Death With Dignity Act May Not Protect Those With Depression
On October 27, 1997, Oregon enacted the Death With Dignity Act. The legislation allows doctors in the state of Oregon to prescribe terminally-ill patients a lethal dose of medication, which they can use to end their lives.
Controversy surrounds one of the stipulations of the act, however. If a physician feels a patient is suffering from depression or another mental disorder, they must refer them for a mental health evaluation. Some feel that the way the act is being administered may fail to protect those with depression from making a decision to die.
Linda Ganzini of Portland Veterans Affairs Medical Center took a look at this issue by surveying 58 patients in Oregon, most dying from cancer or amyotrophic lateral sclerosis, who had requested physician assistance with dying or who had contacted an advocacy group. She assessed whether the patients had anxiety or depression using the Hospital Anxiety and Depression Scale and DSM-IV criteria for diagnosing these disorders.
Ganzini found that 25.8% of patients met the criteria for depression and 22.4% met the criteria for anxiety. By the end of the study, 42 of the 58 had died. Of these patients, 18 had been prescribed a lethal drug and nine died by ingesting the drug.
Three of the patients who had been prescribed a lethal drug had previously met the study criteria for depression and all three took the lethal dose within two months of beginning the study. None had been previously evaluated by a mental health professional.
The study, which was published in the October 25 issue of the British Medical Journal, suggests that, while most patients who request and receive assistance with dying do not suffer from depression, some depressed patients will slip through the cracks and not receive mental health evaluation prior to being prescribed a lethal drug.
What are your thoughts about this topic? Should Oregonian doctors do more to make sure that depression does not influence their patients' decision to die? Is this legislation even a good idea in the first place? Keep in mind, we are not talking about whether a depressed person has the right to die, but rather whether more should be done to make sure a terminally ill person who is also depressed will not make such a decision while they are depressed.
Comments
I can see both sides of this argument, but I have to side with the rights of depressed people to chose how they die.
While people certainly could die prematurely because they’re prescribed lethal drugs while depressed, this law is only meant for people who have just a few months left to live. Would it be better to put these very ill people on antidepressants, which could cause negative side effects and interact with their other medications, and which can take quite awhile to have an effect? It’s possible that someone could enter into the final, painful phases of their disease while waiting to be declared “not depressed,” and then it would be too late for them to die as they wish.
Also, someone who’s terminally ill and also depressed but is denied physician-assisted suicide would likely be at high risk of committing suicide. Dying (somewhat) peacefully in bed is better not only for the sick person, but for their survivors. I know someone who found a loved one who’d shot herself in the head – can you imagine having to live with that memory?
I voted for Death with Dignity when I lived in Oregon, and I just cast my ballot for a similar law in Washington. I hope it passes so that I’m never forced to suffer the final pangs of disease when I’m ready to be done.
So very often, the pain and disability of a fatal illness can cause depression. I think this act is a good one, and the person’s depression might not have a lenghty history.
Having been housebound my times by illness, I know how it exacerbates, and/or causes depression, especially if one has little support from family and friends.
I believe it is a great thing that these people have a choice in Oregon.
I believe all terminally ill people should have someone in the mental health field to talk to, but I don’t believe a depressed, terminally ill patient should be treated with anti-depressants. This is like throwing a cup of water on a forest fire. They should have the right to die the way in which they choose.
Wendy Aron, author of Hide & Seek: How I Laughed at Depression, Conquered My Fears and Found Happiness
http://www.wendyaron.com
I totally agree with the first 2 posts. It is much better to help people with their choice, instead of allowing them to try to die with dignity by therir own hand. So many people end up in nursing homes with the results of more suffering due to not knowing how to end their lives properly..
I have suffered from depression for years but now I am free of it, though still taking medication and getting therapy because I developed a brain disease called multiple system atrophy and my brain is dying. There is no cure and most people die of pneumonia as they can no longer move. I think depression should not be a factor for illnesses. I wish I lived in Oegon.
I see this as boiling down to a question of whether or not a person truly has the right to control their own life, including ending it, or not. Or does the state have rights over everyone’s lives that supersede that of the individual? Why should the subjective opinion of another on whether a person is truly depressed determine whether or not that person can get assistance in a suicide? Depressed or not, if a person really wants to end their life, they can and will, regardless of the belief others hold that they should be in control of the lives of those around them.
There will always be a price to pay when people play God – whether you believe it or not, it is the truth. First, the government is involved in the lives of the unborn and now they are involved in the lives of patients. I guess it’s ok it we give it a nice title – dying with dignity. The price in this case may be more deaths than expected because sometimes when you are in a great deal of pain, you believe the only answer is death but there is no change to that decision.
Thankful I live in a different state for that reason……….
How could a terminally ill patient NOT be depressed???
People who are in mental pain, and have not found relief should qualify also.
People try for years to get a “right” therapist and more to solve problems. Don’t think in the last few, painful, months of going, anyone could accurately diagnose depression.
I live in Oregon, gladly, and don’t believe anyone has the right to decide for me if I can let go…I’ll go anyway eventually.
To those who use a God. Remember, not everyone believes in a God and that’s what scares me that some do gooder blindly following some God will take the right away and be willing to watch some go through the horror, and agony of a painful, month’s long death.
I’ve seen it, and it isn’t nice, ranks right up there with torture.