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Abstract
Suicide is a complex and a poorly understood phenomenon, especially in regard to adolescents. From an ethics perspective, attitudes toward suicide have paralleled societal evolution. Among mental health practitioners, suicide is a not easily solved, multifaceted problem that requires a multi-disciplinary approach for its prevention. In western countries, the ethical debate on suicide is centered on issues of personal autonomy and freedome instead of mental health professionals/ responsibility towards suicidal individuals, while in developing countries the issues are connected to macro-level dilemmas like equity, justice and social condition related to psychological distress and suicidal acts. This paper is meant for mental health and other professionals whose work is concerned with youth who are suicidal. Youth suicide within the context of broad ethical concerns include: the evolution of ethical concepts in relation to youth; autonomy versus societal responsibility toward others; clinical and ethical issues in management of suicidal clients and problems related to suicide prevention in diverse cultural settings. The focus is on intentional suicide and to euthanasia (active or passive) or assisted suicide.
Keywords: Adolescence, suicide, ethics
Introduction
Suicide is one the most personal acts in which a young person can engage that is beyond the control of adult management. Youth suicide affects not only the youth but family, friends, and communities, especially schools. Schools are particularly vulnerable to youth suicide as schools are the places that youth spend most of their time.
Unfortunately, youth suicide is not an uncommon phenomenon. According to the World Health Organization (WHO), the mean suicide rate for this age group is 7.4/100,000 youth (1). Globally, suicide was the fourth leading cause of death among males and the third for young females. Since the reliability of suicide statistics is often questioned (2), it should be noted that the number of suicide deaths per 100,000 youth is grossly underestimated. This underestimation is secondary to cultural and religious phenomenon, as well as different classifications and ascertainment procedures. Additional factors that can also distort reported suicide prevalence data include other mortality diagnoses and misclassification of death by the coroner or medical examiner.
Since youth suicide is considered a public health crisis, youth suicide is studied by various academic disciplines. It has proven difficult, however, to develop a neutral definition of youth...