Had a case like this my first year. A caucasian female, in her 60s has both HIV and Cancer. She's been diagnosed as terminal and the oncologist reccomended palliative care. She's been told she only has about 3-5 months to live. Yeah well guess what. To the pt's detriment she mentioned the suicide word. She said she wasn't going to do it but thought suicide would just be easier. So the oncologist refers her to the crisis psychiatry unit. The psyche attending decides to commit the poor lady, while she sat in the "behavioral room" for about 8 hrs. So then she's transferred to the inpt psyche unit as a committed pt. The inpt attending (and I was working with the inpt attending at the time) now reads the chart and is ticked. I'm talking ticked. This poor lady has only a few months to live and now she's been committed so now she's going to have to waste of few of her last remaining days on the unit. She came in on a Friday afternoon. He told me first thing Monday he was going to discharge her unless anything serious happened. OK---dilemna here. Pt has significant medical stressor, said the S word, has several sx of depression--so its enough for a valid legal commitment. Inpt attending (and I agree with him) says that we're doing an unethical thing because in his opinion she's really not going to commit suicide and we're robbing her of her final days. Further he claimed he felt the crisis psyche doc was just committing the pt to cover her ass and play defensive medicine, and not doing what was in the pt's best interest. Well I agreed with the inpt attending (and I know them both, the inpt doc is a better doctor)... But the question here is--what would you have done? Would you let a pt who fits enough of the criteria for depression and has a severe risk factor for suicide (terminal illness) go, especially if you had a hunch (though not provable) that she wasn't going to commit suicide?