Lm. Range, RATIONAL SUICIDE AND THE CRISIS OF TERMINAL ILLNESS - REPLY TO LOKHANDWALA AND WESTEFELD, Journal of personal and interpersonal loss, 3(2), 1998, pp. 161-165
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
.