Re: "Going Beyond 'Do No Harm'"

11/5/16

To the editor

Haider Javed Warraich (Going beyond 'do no harm') rightly encourages the medical profession to rethink its attitude towards assisted suicide for the terminally ill.  He notes that the often evoked worries around this intervention (encouraging 'eugenic sterilization', harming the vulnerable and uninsured, avoiding palliative care) have not been borne out based on all evidence.  However, he leaves out the most important clinical consideration: the presence of a major depression that exists alongside a terminal medical illness.  A careful clinical assessment by a psychiatrist is crucial to make sure the patient's wish to die is not part of a treatable psychiatric illness.

Respectfully,

Larry S. Sandberg MD