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.