[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Medical ethics](https://durgical.com/en/medical-ethics/) › [Autonomy and consent](https://durgical.com/en/medical-ethics/areas/autonomy/) › Suicide prevention and paternalism # Suicide prevention and paternalism - Topic Intervening when there is a risk of suicide is usually justified as soft paternalism: protecting while it is checked whether the choice is free and capable. Updated Nov 13, 2026 ## Key points - Most suicidal crises are temporary, ambivalent and linked to treatable disorders: intervening protects future autonomy. - Intervening is justified as soft paternalism: protecting while capacity and voluntariness are assessed. - Asking directly about suicidal thoughts is part of the assessment and does not increase the risk. - Protection is proportionate: the least restrictive measure that provides safety, for the shortest time. - Res. 813 de 2026, art. 30, par. 2: if a euthanasia request arises from a mental disorder, documented refractoriness and the absence of an acute phase are required. ## What it is When a person is at risk of suicide, the doctor intervenes even if the person does not ask for it. This is justified because most suicidal crises are temporary and ambivalent, are linked to treatable disorders, and many survivors do not try again: protecting today preserves tomorrow's autonomy. It is an example of soft paternalism, which acts while it is checked whether the decision is capable and voluntary. The limits matter too: protection must be proportionate, as little restrictive as possible and for as short a time as possible, and not every request to die is a psychiatric crisis. In Colombia, a capable person with an extreme health condition can request a dignified death through the legal route, with special rules if the cause is a mental disorder. ## Key facts - Reasons to intervene: frequent treatable mental disorders, ambivalence, the temporary nature of the crisis, and the fact that many survivors do not try again. - Reasons for limits: a capable person with a serious, incurable disease may have stable, considered reasons. - Key distinction: an acute suicidal crisis is protected against and treated; a persistent request to die with dignity goes through the legal route. - Measures from least to most restrictive: safety plan, removal of lethal means, close support, voluntary admission and, exceptionally, involuntary admission. - Confidentiality: a serious, imminent risk to life allows informing whoever can protect the patient. - WHO: more than 740 000 people die by suicide each year; a previous attempt is a major risk factor. ## In clinical practice - When there are suicidal thoughts, ask about a plan, means, previous attempts and support; do not leave a high-risk patient alone. - Limiting access to lethal means (pesticides, firearms, stockpiled medicines) is one of the interventions WHO recommends. - Explain to the patient what will be done and why, even when acting without their agreement; honesty protects the therapeutic relationship. - After the crisis, review the decision with the patient and ensure early follow-up. ## Legal framework in Colombia - Ley 1616 de 2013, art. 8: includes suicide prevention among mental health promotion actions; art. 35: suicidal behaviour is an event under epidemiological surveillance in mental health. - Ley 1616 de 2013, art. 6, num. 13: right to have informed consent taken into account to receive treatment. Several numerals of art. 6 were amended by Ley 2460 de 2025, and Ley 2564 de 2026 rewrote the definition of mental health (art. 3). - Resolución 813 de 2026, art. 30, par. 2: if the extreme health condition arises from a mental illness or disorder, the committee checks documented refractoriness to reasonable alternatives and that it is not an acute phase; if capacity fluctuates, it may postpone the decision. - Official texts checked on 2026-11-13 at normograma.supersalud.gov.co and minsalud.gov.co. ## Test yourself Think of the answer, then tap the question to see it. ## Why is intervening in a suicidal crisis justified even if the patient does not ask for it? Because these crises are usually temporary and ambivalent and are linked to treatable disorders; protecting while capacity is assessed is soft paternalism. ## Does asking a patient directly whether they are thinking of suicide increase the risk? No. Asking directly is part of the risk assessment and makes it possible to offer help. ## What does Resolución 813 de 2026 require if a euthanasia request arises from a mental disorder? That the committee check documented refractoriness to reasonable alternatives and that it is not an acute phase (art. 30, par. 2). ## Which article of Ley 1616 de 2013 includes suicide prevention? Article 8, among mental health promotion actions; article 35 places suicidal behaviour under epidemiological surveillance. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/medical-ethics/suicide-prevention-and-paternalism/) ## Elsewhere in DurgiPedia - [Crisis intervention and supportive psychotherapy](https://durgical.com/en/behavioral-science/crisis-intervention-and-supportive-psychotherapy/) ## Connections ## Related 5 - [Paternalism: soft, hard and why it declined](https://durgical.com/en/medical-ethics/paternalism-soft-hard-and-why-it-declined/) - [Decision-making capacity (competence) and how to assess it](https://durgical.com/en/medical-ethics/decision-making-capacity-and-how-to-assess-it/) - [The limits of confidentiality: duty to warn and legal disclosure](https://durgical.com/en/medical-ethics/the-limits-of-confidentiality-duty-to-warn-and-legal-disclosure/) - [Resolución 813 de 2026: the euthanasia procedure and adjusting therapeutic effort](https://durgical.com/en/medical-ethics/resolucion-813-de-2026-the-euthanasia-procedure-and-adjusting-therapeutic-effort/) - [Respect for autonomy](https://durgical.com/en/medical-ethics/respect-for-autonomy/) [← All of medical ethics](https://durgical.com/en/medical-ethics/) Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal. Sources: [Suicide (fact sheet)](https://www.who.int/news-room/fact-sheets/detail/suicide) (World Health Organization, 2026); [Paternalism](https://plato.stanford.edu/entries/paternalism/) (Stanford Encyclopedia of Philosophy, 2020); [Ley 1616 de 2013, Ley de Salud Mental](https://normograma.supersalud.gov.co/compilacion/docs/ley_1616_2013.htm) (Superintendencia Nacional de Salud, Normograma, 2013); [Boletín Jurídico No. 04 de 2026, sección 2.2.6: Resolución 813 de 2026](https://www.minsalud.gov.co/Normatividad_Nuevo/Bolet%C3%ADn%20Jur%C3%ADdico%20No.%2004%20%20de%202026.pdf) (Ministerio de Salud y Protección Social, 2026); [Ley 1616 de 2013 (compiled text with its amendments)](https://www.secretariasenado.gov.co/senado/basedoc/ley_1616_2013.html) (Secretaría General del Senado de la República, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. 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