Given the incidence and seriousness of suicidality in clinical practice, the need for new and better ways to assess suicide risk is clear. While there are many published assessment instruments in the literature, survey data suggest that these measure are not widely used. One possible explanation is that current quantitatively developed assessment instruments may fail to capture something essential about the suicidal patient's experience. The current exploratory study examined a range of open ended qualitative written responses made by suicidal outpatients to five assessment prompts from the Suicide Status Form (SSF)--psychological pain, press, perturbation, hopelessness, and self-hate. Two different samples of suicidal outpatients seeking treatment, including suicidal college students (n = 119) and active duty U.S. Air Force personnel (n = 33), provided a wide range of written responses to the five SSF prompts. A qualitative coding manual was developed through a step-by-step methodology; two naive coders were trained to use the coding system and were able to sort all the patients' written responses into the content categories with very high interrater reliability (Kappa > .80). Certain written qualitative responses of the patients were more frequent than others, both within and across the five SSF constructs. Among a range of specific exploratory findings, one general finding was that two thirds of the 636 obtained written responses could be reliably categorized under four major content headings: relational (22%), role responsibilities (20%), self (15%), and unpleasant internal states (10%). Theoretical, research, and clinical implications of the methodology and data are discussed.
Seventy-one suicide survivors were surveyed about their perceptions of the clinicians who were treating their loved one at the time of death. Survivors provided information regarding their perceptions and attitudes toward clinician behaviors before and after the suicide and their perceptions of helpful and troubling aspects of clinician behaviors. Results indicated that survivors share a number of common opinions regarding the mental health care providers treating their loved ones. Several differences existed between survivors who consider lawsuits against mental health care providers versus those who do not. The implications of these findings for clinical practice, legal issues, surviving suicide, and future research are discussed.
This study reviews and analyzes the content of dental school oaths taken by students in the United States, Canada, and Puerto Rico in 2006. Each oath was qualitatively reviewed to determine its consistency with each of the five principles set forth in the American Dental Association (ADA)'s Principles of Ethics and Code of Professional Conduct. Fifty-eight oaths were received from sixty-one of sixty-six schools in response to information requests regarding use of oaths and manner of administration. Of these, thirty-nine employ one oath, administered at either graduation or ceremonies marking transition to clinical training; twelve employ an oath at both occasions, with five repeating the same oath; and ten have no formal oaths. Eighteen oaths follow the wording of "The Dentist's Pledge," nine follow the "Oath to the Profession/Professional Pledge," three follow the Modern Hippocratic Oath, and twenty-eight are idiosyncratic. All five of the ADA principles (autonomy, nonmaleficence, beneficence, justice, and veracity) are addressed in thirteen oaths, four principles in nine oaths, and three or fewer principles in thirty-six oaths. Eleven make reference to care for the underserved. As oath-taking is an opportunity to instill and reinforce to students dentistry's most important ethical obligations, recommendations are offered to make the content more meaningful and comprehensive.Dr. Schwartz is a Postgraduate
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