By Hilary White

LEIDEN, January 16, 2006 ( –Â A study published by Dutch researchers in the September 20, 2005 edition of the Journal of Clinical Oncology (JCO) has shown that at least 50% of patients killed under the Dutch euthanasia programme were suffering from depression. In addition, 44% of those suffering from cancer showed clinical signs of depression when they asked for euthanasia.

Titled, Euthanasia and Depression: A Prospective Cohort Study Among TerminallyÂIll Cancer Patients, the study reports that the risk to request euthanasia for patients with depressed mood was 4 times higher than that of patients without a depressed mood. The significance of the study is sharpened since the researchers themselves admitted to a strong bias against their own findings.

The researchers at the Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands, wrote that they were “uncomfortable” with the idea that a request for euthanasia is a symptom of depression and that the patient’s request for suicide should be deferred until his depression was treated.

The authors’ bias in favour of the Dutch euthanasia doctrine is clear: “The patient’s wish to hasten death cannot be put on par with a well-considered and persistent request for euthanasia in an environment where euthanasia is customary.”

“Our clinical impression was that such requests were well considered decisions, thoroughly discussed with healthcare workers and family. We thought the patients requesting euthanasia were more accepting their impending death and we therefore expected them to be less depressed. To our surprise, we found that a depressed mood was associated with more requests.”

In public debate euthanasia advocates insist that euthanasia and physician assisted suicide (PAS) are moral equivalents to withdrawal or withholding of life-sustaining treatments. Unlike PAS or active euthanasia, however, in withdrawing or withholding medical treatment for a terminal patient, the doctor does nothing to hasten or bring about the patient’s death.

Euthanasia and physician assisted suicide – in which a physician prescribes a lethal does of drugs – are intended deliberately to end a patient’s life at his request. The Dutch euthanasia law is often defended because of its “safeguards”, one of which is establishing that the patient is of sound mind. Paradoxically, arguments are being more frequently made in favour of extending euthanasia as a relief to those who suffer from depression.

Recent research has shown that depression and emotional distress are common psychological complications of cancer. 15% to 25% of cancer patients are depressed and approximately 80% of requests for euthanasia or PAS come from cancer patients.

When statistics on depression in cancer patients are combined with epidemiologic data demonstrating that, in general, suicide is approximately 30% to 50% more likely among cancer patients and that depression is a primary motivation for suicide, euthanasia and PAS look more like a method of acting on suicidal ideation than a type of termination of medical treatment.

Alex Schadenberg, president of Ontario’s Euthanasia Prevention Coalition, told that his organization’s concern is for the safety of vulnerable patients in a legal and medical atmosphere that is increasingly unwilling to protect them.

Schadenberg said, “By recognizing the nature of the request for euthanasia we must also recognize the need to keep euthanasia and assisted suicide illegal, in order to prevent vulnerable people from being killed when what they really needed was good care.”


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