Can supervising self-harm be part of ethical nursing practice?

It was reported in 2006 that a regime of 'supervised self harm' had been implemented at St George's Hospital, Stafford. This involves patients with a history of self-harming behaviour being offered both emotional and practical support to enable them to do so. This support can extend to the provision of knives or razors to enable them to self-harm while they are being supervised by a nurse. This article discusses, and evaluates from an ethical perspective, three competing responses to self-harming behaviours: to prevent it; to allow it; and to make provision for supervised self-harm. It is argued that of these three options the prevention strategy is the least plausible. A tentative conclusion is offered in support of supervised self-harm.