Assisted suicide can be defined as “an intervention to terminate life on request.”  As noted, this is technically known as active voluntary euthanasia.  This practice is legal in some of the United States and in some foreign countries, often with specific conditions noted.

However, there is much literature to dispute that assisted suicide is a free choice, but rather there is evidence that significant and treatable depression is usually the underlying cause.  For example, in the Washington and Oregon assisted suicide laws, 96% of patients receive no evaluation for depression and half of them say they requested lethal drugs because they are a “burden” to others.   However, in a study of cancer patients who were depressed and stated they were a burden to others, no correlation was found between the patient’s perception and any actual physical dependency on others.

Whereas pain and lack of support contribute to the wish for death in some people, none is as significant as the presence of depression.  Moreover, hopelessness is a key variable that links depression to suicide.   A study of terminally ill cancer patients who were neither depressed nor hopeless showed that none had a desire for hastened death.  However, two thirds of patients with depression and hopelessness had a high desire for hastened death.

Other factors of concern are stories about the cost of drugs for palliative care being prohibitive whereas assisted suicide was covered by insurance, and there are even stories of people being asked by insurance company personnel if they have considered assisted suicide.  Sometimes family members have been perceived as pushing patients toward suicide.