UK law on assisted suicide and euthanasia is very clear: it is unlawful. However, there have been successive proposals for changes to legislation in this area (in England and Scotland) and a series of individual challenges to current legislation in the courts. This article does not seek to debate the profound ethical arguments that surround this emotive subject, but instead to portray how the law, through court judgment and legislative proposals, has wrestled with opposing views, particularly over the past decade or so, as the impact of the Human Rights Act has presented unique challenges. Some of our closest European neighbours have diverse legislation that could influence our own legislature, and, from across the Atlantic, the Oregon Death with Dignity Act is being mirrored in proposals to change the law in the UK.

Assisting another person's suicide is a criminal offence in England and Wales, although the offence is rare and the law allows for charges not to be brought where there has been no criminal intent. Campaigners for ‘assisted dying’ want something else – a law licensing assisted suicide in advance for certain groups of people in certain circumstances. The present law has been challenged in the courts, hitherto unsuccessfully, as incompatible with article 8 of the European Convention on Human Rights. The Supreme Court has taken the view that, given its social policy implications, this is a matter that Parliament is better placed to consider than the courts.

Providing optimal healthcare for increasingly elderly hospital populations who have high rates of cognitive disorder is a great challenge. Using delirium as an example, we describe how improved management of acute cognitive problems through a multifaceted hospital-wide programme can promote cognitive-friendly hospital environments. A specific plan of action is described that spans interventions in day-to-day clinical care of individual patients all the way to wider organisational practices.

General hospitals and hospices see mostly older people, many of whom have dementia and multiple pathologies: delirium is common, costly and damaging. Informed and kindly care can reduce the incidence of delirium and hasten its resolution. O'Connell et al demand ownership of this phenomenon by the whole hospital. This will require a turnabout of philosophy, management and training for all professions.

Patients with severe and enduring eating disorders (SEED) may constitute a specific group. It is proposed that patients with anorexia nervosa (SEED-AN) or bulimia nervosa (SEED-BN) that requires the regular attention of a multidisciplinary team and is of a duration known to have a low recovery rate should be included in the SEED group. These patients present with a combination of severe symptoms and long-term illness, and may experience serious chronic physical sequelae (e.g. osteoporosis and renal failure), marked social isolation and stigma. Their carers suffer from the stress of caring for them over a prolonged period. Symptoms, treatment and crisis management of SEED-AN are discussed. SEED is a relatively recently described area of eating disorders psychiatry that requires research and service development so that patients and carers are helped to cope with very serious chronic, but not incurable, conditions.

Paul Robinson's article provides an excellent summary of some of the challenges faced by clinicians working with patients with severe and enduring eating disorders (SEED) and outlines a robust approach to the recognition and management of this complex group of patients. This commentary expands on some of the points raised, adds some further views and suggests a tailored approach to establishing a therapeutic alliance with patients and carers.

Cognitive and memory testing are a common part of clinical practice, but professional concerns are sometimes raised that the individual being tested might be feigning deficits. Most clinicians have limited experience and training in detecting malingering in such cognitive testing, and the very issue raises considerable ethical dilemmas. Nevertheless, psychiatric work faces ever greater potential for legal scrutiny, and failure to appropriately evaluate potential malingering risks professional embarrassment and distress. There is a need for clinicians to make themselves aware of the ways in which malingered behaviour might be evaluated through the clinical history, the use of routine psychometric testing and, particularly, the use of symptom validity (‘malingering’) tests. This article describes these factors and gives guidance on the appropriate reporting of findings.

There have been many developments in addiction psychiatry over the past decade. Some of these are political, such as preference for recovery-/ abstinence-based programmes. Prohibition is becoming increasingly unrealistic, especially considering the effective legalisation of recreational cannabis in Uruguay and two US states. Legal highs and diversion of prescribed drugs (such as methadone, gabapentinoids, methylphenidate and benzodiazepines) are now a major problem. Furthermore, diversion of opioid drugs that are prescribed for pain is reaching epidemic proportions, causing a significant change in the nature of patients being referred to addiction services.

The past few decades have witnessed the synthesis of Buddhist mindfulness practice with the Western psychological paradigm, leading to the development of a variety of mindfulness-based interventions. These are delivered to various populations to treat a wide range of physical and psychological disorders, and several protocols have been implemented and evaluated, mostly, if not exclusively, in open or out-patient treatment settings. Little attention has been given to the definition of criteria, guidelines and protocols for the use of mindfulness in residential settings such as in-patient psychiatric wards, secure and forensic services, prisons, nursing homes and hospices. In this article, we discuss the rationale, advantages and obstacles to delivering mindfulness-based interventions in residential treatment settings, with specific reference to forensic settings. We also discuss the problem of developing robust outcome data and recommendations for future research.