Abstract:
:The authors aim to facilitate the psychiatric evaluation of death-hastening decisions, such as cessation of life-support treatment or physician-assisted suicide, by deriving principles for evaluating patients from a literature review and a recently completed prospective study on dialysis discontinuation conducted by consultation psychiatrists. Factors are delineated and suggestions are provided for the evaluation of requests to accelerate dying. Included are the authors' method for determining major depression in the context of terminal illness and their "vector analysis" in assessing patient requests to stop dialysis. As our society heatedly examines the care provided to the terminally ill, psychiatry also needs to reconsider whether actions that foreshorten life can be normative and permissible. Familiarity with competency, psychiatric diagnosis, and ease in communication and negotiation between patient, family, and staff are resources that psychiatrists can bring to these complicated assessments. Challenging areas include diagnosing depression, establishing the adequacy of palliative care, and appreciating issues related to personality features, family dynamics, and ethnic differences.
journal_name
Psychosomaticsjournal_title
Psychosomaticsauthors
Cohen LM,Steinberg MD,Hails KC,Dobscha SK,Fischel SVdoi
10.1176/appi.psy.41.3.195subject
Has Abstractpub_date
2000-05-01 00:00:00pages
195-203issue
3eissn
0033-3182issn
1545-7206pii
S0033-3182(00)70622-0journal_volume
41pub_type
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