History
What country legalized PAS in 1942?
Switzerland
What are the two main types of suffering that can influence a terminally ill patient’s request for physician-assisted suicide?
Physical suffering and mental suffering.
Name 2 of the 4 fundamental principles in medical ethics that can be used to address the ethical dilemma of PAS.
What is autonomy, justice, non-maleficence, and beneficence?
What core aspect of patient decision-making may be impaired in severe depression, making PAS ethically problematic?
Autonomy / decision-making capacity.
What legal case in 1973 was a catalyst that led to the Netherland’s tolerance of “mercy killings”?
Postma case
True or False: A patient with depression automatically lacks the capacity to request physician-assisted suicide.
False, Capacity must be evaluated individually.
A patient receives a full debriefing from a doctor about the risks and benefits of the procedure, and passes all the safeguards that enable PAS. The patient may now give their _____ _____ if they would like to elect for PAS.
Informed consent
Why is physician-assisted suicide considered risky for treatment-resistant depression from a recovery standpoint?
Depression is reversible, fluctuating, and future treatments may still work — PAS ends recovery permanently.
What country first legalized PAS in the EU in 2002?
Netherlands
What is the central ethical tension when a terminally ill patient also has a mental disorder?
Balancing autonomy (respecting their choice) with protection (ensuring mental illness is not impairing judgment).
True or False: All patients with a diagnosed depressive disorder lack competent decision-making abilities.
False
What societal risk occurs when PAS is normalized for psychiatric disorders?
Pressure on vulnerable individuals, reduced mental-health investment, and potential discrimination leading to death instead of care.
What is 1 eligibility for PAS?
Capacity. Autonomous, consistent request. Severe suffering. Consideration of alternatives.
Name one way depression can complicate decision-making in terminal illness.
It can distort future expectations, create hopelessness, or make suffering feel more unbearable.
Why is PAS considered a “safe practice” considering other ways of ending one’s life?
Professionals trained in PAS ensure death in a way that suicide by other means cannot, mandatory safeguards protect abuses, and it provides structure for an act that people will do anyway
Which cognitive effects of severe depression can distort a patient’s ability to make an informed decision about PAS?
Hopelessness bias, impaired future oriented thinking, and narrowed decision-making.
Name 3 steps in the assisted suicide procedure:
Individual contacts an assisted suicide organization. Medical documentation review Physician evaluation of capacity, suffering, and voluntariness. Multiple required conversations.
Why are extra psychiatric evaluations often required in PAS cases involving mental disorders?
To determine whether the patient's request is stable, voluntary, and not driven by impaired judgment.
What is patient autonomy in your own words?
The obligation of medical providers to provide patient-centered care and respect informed consent
List 3 cons that PAS can induce.
Decrease potentials in improving treatments, no future recovery opportunities, produce pressure on vulnerable individuals (not trying to seek help or being discriminated).