts are a significant cause of morbidity, which in catastrophic cases can be both medically and ethically challenging to manage. We discuss the case of a 63-year-old man who survived a suicide attempt by venlafaxine (Effexor) overdose, causing an intracranial hemorrhage and leaving him in an apparently awake but noncommunicative state. Ethical concerns arose when considering if he should be indefinitely maintained on life support. These include the difficulties of characterizing his level of consciousness and prognosis; establishing his decisional capacity regarding end-of-life decisions in a setting of depression and suicidality; and assessing the suitability of a surrogate decision-maker. In conclusion, we discuss whether the fact that his grave neurological condition was caused by a suicide attempt was relevant to the decision to continue or withdraw life support.

Original languageEnglish
Pages (from-to)53-56
Number of pages4
JournalMount Sinai Journal of Medicine
Volume75
Issue number1
DOIs
StatePublished - Jan 2008

Keywords

  • Advance directive
  • Decisional capacity
  • Medical ethics
  • Suicide
  • Venlafaxine

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