When Is Depression a Terminal Illness? Deliberative Suicide in Chronic Mental Illness.
This commentary explores the utility of hope as a therapeutic tool for intervention in the case of a patient with a mental illness that is refractory to treatment over time, who expresses her intention to commit suicide. It begins with a short discussion differentiating a deliberative consideration of suicide from an impulsive act. Then the commentary defines hope, how it might be used as a therapeutic tool, and which limitations a clinician might confront in such a case. This commentary also considers the role of a physician in orientation not only to the patient but also to her own thoughts, feelings, and emotions regarding a patient's expressed desire to end her life.
General adult psychiatrist who practices in Austin, Texas, and works in a small group clinic, and is also active in the Texas Society of Psychiatric Physicians Council on Ethics.
Constance E
CE
George
D001714:Bipolar Disorder / Q000150:complications / Q000628:therapy*; D002908:Chronic Disease; D003863:Depression / Q000150:complications / Q000628:therapy*; D004644:Emotions; D004992:Ethics, Medical; D005260:Female; D065026:Hope; D006801:Humans; D033182:Intention; D008875:Middle Aged; D011570:Psychiatry; D012297:Right to Die; D059020:Suicidal Ideation