In this letter to the editor, Hubbeling comments on a study by Huisman & colleagues (2009) on whether the feedback provided by the Dutch Health Care Inspectorate was in agreement with the American Psychiatric Association’s guidelines for the assessment & treatment of suicidal patients. Hubbeling questions the use of the American guidelines as a standard as they were not published until some years after the study had started. The reply of Huisman et al follows.