Leadership Dimension: Ethical Issues: PDF OnlyCompetency After a Suicide Attempt: An Ethical ReflectionPinch, Winifred J. RN, EdD; Dougherty, Charles J. PhDDimensions of Critical Care Nursing: July 1993 - Volume 12 - Issue 4 - p 206-211 Buy Abstract The provision of critical care services can be complicated by ethical problems involving competency. When a patient's competency is in doubt there is conflict between the principles of autonomy and paternalism. The authors describe an ethical situation involving attempted suicide and administration of chemical restraints where the patient's competency was in doubt. © Williams & Wilkins 1993. All Rights Reserved.