Solidarité et développement

Agreement Contract For Safety

Par • 9 Sep, 2021 • Catégorie: Non classé •

As a Safety Liaison patient, I used my own lessons as conversation points during some of my initial consultations with healthcare facilities. One of these lessons was my knowledge of the limited value of security or non-suicide contracts (NSCs) in preventing suicide. I have discovered through discussions that many healthcare providers use contracts for safety in the assessment of patients at risk of suicide. I also found that many were not aware of the constraints and risks involved. In Durney v. Terk 32 in 2007, the New York Supreme Court rejected most of the relevance of the contractual process by annuding a judgment in favor of a patient who had committed suicide a week after his discharge from a hospital psychiatric ward. As evidence-based medicine becomes the standard of care and psychiatric education evolves to follow this standard, one of the main problems with the continued use of the safety contract is the lack of empirical evidence to support its effectiveness.4,8-11 The contract was born out of a study1. Randomized controlled study, the gold standard of evidence-based medicine, is not an option for many reasons. Prohibition is not possible, because a contract implies a conscious conscience of both parties. There is also a clear ethical dilemma related to comparing the suicide rate of a group of patients with a suicide agreement with that of a group without such an agreement.12 Because of these restrictions, research has fallen into three categories: frequency surveys, retrospective research on the impact of suicide contracts without suicide on suicidal behaviors, and user opinions.4, 13 Some clinicians may use the safety contract as a shortcut to document their assessment of a patient`s suicide risk14 While they can conduct more in-depth risk assessments than this documentation suggests, the abbreviation of the process thus implies too much reliance on contractual action, along with all the other essential elements of the risk assessment they can perform when formulating a Treatment plan…

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