Clinicians are being urged to think about a range of scenarios in which patients with serious medical or psychiatric illnesses may make a considered decision to plan their own deaths.
While variations of laws surrounding euthanasia and physician-assisted death exist in parts of Europe, Canada and some states in the US, no broad consensus exists as to how doctors should manage circumstances involving pre-planned death. However, writing in the Journal of Psychiatric Practice, guest columnist Joel Yager, says as the concepts of assisted suicide and the ‘right to die’ become more accepted in society, “there’s a growing likelihood that clinicians will encounter situations involving pre-planned death by decisionally competent individuals”.
In the article, Dr Yager outlines the complex issues and terminology surrounding pre-planned death.He describes how studies show physicians would prefer a briefer, higher quality life to prolonged low-quality life, dignity in infirmity and death, and avoidance of terminal suffering for their own end-of-life circumstances. “Lay people generally endorse similar preferences,” said Dr Yager, who asked, “shouldn’t they be accorded the same dignities and care that physicians would want for themselves?”
While the issue is complex, Dr Yager said that “considerations regarding pre-planned deaths merit greater professional and public discussion”.
Yager J. Contending With Preplanned Death: Questions for Clinicians. J Psychiatr Pract. 08 September 2017. doi: 10.1097/PRA.0000000000000260