RATIONAL SUICIDE AND THE CRISIS OF TERMINAL ILLNESS - REPLY TO LOKHANDWALA AND WESTEFELD

Lokhandwala and Westefeld's article highlighting the ethical dilemma i n rational suicide raises the pragmatic question of how one would actu ally assess a client's situation. A particularly relevant diagnosis th at should be ruled out is clinical depression. The DSM-IV lists nine s ymptoms of major depressive disorder, eight of which could easily be m asked as symptoms of the physical illness or side effects of treatment . These symptoms can be grouped into three categories: central feature s of depression, physical signs of depression, and cognitive signs of depression. All three of these categories, particularly physical signs , could easily be mistaken for medical problems. Reviewing the nine cr iteria for a diagnosis of clinical depression might be a good way to e xplore the possibility of clinical depression In a terminally ill pers on who is supposedly making a ''rational'' decision to com?nit suicide .