Sunday, May 03, 2015

Treatment resistant depression and access to assisted dying

I have long been in favour of offering access to assisted dying to competent people suffering from treatment resistant major depressive disorder. Other than the occasional newspaper column or blog entry I didn't have time to actually write a proper peer reviewed paper on the issue. Well, that's finally rectified. It came out yesterday. I jointly authored it with Suzanne van de Vathorst of Amsterdam University's Medical Centre. Here's the abstract:

Competent patients suffering from treatment-resistant depressive disorder should be treated no different in the context of assisted dying to other patients suffering from chronic conditions that render their lives permanently not worth living to them. Jurisdictions that are considering, or that have, decriminalised assisted dying are discriminating unfairly against patients suffering from treatment-resistant depression if they exclude such patients from the class of citizens entitled to receive assistance in dying.


  1. Thank you for your recent paper on treatment-resistant major depressive disorder and assisted dying. I have long suffered from treatment-resistant depression and have fought suicidal impulses for years. I have undertaken efforts to keep myself safe in order to avoid a rash decision that would end my life.
    However, I have sought to pursue all possibly effective treatments. Over the years, this has included over 40 thorough drug trials, many alternative treatments, ECT and even DBS treatments. Without lasting success.
    I am aware of the lasting impairments that result from repeated episodes of major depression and I have read extensively on the subject and discussed these issues at length with medical professionals.
    Your paper intelligently discusses the issues far better than I have. I have reached a conclusion that the quality of the remainder of my life is very likely to comprise unbearable suffering.
    With the full knowledge of those close to me, I have obtained the means to end my life reliably and peacefully. The date remains uncertain but having the means available has actually improved my condition far more than most treatments.
    I am very grateful to you for your efforts and recent article. Thank you.
    Cuba D.

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