In the linked study (doi:10.1136/bmj.a1682), Ganzini and colleagues report that most terminally ill patients in Oregon who receive physician assistance in dying do not have depressive disorders.1 In fact, only three (17%) patients who received a lethal prescription met criteria for depression. This finding is in line with a previous study carried out in the Netherlands, where both euthanasia and physician assisted suicide are legal. A major depressive disorder was identified in only two terminally ill oncology patients (17%) at the time they explicitly requested euthanasia.2 This suggests that the prevalence of major depression among patients requesting euthanasia or physician assisted dying is much lower than would be expected from studies on the relation between depression and the desire to die in areas where assisted dying is illegal.

Despite this outcome, depressed mood and an explicit request for euthanasia were associated in terminally ill patients with cancer …