Published 11 November 2008, doi:10.1136/bmj.a2478
Cite this as: BMJ 2008;337:a2478

Letters

Depression and assisted dying

Psychiatric review is mandatory in Australia

The first 150 words of the full text of this article appear below.

Ganzini and colleagues’ finding that 3 of the 18 Oregonians who received a prescription for a lethal drug met caseness criteria for depression raises concerns about the state’s Death with Dignity Act, which demands a psychiatric review only if "concern exists that the patient has a psychiatric disorder."1

We know that depression is common in the terminally ill and that depression may be successfully treated in this population. We know that depression may impair a person’s capacity when requesting physician assisted suicide, and we know that non-psychiatrically trained physicians are poor at detecting depression. We also know that these four facts are true for delirium in patients who are terminally ill.

There is a strong argument for including mandatory psychiatric review in any legislation that enables physician assisted death, to detect and protect those who would not have requested assistance to die had they not been depressed or delirious.2 This . . . [Full text of this article]

Christopher J Ryan, consultant liaison psychiatrist1, Tarra Shaw, consultant liaison psychiatrist1

1 Department of Psychological Medicine, University of Sydney, Sydney, NSW 2006, Australia

cryan@mail.usyd.edu.au


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Relevant Article

Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: cross sectional survey
Linda Ganzini, Elizabeth R Goy, and Steven K Dobscha
BMJ 2008 337: a1682. [Abstract] [Full Text] [PDF]

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