Avoid having the patient spend long periods of time alone. Mobilize support for the patient. Carefully assess the patient's psychological responses at each crisis point over the cancer trajectory. For instance, rapid dose titration in the treatment of a distressing symptom could be difficult or impossible if quantities of medications are limited. Pain and symptom management should not be sacrificed simply to avoid the possibility that a patient will have the means for a suicide attempt.
Patients often have other means for a suicide attempt at their disposal.
Inadequate pain and symptom management might in such instances worsen a patient's suicide risk. Yet the need to manage suicide risk requires some reasonable approach to the problem of patient and family access to lethal doses of medication. The most effective resolution to such a clinical dilemma is frequent contact with, and reassessment of the patient. Only with frequent contact will an appraisal of the success or failure of symptom management and its effect on suicidal risk be possible. Regular delivery of medications for limited durations, perhaps via transdermal patches can be a useful approach to this problem.