This letter to the editor descibes the case of a 54-year-old male who had been in a maximum security state forensic hospital for 14 years after murdering his wife. When he requested the book, “Final Exit”, library staff contacted the clinical team. Although he initially denied it, the patient later acknowledged suicidal thoughts. This case illustrates some of the concerns that this type of book raises for state institutions dealing with patients who may be susceptible to suicidal behaviours.