Predictive models that utilize data from electronic healthcare records (EHR) have been developed, investigated, and appear to provide an important resource for suicide prevention in medical settings. Actuarial approaches to predicting suicide may be particularly important given the relative inability of clinicians to accurately predict suicide. Although research regarding predictive models that utilize EHR is certainly promising, ethical considerations for the use of these models to trigger suicide prevention interventions warrant careful consideration. The current manuscript discusses ethical considerations regarding the use of predictive models in suicide prevention clinical care. The unique characteristics of suicide are explored in terms of how they inform ethical and practical approaches. Additionally, biomedical ethical principles and utilitarian, Kantian, and personal rights ethical models are applied to the topic. Recommendations for navigating the ethical issues are provided as an initial framework for others who are considering the implementation of a predictive model to trigger suicide prevention initiatives.