Psychiatric evaluations for individuals requesting assisted death in Washington and Oregon should not be mandatory

Résumé

This article discusses the psychiatric evaluations for patients requesting physician assisted death in Washington and Oregon. It is noted that the mental health evaluation of the patient requesting physician assisted death (PAD) has two goals. One goal is to ensure that the patient does not have a potentially treatable mental disorder influencing the decision to hasten death. The second goal is to guarantee that the patient is competent to decide to choose PAD. The most important component of the competency evaluation is to confirm that the patient understands alternatives to PAD. In the case of legalized PAD in Washington and Oregon, requiring a psychiatric consultation in every case is burdensome, unnecessary and possibly unworkable. The author argues that individuals with clinical or major depression should not be given lethal prescriptions, even in the context of a terminal illness. In a study of 418 Oregon psychiatrists, only 3% endorsed that a request for physician assisted suicide was prima facie evidence of a mental disorder. Oregonians with depression access legal lethal prescriptions. It is concluded that this could be avoided through careful systematic screening for depression along with longitudinal evaluation by health care system referral to psychiatrists with expertise in care of patients at the end of life of those at higher likelihood for depression. (PsycINFO Database Record (c) 2014 APA, all rights reserved) ORÉGON WASHINGTON ÉTATS-UNIS SUICIDE-ASSISTÉ ÉVALUATION-CLINIQUE PRISE-DÉCISION SANTÉ-MENTALE JURIDIQUE