Assessing Patients Who Seek Help Ending Their Lives

Authors

Sheila Hafter Gray, Past President of the American Academy of Psychodynamic Psychiatry and Psychoanalysis and Chair of the Group for the Advancement of Psychiatry Committee of Professionalism and Ethics (GAP-COPE).
Philip J. Candilis, Professor of Psychiatry, George Washington University School of Medicine and Health Sciences, and co-Chair of GAP-COPE. philip.candilis@dc.gov.
Edmund G. Howe, Professor of Psychiatry, School of Medicine, Uniformed Services University of Health Sciences, and a member of GAP-COPE.
Theodore Fallon, Professor, Department of Psychiatry, Drexel University College of Medicine, and a member of GAP-COPE.
Karen G. Gennaro, Psychiatrist-Psychoanalyst, William Alanson White Institute, St. Vincent's Hospital Westchester, and a member of GAP-COPE.
Robert Nesheim, Emeritus Director, Hamm Memorial Psychiatric Clinic, and a member of GAP-COPE.
Jon A. Van Loon, Psychiatrist at Integrated Behavioral Health, Gundersen St. Elizabeth's Hospital and Clinics, and a member of GAP-COPE.

Document Type

Journal Article

Publication Date

1-1-2022

Journal

Psychodynamic psychiatry

Volume

50

Issue

3

DOI

10.1521/pdps.2022.50.3.435

Keywords

capacity assessment; decision-making capacity; end of life decision-making; narrative; the psychiatric interview

Abstract

As a result of end-of-life movements in a number of states, psychiatrists may be drawn into the capacity assessment of patients requesting assistance to end their lives. Such assessments cannot follow the mere technicalities of common clinical interviews, not simply because of the finality of the choice, but also because of the limitations of common cognitive assessments. The Committee on Professionalism and Ethics of the Group for the Advancement of Psychiatry consequently proposes an interview for such purposes that explores a patient's emotional capacity through a narrative inquiry about the patient's life, past coping, and reversible emotional states. It is a neutral approach that seeks to understand the patient rather than judge the appropriateness of an end-of-life request.

APA Citation

Gray, Sheila Hafter; Candilis, Philip J.; Howe, Edmund G.; Fallon, Theodore; Gennaro, Karen G.; Nesheim, Robert; and Van Loon, Jon A., "Assessing Patients Who Seek Help Ending Their Lives" (2022). GW Authored Works. Paper 1864.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/1864

Department

Psychiatry and Behavioral Sciences