SynthesisBMJ open2019
Management of patients with an advance decision and suicidal behaviour: a systematic review.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 7 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.
- The association between social connectedness and euthanasia and assisted suicide and related constructs: systematic review.BMC public health · 2024Pooled it
- Differential treatment of individuals with mental health conditions in high-consequence decision-making: a comparison of policy on advance directives and assisted suicide in three European countries.Frontiers in psychiatry · 2025Article
- Neurobiology and medico-legal aspects of suicides among older adults: a narrative review.Frontiers in psychiatry · 2024Review
- Development of a pre-hospital emergencies protocol for the management of suicidal patients in Iran.BMC emergency medicine · 2021Article
- [Ethics of resuscitation and end of life decisions].Notfall & rettungsmedizin · 2021Review
- Psychiatric Advance Directives and Artificial Intelligence: A Conceptual Framework for Theoretical and Ethical Principles.Frontiers in psychiatry · 2020Review
- Advance decisions to refuse treatment and suicidal behaviour in emergency care: 'it's very much a step into the unknown'.BJPsych open · 2019Article
Corrections and comments
- Erratum issuedCorrection:2019
Authors and funding
10 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundThe use of advance care planning and advance decisions for psychiatric care is growing. However, there is limited guidance on clinical management when a patient presents with suicidal behaviour and an advance decision and no systematic reviews of the extant literature.
objectivesTo synthesise existing literature on the management of advance decisions and suicidal behaviour.
designA systematic search of seven bibliographic databases was conducted to identify studies relating to advance decisions and suicidal behaviour. Studies on terminal illness or end-of-life care were excluded to focus on the use of advance decisions in the context of suicidal behaviour. A textual synthesis of data was conducted, and themes were identified by using an adapted thematic framework analysis approach.
resultsOverall 634 articles were identified, of which 35 were retained for full text screening. Fifteen relevant articles were identified following screening. Those articles pertained to actual clinical cases or fictional scenarios. Clinical practice and rationale for management decisions varied. Five themes were identified: (1) tension between patient autonomy and protecting a vulnerable person, (2) appropriateness of advance decisions for suicidal behaviour, (3) uncertainty about the application of legislation, (4) the length of time needed to consider all the evidence versus rapid decision-making for treatment and (5) importance of seeking support and sharing decision-making.
conclusionsAdvance decisions present particular challenges for clinicians when associated with suicidal behaviour. Recommendations for practice and supervision for clinicians may help to reduce the variation in clinical practice.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.