[Suicide and malpractice].

Some recent statements on the subject of psychiatrists' responsibility for suicide committed by patients have provoked lively discussions about the welfare duties of public psychiatric services, causing a widespread climate of alarm among medical institutions. The discussion is primarily about the extent of the psychiatrist's "posizione della garanzia", in particular the duty of protection and surveillance in relation to the risk of self-destructive behavior, referring to convictions not only in TSO cases but also in cases of voluntary hospitalization and valid consensus on treatment. The subject of suicide inevitably reminds us of the predictability of self-destructive behavior and, above all, of its prevention. The authors compare data from scientific literature on this subject - the organizational model of territorial psychiatry - with the principles ordered by the convictions, in particular the request for "ulterior and more rigorous protective rules", thus highlighting their complicated synthesis. In the authors' opinion, a possible literal interpretation of the legal indications would risk a profound change in the quality of the relationship between psychiatrist and patient. The authors, striving to adopt the psychiatrists' point of view, want to finally provide some operational advice with the objective to delimit good practice according to a medico-legal view.