This distinction has had the effect of allowing a patient on life support the ability to end his or her life on request, yet a patient who is not dependent on life support does not have such a right.
In fact, this difference in perceived "rights" formed the basis of the arguments made to the Supreme Court in Washington v Glucksberg9 and Quill v Vacco,10 in which it was argued that this distinction violated the due process clause of the 14th Amendment (the Supreme Court unanimously rejected this argument).
Background: Physician-assisted suicide (PAS) is perhaps the most compelling and clinically relevant mental health issue in palliative care today.
The desire for death, the consideration of suicide, the interest in PAS, and the relationship of these issues to depression and other psychosocial issues appear to be of paramount importance.
"If I ever have an accident or a terminal disease that would affect my mind or body, I will end it." Twelve years later, he did so.
Similar sentiments are shared by a significant proportion of Americans.
Both euthanasia and PAS have been distinguished, legally and ethically, from the administration of high-dose pain medication meant to relieve a patient’s pain that may hasten death (often referred to as the rule of double effect) or even the withdrawal of life support.6,7 The distinction between euthanasia/PAS and the administration of high-dose pain medications that may hasten death is premised on the intent behind the act.
In euthanasia/PAS, the intent is to end the patient’s life, while in the administration of pain medications that may also hasten death, the intent is to relieve suffering.
Desire for death has been postulated as a construct that is central to a number of related issues or phenomena, including suicide and suicidal ideation, interest in PAS/euthanasia, and requests for PAS/euthanasia.
This construct, which was initially proposed by Brown and colleagues3 and further developed by Chochinov et al4focuses on the degree to which an individual wishes his or her life could end sooner rather than later.