The Ethics of Referral and Intervention with Non-Life Threatening Suicide Attempts by Overdose of Medication and Ingestion of Harmful Substances

Most suicide attempts by ingestion of substances (including medication overdoses, drinking household or industrial cleaning products, etc.) are not lethal. In fact, many are never reported and there is no medical intervention—the attempter may simply feel “bad” for a while and not seek medical help. In many instances, a minimal intervention may be useful (such as inducing vomiting), although a lethal or harmful outcome is unlikely. In Canada, all major cities have a Poison Information Centre to provide advice concerning cases of potential accidental or intentional poisoning. This article presents data from calls to a Poison Information Centre where callers requested information concerning the dangers and lethality, after they had ingested substances which they thought could be harmful in a possible suicide attempt. We compare information given and referrals made in the case of poisoning in which there was danger of harmful consequences with reactions to cases where the type and quantity of substance ingested was assessed as having no danger for potentially harming the person. In many instances, persons who do not need medical intervention are referred to an emergency room because the possible “overdose” was considered to be a suicide attempt. We discuss the views of key informants (medical personnel, medical/legal experts, front-line suicide prevention workers, a “chronic” suicide attempter) and conclude by discussing the possible benefits and harm from such referrals and, particularly, the ethical issues involved in referring for medical treatment an individual who does not need medical interventions and whose suicide attempt was not potentially harmful

Accidental · Brief intervention · Family medicine · Harm · Injury prevention · Intervention (counseling · Medical emergency · Occupational safety and health · Poison control · Psychiatry · Psychological intervention · Referral · Suicide prevention · Drug-Induced Hepatotoxicity and Protection · Historical and Scientific Studies · Medicine · Poisoning and overdose treatments · Psychology

• Managing Mental Health Crisis Calls Received by a US Poison Center

  Matthew Robert Dernbach, Stephanie Hon et al.•American Journal of Public Health•2025

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