Dr James Schaller
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Suicide Liability & the Ignorant Press

Correcting the Bizarre 1970's Idea Suicide is the Doctor's Fault

The idea that any physician can prevent suicide in an in-patient person willing to hide their suicidal feelings is fantastic. No doctor has the ability to tell the future with a depressed person with extreme stress. You confuse doctors with ancient prophets? This is surprising ignorance in 2005. It makes me wonder what impaired expert gave you this impression. There are plenty of "expert" prostitutes willing to say anything a Board or lawyer tells them to say.

There are dozens of variables involved in suicide, the majority of which are outside a physician's control. I thought we all agreed decades ago, that doctors were not Gods. We cannot prevent all death and all illness and control human acts.

The doctor cannot control the hostility and intensity with a spouse, parents, bosses, the DA, children or friends. The doctor cannot control the new information that is learned by the patient about his poor finances or alienation with loved ones or job trouble. The doctor is not to blame for the proven genetic propensity to use suicide as a coping mechanism that runs in the family genes. The doctor cannot control alcohol or other depressant drug use.

Suicide is the decision of another adult, an adult in pain, to try to end their discomfort and misery. It is their decision, not the doctors.

I suppose thousands of other people in SW Florida should be locked up like criminals, and lose their liberty, if they are sad and have common suicidal thoughts or feelings since suicides will result in the Press doing a doctor hunt -- like dogs chasing a fox. If we locked up every person with these feelings, hundreds of thousands would be in mental health "jail." NBC seems to be saying that we should steal their freedom to be on the safe side, since if a person decides to kill themselves, reporters ignorantly will attack doctors. Perhaps doctors should ask their patients to sign a contract swearing they will not kill themselves in order to be released. Of course if they are faced with new family or business tensions or losses, or drink, or get agitated -- that contract is worth nothing.

I have never met this doctor, but I suppose he should stop treating and evaluating depressed folks and merely treat slightly sad folks? I have news for you, he treats almost the entire NCH hospital and no one is eager to replace him at his job.

You seem to assume that outcome equals error. I suppose psychiatric specialists should play it safe and avoid the treatment of depression since the death rate runs at 15%? Years ago a fine advanced psychopharmacologist was treating the sickest folks in a large city. She mentioned she was losing 5 patients a year to suicide. I was stunned. She said if they were not accepted into her practice the number would likely be 15 or more a year. And simply, it was her job to try to help the sickest of the sick.

Rather than attacking the good guys and acting like one more castrating anti-physician entity, please do some education on biological depression and suicide.


James Schaller, MD, MAR

Bank Towers, Tamiami Trail, Naples, FL
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