Depression and Euthanasia

I am deeply troubled by the availability of euthanasia to people suffering from depression and mental illness. Recent research from Oregon, USA, where euthanasia is available has not stilled my troubled soul. See, Assisted Suicide in Oregon: Evidence of Missed Evaluation for Depression. Excerpt from the article:

More important, the ongoing failure to refer patients seeking assisted suicide for psychiatric evaluation put these patients at risk when there are treatment options available for their depression.  As the previously cited JAMA study shows, terminally ill patients’ attitudes towards assisted suicide “appear to be quite unstable.”  Of those patients who during an initial interview said they would consider assisted suicide/euthanasia for themselves, about half had changed their minds at a later, follow-up interview.  By the same token, some terminally ill patients who had not considered assisted suicide/euthanasia for themselves at the initial interview began to do so at the follow-up interview.  The reason?  “Depressive symptoms and dyspnea were associated with this instability.”  “Thus,” the authors recommend, “physicians who receive requests for euthanasia or PAS should recognize their volatility and not take such requests as settled views but should evaluate patients for depression and unrelieved dyspnea.”


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Depression and Euthanasia — 1 Comment

  1. Some observations on your reservations on depression, the terminally ill and voluntary euthanasia.

    It would be surprising if any person dying and suffering with a terminal illness did not have some degree of depression.

    If referral to a psychiatrist was mandatory for every person requesting an assisted death under the proposed Giddings/McKim legislation, in addition to the treating doctor’s diagnosis and confirmation by specialist in that illness, would you then support it?

    Can you explain this, a patient frequently is LESS depressed once they are approved for an assisted death? –
    Dr Nathanson, who rejects the argument that prescribing lethal medication is enabling suicide — “Terminal people don’t have a choice, they are going to die from disease” — said the drugs may actually produce an unexpected outcome.
    “One of the paradoxes is that when a patient gets the medicine, they frequently will live longer than expected,” he said. “The hospice nurse will tell the family that their mother who wasn’t eating hardly at all or watching TV or reading or interacting is now eating like a horse and now doing those things. It’s because the person no longer has that toxic anxiety. They know that they are empowered if things become intolerable. And the definition of that is whatever the patient says is intolerable.” Ref: http://www.civilbeat.com/articles/2012/04/03/15400-doctors-form-aid-in-dying-advisory-council/
    I note that the JAMA article cited was PRIOR to the Oregon legislation taking effect, and that community attitudes to assisted dying have changed since then.

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