Depression Killers

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.

depression.about.com