Rapid-Response Treatments for Depression and Requests for Physician-Assisted Death: An Ethical Analysis.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry November 1, 2022 Noah Berens, Scott Yh Kim 12 citations
Depression is common in terminally ill patients and can influence requests for physician-assisted death (PAD), but clinicians struggle to assess its role. A case series showed that rapid treatment with intranasal ketamine clarified whether depression was driving the PAD request: one patient withdrew her request after realizing it was depression-driven, while others maintained theirs. Other emerging rapid treatments, such as psilocybin with support and transcranial magnetic stimulation, raise ethical issues. These include using such treatments to evaluate decision-making capacity, tensions between legal definitions of irremediability and clinicians' ethical duties, and obstacles to treatment access that may undermine equal respect for patient autonomy.