Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Schuklenk and van de Vathorst's paper is a very welcome addition to the literature on the assisted dying debate and will be of great interest to clinicians working in the field of mental health.1 Many psychiatrists will have had patients who have asked them to allow them to die, to desist in their efforts to prevent their suicide, and one of us has had personal experience, outside of professional life, of being asked to aid in someone's attempt to end their life in the context of an episode of mood disorder. The person with depression asking professionals, friends and family members to aid them in ending their life is a very real phenomenon. In their discussion, Schuklenk and van de Vathorst's paper uses two principles that we endorse and add weight to their argument: namely, the reality of suffering in depression and the parity of mental and physical illness. Indeed, the case Schuklenk and van de Vathorst make is a strong one and our commentary will focus on the premise of the argument around choosing death and some empirical clarification about competence in depression and the nature of treatment-resistant depression (TRD) and its prognosis.
The conceptual concern we wish to discuss in relation to assisted dying, endorsed by the state and legislature, is not linked to any moral or religious concern, or even on grounds related to ‘slippery slope’ or ‘abuse’ arguments. Rather the worry is how one could operationalise decisions around assisted dying as based on competence and capacity and view such decisions as rational. I think this concern is not limited to depressive illness, but to all decisions regarding choosing non-existence. Schuklenk and van de Vathorst offer the following useful criteria to regulate assisted suicide:1
The patients …
Contributors The paper is jointly authored with MRB writing the first draft and preparing final draft for submission.
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
- Feature article
- End of life
- The concise argument
- Current controversy
Read the full text or download the PDF:
Other content recommended for you
- Treatment-resistant major depressive disorder and assisted dying
- Drawing the line on physician-assisted death
- New use for an old drug: oral ketamine for treatment-resistant depression
- Esketamine for treatment-resistant depression
- Physician-assisted dying and two senses of an incurable condition
- Commentary on ‘Treatment-resistant major depressive disorder and assisted dying’
- Efficacy of repetitive transcranial magnetic stimulation in treatment-resistant depression: the evidence thus far
- Why extra caution is needed in the case of depressed patients
- Effects of ketamine treatment on suicidal ideation: a qualitative study of patients’ accounts following treatment for depression in a UK ketamine clinic
- Safeguarding choice at the end of life