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To the Editor: We are pleased that Dr Komrad and colleagues have seen and commented on our article, and we welcome the opportunity to extend the conversation about how psychiatrists respond to decisionally capable patients with advanced medical illnesses who wish to end their lives. The authors succinctly present important ethical arguments against psychiatrists’ participating in competency assessments for legalized physician-assisted death (PAD). Many readers will resonate with their analysis.
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See Letter by Komrad et al and article by Yager et al
Dr Yager and Colleagues Reply
To the Editor: We are pleased that Dr Komrad and colleagues have seen and commented on our article,1 and we welcome the opportunity to extend the conversation about how psychiatrists respond to decisionally capable patients with advanced medical illnesses who wish to end their lives. The authors succinctly present important ethical arguments against psychiatrists’ participating in competency assessments for legalized physician-assisted death (PAD). Many readers will resonate with their analysis.
Our article, although informed by research on PAD, addresses considerations that are broader than competency assessments for legalized PAD. We do not describe actively taking part in activities that will hasten a patient’s death. Instead, we ask psychiatrists to reflect on the ways in which they might effectively work with these patients over time by putting the relationship with and respect for the patient above directly interfering with, in every case, the patient’s plans to die. As we are not advising that psychiatrists either prescribe lethal medications or propose lethal medications as an option to ill patients, we believe our views are consistent with the original Hippocratic Oath and its contemporary versions, the Declaration of Geneva and the Oath of Maimonides.
Reference
1. Yager J, Ganzini L, Nguyen DH, et al. Working with decisionally capable patients who are determined to end their own lives. J Clin Psychiatry. 2018;79(4):17r11767. PubMed CrossRef
aDepartment of Psychiatry, University of Colorado School of Medicine, Aurora, Colorado
bVA Portland Health Care System and Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
Potential conflicts of interest: None.
Funding/support: None.
Published online: November 27, 2018.
J Clin Psychiatry 2018;79(6):18lr12566a
Disclaimer: The views expressed in this letter are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.
To cite: Yager J, Ganzini L, Nguyen DH, et al. Dr Yager and colleagues reply. J Clin Psychiatry. 2018;79(6):18lr12566a.
To share: https://doi.org/10.4088/JCP.18lr12566a
© Copyright 2018 Physicians Postgraduate Press, Inc.
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