87 The role and responsibility of palliative care physicians with a suicidal relative

<h3>Background</h3> Providing emotional and psychological support to relatives at the end of a patient’s life is a key tenet of palliative care. However, it is difficult to delineate (both ethically and professionally) the responsibilities of palliative care healthcare professionals when a relative is describing suicidal ideation specifically due to their loved one’s palliative condition. Our aim is to look at the main underlying factors, spark debate and suggest a potential practical framework for this highly emotive and complex topic. <h3>Method</h3> This framework has been developed through a combination of sources. This includes discussions with psychiatry, the inpatient palliative care team, the medical defence union and personal historical experience within the team. A recent case prompted this piece of work. <h3>Results (Suggested protocol)</h3> Consensus suggests the following key interventions outlined in our framework: Clarify if already known to mental health services. Signposting towards appropriate mental health services. Contacting primary care physician to raise concerns (may have additional relevant history not widely known) Utilise support networks with patient consent (including family and multi-disciplinary teams) In the event of a crisis episode where risk of harm is demonstrable contact the local authorities for transfer to immediate psychiatric assessment and/or police in-keeping with jurisdictional legislation. <h3>Conclusions</h3> The main role of the healthcare provider is in timely signposting the suicidal relative to the appropriate services. This framework outlines a pragmatic model which clearly outlines a stepwise approach. Utilising this can be practically helpful in a pressurised situation, keep everyone legally safe and promote an appropriate focus on the individual given the complexity of these issues. <h3>References</h3> General Medical Council, Good Medical Practice 2024. Ward, B, Learning lessons from complaints and claims about suicide, MDU Journal, Summer 2017. Kustanti CY, Chu H, Kang XL, <i>et al</i>. Anticipatory grief prevalence among caregivers of persons with a life-threatening illness: A meta-analysis. <i>BMJ Supportive &amp; Palliative Care</i> 2023;<b>13</b>:e1074-e1083.