Internet communication about assisted or “rational” suicide: legal and ethical considerations for practice
Thomas J. Rankin(1), Elena S. Yakunina(1), Jessica Richmond Moeller(1), James L. Werth, Jr.(2)
(1)The University of Akron, Akron, Ohio, USA and (2)Radford University, Radford, Virginia, USA
Internet and Suicide. Hauppauge, New York: Nova Science Publishers, 2009, 452 pages.
Assisted suicide and “rational” suicide are each divisive issues that cause legal and ethical quandaries for physicians and mental health professionals in their practices. This chapter uses a case example of a person with amyotrophic lateral sclerosis (ALS; i.e., Lou Gehrig’s disease) to explore the benefits and risks that the Internet and related electronic communication technology have brought to professionals’ consideration of how to appropriately engage with people who are thinking about assisted or rational suicide. ALS is a progressive, neurological disease that slowly destroys nerves and atrophies muscles. Most people with ALS eventually become paralyzed, unable to breathe or swallow on their own, and require the use of a ventilator to survive. The case example of a person with ALS considering assisted or rational suicide by writing about it online is utilized to elucidate legal responsibilities that physicians or psychotherapists owe to non-patients and patients. Medical, psychological, and counseling ethical codes are examined for suggestions regarding best practices toward non-patients and patients considering assisted or rational suicide. Those codes are also examined for their views about the proper role of the Internet in mental health care. The benefits of Internet communication with medical or psychotherapeutic patients are elaborated, dangers to patient confidentiality posed by electronic communication are detailed and potential solutions explored. Finally, the Internet as a source of unprecedented information and misinformation for patients is described, and thoughts are offered about how to encourage professionals and patients to make the most of the medium while minimizing its inherent risks.