Depresion

Depression and Euthanasia

In the November 15, 2000 Journal of the American Medical Association, a special issue dedicated to end-of-life care, Drs. Linda and Ezekiel Emanuel and Diane Faircloughreport on a survey of 988 terminally ill patients receiving care in five cities and one rural county in the U.S. Some of their findings:

60.2% of the patients supported euthanasia orphysician-assisted suicide (PAS) in a hypothetical situation of unremitting pain, but only 10.6% had seriously considered such things for themselves.

While a majority supported euthanasia or PAS in a case ofunremitting pain, "less than a third support it when the patient desires it because of fear of being a burden on the family." {Ironically, 63% of the patients receiving assisted suicide in Oregon lastyear were motivated by fear of being a burden on others, while only 30% cited unrelieved pain as a consideration)

Those most likely to consider euthanasia or PAS for themselves were those who haddepressive symptoms, substantial caregiving needs, and pain. Those least likely to consider it were those who felt appreciated, were 65 years old or older, were African American, or were religious.At a follow-up interview, half the patients who had considered euthanasia or PAS for themselves had changed their minds, while an almost equal number of patients had begun considering theseinterventions, especially those who had developed depressive symptoms or dyspnea.

Of the 256 patients who died during the study, only one (0.4%) died by euthanasia or assisted suicide, oneunsuccessfully attempted suicide, and one repeatedly asked to have her life ended but family and physicians refused.

The authors note "a tension between attitudes and practices, between the reason people findeuthanasia and PAS acceptable - predominantly pain - and the main factor motivating interest in euthanasia or PAS - patient depression." They propose that physicians who are asked to perform...