The suicide of a patient is a serious event that may constitute a therapeutic failure. To prevent these situations, national and international guidelines exist. When a suicide occurs in a psychiatric hospital or immediately after release, legal action may follow, most frequently for malpractice claims related to the failure to provide reasonable management of the suicide risk. In an attempt to respond to the increased anxiety in the health care system and among practitioners, we used case reports to determine the minimum medico-legal standards that the physician must follow in the context of suicide.

From February 1st to May 30th, 2019, we gathered all available expert psychiatric reports following criminal prosecutions from the University Center of Legal Medicine of Geneva. We restricted the extraction of cases to those from January 1st, 2007, to May 30th, 2019.

We identified 7 cases. The psychiatrist expert provided a care setting assessment, clinical/survey assessment, and suicidal risk assessment. Improper care setting assessment was the most commonly found conclusion, but the two other categories were as detrimental concerning suicidal risk. Only one psychiatrist was condemned, but the decision was revoked on appeal. The combination of our cases and a scoping review on the subject leads to the recommendation of minimum medico-legal standards to complete individualized suicide risk reduction plans.

Minimal medico-legal standards should be applied and documented to optimize care practice for the reduction of suicidal risk at three different levels: the initial evaluation, the treatment, and the surveillance.

患者自杀是可能构成治疗失败的严重事件。为了防止这些情况发生，存在国家和国际准则。当在精神病院或出院后立即发生自杀事件时，可能会采取法律行动，最常见的是与未能对自杀风险进行合理管理有关的医疗事故索赔。为了应对医疗保健系统和从业者日益增加的焦虑，我们使用病例报告来确定医生在自杀情况下必须遵循的最低医疗法律标准。

从 2019 年 2 月 1 日至 5 月 30 日，我们收集了日内瓦大学法律医学中心刑事起诉后所有可用的专家精神病学报告。我们将提取案例的时间限制在 2007 年 1 月 1 日至 2019 年 5 月 30 日期间。

我们确定了 7 个案例。精神科医生专家提供了护理环境评估、临床/调查评估和自杀风险评估。不适当的护理环境评估是最常见的结论，但其他两个类别在自杀风险方面同样有害。只有一名精神科医生受到谴责，但该决定在上诉时被撤销。结合我们的案例和对该主题的范围审查，我们推荐了最低医疗法律标准，以完成个性化的自杀风险降低计划。

应应用并记录最低限度的医学法律标准，以优化护理实践，以降低三个不同级别的自杀风险：初始评估、治疗和监测。