title: Should Mental Disorders Be a Basis for Physician-Assisted Death?
abstract: Laws permitting physician-assisted death in the United States currently are limited to terminal conditions. Canada is considering whether to extend the practice to encompass intractable suffering caused by mental disorders, and the question inevitably will arise in the United States. Among the problems seen in countries that have legalized assisted death for mental disorders are difficulties in assessing the disorder's intractability and the patient's decisional competence, and the disproportionate involvement of patients with social isolation and personality disorders. Legitimate concern exists that assisted death could serve as a substitute for creating adequate systems of mental health treatment and social support.
authors.affiliation: Dr. Appelbaum, who is editor of this column, is the Elizabeth K. Dollard Professor of Psychiatry, Medicine and Law, Department of Psychiatry, Columbia University, New York City (e-mail: psa21@columbia.edu ).
authors.forename: Paul S
authors.initials: PS
authors.lastname: Appelbaum
mesh_terms: D002170:Canada; D006801:Humans; D001523:Mental Disorders; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D011570:Psychiatry / Q000331:legislation & jurisprudence*; D017236:Suicide, Assisted / Q000331:legislation & jurisprudence*; D014481:United States
keywords: Administration & management; Law & psychiatry