[Liability in cases of suicide during inpatient treatment].

Background: Suicide during inpatient treatment represents distressing events for clinics and medical staff while raising questions about liability consequences. They require a differentiated approach balancing patient protection and therapeutic necessities.

Objective: To analyze long-standing case law to identify practice-relevant principles for clinical risk management regarding suicidal ideation.

Material and methods: Systematic evaluation of 22 decisions from German high and supreme courts (1985-2025) concerning suicides during inpatient treatment.

Results: Case law acknowledges the impossibility of absolute suicide prevention and grants psychiatric treatment teams considerable discretionary latitude. The legal assessment is based on the treating physician's ex-ante perspective. Specific duties of care arise in cases of acute suicidal ideation, risk situations such as therapeutic relaxations and necessary structural and organizational measures. The balance between security interests and therapeutic requirements remains central.

Conclusion: The jurisprudence demonstrates a nuanced understanding of the clinical challenges in suicide prevention. The identified assessment standards provide orientation for the clinical practice and emphasize the necessity of individual risk assessments and documentation of all relevant decisions.