title: [Should assistance to suicide be allowed in a case of chronic persistent depression in a nursing home patient].
abstract: A 75 years old widower suffered since 26 years of many episodes of recurrent depressions. A compensated diabetes and a chronic, slowly progressive sensory-motor Neuropathy are relevant somatic comorbidities. Because of anxiety attacks complicating his progressively severe depression he could not be cared adequately in the old people home he lived in and was hospitalised. The anxiety responded well to Benzodiazepines, but the severe depression persisted despite a pharmacotherapy with Lithium, Mianserin and Citalopran. He was therefore transferred into a nursing home. There he demanded - supported by his son - an assisted suicide. 2 psychiatrists judged his wish to die as independent to his actual depression, a geronto-psychiatrist judged his suicidal ideas as a typical symptom of depression. Therefore the demanded assisted suicide was not allowed in the nursing home according to communal legal rules not allowing assisted suicide of persons with psychiatric illness in communal institutions. A hospitalisation against his own and his son's will was however not done and the assisted suicide was executed in privacy. This in Switzerland is legal even in cases of severe chronic psychiatric illness without a terminal disease.
authors.affiliation: Stadtärztlicher Dienst Zürich. Wettstein.Albert@zuerich.ch
authors.forename: A
authors.initials: A
authors.lastname: Wettstein
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D004992:Ethics, Medical; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D019983:Guideline Adherence / Q000331:legislation & jurisprudence; D006707:Homes for the Aged / Q000941:ethics* / Q000331:legislation & jurisprudence*; D006801:Humans; D007872:Legal Guardians / Q000331:legislation & jurisprudence; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence; D009735:Nursing Homes / Q000941:ethics* / Q000331:legislation & jurisprudence*; D012017:Referral and Consultation / Q000331:legislation & jurisprudence; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence*; D013557:Switzerland