Rodriguez Davila Sandra L, Vidal Elizabeth, Stewart Jonathan T, Caserta Maria T
James A. Haley VA Hospital University of South Florida College of Medicine, Tampa, Florida 33612, USA.
Am J Hosp Palliat Care. 2010 Feb;27(1):63-5. doi: 10.1177/1049909109341874. Epub 2009 Aug 7.
With the legalization of physician-assisted suicide (PAS) in several states, it remains controversial whether present guidelines take into account the complexity of identifying treatable sources of suffering, including underlying depression and other psychiatric disorders, in this high risk population. We present a case in which a patient with end-stage prostate cancer requested PAS; this request was in a state where PAS is not a legal option. He was evaluated psychiatrically and was not found to be depressed, but ample opportunities were found to improve his quality of life. With appropriate treatment, he lost interest in PAS as an option. We discuss the need for a comprehensive evaluation to properly assess and manage the untreated physical and emotional suffering that may influence a patient's decision to hasten death.
随着几个州将医生协助自杀（PAS）合法化，目前的指导方针是否考虑到在这个高风险人群中识别可治疗的痛苦来源（包括潜在的抑郁症和其他精神疾病）的复杂性，仍然存在争议。我们报告了一例晚期前列腺癌患者请求医生协助自杀的病例；该请求发生在一个医生协助自杀并非合法选择的州。对他进行了精神评估，未发现他患有抑郁症，但发现有很多机会可以改善他的生活质量。经过适当治疗，他不再对医生协助自杀感兴趣。我们讨论了进行全面评估的必要性，以正确评估和处理可能影响患者加速死亡决定的未得到治疗的身体和情感痛苦。
