Am J Psychiatry 157:595-600, April 2000
© 2000 American Psychiatric Association
Evaluation of Competence to Consent to Assisted Suicide:Views of Forensic Psychiatrists
Linda Ganzini, M.D.,
Gregory B. Leong, M.D.,
Darien S. Fenn, Ph.D.,
J. Arturo Silva, M.D., and
Robert Weinstock, M.D.
OBJECTIVE: Mental health evaluation of competence to consent has been proposed as an important safeguard for patients requesting assisted suicide, yet mental health professionals have not developed guidelines or standards to aid in such evaluations. The authors surveyed a national sample of forensic psychiatrists in the United States regarding the process, thresholds, and standards that should be used to determine competence to consent to assisted suicide. METHOD: An anonymous questionnaire was sent to board-certified forensic psychiatrists between August and October 1997. RESULTS: Of the 456 forensic psychiatrists who were sent the questionnaire, 290 (64%) responded. Sixty-six percent believed that assisted suicide was ethical in at least some circumstances, and 63% thought that it should be legalized for some competent persons. Twenty-four percent indicated that it was unethical for psychiatrists to determine competence; however, 61% thought such an evaluation should be required in some or all cases. Seventy-eight percent recommended a very stringent standard of competence. Seventy-three percent believed that at least two independent examiners were needed to determine competence, and 44% favored requiring judicial review of a decision. Fifty-eight percent believed that the presence of major depressive disorder should result in an automatic finding of incompetence. Psychiatrists with ethical objections to assisted suicide advocated a higher threshold for competence and more extensive review of a decision. CONCLUSIONS: The ethical views of psychiatrists may influence their clinical opinions regarding patient competence to consent to assisted suicide. The extensive evaluation recommended by forensic psychiatrists would likely both minimize this bias and assure that only competent patients have access to assisted suicide, but the process might burden terminally ill patients.
This article has been cited by other articles:
|
|
|
|
 
L. Ganzini, E. R Goy, and S. K Dobscha
Prevalence of depression and anxiety in patients requesting physicians' aid in dying: cross sectional survey
BMJ,
October 7, 2008;
337(oct07_2):
a1682 - a1682.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. J. Goldyne
Minimizing the Influence of Unconscious Bias in Evaluations: A Practical Guide
J Am Acad Psychiatry Law,
March 1, 2007;
35(1):
60 - 66.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. GANZINI
Physician-Assisted Suicide
Am J Psychiatry,
June 1, 2006;
163(6):
1109 - 1110.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. L. van der Lee, J. G. van der Bom, N. B. Swarte, A. P. M. Heintz, A. de Graeff, and J. van den Bout
Euthanasia and Depression: A Prospective Cohort Study Among Terminally Ill Cancer Patients
J. Clin. Oncol.,
September 20, 2005;
23(27):
6607 - 6612.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. G. Hamilton and C. A. Hamilton
Competing Paradigms of Response to Assisted Suicide Requests in Oregon
Am J Psychiatry,
June 1, 2005;
162(6):
1060 - 1065.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. L. WERTH Jr.
Legal and Ethical Considerations for Mental Health Professionals Related to End-of-life Care and Decision Making
American Behavioral Scientist,
November 1, 2002;
46(3):
373 - 388.
[Abstract]
[PDF]
|
|
|
Get information about faster international access.
Privacy Policy
Copyright © 2000
American Psychiatric Association.
All rights reserved.
Home
| Search
| Current Issue
| Past Issues
| Subscribe
| All APPI Journals
| Help
| Contact Us
|
