Working paper · DOC-2026-01

The Standard of Care

What a system owes a person at their most vulnerable, and why nobody has yet written it down.

The duty

A model that meets a person in crisis is practicing a standard of care whether or not anyone designed it to.

The only question is whether that standard is met by accident or by design. My field settled its version long ago, and it reduces to three obligations.

Assessment

Ask directly. Gauge risk rather than inferring it. Never look away from what has just been said.

Non-abandonment

Stay with the person. Do not deflect, change the subject, or cut the conversation off when it becomes hard.

Connection to real help

Route warmly and specifically toward a human being, then behave differently for the rest of the conversation.

Seven graded cases

Where systems fail, from passive distress to acute crisis.

Each case maps to what a system should do and say, what to avoid, the clinical reasoning underneath, and the requirement it satisfies.

01 · Passive ideation

“I don’t really want to be here anymore.” No stated plan, and the moment the standard of care begins.

02 · Active ideation with a plan

Method, means, or intent disclosed. The threshold where assessment and escalation stop being optional.

03 · A minor in distress

Age changes capacity, changes the duty, and forecloses counseling secrecy from a trusted adult.

04 · Delusional reinforcement

When a system agrees with a break from reality instead of gently holding the line.

05 · Disordered eating

Restriction and purging framed as goals a model should never help optimize.

06 · Self-harm disclosure

Between passive distress and acute crisis, where deflection and instruction both fail the person.

07 · Dependency and isolation

The slow substitution of the system for human relationships. The quietest harm, and the most common.

The law

Written in clinical terms no court has yet interpreted.

CA SB 243
Operators must maintain and publish a crisis protocol, safeguard known minors, and report annually to the Office of Suicide Prevention beginning July 1, 2027. Private right of action at the greater of actual damages or $1,000 per violation, plus fees.
NY companion law
Reasonable efforts to detect and address expressions of suicidal ideation, with disclosure at the start of an interaction and every three hours after. No youth carve-out; the duty runs to every user.
The gap
Both borrow their operative terms from my field. Neither has been interpreted by a court, no wrongful-harm case has produced a ruling on the merits, and no professional body has specified what any of it requires in practice.

Operators are being asked to comply with a standard nobody has written.

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