Differentiating suicide from life-ending acts and end-of-life decisions: a model based on chronic kidney disease and dialysis.
Author Department
Psychiatry
Document Type
Article, Peer-reviewed
Publication Date
1-2009
Abstract
BACKGROUND:
Technological advances continue to yield life-prolonging treatments that complicate the occurrence of death. Until recently, refusal to submit to recommended care was considered suicide.
OBJECTIVE:
Physicians must now decide how to respond to requests for hastened dying.
METHOD:
The authors propose a four-square grid distinguishing true suicide from behaviors such as treatment termination and lethal noncompliance.
RESULTS:
One axis characterizes whether actions hasten death. The other identifies how the patient's social and medical network collaborate in the decision-making process.
CONCLUSION:
Using chronic kidney disease to model intent and collaboration, treatment is framed within a paradigm that reflects both end-of-life decision-making complexities and contemporary conceptualizations of suicide.
Recommended Citation
Bostwick JM, Cohen LM. Differentiating suicide from life-ending acts and end-of-life decisions: a model based on chronic kidney disease and dialysis. Psychosomatics. 2009 Jan-Feb;50(1):1-7.