The study of fatal suicides in York, 1990–1994, by Elwood & De Silva (1998) is valuable confirmation that other people than general practitioners (GPs) and psychiatrists have responsibilities in averting such deaths, but does not go far enough. It is assumed that the GP or general hospital doctor has failed to recognise the suicidal risk, and better teaching would have increased their diagnostic awareness and so saved lives. But examining the detailed sequence of events leading up to death (medical audit) will show that in a number of cases medical diagnosis was not lacking, and the problem lay elsewhere.