Ethics and the Suicidal Student

Ethics often comes down to answering  the basic question, “What is the right thing to do?” Sometimes the wrong option will be easy to identify, but finding the right action is nearly impossible, complicated by diverse stakeholders, conflicting values and legal entanglements. This is the situation universities face when a student becomes suicidal. What action is in the best interest of the student, as well as the other students and the institution itself?

Psychiatrist Sally Satel recently raised this issue in reaction to the release of a report from the State of New Jersey titled “College Students in Crisis: Preventing Campus Suicides and Protecting Civil Rights.” Increasingly, some colleges and universities are expelling students who show signs of serious depression, justifying the policy as a way to force students to seek treatment, but really reacting to the fear of liability if students harm themselves on campus. Kicking an already depressed and possibly suicidal student out of school is the easily identified “wrong thing,” a self-serving and defensive measure that can put the life of a young student at greater risk.

Satel cites the opinion of  David Fassler, M.D., a clinical professor of psychiatry at the University of Vermon, who argues that expulsion “can discourage students from getting the help they need” Removing a student from familiar and supportive surroundings isn’t always the best course of action, Fassler says. “The response should be individualized, based on a careful assessment of the student’s clinical needs as well as the realistic safety considerations.”

It should be obvious, as Satel points out, that a college sending a troubled student away can easily make him or her worse, removing the student from friends and support networks, increasing anxiety and feelings of inadequacy. But what if the challenge of college is the source of the depression?

The law and civil libertarians are both involved, for removing a student with emotional difficulties can be a violation of the American with Disabilities Act and basic civil rights. The most ethical course for universities might be to not admit some students in the first place, as subjecting under-prepared or unqualified students to academic challenges they have little hope of meeting is one likely cause of the increase in clinical depression among college students. An ethical course might also include identifying students at risk for anxiety, depression and emotional problems when they are admitted, and developing programs to help these high-risk students avoid falling into despair.

The best course is far from clear. What is certain, however, is that colleges and universities cannot ethically avoid the problem of suicidal students by automatically sending them home. The institutions have ethical obligations; the challenge is meeting them. They can’t be avoided.

4 thoughts on “Ethics and the Suicidal Student

  1. Unless being at school is contributing to the student’s depression, and who can determine that? Would the student even know before changing environments? I would think a depressed student would receive better attention and care at home than at a busy educational institution where fellow inexperienced students are making the judgments and may be afraid to actually take action. And the school also has to worry about the affect of the depressed student on the rest of the student body. Separate from the risk of litigation (which, now, sadly, is huge), I tend to think that universities sending students home is the better choice for the student. The problem then lies with the student that does not have a home or concerned adults to care for him / her.

  2. I don’t disagree at all. The school, though, needs to assess what is in the student’s best interest, not just the school’s financial interests. You have to admit, being expelled from school doesn’t have a lot of positive vibes attached to it. I’d guess that it would be far more likely to exacerbate depression, at least initially.

  3. Perhaps they should send the student home on medical suspension? Kind of like sports when doctors won’t let players play, maybe psychologists or other qualified professionals can issue a medical suspension. It has less of a stigma as “expulsion” and has the effect of giving the student time to re-evaluate their position. I would think they would then be able to say, “Yes I want to be there and I’m going back” or “No they are right and I’m not going back”.

    To expel someone is to say “Don’t come back.”

    • All schools that I know of have a medical leave of absence policy and these have been around for a long time. Under these, students can ask for such a leave of absence. The schools would have to change the policies on medical leave of absence to force students to take one. This would lead to debate, bad publicity, etc. Instead, the schools are just expelling them, probably using the Dean of Students authority to do so. School administrators really aren’t bright enough to see that this will lead to even more bad publicity than the first option. The schools just want these students gone so they don’t commit suicide or murder on the campus.
      Students today are under more stress because of bad parenting and bad schools (
      http://news.yahoo.com/s/ap/20100111/ap_on_re_us/us_stressed_out_students ). Their parents and schools praise every minor accomplishment and don’t ever criticize (at least not constructively). For 13 years a C meant you turned in papers with your name on them and an A meant that you behaved well in class. Their parents wake them up every morning and call them 5 times a day to make sure they didn’t forget anything and reinforce how special they are. Anytime they break the rules, the parents step in to take care of it for them, no worries. After 18 years of this, college is stressful and frightening.
      The question is, whose job is it to undo all of that damage?

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