Assisted suicide for depression is controversial, and experts worry about unclouded decision-making in patients and physicians.
Depression is a diagnosable mental health disorder. It can significantly impact your quality of life and your ability to function at home, work, and/or interpersonally.
The flagship features of depression are persistent low mood and an inability to experience — or loss of interest in —pleasurable activities.
Low mood can be more than just “feeling down.” It’s often feelings of worthlessness, irrational guilt, and thoughts about death or dying, known as suicide ideation.
For many people, relentless negative thoughts can make assisted suicide for depression seem like a reasonable option.
Assisted suicide, now referred to as physician-assisted death, is one type of medical assistance in dying (MAiD).
MAiDs are a part of the “death with dignity” movement, a social rights concept that asserts no one should have to go through the indignity of needless suffering at the end of life.
It isn’t the same as euthanasia, a term familiar from the veterinary world, which indicates the doctor is the one administering life-ending medications.
Controversy of assisted suicide
Allowing people to request death due to suffering has always been controversial.
The AMA states that, because physicians are people too, they’re not solely governed by their profession. Their own feelings, moral beliefs, and current mindset might influence their ability to make life or death determinations.
How to set approval standards for MAiD is another reason for controversy.
When you request physician-assisted death, you’re relying on someone else’s ability to assess your level of suffering, something the AMA and other professional agencies believe is impossible to regulate.
If two people are experiencing the same terminal illness, for example, why would one qualify for physician-assisted death but not the other?
Medical assistance in dying, including euthanasia, is not currently an option for people living with mental health disorders in the United States.
The American Psychiatric Association (APA) adopted the same stance as the AMA in 2016, stating that “a psychiatrist should not prescribe or administer any intervention to a non-terminally ill person for the purpose of causing death.”
Suicide ideation in depression, for example, may be a symptom of the condition rather than rational thought. It can often be managed through medication and psychological interventions.
Depression screening for assisted suicide
Mental health professionals do have a role to play when it comes to physician-assisted death. Under most laws, your ability to make unclouded decisions is a part of eligibility.
If you’ve requested physician-assisted death, you may be required to undergo a mental health evaluation, including a depression screening, to see if underlying factors might be impairing judgment.
The ability of depression and other mental health disorders to skew perception and impact cognitive function is one of the main reasons why they may disqualify you from receiving MAiD services.
Physician-assisted death is not a universal privilege in the United States.
Currently, only the District of Colombia and 7 states have laws in place allowing physician-assisted death. These states include:
- New Mexico
- New Jersey
Two other states, Montana and California, will consider requests for physician-assisted death through court rulings.
This means, in these two states, you’re not entitled to physician-assisted death by law, but individual cases may be granted permission based on their circumstances.
Death with dignity laws in the U.S. can differ by state but share certain eligibility requirements. To qualify under most provisions, you must be:
- an adult as defined by the state
- a resident of the state where the law is in effect
- capable of using the prescribed medications without assistance
- able to make your own healthcare decisions and communicate them
- living with a terminal illness that is expected to cause death within 6 months as verified by qualified healthcare professionals
The stance around physician-assisted death in the U.S. is more rigid compared to other countries, particularly in Europe.
Switzerland, for example, allows non-medicalized assisted death and
In the Netherlands, you can qualify for MAiD if you’re living with a severe mental health condition, such as treatment-resistant depression or dementia. Eligibility is determined if you feel your health circumstances are unbearable and there’s no prospect for improvement.
Belgium and Luxemburg have similar positions. Physician-assisted death is available regardless of life-expectancy for physical and mental health conditions.
In North America, Canada may soon join the ranks of countries offering MAiD for mental health conditions. A final decision is expected early in 2023.
In the U.S., seven states and the District of Colombia have laws in place allowing physician-assisted death. California and Montana may allow MAiD on a case-by-case court-ruled basis.
No states currently allow physician-assisted death for depression or other mental health disorders.
Depression is considered treatable, and concerns about decision-making ability in depression are what keep it from being an approved MAiD condition in the U.S.
If you’re experiencing persistent thoughts about death or dying, help is available 24/7 by calling the SAMHSA National Helpline at 1-800-662-4357.