In our upcoming book, Short Cuts, I wrote a section on the meaning and construction of suicide notes.   During the research for this piece, I found that legal issues can surround these notes.

Firstly, who is the legal owner of the note?  Just because the note is marked “To Mary”, it’s still considered part of a legal judgement as to the cause of death.  In cases of celebrities, the press can and have requested the text and facsimile of notes, since they are part of the public legal record.

The legal system enters the picture again in cases where a medical examiner, after viewing all the evidence, including the content of a note left at the scene, rules the cause of death a suicide.   When the surviving family disagrees, a lawsuit can follow.  A similar case entered the headlines this week when the wife of talk-show host Larry King was hospitalized following a drug overdose, leaving behind a note that stated a purposeful intent, according to authorities:

“Wording on the letter led me to believe that [Southwick] had intentionally taken the quantity of pills,”

while the family disagrees with the evidence:

“Southwick’s father told investigators that Southwick is ‘always depressed, but she had not mentioned … that she would want to hurt herself or take her own life.’ “

In the end, this case is reported as “possible” suicide, despite evidence to the contrary.

The third legal area is the issue of a medical directive, common in “living wills” and other legal instruments.  Should a medical directive placed in a suicide note be followed?  If it is considered that a person that takes their own life is mentally altered, does the document have validity?

In a paper in the May 2001 issue of “Critical Care” titled “‘Round-table’ ethical debate: is a suicide note an authoritative ‘living will’?” these questions were addressed.

In this paper, a scenario is introduced where a patient is rushed to the emergency room with a near fatal gunshot wound to the head.  Damage is extensive, and survival is possible, but the patient’s  quality of life could be significantly diminished. A note found at the scene clearly indicated the individual’s wish to die.  The individual is estranged from family.

Should extraordinary measures be pursued?  Should life support systems be implemented?

The participants in this paper were spilt.  While most argued that the competency of the note’s author was central and that because the cause of the critical situation was self-inflicted (as opposed to a terminal decease) the emergency room staff was left with no course other than to pursue all measures to save the individual’s life.  Others argued that note must be considered to some extent, arguing that “informal” methods of receiving directives, such as a patient stating “Don’t do stupid stuff to me”, is often weighed in the hospital staff’s decision-making process.

What do you think?  Do we consider the competency and emotional state of a living will posted to an attorney?  What rights do we have as individuals?

“Police: Larry King’s Wife May Have Attempted Suicide”
By Ken Lee and Dahvi Shira
Thursday June 10, 2010
http://www.people.com/people/article/0,,20393298,00.html

“‘Round-table’ ethical debate: is a suicide note an authoritative ‘living will’?”
http://ccforum.com/content/5/3/115

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