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Addressing treatment futility and assisted suicide in psychiatry
Dembo, Justine S.
Dembo, Justine S.
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jemh2.pdf
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Abstract
In somatic medicine, increasingly, physicians and the public are discussing the questions of legalizing terminal sedation, assisted suicide, and euthanasia for suff ering related to refractory, incurable illness. As a resident in psychiatry, I struggle to understand the discrepancies in this regard between psychiatry and other medical specialties. Aft er discussion with several advisors and bioethicists, I have come to believe that several questions should be open for discussion: what are the ethical issues we must address in psychiatry when considering how to help patients with unbearable, prolonged treatment-refractory suff ering? Why is it that we are more comfortable with the notions of “refractoriness” and “terminality” in physical illness than in mental illness? What would “palliative psychiatry” look like, and when – if ever - might assisted suicide be a reasonable course of action in mental health care? In addressing these issues here, I intend to open a critical discussion, but not to argue an opinion. Given the tragedies that have historically ensued in the fi eld of medicine as a result of refusal to discuss ethically contentious issues, and given the increasing publicity regarding assisted suicide in the western world, it seems pertinent to address this as it may apply to psychiatry.
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2010-11
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With permission of the license/copyright holder