FOCUS ON ETHICS Jeffrey E. Barnett, Editor Ethical and Competent Care of Suicidal Patients: Contemporary Challenges, New Developments, and Considerations for Clinical Practice David A. Jobes The Catholic University of America M. David Rudd Texas Tech University James C. Overholser Case Western Reserve University Thomas E. Joiner Jr. Florida State University Clinical work with suicidal patients has become increasingly challenging in recent years. It is argued that contemporary issues related to working with suicidal patients have come to pose a number of considerable professional and even ethical hazards for psychologists. Among various concerns, these challenges include providing sufficient informed consent, performing competent assessments of suicidal risk, using empirically supported treatments/interventions, and using suitable risk management techniques. In summary, there are many complicated clinical issues related to suicide (e.g., improvements in the standard of care, resistance to changing practices, alterations to models of health care delivery, the role of research, and issues of diversity). Three experts comment on these considerations, emphasizing acute versus chronic suicide risk, the integration of empirical findings, effective documentation, graduate training, maintaining professional competence, perceptions of medical versus mental health care, fears of dealing with suicide risk, suicide myths, and stigma/blame related to suicide. The authors’ intention is to raise awareness about various suicide-related ethical concerns. By increasing this awareness, they hope to compel psychologists to improve their clinical practices with suicidal patients, thereby helping to save lives. Keywords: suicide, informed consent, risk assessment, treatment, risk management Clinical Work With Suicidal Patients: Emerging Ethical Issues and Professional Challenges David A. Jobes Clinical work with suicidal patients is fraught with profes- sional challenges. Some of these challenges include psycholo- gists’ inability to predict behaviors with low base rates (such as suicide attempts and completions), the decision to commit a person to an inpatient setting, intense countertransference is- sues, and the potential life-or-death implications of treatment (Jobes & Berman, 1993; Jobes & Maltsberger, 1995; Malts- berger & Buie, 1974). Although these concerns continue, addi- tional challenges have recently emerged, which make providing this care even thornier. In this article, I examine various present-day issues that clinicians face with suicidal patients, with an eye to ultimately enhancing the ethical and effective clinical care of suicidal patients. The following fictitious cases capture a sampling of current concerns. DAVID A. JOBES received his PhD in clinical psychology at American University, and he completed his clinical internship at the Washington, DC, Veterans Affairs Medical Center. He is a professor of psychology and a codirector of clinical training at The Catholic University of America. He maintains a private clinical and forensic practice at the Washington Psychological Center (Washington, DC). His areas of professional interest include clinical suicidology, ethics, and risk man- agement. M. DAVID RUDD received his PhD in psychology from the University of Texas– Austin and completed his internship in clinical psychology at Silas B. Hays Army Community Hospital, Fort Ord, California. He completed 2 years of postdoctoral training at the Beck Institute in Philadelphia. He is a professor and chair of the Department of Psychology at Texas Tech University and also maintains a part- time private practice and risk management consulting business. JAMES C. OVERHOLSER received his PhD in clinical psychology from the Ohio State University, and he completed a clinical internship as well as a postdoctoral fellowship at the Department of Psychiatry, Brown University. He is a professor of psychology and director of clinical training at Case Western Reserve University. He maintains a part-time clinical practice and serves as a consultant to the Cleveland Veterans Affairs Medical Center. His areas of interest and specialization include depression, suicide risk, and psychotherapy with the Socratic method. THOMAS E. JOINER JR. received his PhD in clinical psychology from the University of Texas at Austin. He is a distinguished research professor and the Bright-Burton professor of psychology at Florida State Univer- sity. His areas of research interest are the psychology, neurobiology, and treatment of suicidal behavior and related conditions. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to David A. Jobes, Catholic University, Department of Psychology, 314 O’Boyle Hall, Washington, DC 20064. E-mail: jobes@cua.edu Professional Psychology: Research and Practice, 2008, Vol. 39, No. 4, 405– 413 Copyright 2008 by the American Psychological Association 0735-7028/08/$12.00 DOI: 10.1037/a0012896 405