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Receiving a terminal diagnosis is one of the most devastating things that can happen to a person. So many emotions and fears can race through a person’s mind and those of their loved ones. And on top of that, they may be dealing with a whole host of physical and mental difficulties – such as pain, nausea, exhaustion, confusion, intense emotions – caused by their condition and sometimes by the treatment they are receiving.
It’s no surprise that depression is relatively common amongst the terminally ill.
In Oregon, adults who are competent and have a prognosis of six months or less to live may ask their doctor for an assisted suicide death. The intention is that only patients who have a settled desire to end their life may request that a doctor provide them with lethal drugs. Assisted suicide is not meant to be for those who are depressed because depression is held to diminish a person’s capacity to make a rational, competent decision.
The prevalence of depression amongst the terminally ill makes it vitally important that doctors, who are the gatekeepers of assisted suicide, can tell if the patient in front of them is asking for lethal drugs because they’re depressed and want to die. But doctors sometimes miss signs of depression, especially in their terminally ill patients and especially if they haven’t known their patient that long. Research from Oregon show that about 1 in 6 people who are given lethal drugs suffer from clinical depression.
Source: L Ganzini, E R Goy, S K Dobscha, “Prevalence of depression and anxiety in patients requesting physicians’ aid in dying: a cross sectional survey,” BMJ (2008) 337; I Levene and M Parker, “Prevalence of depression in granted and refused requests for euthanasia and assisted suicide: a systematic review,” Journal of Medical Ethics (2011) 37: 205-211; Government Inquiry into Mental Health and Addiction, He Ara Oranga: Report of the Government Inquiry into Mental Health and Addiction (2018).